Androgenetic alopecia and cardiovascular risk factors in men and women: A comparative study

• Published in: Journal of the American Academy of Dermatology Vol. 63; no. 3; pp. 420 - 429
• Main Authors: Arias-Santiago, Salvador, Gutiérrez-Salmerón, María Teresa, Castellote-Caballero, Luisa, Buendía-Eisman, Agustín, Naranjo-Sintes, Ramón
• Format: Journal Article
• Language: English
• Published: United States Mosby, Inc 01.09.2010
• Subjects: acute phase reactant; Adult; Age Distribution; Age of Onset; Alopecia - diagnosis; Alopecia - epidemiology; Anthropometry; atheroma plaque; Blood Sedimentation; C-Reactive Protein - analysis; Cardiovascular Diseases - diagnosis; Cardiovascular Diseases - epidemiology; cardiovascular risk factors; Carotid Stenosis - diagnosis; Carotid Stenosis - epidemiology; Case-Control Studies; Comorbidity; Confidence Intervals; Dermatology; Female; Fibrin Fibrinogen Degradation Products - analysis; Follow-Up Studies; hormonal study; Humans; Life Style; Male; male and female androgenetic alopecia; metabolic syndrome; Metabolic Syndrome - diagnosis; Metabolic Syndrome - epidemiology; Middle Aged; Odds Ratio; Prevalence; Risk Factors; Severity of Illness Index; Sex Distribution; Spain - epidemiology; male and female androgenetic alopecia; CRP; OR; atheroma plaque; CI; MS; cardiovascular risk factors; hormonal study; BP; metabolic syndrome; HDL-C; DHT; HOMA-IR; PCOS; AGA; acute phase reactant; SHBG; ATP; BMI; C-reactive protein; dihydrotestosterone; odds ratio; Adult Treatment Panel; polycystic ovary syndrome; high-density lipoprotein cholesterol; androgenetic alopecia; blood pressure; homeostasis model assessment of insulin resistance; body mass index; sex hormone–binding globulin; confidence interval
• ISSN: 0190-9622; 1097-6787; 1097-6787
• DOI: 10.1016/j.jaad.2009.10.018

Numerous studies in recent decades have associated male androgenetic alopecia (AGA) with the risk of cardiovascular disease. However, only 3 studies have addressed this association in female patients. Most studies considered the risk of myocardial infarction or mortality as a result of heart disease, without analyzing cardiovascular risk factors. The objectives of this study were to analyze the presence of cardiovascular risk factors included in the Adult Treatment Panel-III criteria for metabolic syndrome, the prevalence of carotid atheromatosis, hormonal (aldosterone, insulin, testosterone, and sex hormone–binding globulin) factors, and acute phase reactant (C-reactive protein, fibrinogen, D-dimers, erythrocyte sedimentation rate) variables in male and female patients with AGA and in a control group, and to analyze differences among the groups. This case-control study included 154 participants, 77 with early-onset AGA (40 male and 37 female) and 77 healthy control subjects (40 male and 37 female) from the dermatology department at a university hospital in Granada, Spain. Metabolic syndrome was diagnosed in 60% of male patients with AGA (odds ratio [OR] = 10.5, 95% confidence interval [CI] 3.3-32.5), 48.6% of female patients with AGA (OR = 10.73, 95% CI 2.7-41.2), 12.5% of male control subjects, and 8.1% of female control subjects ( P < .0001). Atheromatous plaques were observed in 32.5% of male patients with AGA (OR = 5.93, 95% CI 1.5-22.9) versus 7.5% of male control subjects ( P = .005) and 27% of female patients with AGA (OR = 4.19, 95% CI 1.05-16.7) versus 8.1% of female control subjects ( P = .032). Aldosterone and insulin levels were significantly higher in the male and female patients with AGA versus their respective control subjects. Mean values of fibrinogen were significantly higher in male patients with AGA, whereas values of fibrogen, C-reactive protein, and D-dimers were significantly higher in female patients with AGA versus their respective control subjects. The study of a wider sample of patients with AGA would confirm these findings and allow a detailed analysis of the above factors as a function of the degree of alopecia or between menopausal and premenopausal women. The determination of metabolic syndrome and ultrasound study of the carotid arteries may be useful screening methods to detect risk of developing cardiovascular disease in male and female patients with early-onset AGA and signal a potential opportunity for early preventive treatment.