{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T22:52:24Z","timestamp":1789426344200,"version":"build-2803163510"},"reference-count":28,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2021,5,26]],"date-time":"2021-05-26T00:00:00Z","timestamp":1621987200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2021,5,26]],"date-time":"2021-05-26T00:00:00Z","timestamp":1621987200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Hepatology"],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>The impact of sex on the postcirrhosis progression of primary biliary cholangitis (PBC) has not been well defined. Prior studies have suggested that men have worse outcomes but present at more advanced stages of fibrosis than women. This observation, however, has been limited by small numbers of men and even fewer patients with cirrhosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Approach and Results<\/jats:title>\n                    <jats:p>\n                      We investigated the association of sex with the development of all\u2010cause and liver\u2010related mortality or transplantation, decompensation, and hepatocellular carcinoma (HCC), using competing\u2010risk time\u2010updating Cox proportional hazards models in a large cohort of predominantly male patients with PBC cirrhosis assembled from the Veterans Health Administration. In a cohort of 532 participants (418 male) with PBC\u2010related cirrhosis with a total follow\u2010up of 3,231.6 person\u2010years (PY) from diagnosis of compensated cirrhosis, male participants had a higher unadjusted rates of death or transplantation (8.5 vs. 3.8 per 100 PY;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u00a0&lt;\u00a00.0001), liver\u2010related death or transplantation (5.5 vs. 2.7 per 100 PY;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u00a0&lt;\u00a00.0001), decompensation (5.5 vs. 4.0 per 100 PY;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u00a0=\u00a00.002), and HCC (0.9 vs. 0.3 per 100 PY;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u00a0&lt;\u00a00.0001). After adjusting for confounders,\u00a0male sex was associated with a\u00a0higher\u00a0risk of death or transplantation (adjusted hazard ratio, 1.80; 95% CI, 1.01\u20103.19;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u00a0=\u00a00.046), and liver\u2010related death or transplantation (subhazard ratio, 2.17; 95% CI, 1.15\u20104.08;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u00a0=\u00a00.02).\u00a0A sensitivity analysis that defined ursodeoxycholic acid response as normalization of alkaline phosphatase and total bilirubin revealed similar findings.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In patients with PBC and\u00a0well\u2010compensated\u00a0cirrhosis, male\u00a0sex is associated with a higher risk of both death and liver\u2010related death or transplantation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hep.31776","type":"journal-article","created":{"date-parts":[[2021,2,26]],"date-time":"2021-02-26T12:09:12Z","timestamp":1614341352000},"page":"879-891","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":58,"title":["Male Sex Is Associated With Higher Rates of Liver\u2010Related Mortality in Primary Biliary Cholangitis and Cirrhosis"],"prefix":"10.1097","volume":"74","author":[{"given":"Binu V.","family":"John","sequence":"first","affiliation":[{"name":"Division of Hepatology,Bruce W Carter VA Medical Center,Miami,FL,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriella","family":"Aitcheson","sequence":"additional","affiliation":[{"name":"Department of Medicine,Jackson Memorial Hospital,Miami,FL,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaley B.","family":"Schwartz","sequence":"additional","affiliation":[{"name":"Division of Hepatology,Bruce W Carter VA Medical Center,Miami,FL,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nidah S.","family":"Khakoo","sequence":"additional","affiliation":[{"name":"Department of Medicine,Jackson Memorial Hospital,Miami,FL,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bassam","family":"Dahman","sequence":"additional","affiliation":[{"name":"Department of Health Behavior and Policy,Virginia Commonwealth University,Richmond,VA,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yangyang","family":"Deng","sequence":"additional","affiliation":[{"name":"Department of Health Behavior and Policy,Virginia Commonwealth University,Richmond,VA,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Goldberg","sequence":"additional","affiliation":[{"name":"Division of Digestive Health and Liver Diseases,University of Miami Miller School of Medicine,Miami,FL,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Martin","sequence":"additional","affiliation":[{"name":"Division of Digestive Health and Liver Diseases,University of Miami Miller School of Medicine,Miami,FL,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamar H.","family":"Taddei","sequence":"additional","affiliation":[{"name":"Section of Digestive Diseases,Yale School of Medicine,New Haven,CT,USA"},{"name":"Division of Gastroenterology and Hepatology,VA Connecticut Healthcare System,West Haven,CT,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cynthia","family":"Levy","sequence":"additional","affiliation":[{"name":"Division of Digestive Health and Liver Diseases,University of Miami Miller School of Medicine,Miami,FL,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David E.","family":"Kaplan","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology,University of Pennsylvania,Philadelphia,PA,USA"},{"name":"Division of Gastroenterology and Hepatology,Corporal Michael J. 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