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Are there any sex differences in fatty liver? A study of glucose metabolism and body fat distribution


Correspondence: DrALonardo Division of Internal Medicine and Gastroenterology, Ospedale Civile—P.le S. Agostino 2 41100 Modena, Italy. Email:


Background and Aims: Fatty liver is a common condition found more often in males. Whether sex differences affect its development is presently unknown. The hypothesis that glucose metabolism alterations or central body fat distribution are gender-related in fatty liver was investigated.

Methods: Overall 199 consecutive subjects seen in the Division of Internal Medicine and Gastroenterology, Modena City Hospital, were enrolled. In the main arm of the present study, 44 men with sonographic fatty liver and 47 controls without, and 18 women with and 19 without fatty liver had their body mass index (an index of overall adiposity), hepatobiliary serum enzymes, serum cholesterol and triglycerides determined. All underwent oral glucose tolerance tests (estimated through the glucose area under the curve with the trapezoidal method). In the ancillary arm study, 17 other men with and 14 without, and 11 other women with and 29 without fatty liver had anthropometric measurements of body fat distribution (waist/hip, waist/height and skinfold thickness).

Results: Following statistical evaluation including univariate and multivariate analyses (main study), elevated body mass index was found to be an independent predictor of fatty liver in either sex. Glucose area under the curve and a central-type body fat distribution (ancillary study) predicted FL only in women.

Conclusions: Fatty liver could be gender-related in the present series.