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Androgenetic alopecia is a common cosmetical condition that accompany by some disorders with high androgen level. Evaluating the possible relationship between androgenetic alopecia and bone mineral density, and its relevance with hair-loss stages were aimed. A cross-sectional study including 106 alopecia patients who also had joint complaints, was conducted on screening of recorded data regarding hair loss stages, bone mineral density and fix and modifiable factors related with bone density, such as body mass index, daily consumptions of calcium, caffeine and alcohol, smoking, birth count, daily sun exposure, usual physical activity, and hormone values including free and total testosterone, dehydroepiandrosterone sulfate, androstenedione, sex hormone binding globulin, follicular stimulating hormone, leutinizing hormone, 25-hydroxy cholecalciferol, ionized calcium, inorganic phosphorus and alkaline phosphatase. Alopecia was classified by hair loss-scale of Ludwig. Bone mineral density in the hip and lumbar spine was measured by dual energy X-ray absorptiometry (Stratos dR 2D Fan-Beam). Data was analysed by Number Cruncher Statistical System, 2007. Results were compared to p<0.05. About 90% of the subjects were under the age of 35 and 60% of them were in the Ludwig stage-2. Osteopenia was detected in the rates of 34.90%, 36.79% and 23.58%, and osteoporosis was detected in the rates of 4.72%, 5.66% and 3.77% in femur-neck, total hip and lumbar spine T-scores, respectively. Z-scores were lower in the rates of 19.81%, 14.15% and 11.32 % in the same order, compare to the agematched reference values. Predisposing factors, laboratory test results and bone mineral density scores did not show any differences according to the Ludwig stages (each at p>0.05). We suggest that all women with early-onset androgenetic alopecia should be thoroughly investigated to the possibility of premature bone loss.

Hirsutism is a condition defining as acquired excess of hairs in the androgen-sensitive skin regions of women. It may be idiopathic, or can be resulted from metabolic or androgen-related disorders. Objective: In order to determine of possible correlation between hirsutism scores and central obesity, comparisons of abdominal subcutaneous fatty tissue thickness, metabolic syndrome criteria and also hirsutism-related hormones, according to hirsutism stages were aimed. Method: A prospective study was conducted on 144 women between the ages of 18-50, from October 2014 to March 2016. Beside hirsutism scores (determined by modified Ferriman-Gallway evaluation system) and subcutaneous abdominal fatty tissue thickness, metabolic syndrome criteria and hirsutism-related hormones were detected. Fatty tissue thicknes were determined by ultrasonographic measurements from 4 points around the umbilicus. Data was compared to hirsutism stages, and evaluated with Number Cruncher Statistical System 2007, as considered p < 0.05 was significant. Results: Only moderate and severe hirsutism groups were detected, and mean age was 24.47 ±7.52 years. The most accompanying finding was polycystic ovary syndrome. Higher means for fatty tissue thickness (p=0.0001 for each four region), weight, body mass index, waist circumferences, systolic and diastolic blood pressures (each p=0.0001), insulin (p=0.038), Homeostatic Model Assesment for Insulin Resistance (p=0.033), triglyceride (p=0.003), free androgen index (p=0.004) and total testosterone (p=0.036), and lower means for high density lipoprotein cholesterol (p=0.003) and sex hormone binding globuline (p=0.008) were obtained in severe hirsutism group. Existence of 1, 2 and 3 metabolic syndrome criteria, and diagnosis of metabolic syndrome were also more detected in higher-score group (each p=0.0001). Conclusions: Women with higher hirsutism scores are more likely to develop thicker subcutaneous abdominal fatty tissue and metabolic syndrome than those with moderate scores. Subcutaneous abdominal fatty tissue thicknesss may a simple metabotrophic indicator for preliminary assessment of severity of hirsutism in especially overweight women.

BackgroundWe aimed to test the hypothesis that the correlation of the changes in the blood Androstenedione (A4) levels to the number of selected follicles during ovulation induction with low-dose recombinant human follicle stimulating hormone (rhFSH) is as strong as the correlation to changes in the blood Estradiol (E2) levels in polycystic ovary syndrome (PCOS).MethodsProspective Case-control study conducted from October 2014 to January 2016. 61 non-PCOS control (Group I) and 46 PCOS (Group II) patients treated with the chronic low-dose step up protocosl with rhFSH. A4, E2, progesterone blood levels and follicular growth were monitored.. Univariate and hierarchical multivariable analysis were performed for age, BMI, HOMA-IR, A4 and E2 (with the number of selected follicles as the dependent variable in both groups). ROC analysis was performed to define threshold values for the significant determinants of the number of selected follicles to predict cyle cancellations due to excessive ovarian response.ResultsThe control group (Group I) was comprised of 61 cycles from a group of primary infertile non-PCOS patients, and the study group (Group II) of 46 cycles of PCOS patients. The analysis revealed that the strongest independent predictor of the total number of selected follicles in Group I was the E2(AUC) (B = 0.0006[0.0003-0.001]; P < 0.001); whereas for Group II, it was the A4 (AUC) (B = 0.114[0.04-0.25]; P = 0.01). Optimum thresholds for the A4 related parameters were defined to predict excessive response within Group II were 88.7%, 3.1 ng/mL and 5.4 ng*days for the percentage increase in A4, the maximum A4 value and area under the curve values for A4, respectively.ConclusionA4 response to low-dose rhFSH in PCOS has a stronger association with the number of follicles selected than the E2 reponse. A4 response preceding the E2 response is essential for progressive follicle development. Monitoring A4 rather than E2 may be more preemptive to define the initial ovarian response and accurate titration of the rhFSH doses.Trial registrationThe study was registered as a prospective case-control study in the ClinicalTrials.gov registry with the identifier NCT02329483.

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