For example, animal studies have demonstrated a sexually dimorphic response to alcohol, with alcohol specifically activating lysine demethylase 5B in male mice, promoting hepatocyte dedifferentiation and subsequent tumor development, an outcome not observed in female mice.37 However, it should be acknowledged that sex differences in ALD-related adverse events may also be influenced by differences in alcohol consumption,34 the presence of secondary liver disease etiologies such as viral hepatitis, and other unmeasured confounders not reported in the database. This evidence concerns the gene KDM5B and animal viral hepatitis.