Background and Aim: Age- related decline in circulating oestradiol (E2) is associated with visceral obesity, insulin resistance, diabetes and impaired lipids metabolism. Using age as a surrogate marker of oestrogen status in women, aimed to determine if severity of liver histology in subjects with NAFLD differed between men and women older or younger than 50 years of age.
Method: Patients diagnosed with NAFLD were selected from the database of LTSBank. Staging of liver fibrosis was interpreted from a set of histological markers (Kleiner DE et al, Hepatology, 2005).
Results:Total 128 subjects with 53 bariatrics. 43 men:22 aged over 50,21 aged less than 50(51%and49%) and 85women:52 aged over 50,33 aged less than 50(61%and39%).Within these 4 groups,No significant (NS) differences were found in prevalence of diabetes,body mass index or routine metabolic biomarkers including serum alanine aminotransferase (ALT).Significant differences in mean SBPwas noted, being higher in older females,p=0.044.In liver histology,steatosis score was not different between groups.Lobular inflammation and fibrosis scores were higher in women and men aged over 50 than men and women aged less than 50(p=0.03 and p=0.001,respectively).In the aged over 50 group,HDLwas lower in men than in women(1.00+ 0.27 Vs 1.16+ 0.25),p=0.018. SBPwas lower in men than in women (129+ 13 Vs137+ 15), p=0.042. Men and women over 50 years of age had no difference in liver steatosis, inflammation or fibrosis (p>0.1 for all).In the aged less than 50 group, waist circumference was significantly higher in men than in women,
(129+ 17 Vs 118+ 14) p =0.018, no difference in other metabolic factors. Liver fibrosis stage was significantly higher in men than women (1.05+ 1.04 Vs 0.30+ 0.59), p=0.001. Conclusion: Histological severity of NAFLD increases with age however female sex is associated with a significant reduction in liver fibrosis in those aged less than 50 ears. This suggests estrogen may be protective of liver fibrosis.