Published in:
22-03-2024 | Primary Sclerosing Cholangitis | Original Article
Primary Sclerosing Cholangitis: Gender Effects in Valencia’s Low-Prevalence Region
Authors:
Alejandro Mínguez, Isabel Conde, Cristina Montón, Lara Gonzalez, Sonia Pascual, María Dolores Antón, Antonio Palau, Ana Forés, Concha Gisbert, Asunción Ojeda, Eva Girona, Tommaso Di Maira, Marina Berenguer
Published in:
Digestive Diseases and Sciences
|
Issue 5/2024
Login to get access
Abstract
Background and Aims
Recent studies point out to epidemiological changes in primary sclerosing cholangitis (PSC). Our aims were to determine in PSC patients followed in several centers in a Mediterranean geographic area: (i) changes in baseline features and (ii) effect of gender on clinical course.
Methods
Retrospective multicenter study of PSC patients treated in 8 hospitals in a Mediterranean area between 2000 and 2021. Charts were reviewed compiling demographic, clinical, radiological, and histological variables.
Results
Cohort of 112 PSC patients included, 42% women, 70% diagnosed after 2010. Women were increasingly diagnosed in recent cohorts. The median time from diagnosis to the combined endpoint liver transplantation (Lt) and/or death was 6.9 years. Asthenia at diagnosis (p = 0.009) was associated with lower transplant-free survival, while diagnosis before 2005 was associated with greater LT-free survival (p < 0.001). By Cox regression, LT-free survival was not influenced by age, sex, or cirrhosis at the time of diagnosis. Women were found to have less jaundice at diagnosis (2 vs 14%; p = 0.013), higher prevalence of ANA antibodies (43.9 vs 15.7%; p = 0.003), and lower GGT levels at diagnosis (GGT 123 vs 209U/L; p = 0.014) than men.
Conclusion
In an area traditionally considered to have low prevalence, the prevalence of affected women surpasses expectations based on existing literature. There appear to be gender-related variations in the presentation of the condition, highlighting the need for confirmation through larger-scale studies.