University of Southern California Study Finds Women Face Higher Liver Fibrosis Risks From Metabolic Disorders Than Men

New USC research shows metabolic risk factors like diabetes and high waist circumference cause more severe liver fibrosis in women. See the latest health data.

By: AXL Media

Published: Mar 9, 2026, 11:29 AM EDT

Source: The information in this article was sourced from Keck School of Medicine of USC

The Discovery of Disproportionate Physiological Scars

A comprehensive analysis published in JAMA Network Open reveals a stark disparity in how cardiometabolic health affects the liver based on biological sex. Researchers found that while men generally exhibit higher overall rates of liver fibrosis, women suffer a much more aggressive escalation of the condition when faced with specific metabolic triggers. According to Jennifer Dodge, an associate professor at the Keck School of Medicine, women appear to progress toward advanced liver scarring more quickly than their male counterparts once a disease state is established. This suggests that the traditional focus on heart health regarding metabolic risk factors must be expanded to include the liver, particularly for female patients.

A Robust Foundation of National Health Metrics

The investigation relied on a high-fidelity dataset from the National Health and Nutrition Examination Survey, encompassing a representative sample of 5,981 American adults. Unlike many studies that depend on self-reported medical histories, this research utilized objective clinical data including ultrasound imaging, blood glucose levels, and physical measurements of waist circumference. By examining participants with an average age of 47, the team established a baseline that reflects the current health landscape of the United States. According to the study authors, this objective approach allowed for a precise calculation of how lifestyle factors, such as alcohol intake and exercise, interact with biological markers like triglycerides and cholesterol.

Quantifying the Female Metabolic Penalty

The statistical findings highlight a dramatic "risk gap" between the sexes when metabolic health fails. For women, a high waist circumference was linked to an 11 fold increase in fibrosis rates, jumping from 0.8% to 9.2%. In contrast, men saw a more modest fourfold increase under the same conditions. The disparity continued with type 2 diabetes and pre-diabetes, which were associated with a 2.8 fold risk increase for women compared to only a 1.4 fold increase for men. According to the data, the presence of two or more cardiometabolic risk factors resulted in an 8.4 fold risk surge for women, whereas men experienced a significantly lower 2.6 fold increase.