Abstract: Objective To explore the incidence trend, clinical features and prognosis of primary biliary cholangitis (PBC) in different genders.Methods A retrospective study was conducted on 497 patients with PBC who were treated in the Second Affiliated Hospital of Kunming Medical University from July 2013 to September 2020. According to the age 1∶1 propensity score matching, the clinical characteristics, serum laboratory indexes and adverse events of patients of different genders were compared and analyzed. The prognosis parameters of patients were calculated by UK-PBC and GLOBE prognostic scores, and we compared the short-term and long-term prognosis of the patients.Results The ratio of male to female was 1:5.9. In the gender distribution of different age groups, the peak age of male was 10 years later than that of female (Z=28.12, P<0.05); according to the propensity score matching, compared with the clinical characteristics and signs of PBC patients, women were more likely to show fatigue, weight loss and edema of both lower limbs, and were more likely to merge with other autoimmune diseases (62.5% VS 37.5%, 27.8% VS 8.3%, 18.1% VS 6.9%, 30.6% VS 13.9%, P＜0.05); Compared with the baseline level of laboratory indicators, the levels of serum bilirubin and gamma glutamyl transpeptidase in men were higher than those in women [40.0 (18.4, 89.1) μmol/L VS 26.2 (15.8, 49.0) μmol/L, 350.0 (134.3, 680.5) U/L VS 240.5 (74.8, 439.5) U/L, P＜0.05]. There was no significant difference in albumin, alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, immunoglobulin and hepatopathy associated antibody between male and female. The UK-PBC risk score showed that there was no difference in the risk of adverse events between men and women in 5 years (P>0.05). The risk of adverse events in men was higher than that in women in 10 years and 15 years [11.1 (6.3, 53.3) VS 10.0 (2.8, 19.9); 17.5 (12.4, 54.6) VS 15.2 (5.9, 23.5), P＜0.05].The GLOBE score showed that there was no difference in the 3 year- and 5 year-survival rates between men and women, compared with 10 year-and 15 year-survival rates, women had a higher survival rate than men [67.2 (52.5, 92.3) VS 50.4 (14.2, 84.6); 46.5 (30.2, 84.3) VS 28.9 (3.2, 73.3), P＜0.05].Conclusion The peak age of male patients with PBC is later than that of female patients, and the clinical symptoms and signs are few and atypical. The short-term prognosis of male and female patients is similar, but the long-term prognosis of male patients is worse than that of female patients, which should be paid attention.

Key words: Primary biliary cholangitis, Gender difference, Clinical features, Prognosis