Obesity risks are sex-dependent, manifesting as distinct heart, metabolic, and inflammatory health patterns in men versus women.
There is a significant biological disparity in how weight impacts the body by sex. Findings from the groundbreaking research presented at the European Congress on Obesity (ECO) in Istanbul reveal that men with obesity face a higher risk of visceral fat accumulation and elevated liver enzymes, signaling potential liver damage.(1✔ ✔Trusted Source
Worldwide trends in metabolic syndrome from 2000 to 2023: a systematic review and modelling analysis
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Conversely, women are more susceptible to systemic inflammation and poor lipid profiles (high cholesterol), increasing their risk for type 2 diabetes and heart disease. The study, led by Dokuz Eylul University, suggests that obesity management requires a gender-specific approach.
The data supports the shift toward precision medicine to address these unique metabolic and inflammatory setbacks.
Why Sex-Based Cardiometabolic Profiling in Obesity is Lacking
“Our findings reveal intriguing differences in the way men and women respond to obesity,” said lead author Dr. Zeynep Pekel, from Dokuz Eylul University, Izmir, Turkey. “They show just how important gender-specific research is. Not only are sex differences a powerful player in the pathology and course of obesity, but our results indicate that such differences could be a stepping stone toward finding targeted, sex-based therapies to help in the management of people living with obesity.”
In 2023, an estimated 1.54 billion adults (around 1 in 3 women and 1 in 4 men) were living with metabolic syndrome worldwide—a cluster of the most dangerous risk factors for cardiovascular disease and type 2 diabetes, including abdominal obesity, high cholesterol, high blood pressure, and raised fasting plasma glucose.
Obesity is a complex chronic disease characterized by varied metabolic and inflammatory responses. Biological sex influences adipose (fat) tissue distribution, hepatic (liver) metabolism, and systemic inflammatory activity.
However, sex-based profiling of cardiometabolic and inflammatory markers among adults living with obesity is lacking.
Elevated Liver Enzymes and Visceral Fat Risks: Key Findings in Men
To address this knowledge gap, researchers analyzed data from 886 women (average age 45 years) and 248 men (average age 41 years) with obesity attending the Obesity Clinic at the Department of Internal Medicine, Dokuz Eylul University Faculty of Medicine between 2024 and 2025, to compare anthropometric, metabolic, and inflammatory parameters and identify sex-specific patterns.
All participants underwent physical measurements:
- Height
- Weight
- Body mass index [BMI]
- Blood pressure
And extensive evaluations of blood lipid profiles to quantify cardiovascular risk factors:
- Total cholesterol
- Low-density lipoprotein [LDL] or “bad” cholesterol
- High-density lipoprotein [HDL] or “good” cholesterol
- Triglycerides
- Fasting blood glucose
Biochemical markers of liver (alanine aminotransferase [ALT] and gamma-glutamyl transferase [GGT] levels) and kidney function (creatinine levels) as well as inflammatory parameters (C-reactive protein, erythrocyte sedimentation rate, white blood cell count, and platelet count) were also assessed.
The analysis found that, on average, men had slightly higher body mass index (BMI) than women (37.5 vs 36 kg/m²), but their waist circumference was significantly greater (120 vs 108cm), while systolic blood pressure tended to be higher (128 vs 122 mmHg)—both factors associated with a range of health problems including cardiovascular disease and diabetes.
Additionally, liver enzymes (ALT and GGT) and triglyceride levels were significantly elevated in men, as were creatinine levels, which can lead to a range of complications, including liver disease.
Elevated Cholesterol and Systemic Inflammation: Key Risks for Women
In contrast, women had significantly higher total cholesterol (215 vs 203 mg/dL) and LDL or “bad” cholesterol (130 vs 123 mg/dL) than men. Additionally, inflammatory markers including erythrocyte sedimentation rate, C-reactive protein, and platelet count, were also significantly higher in women.
Pekel explained that sex differences in hormones, immune response, and fat distribution help explain the patterns observed. For example, hormones (especially estrogen) affect how fat is stored and how the body responds to inflammation. Women tend to store more fat under the skin and show a different inflammatory profile, which can be seen in higher levels of markers like C-reactive protein and erythrocyte sedimentation rate.
Women also generally have a stronger immune response, partly related to genetic factors such as the X chromosome. In contrast, men are more likely to accumulate fat around internal organs, which is more closely linked to metabolic complications.
“It’s still early days and these findings need to be confirmed in other patient groups, but they offer important insight into how obesity may affect men and women differently,” said Pekel.
“These differences are likely influenced by biological factors such as hormones, immune responses, and fat distribution. Our next steps are to validate these findings in larger populations, better understand the biological processes behind these differences, and explore how these patterns relate to clinical risk.”
Reference:
- Worldwide trends in metabolic syndrome from 2000 to 2023: a systematic review and modelling analysis – (https://www.nature.com/articles/s41467-025-67268-5)
Source-Eurekalert