title: Evolving Trends in Female to Male Incidence and Male Mortality of Primary Biliary Cholangitis.
abstract: Primary biliary cholangitis (PBC) has been regarded as female-predominant without evidence of gender difference in survival. We aimed to compare the overall survival, incidence and prevalence of PBC in two well defined population-based studies over a recent decade, considering also sex ratios and mortality. We have taken advantage of population-wide records, during 2000-2009, in Lombardia, Northern Italy, and Denmark. We focused on the incident cases of PBC, including gender and outcome, among 9.7 million inhabitants of Lombardia and 5.5 million of Denmark. In Lombardia there were 2,970 PBC cases with a female:male ratio of 2.3:1. The age/sex-adjusted annual incidence of PBC was 16.7 per million. Point prevalence was 160 per million on January 1(st) 2009. In Denmark there were 722 cases of incident PBC, female:male ratio was 4.2:1, and the annual incidence was 11.4 per million, a point prevalence of 115 per million in 2009. Cox regression multivariate analysis identified male sex as an independent predictor of all-cause mortality in both Italian (HR 2.36) and Danish population (HR 3.04). Our data indicate for PBC a sex ratio significantly lower than previously cited, a reversal of the usual latitudinal difference in prevalence and a surprisingly higher overall mortality for male patients.
authors.affiliation: Liver Unit, Humanitas Clinical and Research Center, Rozzano (MI), Italy.
authors.forename: Ana
authors.initials: A
authors.lastname: Lleo
authors.affiliation: Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.|Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Peter
authors.initials: P
authors.lastname: Jepsen
authors.affiliation: Biostatistic Unit, Humanitas Clinical and Research Center, Rozzano (MI), Italy.
authors.forename: Emanuela
authors.initials: E
authors.lastname: Morenghi
authors.affiliation: Liver Unit, Humanitas Clinical and Research Center, Rozzano (MI), Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Carbone
authors.affiliation: Department of Internal Medicine, Policlinico IRCCS San Donato, University of Milan, San Donato Milanese, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Moroni
authors.affiliation: Department of Health Sciences, School of Medicine Ospedale San Paolo, Università degli Studi di Milano, Milan, Italy.
authors.forename: Pier Maria
authors.initials: PM
authors.lastname: Battezzati
authors.affiliation: Liver Unit, Humanitas Clinical and Research Center, Rozzano (MI), Italy.
authors.forename: Mauro
authors.initials: M
authors.lastname: Podda
authors.affiliation: Department of Biochemistry and Molecular Biology, Monash University, Clayton, VIC 3800, Australia.
authors.forename: Ian R
authors.initials: IR
authors.lastname: Mackay
authors.affiliation: Division of Rheumatology, Allergy, and Clinical Immunology, University of California at Davis, Davis, CA, USA.
authors.forename: M Eric
authors.initials: ME
authors.lastname: Gershwin
authors.affiliation: Liver Unit, Humanitas Clinical and Research Center, Rozzano (MI), Italy.|Division of Rheumatology, Allergy, and Clinical Immunology, University of California at Davis, Davis, CA, USA.|Program for Autoimmune Liver Diseases, International Center for Digestive Health, Department of Medicine and Surgery, University of Milan-Bicocca, Milan, Italy.
authors.forename: Pietro
authors.initials: P
authors.lastname: Invernizzi
mesh_terms: D003718:Denmark / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008105:Liver Cirrhosis, Biliary / Q000453:epidemiology*; D008297:Male; D015995:Prevalence; D012042:Registries; D012044:Regression Analysis; D012727:Sex Characteristics; D016019:Survival Analysis