Men with primary biliary cholangitis (PBC) may face a higher risk of death or liver transplantation than women, found a study recently published in Scientific Reports.
Researchers found that men had about 3.7 times higher odds of death or liver transplantation after adjusting for age and comorbidities. By contrast, men with cirrhosis from other causes had lower risks of these outcomes.
Although PBC primarily affects women, there is growing recognition of the disease in men. Some studies have suggested men may have more unfavorable outcomes than women with PBC. To better understand how PBC affects men, the researchers analyzed 940 hospital admissions for PBC in Germany from 2011 to 2022, including 171 men with PBC.
They found that men with PBC had worse liver test results and were younger at the time of hospitalization than women. “Men had significantly greater abnormalities in liver function, including higher liver enzyme and bilirubin levels on admission compared to women,” the authors wrote. These markers reflect liver damage and bile duct dysfunction and are commonly used to monitor liver function.
Men also showed signs of more advanced liver disease and experienced higher rates of complications, including bacterial infections and blood clots in the liver.
Notably, these patterns were not observed in patients with other causes of cirrhosis. In that group, men had lower risks of death or transplantation, suggesting that sex-related differences in outcomes may be specific to PBC.
Several factors may help explain these differences. Men were younger at the time of hospitalization, which may suggest delayed diagnosis. The authors also noted that men may be less likely to engage in regular follow-up care. In addition, differences in response to standard treatments or biological factors, such as hormones, may influence disease progression.
These findings may have important implications for earlier detection strategies in men with PBC. This group may require closer monitoring and earlier intervention to improve outcomes. Further research is needed to better understand the reasons behind these differences and their implications for treatment.
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