Cardiometabolic comorbidities associated with androgenetic alopecia: Findings from a sex-stratified, propensity-matched national cohort

Abstract

Background: Androgenetic alopecia (AGA), the most common form of hair loss, has been linked to systemic health, but prior studies are limited by small sample sizes and inadequate control for confounders.

Objective: To examine associations between AGA and cardiometabolic comorbidities in a large, diverse U.S. cohort with adjustment for socioeconomic and behavioral factors.

Methods: We conducted a cross-sectional, 1:2 propensity score–matched analysis using All of Us Research Program data. Participants with AGA (n=1,015) were matched to controls on age, sex, race, and ethnicity. Thirteen cardiovascular and metabolic conditions were assessed using electronic health records. Conditional logistic regression, adjusted for smoking, insurance, income, healthcare access, and marital status, was performed overall and by sex.

Results: AGA was significantly associated with hyperlipidemia in men (adjusted OR 2.32, 95% CI 1.56–3.46) and women (2.55, 1.98–3.28). In women, AGA was also independently associated with obesity (1.48, 1.17–1.86), but this association was not observed in men. Associations with hypertension and valvular heart disease did not persist after adjustment. Limitations: Cross-sectional design and reliance on structured EHR data limit causal inference.

Conclusions: AGA is independently associated with hyperlipidemia and obesity in women, suggesting its potential as a clinical marker of cardiometabolic risk.