Sex Differences in Patients with MASLD and Their Association with Cardiometabolic Risk Factors: Insights from the Polish Gallstone Surgery Registry

Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) is defined by the presence of hepatic steatosis and at least one the cardiometabolic risk factors. Differences in the incidence of MASLD between men and women are primarily due to distinct metabolic and cardiovascular profiles. The aim of this observational study was to investigate the prevalence and characteristics of MASLD in men and women. Methods: The study included patients from The Polish Gallstone Surgery Registry diagnosed with MASLD according to current criteria. Results: Among 3419 patients, MASLD was diagnosed in 24.2%. Its prevalence was significantly higher in man (29.8%) than in women (21.9%) (p< 0.0001), with the highest incidence observed in men aged 70-79 (32.1%) and women aged 70-79 (33.3%). MASLD was associated with overweight in both men (OR 1.60; 95% CI: 1.03–2.48) and women (OR 2.45; 95% CI: 1.80–3.35), as well as with obesity in men (OR 3.44; 95% CI: 2.21–5.34) and women (OR 5.51; 95% CI: 4.10–7.40). Conclusions: In this study, MASLD was diagnosed more frequently in men than in women. The incidence of MASLD increased with age and BMI, with this relationship being more pronounced in women. Therefore, age and excess body weight are key predictors of MASLD, highlighting the need for individualized treatment strategies, regardless of gender.