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World J Clin Cases. Feb 26, 2023; 11(6): 1236-1244
Published online Feb 26, 2023. doi: 10.12998/wjcc.v11.i6.1236
Sex dimorphism and metabolic profiles in management of metabolic-associated fatty liver disease
Maria Martin-Grau, Daniel Monleon
Maria Martin-Grau, Daniel Monleon, Department of Pathology, University of Valencia, Valencia 46010, Spain
Author contributions: Martin-Grau M and Monleon D contributed to writing and revising; All authors have read and approved the final manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Daniel Monleon, PhD, Professor, Department of Pathology, University of Valencia, Avenue Blasco Ibañez, 15, Valencia 46010, Spain. daniel.monleon@uv.es
Received: September 20, 2022
Peer-review started: September 20, 2022
First decision: October 18, 2022
Revised: November 30, 2022
Accepted: February 2, 2023
Article in press: February 2, 2023
Published online: February 26, 2023
Processing time: 156 Days and 18.4 Hours
Abstract

Metabolic-associated fatty liver disease (MAFLD) refers to the build-up of fat in the liver associated with metabolic dysfunction and has been estimated to affect a quarter of the population worldwide. Although metabolism is highly influenced by the effects of sex hormones, studies of sex differences in the incidence and progression of MAFLD are scarce. Metabolomics represents a powerful approach to studying these differences and identifying potential biomarkers and putative mechanisms. First, metabolomics makes it possible to obtain the molecular phenotype of the individual at a given time. Second, metabolomics may be a helpful tool for classifying patients according to the severity of the disease and obtaining diagnostic biomarkers. Some studies demonstrate associations between circulating metabolites and early and established MAFLD, but little is known about how metabolites relate to and encompass sex differences in disease progression and risk management. In this review, we will discuss the epidemiological metabolomic studies for sex differences in the development and progression of MAFLD, the role of metabolic profiles in understanding mechanisms and identifying sex-dependent biomarkers, and how this evidence may help in the future management of the disease.

Keywords: MAFLD; Sex differences; Metabolic profiles; Metabolism

Core Tip: Metabolic-associated fatty liver disease (MAFLD) refers to the build-up of fat in the liver associated with metabolic dysfunction and has been estimated to affect a quarter of the population worldwide. Metabolomics represents a powerful approach to studying metabolic disease, including MAFLD, and to identify potential biomarkers and putative mechanisms. Some studies demonstrate associations between circulating metabolites and early and established MAFLD, but little is known about how metabolites relate to and encompass sex differences in disease progression and risk management. In this review, we will discuss the role of metabolic profiles in understanding mechanisms and identifying sex-dependent biomarkers, and how this evidence may help in the future management of the disease.