Women with nonalcoholic fatty liver disease (NAFLD) lose the cardiovascular protection conferred by female sex, and so their risk of cardiovascular events is underestimated, researchers say.

Researchers identified 3,869 adults diagnosed with NAFLD between 1997 and 2014, and 15,209 age- and sex-matched controls from the general population. During follow-up for a median of seven years, 3,851 cardiovascular events were recorded. Female sex was protective against ischemic cardiovascular events in the control group (hazard ratio, 0.71), but the impact was significantly attenuated among those with NAFLD (HR, 0.90). The findings were reported online October 2 in the American Journal of Gastroenterology.