Associations of gender and a proxy of female menopausal status with histological features of drug-induced liver injury.

Journal Article (Journal Article)

BACKGROUND & AIM: Gender and menopause may contribute to type and severity of drug-induced liver injury (DILI) by influencing host responses to injury. The aim of this study was to assess the associations of gender and female age 50 [a proxy of menopause] with histological features of liver injury in 212 adults enrolled in the Drug-Induced Liver Injury Network (DILIN) registry. METHODS: All participants had a causality score of at least 'probable', a liver biopsy within 30 days of DILI onset, and no prior chronic liver disease. Biochemical and histological injury types were classified as hepatocellular or cholestatic/mixed injury. The cohort was divided into three gender/age categories: men (41.0%), women <50 years (27.4%) and women ≥50 years of age (31.6%). Interaction of gender and age category (≥50 or not) was assessed. RESULTS: Hepatocellular injury was more prevalent in women <50 years vs. others (P=.002). After adjusting for biochemical injury types, black race and possible ageing effects, more severe interface hepatitis was noted in biopsies of women <50 years compared to those of men and women ≥50 years (P=.009 and P=.055 respectively). Compared to those of men, biopsies of women showed greater plasma cell infiltration, hepatocyte apoptosis, hepatocyte rosettes and lobular disarray but less iron-positive hepatocytes and histological cholestasis (P<.05). These associations persisted after excluding cases of amoxicillin/clavulanic acid, anabolic steroids or nitrofurantoin DILI which showed gender-specific distributions. CONCLUSION: Gender and a proxy of menopause were associated with various features of inflammation and injury in DILI.

Full Text

Duke Authors

Cited Authors

  • Suzuki, A; Barnhart, H; Gu, J; Bonkovsky, HL; Tillmann, HL; Fontana, RJ; Kleiner, DE; Drug-induced Liver Injury Network (DILIN),

Published Date

  • November 2017

Published In

Volume / Issue

  • 37 / 11

Start / End Page

  • 1723 - 1730

PubMed ID

  • 28161910

Pubmed Central ID

  • PMC5545077

Electronic International Standard Serial Number (EISSN)

  • 1478-3231

Digital Object Identifier (DOI)

  • 10.1111/liv.13380


  • eng

Conference Location

  • United States