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

BACKGROUND: To examine associations between androgenetic alopecia (AGA) and cardiometabolic comorbidities in a large, diverse United States cohort with adjustment for socioeconomic and behavioral factors. METHODS: We conducted a cross-sectional, 1:2 propensity score-matched analysis using data from the All of Us Research Program. Participants with AGA (n = 1015) were matched to controls on age, sex, race, and ethnicity. Thirteen cardiovascular and metabolic conditions were assessed using electronic health records (EHRs). 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 males (adjusted odds ratio [OR], 2.32; 95% confidence interval [CI], 1.56-3.46) and females (adjusted OR, 2.55; 95% CI, 1.98-3.28). In females, AGA was also independently associated with obesity (adjusted OR, 1.48; 95% CI, 1.17-1.86), but this association was not observed in males. Associations with hypertension and valvular heart disease did not persist after adjustment. The cross-sectional design and reliance on structured EHR data limited causal inference. CONCLUSION: AGA is independently associated with hyperlipidemia in both sexes and with obesity in females, suggesting its potential as a clinical marker of cardiometabolic risk.