A NEW population-based study reports a significant link between metabolic dysfunction–associated steatotic liver disease (MASLD) and androgenetic alopecia (AGA), with the strongest associations observed in women and individuals with unhealthy lifestyle patterns. The findings highlight the growing intersection between dermatology and metabolic health.
Researchers analysed 7,993 adults aged 35–70 years from the Fars Cohort Study in Iran, excluding participants with factors that could skew androgen or metabolic profiles, including pregnancy, cancer, thyroid disease, and extreme dietary intake. MASLD was diagnosed using the Fatty Liver Index and established cardiometabolic criteria, while AGA was determined clinically.
AGA was widespread, affecting 6,004 participants, and MASLD was also prevalent. After adjustment for age, sex, and metabolic confounders, MASLD was linked to a 31% increase in the odds of AGA (OR 1.31; 95% CI 1.13–1.52; p < 0.001).
Stronger Association Between MASLD and Androgenetic Alopecia in Women
Women with MASLD demonstrated a striking 62% higher likelihood of developing AGA (OR 1.62; 95% CI 1.30–2.03), suggesting sex-specific metabolic or hormonal mechanisms may underlie the relationship. The authors note that while AGA is more common in men, its metabolic associations may be more clinically significant in women.
Unhealthy Lifestyle Patterns Intensify the MASLD–AGA Link
Lifestyle factors strongly influenced outcomes. Individuals with MASLD who also had high carbohydrate intake, low physical activity, or were not receiving lipid-lowering therapy showed elevated odds of AGA (ORs 1.45, 1.48, and 1.30, respectively). Importantly, no significant association was found in adults with healthier lifestyle profiles, suggesting a potential interaction between metabolic dysfunction and behaviour-driven risk.
The relationship remained independent of overall calories, macronutrient composition, insulin resistance, and inflammatory markers, indicating a more specific connection between liver steatosis and hair follicle biology.
Clinical Implications
The study supports the concept that androgenetic alopecia may serve as a visible marker of underlying metabolic disease, particularly MASLD. The authors recommend that dermatologists consider metabolic evaluation, especially in women presenting with unexplained or early-onset AGA.
Although the cross-sectional design limits causal conclusions, the findings reinforce the need for longitudinal research to determine whether treating MASLD may help mitigate AGA progression.
Reference
Bazmi S et al. Metabolic dysfunction-associated steatotic liver disease is associated with androgenetic alopecia in adults with stronger effects in women and unhealthy lifestyles. Sci Rep. 2025; 15:42399
