{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T18:33:53Z","timestamp":1792089233934,"version":"4.4.0"},"reference-count":182,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2023,3,20]],"date-time":"2023-03-20T00:00:00Z","timestamp":1679270400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>Gender differences in the epidemiology, pathophysiological mechanisms and clinical features in chronic liver diseases that may be associated with type 2 diabetes (T2D) have been increasingly reported in recent years. This sexual dimorphism is due to a complex interaction between sex- and gender-related factors, including biological, hormonal, psychological and socio-cultural variables. However, the impact of sex and gender on the management of T2D subjects with liver disease is still unclear. In this regard, sex-related differences deserve careful consideration in pharmacology, aimed at improving drug safety and optimising medical therapy, both in men and women with T2D; moreover, low adherence to and persistence of long-term drug treatment is more common among women. A better understanding of sex- and gender-related differences in this field would provide an opportunity for a tailored diagnostic and therapeutic approach to the management of T2D subjects with chronic liver disease. In this narrative review, we summarized available data on sex- and gender-related differences in chronic liver disease, including metabolic, autoimmune, alcoholic and virus-related forms and their potential evolution towards cirrhosis and\/or hepatocarcinoma in T2D subjects, to support their appropriate and personalized clinical management.<\/jats:p>","DOI":"10.3390\/jpm13030558","type":"journal-article","created":{"date-parts":[[2023,3,20]],"date-time":"2023-03-20T07:06:37Z","timestamp":1679295997000},"page":"558","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Impact of Sex and Gender on Clinical Management of Patients with Advanced Chronic Liver Disease and Type 2 Diabetes"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0383-6121","authenticated-orcid":false,"given":"Anna","family":"Licata","sequence":"first","affiliation":[{"name":"Internal Medicine & Hepatology Unit, University Hospital of Palermo, PROMISE, University of Palermo, 90127 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppina T.","family":"Russo","sequence":"additional","affiliation":[{"name":"Internal Medicine and Diabetology Unit, University of Messina, 98125 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0778-4130","authenticated-orcid":false,"given":"Annalisa","family":"Giandalia","sequence":"additional","affiliation":[{"name":"Internal Medicine and Hepatology Unit, University Hospital of Messina, 98124 Messina, Italy"},{"name":"Department of Clinical and Experimental Medicine, University of Messina, 98124 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcella","family":"Cammilleri","sequence":"additional","affiliation":[{"name":"Internal Medicine & Hepatology Unit, University Hospital of Palermo, PROMISE, University of Palermo, 90127 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0427-6963","authenticated-orcid":false,"given":"Clelia","family":"Asero","sequence":"additional","affiliation":[{"name":"Internal Medicine and Hepatology Unit, University Hospital of Messina, 98124 Messina, Italy"},{"name":"Department of Clinical and Experimental Medicine, University of Messina, 98124 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7721-6799","authenticated-orcid":false,"given":"Irene","family":"Cacciola","sequence":"additional","affiliation":[{"name":"Internal Medicine and Hepatology Unit, University Hospital of Messina, 98124 Messina, Italy"},{"name":"Department of Clinical and Experimental Medicine, University of Messina, 98124 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,3,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1016\/S0140-6736(20)31561-0","article-title":"Sex and gender: Modifiers of health, disease, and medicine","volume":"396","author":"Barnes","year":"2020","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1969","DOI":"10.1007\/s11739-022-03049-y","article-title":"The SIMI Gender \u20185 Ws\u2019 Rule for the integration of sex and gender-related variables in clinical studies towards internal medicine equitable research","volume":"17","author":"Raparelli","year":"2022","journal-title":"Intern. 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