Severe androgenetic alopecia as a maker of metabolic syndrome in male patients of androgenetic alopecia: a hospital based case control study

Abstract

Background: Several previous studies have investigated the association between androgenetic alopecia (AGA) and metabolic syndrome (MS), with inconsistent results. Objectives of the study were to study the prevalence of metabolic syndrome in male patients of androgenetic alopecia and compare with control population and study the relationship of metabolic syndrome with different grades of AGA.Methods: This prospective hospital based case control study included 100 new clinically diagnosed males of androgenetic alopecia, and age and sex matched control group. Assessment for presence of various components of metabolic syndrome was done following a uniform protocol in cases and controls. AGA was classified as per Hamilton –Narwood classification, grade I to III was classified as mild –moderate and grade IV and higher as severe AGA.Results: Of the 100 male AGA patients (age range 21-50, mean 34.49), 36 had grade II AGA, 24 had grade III AGA, 20 had grade IV AGA, 15 had grade V AGA and 5 had grade VI AGA. Among AGA patients, 60 of patients had mild-moderate AGA and 40 patients had severe AGA. Metabolic syndrome was statistically significantly more common in patients with AGA compared to controls. Among patients of AGA, metabolic syndrome was statistically significantly present in severe AGA compared to mild-moderate AGA. Among the evaluated parameters, like blood pressure, fasting blood sugar, dyslipedemia, abdominal obesity, all were significantly more common in AGA patients compared to controls except abdominal obesity.Conclusions: In the present study, metabolic syndrome was found to be 4.6 times more common in patients of androgenetic alopecia as compared to controls, being statistically significant, and more common in those with severe grades. This suggests that androgenetic alopecia patients especially with severe grades are at risk of metabolic syndrome and other cardiovascular diseases.

Androgenetic Alopecia as a Marker of Metabolic Syndrome

“…LDL was increased in 30% of patients who had severe androgenetic alopecia as compared to 5% in patients who had mildmoderate androgenetic alopecia Serum cholesterol and triglyceride level was increased in 30% of androgenetic alopecia patients with severe AGA as compared to 6.67% in patients with mild-moderate AGA. Among the patients who had androgenetic alopecia impaired fasting glucose was seen in 30% of patients with severe AGA as compared to 5% of patients with mildmoderate AGA [28]. In present study, the NCEP ATP III definition was used to diagnose the metabolic syndrome [30], while in Malaysia and Bangladesh NCEP ATP III and IDF criteria was used to determine the metabolic syndrome whereas in India NCEP ATP III criteria used to diagnose the metabolic syndrome [31][32][33].…”

“…Raised aldosterone levels have been considered answerable for both androgenetic alopecia and hypertension, clearing path for the job of aldosterone adversaries for control of circulatory strain and end in movement of alopecia [26][27]. Aldosterone causes expansion in the degree of ROS, EGF beta and TGF beta which tweak fibrinolytic impacts and fiery reaction which might be dependable, alongside different components in causing perifollicular fibrosis and aggravation in androgenetic alopecia [28].…”

Circulating and/or cutaneous irisin resistance: A novel link among androgenetic alopecia, comorbid metabolic syndrome and cardiovascular risks

“…Body mass index (BMI = kg/m2) was calculated, 14 and blood pressure was measured twice in a resting state and the average was considered. Blood pressure was considered high if it is greater than 130/85 15 …”

Alopecia and Clinical Presentation of Endocrinopathies: Pathogenetic and Diagnostic Aspects

“…Традиционно же считается, что фиброз -это следствие перифолликулярногомикровоспаления в результате повреждающего действия ДГТ [58]. Однако, вне зависимости от последовательности процессов, установлено, что метаболические нарушения и АГА связаны, и АГА может быть одним из маркеров МС и кардиоваскулярных рисков [59,60].…”

“…У подавляющего числа пациентов с гнездной алопецией также выявляется критически низкий уровень 25(ОН)D [59].…”