Is early onset androgenic alopecia a marker of metabolic syndrome and carotid artery atherosclerosis in young Indian male patients?

Abstract

Background:Androgenic alopecia (AGA) is a common cosmetically and psychosocially distressing condition. High androgen level contributes to the development of atherosclerosis, thrombosis leading to hypertension and hypercholesterolemia.Objectives:To study the clinico-epidemiological profile of AGA and the presence of metabolic syndrome (MetS) and carotid artery atherosclerosis in male patients with early onset AGA as compared to controls.Materials and Methods:In this case-control study, 100 male patients of age 18-35 years with AGA and an equal number of age-matched healthy controls attending skin and STD OPD were included. Assessment of the degree of hair loss, evaluation of MetS and carotid artery color Doppler for the atherosclerotic plaque was done in all patients.Results:Statistically significant number of patients with early onset AGA 22/100 (22%) (P < 0.05) fulfilled the criteria for MetS compared to 8/100 (8%) in the control group. There were statistically significant differences in mean values of waist circumference, serum triglycerides, serum cholesterol, systolic blood pressure, diastolic blood pressure, fasting glucose concentration, and very low-density lipoprotein (LDL). However, no significant differences were observed in the mean values of high-density lipoprotein cholesterol and LDL cholesterol. The atherosclerotic plaque was found in two patients of the study group, and no plaque was found in control patients.Conclusion:We suggest that all men with AGA should be thoroughly investigated, and lifestyle changes should be started in the early period of life so as to reduce the risk of various problems associated with MetS. AGA can be considered as an early marker for MetS.

Metabolic syndrome and the skin: a more than superficial association. Reviewing the association between skin diseases and metabolic syndrome and a clinical decision algorithm for high risk patients

“…In 2000 Matilainen et al observed early AGA associated with increased insulin resistance [ 60 ]. A case control study of 100 young male patients conducted by Banger et al detected a statistically significant difference regarding the number of individuals in the group of AGA fulfilling the criteria for MeTS in comparison with the control group [ 61 ]. The study by El Sayed et al among 90 female patients with AGA showed a statistically significant increase in the incidence and severity of female pattern hair loss especially in relation to hypertension and obesity (defined by NCEP-ATP III criteria) [ 62 ].…”

Association of androgenetic alopecia with metabolic syndrome: A case–control study on 100 patients in a tertiary care hospital in South India

“…Androgenetic alopecia (AGA) is the most common cause of hair loss. [ 1 2 ] Although it is a medically benign condition, it can have a significant psychosocial impact on patients. It is a very common condition encountered in almost all dermatology outpatient departments across the world.…”

“…A population-based study in India of 1005 participants showed 58% AGA in males aged 30–50 years. [ 1 ]…”

Glycolipid and Hormonal Profiles in Young Men with Early-Onset Androgenetic Alopecia: A meta-analysis

“…A higher number of articles investigating the metabolic profile was found compared to those investigating the hormonal status. We did not considered in the meta-analysis the total testosterone levels of the study by Banger and colleagues 22 and the SHBG levels of the study by Gonzalez-Gonzalez and colleagues 9 , since they were not comparable with those of the other studies. We unsuccessfully tried to get in touch with the authors.…”

“… 21 India, single institution 85 85 ≥I 26.44 [2.64] 25.65 [3.19] Blood pressure, FBS, HOMA-index, total-C, HDL-C, LDL-C, VLDL, triglycerides, BMI − *** * *** Moderate Banger et al . 22 India, single institution 100 100 ≥I 27.03 [5.36] 26.22 [5.1] Blood pressure, FBG, total-C, HDL-C, LDL-C, triglycerides, BMI, WC, WHR, CRP, ESR − **** * *** Low Sanke et al . 23 India, single institution 57 32 ≥III 24.7 [2.8] 24.2 [2.6] FBS, insulin, HOMA-index, BMI, LH, FSH, LH/FSH ratio, total testosterone, FAI, DHEAS, SHBG, − **** * *** Low Abbreviations: AGA = androgenetic alopecia; BMI = body mass index; CRP = C-reactive protein; DHEAS = dehydroepiandrosterone sulphate; ESR = erythrocyte sedimentation rate; FAI = free androgen index; FBS = fasting blood sugar; FIRI = fasting insulin resistance index; HDL-C = HDL cholesterol; LDL-C = LDL cholesterol; SHBG = sex hormone binding globulin; total-C = total cholesterol; VLDL = very low-density lipoproteins; WC = waist circumference; WHR = waist to hip ratio.…”