Aaminah Mohammed iBSc

Medical Student Bursary Winner

“Sex-related differences in alcohol-related liver disease.”

Liver disease now constitutes the third most common cause of premature death in the UK with alcohol being the major factor in 70% of patients with cirrhosis. Traditionally alcohol-related cirrhosis was a disease of middle-aged men but since the 1970s the male-female ratio amongst hospital admissions had reduced from 5:1 to 2:1. Although this undoubtedly reflects that more women are regularly consuming alcohol, studies have shown that they are at greater risk of developing cirrhosis than men at given levels of consumption.

Apparent variations in the prevalence, disease manifestation and outcome between men and women are inadequately research and ill-understood, which may impact significantly on their care. Furthermore, evidence of conscious and unconscious bias towards women with alcohol-related cirrhosis is concerning. Studies undertaken in the USA show that, despite no difference in transplant survival, women are less likely to be selected for liver transplantation that men and, if listed, are more likely to die on the waiting list or be delisted’

“A preliminary analysis of 142 patients revealed that women maintaining abstinence from alcohol survive significantly longer than their male counterparts; while there were no sex-related differences in outcome among those continuing to drink’

Recently I reviewed a further 150 patients to obtain more detailed information on sex differences in the management of alcohol-related cirrhosis. In current clinical practice, there is no difference in the management of alcohol-related cirrhosis by sex; a key issue which clearly needs to be addressed.”

Why did you choose this project?

“As a long standing advocate of equality and diversity within access to healthcare, the opportunity to undertake a project focusing on sex related differences in the outcome of patients with decompensated alcohol-related cirrhosis had obvious appeal.”