New research to be presented at this year’s European Congress on Obesity (ECO) in Istanbul, Turkey (12-15 May) reveals distinct patterns of cardiac, metabolic and inflammatory health risks among men and women with obesity and provides insights into how clinicians can tailor their management approaches.
A study led by researchers at Turkey’s Dokuz Eylul University found that obese men were more likely to have abdominal (visceral) fat, a key factor contributing to major heart and metabolic health risks, and elevated levels of liver enzymes, an indicator of liver damage. In contrast, obese women appear to be more likely to develop systemic inflammation and high cholesterol, which can lead to heart disease and type 2 diabetes.
“Our findings reveal interesting differences in the way men and women respond to obesity,” said lead author Dr. Zeynep Peker from Dokuz Eylul University in Izmir, Turkey. “These studies demonstrate how important gender-specific research is. Not only do gender differences play a powerful role in the pathogenesis and course of obesity, but our findings show that such differences may provide a stepping stone to the discovery of targeted gender-based treatments to help manage people living with obesity.”
By 2023, an estimated 1.54 billion adults worldwide (approximately 1 in 3 women and 1 in 4 men) will be living with metabolic syndrome. Metabolic syndrome is a collection of the most dangerous risk factors for cardiovascular disease and type 2 diabetes, including abdominal obesity, high cholesterol, hypertension, and elevated fasting plasma glucose levels.
Obesity is a complex chronic disease characterized by diverse metabolic and inflammatory responses. Biological sex influences the distribution of adipose (fat) tissue, hepatic (liver) metabolism, and inflammatory activity throughout the body. However, gender-based profiling of cardiometabolic and inflammatory markers in adults with obesity is lacking.
To address this knowledge gap, researchers analyzed data from 886 obese women (mean age 45 years) and 248 men (mean age 41 years) who visited the Obesity Clinic of the Department of Internal Medicine, Faculty of Medicine, Dokuz Eylul University between 2024 and 2025, comparing anthropometric, metabolic, and inflammatory parameters and identifying sex-specific patterns.
All participants underwent an extensive assessment of anthropometric measurements (height, weight, BMI, blood pressure, etc.) and 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).
Liver biochemical markers (alanine aminotransferase (ALT) and gamma glutamyl transferase (GGT) levels) and renal function (creatinine levels), as well as inflammatory parameters (C-reactive protein, erythrocyte sedimentation rate, white blood cell count, and platelet count) were also evaluated.
The analysis found that, on average, men had a slightly higher body mass index (BMI) than women (37.5 vs. 36 kg/m2), had significantly larger waist circumference (120 vs. 108 cm), and tended to have higher systolic blood pressure (128 vs. 122 mmHg). Both factors are associated with a variety of health problems, including cardiovascular disease and diabetes (see table in Notes to the Editor).
Additionally, liver enzymes (ALT and GGT) and triglyceride levels are significantly elevated in men, as are creatinine levels, which can lead to various complications including liver disease.
In contrast, women had significantly higher total cholesterol (215 vs. 203 mg/dL) and LDL cholesterol (130 vs. 123 mg/dL) than men. In addition, inflammatory markers such as erythrocyte sedimentation rate, C-reactive protein, and platelet count were also significantly higher in women (see table in Notes to the Editor).
Pekel explained that sex differences in hormones, immune responses, and fat distribution help explain the observed patterns. For example, hormones (particularly estrogen) affect how fat is stored and how the body responds to inflammation. Women tend to store more fat under their skin and exhibit a different inflammatory profile. This is seen in high levels of markers such as C-reactive protein and erythrocyte sedimentation rate. Women also generally have a stronger immune response, which is partly related to genetic factors such as their X chromosome. In contrast, men are more likely to accumulate fat around internal organs, which is more closely associated with metabolic complications.
“Although it is still early days and these findings need to be confirmed in other patient groups, they provide important insight into how obesity may affect men and women differently,” Pekel said. “These differences may be influenced by biological factors such as hormones, immune responses, and fat distribution. Our next steps are to validate these findings in larger populations to better understand the biological processes behind these differences and investigate how these patterns relate to clinical risk.”
The authors acknowledge several limitations of the study, including its cross-sectional design, which prevents the establishment of causal relationships and the potential for confounding and reverse causality errors. Additionally, the researchers noted that the study included primarily adults of Turkish ethnicity, making the generalizability of the findings to other ethnicities uncertain, and that larger studies could confirm and extend the findings.
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European Obesity Research Association
