Androgenetic Alopecia Is Not Associated with Increased Incidence of Cardiovascular Disease Risk Factors: A Retrospective Cohort Study

Introduction: Prior studies suggest that androgenetic alopecia (AGA) may increase cardiovascular and metabolic disease risk, but findings have been inconsistent due to methodological limitations, reliance on self-reported data, and small sample sizes. This study aimed to evaluate the association between AGA and cardiometabolic outcomes using large-scale clinical data. Methods: We conducted a retrospective cohort study using the TriNetX US Collaborative Network to evaluate cardiometabolic outcomes, including abdominal obesity, dyslipidemia, hypertension, and diabetes mellitus, in 30, 282 propensity-matched male patients (aged 18–45 years) diagnosed with AGA compared to 30, 282 controls from general screening encounters. Outcomes were analyzed up to 5 years post-diagnosis using risk ratios (RRs), risk differences, and Kaplan-Meier survival analysis. Results: Patients with AGA demonstrated significantly lower risks of abdominal obesity (RR: 0.53; 95% confidence interval [CI]: 0.45–0.61), dyslipidemia (RR: 0.63; 95% CI: 0.60–0.67), hypertension (RR: 0.59; 95% CI: 0.54–0.65), and diabetes mellitus (RR: 0.43; 95% CI: 0.36–0.51) compared to controls. Kaplan-Meier analysis confirmed a reduced hazard for diabetes mellitus (hazard ratio: 0.44; 95% CI: 0.37–0.52). Conclusion: AGA diagnosis was not associated with increased cardiometabolic risk. The observed risk reduction may reflect healthcare-seeking behaviors rather than a biological relationship.