Features of the course of non-alcoholic fatty liver disease in women at different age periods: literature review

Abstract

The review examines the epidemiology and risk factors of non-alcoholic fatty liver disease (NAFLD) for women. According to various sources, the global prevalence of NAFLD ranges from 20 to 40% of the adult population in the world. In Russia, 37.3% of polyclinic patients have NAFLD. NAFLD can occur at any age and has differences in prevalence and severity depending on ethnicity and gender. Over the past 10 years, there has been a trend towards an increase in the prevalence of NAFLD among women, as well as a sharper increase in mortality compared to men. Regardless of gender, prognostically significant risk factors for NAFLD include age, obesity, type 2 diabetes mellitus, insulin resistance, dyslipidemia. The clinical course and prognosis of NAFLD in women depends on age, reproductive stage and use of synthetic hormones. Premenopausal women have less pronounced liver fibrosis and a better life prognosis compared to postmenopausal men and women. The article describes the features of the course of NAFLD in the reproductive period, pre- and postmenopausal period, characterizes the effect of liver steatosis on the course and outcome of pregnancy, the perinatal condition of the mother and fetus. Thus, there are gender differences in the prevalence, risk factors, fibrosis, and clinical outcomes of NAFLD. The prevalence and severity of NAFLD in reproductive age is higher in men, but after menopause, there is an increase in this pathology in women, especially those with metabolic disorders. Liver steatosis can affect the course of pregnancy, labor and postpartum periods.