CO36 | Gender-based differences in alcoholic and metabolic-associated chronic liver disease in the hepatology outpatient clinic

Background: Metabolic-associated liver disease is increasing in Italy, while viral hepatitis is decreasing due to efficacy of antiviral therapies and vaccination. We explored the differences in gender and etiology of patients referred to the Hepatology outpatient clinic of our Internal Medicine Unit over the last 2 years.Methods: All outpatients presenting for Hepatology outpatient visits for suspicion of or established chronic liver disease were included. After at least 2 visits, patients were classified as having steatosis without evidence of liver damage, chronic hepatitis or liver cirrhosis based on clinical, laboratory and imaging tests. Results: 137 outpatients were included (57.6% males, median age 65 years, IQR 9). Cirrhosis was present in 45 (71% males) and etiology was: alcohol 40%, viral 22%, metabolic 18%. Concomitant HCC was present in 15%. Chronic hepatitis cases were 48 (60% males) and etiology was alcohol 37.5%, viral 25%, metabolic 25%. Steatosis without evidence of liver damage was present in 44 (41% males) and alcoholic etiology was present only in 16%. Prevalence of diabetes mellitus did not differ among the three groups of patients.Conclusions: Patients with advanced liver disease presenting to our Hepatology outpatient clinic are prevalently male and alcohol is the most common etiological factor. However, in patients with simple steatosis without liver dysfunction, female gender is more prevalent and alcoholic etiology is uncommon. These patients are likely to benefit from lifestyle interventions to prevent metabolic associated liver disease.