Study Finds Women at Higher Risk of Cardiometabolic-Linked Liver Fibrosis Than Men

A new study suggests that women with certain cardiometabolic risk factors may face a sharper increase in the risk of Liver Fibrosis than men with the same conditions. The research, published in JAMA Network Open, highlights important sex differences in how metabolic health influences liver disease risk.

Liver fibrosis occurs when repeated inflammation causes scar tissue to build up in the liver. Over time, this scarring can progress to serious complications such as Cirrhosis, liver failure, and Liver Cancer. Although men generally have higher overall rates of fibrosis, severe cases are increasingly being observed in women, prompting researchers to investigate possible underlying factors.

The study was conducted by scientists from the Keck School of Medicine of USC using data from nearly 6,000 U.S. adults collected between 2017 and 2020 through the National Health and Nutrition Examination Survey (NHANES). The dataset included detailed information such as blood tests, clinical measurements, lifestyle factors, and ultrasound imaging used to detect liver fibrosis and fat accumulation in the liver.

Researchers examined several cardiometabolic risk factors, including Type 2 Diabetes, high waist circumference, high blood pressure, abnormal cholesterol levels, and the presence of multiple metabolic risk factors. While women initially had lower baseline rates of liver fibrosis than men, their risk increased more sharply when these factors were present.

For example, high waist circumference increased fibrosis rates about 11-fold in women, compared with a fourfold increase in men. Similarly, diabetes or prediabetes was associated with a 2.8-fold increase in fibrosis risk in women, compared with a 1.4-fold increase in men. Women with two or more metabolic risk factors had an 8.4-fold higher risk of fibrosis.

Researchers believe hormonal factors, including changes in Estrogen during menopause, may partly explain these differences. The findings emphasize that managing cardiometabolic health is crucial not only for preventing heart disease but also for protecting liver health.

REFERENCE: Albhaisi, S., et al. (2026). Sex-Specific Cardiometabolic Profiles and Severity of Liver Fibrosis. JAMA Network Open. DOI: 10.1001/jamanetworkopen.2026.0863. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2846021