{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:20:05Z","timestamp":1787750405566,"version":"build-2784847793"},"reference-count":14,"publisher":"Ovid Technologies (Wolters Kluwer Health)","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\n Background.<\/jats:title>\n Healthcare outcomes research has historically used males as the reference; however, such a comparison ignores key biological processes. Thus, the present study aimed to evaluate metabolic health in female liver transplant (LT) recipients, using female sex itself as the reference standard.<\/jats:p>\n <\/jats:sec>\n \n Methods.<\/jats:title>\n Social vulnerability index (SVI) is a composite marker of external stressors to individual health, with a high SVI indicative of higher social vulnerability. Kaplan-Meier curves were constructed to determine the association between SVI and the likelihood of developing metabolic complications, including type 2 diabetes, obesity, hypertension, and all-cause mortality, 36 mo after LT in 252 adult females.<\/jats:p>\n <\/jats:sec>\n \n Results.<\/jats:title>\n The baseline clinical profile was similar between patients with low (below median) and high (above median) SVI. Black females had a higher SVI than non-Hispanic White (hereafter, White) females. No difference in overall mortality or new-onset metabolic diseases was noted when patients were stratified based on high versus low SVI. Among patients with high SVI, Black females had a higher incidence of post-LT obesity and type 2 diabetes than White females. Survival was also lower in Black females with high SVI when compared with White females. When females with a low SVI were stratified according to ethnicity, no significant differences in survival or risk of metabolic conditions were noted.<\/jats:p>\n <\/jats:sec>\n \n Conclusions.<\/jats:title>\n As defined by SVI, these data underscore the need to better understand healthcare disparities in LT patients to improve clinical outcomes.<\/jats:p>\n <\/jats:sec>","DOI":"10.1097\/tp.0000000000005809","type":"journal-article","created":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T04:00:12Z","timestamp":1782705612000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Impact of Social Vulnerability on Future Risk of Metabolic Complications and Survival in Female Liver Transplant Recipients"],"prefix":"10.1097","author":[{"given":"Hiba","family":"Khan","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Virginia Commonwealth University, Richmond, VA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rehan","family":"Razzaq","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Virginia Commonwealth University, Richmond, VA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shreya","family":"Shah","sequence":"additional","affiliation":[{"name":"School of Medicine, Virginia Commonwealth University, Richmond, VA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexis","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Virginia Commonwealth University, Richmond, VA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madison","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Virginia Commonwealth University, Richmond, VA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shilpa","family":"Jasti","sequence":"additional","affiliation":[{"name":"School of Medicine, Virginia Commonwealth University, Richmond, VA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ibrahim M.","family":"Siddiqui","sequence":"additional","affiliation":[{"name":"University of Virginia, Charlottesville, VA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheila","family":"Bullock","sequence":"additional","affiliation":[{"name":"Hume-Lee Transplant Center, Virginia Commonwealth University Health System, Richmond VA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vaishali","family":"Patel","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Virginia Commonwealth University Health System, Richmond, VA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,6,29]]},"reference":[{"key":"R1-20260629","first-page":"49","article-title":"Sex inequalities in medical research: a systematic scoping review of the literature.","volume":"3","author":"Merone","year":"2022","journal-title":"Women\u2019s Health Rep (New Rochelle)"},{"key":"R2-20260629","doi-asserted-by":"crossref","first-page":"2145","DOI":"10.1161\/CIRCULATIONAHA.110.968792","article-title":"Sex\/gender differences in cardiovascular disease prevention: what a difference a decade makes.","volume":"124","author":"Mosca","year":"2011","journal-title":"Circulation"},{"key":"R3-20260629","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1016\/S0140-6736(02)07494-9","article-title":"Effect of race on outcome of orthotopic liver transplantation: a cohort study.","volume":"359","author":"Nair","year":"2002","journal-title":"Lancet"},{"key":"R4-20260629","doi-asserted-by":"crossref","first-page":"900","DOI":"10.1002\/lt.25996","article-title":"Racial, gender, and socioeconomic disparities in liver transplantation.","volume":"27","author":"Nephew","year":"2021","journal-title":"Liver Transpl"},{"key":"R5-20260629","doi-asserted-by":"crossref","first-page":"1441","DOI":"10.1002\/lt.26473","article-title":"Neighborhood poverty is associated with failure to be waitlisted and death during liver transplantation evaluation.","volume":"28","author":"Mohamed","year":"2022","journal-title":"Liver Transpl"},{"key":"R6-20260629","doi-asserted-by":"crossref","first-page":"2424","DOI":"10.1016\/j.cgh.2024.06.020","article-title":"Vibration-controlled transient elastography-based parameters predict clinical outcomes in liver transplant recipients.","volume":"22","author":"Baral","year":"2024","journal-title":"Clin Gastroenterol Hepatol"},{"key":"R7-20260629","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1016\/j.cgh.2022.02.028","article-title":"Factors impacting survival in those transplanted for NASH cirrhosis: data from the NailNASH consortium.","volume":"21","author":"Rinella","year":"2022","journal-title":"Clin Gastroenterol Hepatol"},{"key":"R8-20260629","doi-asserted-by":"crossref","first-page":"2323","DOI":"10.1097\/TP.0000000000002714","article-title":"The relationship between hypoadiponectinemia and cardiovascular events in liver transplant recipients.","volume":"103","author":"Siddiqui","year":"2019","journal-title":"Transplantation"},{"key":"R9-20260629","doi-asserted-by":"crossref","first-page":"889","DOI":"10.1002\/lt.24137","article-title":"Cardiovascular disease after liver transplantation: when, what, and who is at risk.","volume":"21","author":"Fussner","year":"2015","journal-title":"Liver Transpl"},{"key":"R10-20260629","first-page":"24","article-title":"A social vulnerability index for disaster management.","volume":"8","author":"Flanagan","year":"2011","journal-title":"J Homel Secur Emerg Manag"},{"key":"R11-20260629","doi-asserted-by":"crossref","first-page":"e14938","DOI":"10.1111\/ctr.14938","article-title":"Critical interactions between race and the highly granular area deprivation index in liver transplant evaluation.","volume":"37","author":"Strauss","year":"2023","journal-title":"Clin Transplant"},{"key":"R12-20260629","doi-asserted-by":"crossref","first-page":"774","DOI":"10.1016\/j.surg.2014.10.018","article-title":"Independent effect of black recipient race on short-term outcomes after liver transplantation.","volume":"157","author":"Quillin","year":"2015","journal-title":"Surgery"},{"key":"R13-20260629","first-page":"1401","article-title":"Differential fuel utilization in liver transplant recipients and its relationship with non-alcoholic fatty liver disease.","volume":"42","author":"Siddiqui","year":"2022","journal-title":"Liver Int Off J Int Assoc Study Liver"},{"key":"R14-20260629","doi-asserted-by":"crossref","first-page":"639","DOI":"10.1007\/s10620-019-05800-6","article-title":"Office-based weight loss counseling is ineffective in liver transplant recipients.","volume":"65","author":"Patel","year":"2020","journal-title":"Dig Dis 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