The pinking of drinking and liver disease: Sex and gender in alcohol-related liver disease
Recommended Citation
Mellinger J. The pinking of drinking and liver disease: Sex and gender in alcohol-related liver disease. Alcohol Clin Exp Res 2025; 49.
Document Type
Conference Proceeding
Publication Date
6-1-2025
Publication Title
Alcohol Clin Exp Res
Abstract
Rates of alcohol-related liver disease (ALD) have risen dramatically over the past decade, but particularly amongst women. This presentation will examine existing data on the changing epidemiology of both alcohol use and ALD, with an emphasis on trends among women, and discuss potential strategies for reducing the ALD disease burden among women. Epidemiologic trends among women, both for development of ALD and for transplantation for ALD, will be reviewed and explored. Women are less likely to be listed for ALD (10% vs 19%, p < 0.05) and less likely to be transplanted for ALD (42% vs 47%, p < 0.05) compared to men. Psychosocial reasons (e.g. substance use) for not listing women are more common. In addition, trends for accessing alcohol use treatment will be discussed, including data showing that women with ALD are 15% less likely to access alcohol use treatment, despite the fact that such treatment reduces liver-related symptoms and is associated with improved mortality in the ALD population. Finally, we will present updated data after 5 years of implementation of a novel multidisciplinary ALD clinic which combines hepatology and mental health/substance abuse care in a single co-located clinic to treat patients with recent drinking and advanced ALD. 51% of patients in this clinic were women with a mean age of 45 years (range 23–78 years). 90% had a severe alcohol use disorder. Over 90% had a comorbid mental health disorder, with the most frequent being anxiety (72%) and depression (49%). Trauma, which was much more likely to be reported by women, was experienced by 34%. For some women, their first disclosure of trauma occurred in the ALD clinic. Differences in alcohol treatment choice between men and women were found. Findings from the ALD clinic may suggest different ways of targeting women with ALD to increase their attendance at alcohol treatment. Finally, research gaps in sex and gender research in ALD will be highlighted.
Volume
49
