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Mogi M, Ikegawa Y, Haga S, Hoshide S, Kario K. Hypertension facilitates age-related diseases. ~ Is hypertension associated with a wide variety of diseases?~. Hypertens Res 2024; 47:1246-1259. [PMID: 38491107 DOI: 10.1038/s41440-024-01642-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 02/21/2024] [Accepted: 02/22/2024] [Indexed: 03/18/2024]
Abstract
Hypertension, a disease whose prevalence increases with age, induces pathological conditions of ischemic vascular disorders such as cerebral infarction and myocardial infarction due to accelerated arteriosclerosis and circulatory insufficiency of small arteries and sometimes causes hemorrhagic conditions such as cerebral hemorrhage and ruptured aortic aneurysm. On the other hand, as it is said that aging starts with the blood vessels, impaired blood flow associated with vascular aging is the basis for the development of many pathological conditions, and ischemic changes in target organs associated with vascular disorders result in tissue dysfunction and degeneration, inducing organ hypofunction and dysfunction. Therefore, we hypothesized that hypertension is associated with all age-related vascular diseases, and attempted to review the relationship between hypertension and diseases for which a relationship has not been previously well reported. Following our review, we hope that a collaborative effort to unravel age-related diseases from the perspective of hypertension will be undertaken together with experts in various specialties regarding the relationship of hypertension to all pathological conditions.
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Affiliation(s)
- Masaki Mogi
- Department of Pharmacology, Ehime University Graduate School of Medicine, Matsuyama, Japan.
| | - Yasuhito Ikegawa
- Department of Pharmacology, Ehime University Graduate School of Medicine, Matsuyama, Japan
- Department of Ophthalmology, Ehime University Graduate School of Medicine, Matsuyama, Japan
| | - Shunsuke Haga
- Department of Pharmacology, Ehime University Graduate School of Medicine, Matsuyama, Japan
- Department of Urology, Ehime University Graduate School of Medicine, Matsuyama, Japan
| | - Satoshi Hoshide
- Division of Cardiovascular Medicine, Jichi Medical University School of Medicine, Shimotsuke, Japan
| | - Kazuomi Kario
- Division of Cardiovascular Medicine, Jichi Medical University School of Medicine, Shimotsuke, Japan
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Oiwoh SO, Enitan AO, Adegbosin OT, Akinboro AO, Onayemi EO. Androgenetic Alopecia: A Review. Niger Postgrad Med J 2024; 31:85-92. [PMID: 38826011 DOI: 10.4103/npmj.npmj_47_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2024] [Accepted: 05/16/2024] [Indexed: 06/04/2024]
Abstract
This study reviewed the current knowledge on the epidemiology, pathophysiology, clinical presentations, diagnosis, treatment, quality-of-life assessment and recent trends in androgenetic alopecia (AGA). Relevant articles on AGA from PubMed, Google Scholar, Medline and Scopus from 1950 to 2024 were obtained and scrutinized.. Key search words included each term like 'androgenetic alopecia', 'androgenic alopecia', 'pattern baldness' and 'pattern hair loss' AND each term like 'epidemiology', 'pathophysiology', 'genetics', 'hormones', 'micronutrient', 'stress and inflammation', 'growth factors', 'clinical features', 'staging', 'cardiovascular associations', 'diagnosis' and 'management' were used in the search. AGA is a non-scarring hair loss that is exemplified by a progressive decline of hair follicles, or non-functional or dead hair follicles in the scalp in a defined pattern. It is the most common hair loss, more common in men but can also present in younger age as premature AGA. Hormones, genetics, micronutrient deficiency, microinflammation and stress have been implicated, while psychosocial distress and cutaneous correlate of cardiovascular diseases have become sources of relentless research. AGA is a patterned hair loss that is more prevalent in Men. It results from the interactions between hormonal, genetic and other factors which determine the extent of hair loss and associated disorders (psychosocial and cardiovascular). As results of more research become available, the extent of AGA, its comorbidities as well as the full spectrum of their manifestations will continue to be sources of health education and more holistic examination by dermatologists and patients.
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Affiliation(s)
- Sebastine Oseghae Oiwoh
- Department of Internal Medicine, Dermatology and Venereology Unit, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria
| | - Ademola Olusegun Enitan
- Department of Dermatology and Venereology, Obafemi Awolowo University Teaching Hospitals Complex, Ile Ife, Osun State, Nigeria
| | | | - Adeolu Oladayo Akinboro
- Department of Medicine, Dermatology and Venereology Unit, Ladoke Akintola University of Technology, Ogbomoso, Oyo State, Nigeria
| | - Emmanuel Olaniyi Onayemi
- Department of Dermatology and Venereology, Obafemi Awolowo University, Ile Ife, Osun State, Nigeria
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Liu LP, Wariboko MA, Hu X, Wang ZH, Wu Q, Li YM. Factors associated with early-onset androgenetic alopecia: A scoping review. PLoS One 2024; 19:e0299212. [PMID: 38451966 PMCID: PMC10919688 DOI: 10.1371/journal.pone.0299212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Accepted: 02/07/2024] [Indexed: 03/09/2024] Open
Abstract
BACKGROUND Early-onset androgenetic alopecia (AGA) has been associated with various chronic conditions, including metabolic syndrome (MetS). Gaining a deep understanding of early-onset AGA may enable earlier intervention in individuals at high risks. This scoping review aims to explore the risk factors and etiology, associated conditions, and adverse effects on wellbeing in early-onset AGA. METHODS Electronic literature searches were conducted in MEDLINE, EMBASE and CENTRIAL. Eligible studies included case-control, cohort, cross-sectional, and meta-analysis studies. Selected studies needed to clearly define early-onset AGA cases or include only cases starting before the age of 40 and compare them with appropriate controls. The exclusion criteria comprised editorials, commentaries, case series, and non-systematic reviews, among others. Data extraction involved collecting study characteristics, methodologies, main outcomes, and findings. Descriptive tables were used to summarize key information and relevant variables when necessary. RESULTS Among the 65 eligible articles, 67.69% were case-control studies and 78.46% evaluated only male patients. "Early-onset" was defined as cases developing before the age of 30 years in 43.08% of the studies. The Hamilton-Norwood scale was the most frequently used method for evaluating the severity of alopecia in men (69.23%). Reported risk factors for early-onset AGA included a family history of AGA, cigarette smoking, unhealthy dietary habits, and a high body mass index. Early-onset AGA may also be associated with hormonal profiles, 5α-reductase enzyme activity, androgen receptor genes, and some susceptibility loci. Comorbidities investigated included MetS, cardiovascular disease, insulin resistance, dyslipidemia, and Parkinson's disease. Men with early-onset AGA may have reduced treatment efficacy with drug like rosuvastatin, metformin or lisinopril for dyslipidemia, prediabetes, or hypertension. Additionally, young men with AGA tended to suffer from psychological issues such as anxiety and low self-esteem compared to those without hair loss. CONCLUSION Early-onset AGA is a complex condition with various risk factors and etiology, associated comorbidities, and potential implications for treatment response and psychological health.
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Affiliation(s)
- Li-Ping Liu
- Department of Dermatology, Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu, China
- Institute of Regenerative Medicine, Jiangsu University, Zhenjiang, Jiangsu, China
| | - Mary Adumo Wariboko
- Department of Dermatology, Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu, China
- Institute of Regenerative Medicine, Jiangsu University, Zhenjiang, Jiangsu, China
| | - Xiao Hu
- Department of Urology, The First People's Hospital of Zhenjiang, Zhenjiang, Jiangsu, China
| | - Zi-Han Wang
- Department of Dermatology, Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu, China
- Institute of Regenerative Medicine, Jiangsu University, Zhenjiang, Jiangsu, China
| | - Qian Wu
- Department of Dermatology, Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu, China
- Institute of Regenerative Medicine, Jiangsu University, Zhenjiang, Jiangsu, China
| | - Yu-Mei Li
- Department of Dermatology, Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu, China
- Institute of Regenerative Medicine, Jiangsu University, Zhenjiang, Jiangsu, China
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4
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Wu Y, Hui Y, Liu F, Chen H, Liu K, Chen Q, He Y, Hong N, Yan W, Kong Q, Sang H. The Association of Serum Adipokines, Insulin Resistance and Vitamin D Status in Male Patients with Androgenetic Alopecia. Clin Cosmet Investig Dermatol 2023; 16:419-427. [PMID: 36817642 PMCID: PMC9936883 DOI: 10.2147/ccid.s396697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 02/08/2023] [Indexed: 02/15/2023]
Abstract
Background The frequent coexistence of obesity and metabolic syndrome in patients with Androgenetic alopecia (AGA), may indicate a common pathogenetic pathway with adipokines being a possible implicating cytokine. Objective This study was conducted to investigate the changes in serum levels of adipokines, insulin resistance, vitamin D status and their relationship with AGA, and the relationship between serum levels of adipokines and insulin resistance. Methods 80 male patients with AGA were selected as the experimental group and 60 healthy males served as the control group. Both the AGA group and healthy control group were divided into 2 groups according to the presence or absence of insulin resistance (IR): the IR group and the NIR group. Serum levels of leptin, adiponectin, resistin, visfatin, insulin and 25(OH)D were evaluated in all subjects. Results Compared with the control group, AGA patients showed higher serum levels of leptin and lower adiponectin/leptin (Adpn/Lep) ratio (P<0.05), and both were positively correlated with the severity of the disease. Compared with the AGA NIR group, serum leptin levels were increased in the AGA IR group (P<0.05). AGA IR group and AGA NIR group possessed lower Adpn/Lep ratio when compared with the healthy IR group and healthy NIR group respectively (P<0.05). The multi-factor logistic regression analysis results showed decreased Adpn/Lep level and increased leptin level as risk factors for AGA. AGA Patients had lower vitamin D levels than healthy controls (P<0.05). Conclusion Patients with AGA show an imbalance between pro- and anti-inflammatory adipokines, and probably be involved in AGA pathogenesis. Insulin resistance may influence levels of adipokines, but the present findings cannot indicate insulin resistance plays a role in the onset of AGA. The insufficiency and deficiency of vitamin D are common health concern in our subjects and may be involved in the dysfunction of adipocytes and the development of AGA.
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Affiliation(s)
- YiFan Wu
- Nanjing Medical University, Nanjing, 210002, People’s Republic of China
| | - Yun Hui
- Department of Dermatology, Jinling Hospital, Nanjing University, Nanjing, 210002, People’s Republic of China
| | - Fang Liu
- Department of Dermatology, Jinling Hospital, Nanjing University, Nanjing, 210002, People’s Republic of China
| | - Huan Chen
- Department of Dermatology, Jinling Hospital, Nanjing University, Nanjing, 210002, People’s Republic of China
| | - KeHan Liu
- Nanjing Medical University, Nanjing, 210002, People’s Republic of China
| | - QiYing Chen
- Department of Dermatology, Jinling Hospital, Nanjing University, Nanjing, 210002, People’s Republic of China
| | - YiFan He
- Nanjing Medical University, Nanjing, 210002, People’s Republic of China
| | - Nan Hong
- Department of Dermatology, Jinling Hospital, Nanjing University, Nanjing, 210002, People’s Republic of China
| | - WenLiang Yan
- Department of Dermatology, Jinling Hospital, Nanjing University, Nanjing, 210002, People’s Republic of China
| | - QingTao Kong
- Department of Dermatology, Jinling Hospital, Nanjing University, Nanjing, 210002, People’s Republic of China,Correspondence: QingTao Kong; Hong Sang, Jinling Hospital, Nanjing, Jiangsu, People’s Republic of China, Tel +86 025-80860092, Email ;
| | - Hong Sang
- Nanjing Medical University, Nanjing, 210002, People’s Republic of China,Department of Dermatology, Jinling Hospital, Nanjing University, Nanjing, 210002, People’s Republic of China
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Shi X, Tuan H, Na X, Yang H, Yang Y, Zhang Y, Xi M, Tan Y, Yang C, Zhang J, Zhao A. The Association between Sugar-Sweetened Beverages and Male Pattern Hair Loss in Young Men. Nutrients 2023; 15:nu15010214. [PMID: 36615870 PMCID: PMC9824121 DOI: 10.3390/nu15010214] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 12/17/2022] [Accepted: 12/29/2022] [Indexed: 01/04/2023] Open
Abstract
We performed this study to investigate the association between sugar-sweetened beverage (SSB) consumption and male pattern hair loss (MPHL) in young men. We conducted this cross-sectional study from January to April 2022 in mainland China. Young people aged 18-45 years (n = 1951) were recruited from 31 provinces in China. We used a self-reported online survey for data collection. We explored the associations between the amount/frequency of SSB consumption and MPHL by using a binary logistic regression model, with adjustments for sociodemographic, hair status, dietary intake, lifestyle, and psychological factors. Among the 1028 participants (27.8 ± 7.2 years) in the final analysis, we found that high SSB consumption is associated with a higher risk of MPHL. We recommend more support to decrease SSB consumption among young people to minimize negative health outcomes.
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Affiliation(s)
- Xiaojin Shi
- Vanke School of Public Health, Tsinghua University, Beijing 100084, China
| | - Hsiaohan Tuan
- Department of Dermatology, School of Clinical Medicine, Beijing Tsinghua Changgung Hospital, Tsinghua University, Beijing 102218, China
| | - Xiaona Na
- Vanke School of Public Health, Tsinghua University, Beijing 100084, China
| | - Haibing Yang
- Vanke School of Public Health, Tsinghua University, Beijing 100084, China
| | - Yucheng Yang
- Vanke School of Public Health, Tsinghua University, Beijing 100084, China
| | - Yulin Zhang
- Vanke School of Public Health, Tsinghua University, Beijing 100084, China
| | - Menglu Xi
- Vanke School of Public Health, Tsinghua University, Beijing 100084, China
| | - Yuefeng Tan
- Vanke School of Public Health, Tsinghua University, Beijing 100084, China
| | - Celi Yang
- Vanke School of Public Health, Tsinghua University, Beijing 100084, China
| | - Junhan Zhang
- Vanke School of Public Health, Tsinghua University, Beijing 100084, China
| | - Ai Zhao
- Vanke School of Public Health, Tsinghua University, Beijing 100084, China
- Correspondence: ; Tel.: +86-010-6279-6447
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Zhu H, Guo H, Gao Y, Wei Y, Mao T, Yang J. A community-oriented survey on the association between androgenetic alopecia and metabolic syndrome in Chinese people. Front Med (Lausanne) 2022; 9:1009578. [PMID: 36438037 PMCID: PMC9684335 DOI: 10.3389/fmed.2022.1009578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 10/07/2022] [Indexed: 11/11/2022] Open
Abstract
Background Several studies on Caucasians have revealed a positive relationship between androgenetic alopecia (AGA) and metabolic syndrome (MS). However, this correlation varies in different contexts. Currently, the association of AGA with MS is yet to be studied and elucidated in Chinese people. Objective To evaluate the association between AGA and MS in the Chinese population. Methods This study included information on components of MS along with other possible risk factors in a total of 3,703 subjects. The patients' loss of hair was assessed using Hamilton-Norwood and Ludwig classification method. Results In this study, 29.88% of male and 27.58% of female AGA patients were diagnosed with MS, while the rest were regarded as controls (29.95% of male and 27.89% of female control subjects) (P > 0.05). The AGA males presented significantly higher systolic and diastolic blood pressure than the male control subjects (SP: P = 0.000; DP: P = 0.041). Among females with AGA, waist circumference, hip circumference, and waist-hip ratio elevated the loss of hair compared to that of the female controls (P = 0.000, P = 0.020, P = 0.001, respectively). Conclusion Our study indicated no direct association between AGA and MS in Chinese people. However, a close relationship was observed between AGA and systolic blood pressure.
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Affiliation(s)
- Hongliu Zhu
- Department of Dermatology, Jiangyin Hospital of Traditional Chinese Medicine, Wuxi, China
| | - Haijian Guo
- Integrated Business Management Office, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Yihong Gao
- Department of Dermatology, Jiangyin Hospital of Traditional Chinese Medicine, Wuxi, China,*Correspondence: Yihong Gao,
| | - Yuegang Wei
- Department of Dermatology, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Tao Mao
- Department of Health Education, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Jianqiu Yang
- Department of Dermatology, Jiangyin Hospital of Traditional Chinese Medicine, Wuxi, China
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Comorbidities in Androgenetic Alopecia: A Comprehensive Review. Dermatol Ther (Heidelb) 2022; 12:2233-2247. [PMID: 36115913 PMCID: PMC9483356 DOI: 10.1007/s13555-022-00799-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Accepted: 08/18/2022] [Indexed: 11/06/2022] Open
Abstract
Androgenetic alopecia is the most common form of hair loss, affecting 85% of men and 40% of women. Androgenetic alopecia is a disease caused by multiple factors, such as genetics, hormones, and systemic diseases; however, the exact cause remains undetermined. Recent studies have found that it is associated with a high incidence of endocrine diseases and other comorbidities. It may not only be a skin disease but also an early signal of underlying systemic diseases. Effective management requires timely diagnosis and treatment initiation. However, in current clinical practice, androgenetic alopecia is still not fully understood or treated. Recognizing the true physical, social, and emotional burden of androgenic alopecia, as well as its associated comorbidities, is the first step in improving the prognosis of affected patients. This review aimed to gather the known pathological factors and provide a reference for clinical physicians to understand androgenetic alopecia and its comorbidities in depth, thereby enabling early recognition of the underlying systemic diseases and providing timely treatment.
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Ohn J, Son HY, Yu DA, Kim MS, Kwon S, Park WS, Kim JI, Kwon O. Early onset female pattern hair loss: a case–control study for analyzing clinical features and genetic variants. J Dermatol Sci 2022; 106:21-28. [DOI: 10.1016/j.jdermsci.2022.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 02/13/2022] [Accepted: 02/27/2022] [Indexed: 11/26/2022]
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Liang B, Ding Y, Zhou Y, Yang C, Cheng Z. Evaluation of Susceptibility Genes/Loci Associated with Male Androgenetic Alopecia (MAGA) for Female-Pattern Hair Loss in a Chinese Han Population and a Brief Literature Review. Med Sci Monit 2021; 27:e933424. [PMID: 34753897 PMCID: PMC8591919 DOI: 10.12659/msm.933424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background Female-pattern hair loss (FPHL) is a common disorder affecting women, and FPHL can cause psychological dysfunction and affect the social activities of patients. The disease-causing mechanisms are believed to be similar to those of male androgenetic alopecia (MAGA). Although genome-wide association studies (GWAS) have confirmed susceptibility genes/loci for MAGA, the associations between these genetic loci and FPHL are largely unknown. We investigated the associations between susceptibility loci for MAGA and FPHL in a Chinese Han population; a literature review of susceptibility loci associated with MAGA for FPHL was also performed. Material/Methods Twenty-two previously reported sites were analyzed with the Sequenom iPlex platform, and the genotype statistical analysis consisted of a trend test and conservative accounting. The samples comprised 82 patients diagnosed with FPHL by dermatoscopy and 381 healthy controls from the Chinese Han population. Results No significantly associated variants were found in this FPHL study. The examined 22 tag SNPs in MAGA may not be associated with FPHL. The results of the current study in a Chinese Han population support the previous negative association obtained for a European population. Conclusions This was the first study exploring whether identified MAGA-associated loci confer susceptibility to FPHL in a Chinese Han population, and dermatoscopy was used to improve the diagnostic accuracy. However, there was no evidence of a relationship between susceptibility genes for MAGA and FPHL, and the results indicated that FPHL and MAGA are etiologically separate entities. Therefore, a systematic GWAS approach to FPHL may be required to clarify associated pathophysiological uncertainties.
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Affiliation(s)
- Bo Liang
- Department of Dermatology and Venereology, The First Affiliated Hospital, Anhui Medical University, Hefei, Anhui, China (mainland).,Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, China (mainland).,Key Laboratory of Dermatology, Anhui Medical University, Ministry of Education, Hefei, Anhui, China (mainland)
| | - Yantao Ding
- Department of Dermatology and Venereology, The First Affiliated Hospital, Anhui Medical University, Hefei, Anhui, China (mainland).,Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, China (mainland).,Key Laboratory of Dermatology, Anhui Medical University, Ministry of Education, Hefei, Anhui, China (mainland)
| | - Yi Zhou
- Department of Dermatology and Venereology, The First Affiliated Hospital, Anhui Medical University, Hefei, Anhui, China (mainland).,Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, China (mainland).,Key Laboratory of Dermatology, Anhui Medical University, Ministry of Education, Hefei, Anhui, China (mainland)
| | - Chunjun Yang
- Department of Dermatology and Venereology, The Second Affiliated Hospital, Anhui Medical University, Hefei, Anhui, China (mainland)
| | - Zhixiang Cheng
- Department of Blood Transfusion, The Fourth Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China (mainland)
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Wang YX, Chen XW, Wang SB, Gu LF, Li YF, Ma Y, Wang H, Wang LS. Association Between Androgenic Alopecia and Coronary Artery Disease: A Cross-Sectional Study of Han Chinese Male Population. Int J Gen Med 2021; 14:4809-4818. [PMID: 34475775 PMCID: PMC8406423 DOI: 10.2147/ijgm.s326812] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Accepted: 08/13/2021] [Indexed: 12/17/2022] Open
Abstract
Purpose This research aimed to investigate the correlation between androgenic alopecia (AGA) and coronary artery disease (CAD) and analyze its value in predicting the severity of coronary atherosclerosis in the Han Chinese male population. Patients and Methods A total of 402 Han Chinese male patients aged 28-75 years were enrolled and performed coronary angiography (CAG) after admission. According to the BASP classification, the participants were divided into mild, moderate and severe AGA. CAD was determined via CAG and defined as stenosis of ≥50% in at least one major coronary artery, and the Gensini score was calculated to evaluate the severity of coronary atherosclerosis. Results In this study, CAD status (P = 0.002), dyslipidemia status (P = 0.002), age (P = 0.003) and coronary atherosclerosis severity (P < 0.001) were different in patients with different levels of AGA. Multivariate logistic regression analysis revealed that severe AGA was independently correlated to CAD risk (OR, 2.111; 95% CI 1.152 to 3.870, P = 0.016), while the relative CAD risk of early-onset AGA was 2.292 (OR, 2.292; 95% CI 1.132 to 4.640, P = 0.021). AGA status (OR, 2.247; 95% CI 1.396 to 3.617, P = 0.001), severe AGA (OR, 2.360; 95% CI 1.506 to 3.699, P < 0.001) and early-onset AGA (OR, 3.474; 95% CI 2.069 to 5.832, P < 0.001) were all independently associated with the severity of coronary atherosclerosis. The area under the receiver operating characteristic (ROC) curve plotted using severe AGA was 0.601, which is predictive of severe coronary atherosclerosis. Moreover, the presence of severe AGA increases the risk of developing CAD associated with obesity (SI = 1.663, SIM = 1.222, AP = 0.289), diabetes (SI = 2.239, SIM = 1.149, AP = 0.503) and dyslipidemia (SI = 1.062, SIM = 0.646, AP = 0.045). Conclusion This study suggested that AGA is independently associated with CAD in a Han Chinese male population. AGA may be a simple and feasible method for screening CAD and indicative of the severity of coronary atherosclerosis.
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Affiliation(s)
- Ya-Xin Wang
- Department of Cardiology, Jiangsu Province People's Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, 210029, People's Republic of China
| | - Xiao-Wen Chen
- Department of Cardiology, Jiangsu Province People's Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, 210029, People's Republic of China
| | - Si-Bo Wang
- Department of Cardiology, Jiangsu Province People's Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, 210029, People's Republic of China
| | - Ling-Feng Gu
- Department of Cardiology, Jiangsu Province People's Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, 210029, People's Republic of China
| | - Ya-Fei Li
- Department of Cardiology, Jiangsu Province People's Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, 210029, People's Republic of China
| | - Yao Ma
- Department of Cardiology, Jiangsu Province People's Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, 210029, People's Republic of China
| | - Hao Wang
- Department of Cardiology, Jiangsu Province People's Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, 210029, People's Republic of China
| | - Lian-Sheng Wang
- Department of Cardiology, Jiangsu Province People's Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, 210029, People's Republic of China
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Saafan FA, Elsamanoudy AZ, Shaalan D, Zeidan N, Gaballah MA. MTHFR C677T Polymorphism and Serum Homocysteine Level as Risk Factors of Coronary Heart Disease in Patients with Androgenetic Alopecia: A Case Control Study. Am J Med Sci 2021; 362:375-380. [PMID: 34192512 DOI: 10.1016/j.amjms.2021.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 10/21/2020] [Accepted: 06/08/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Androgenetic alopecia (AGA) is associated with a risk of coronary heart disease (CHD), although the causes underlying this association are not clear. Serum homocysteine (SH) is a known risk factor for CHD, and methylene tetrahydrofolate reductase enzyme (MTHFR) plays a crucial role in the remethylation of homocysteine to methionine. The polymorphism C677T that affects the catalytic domain of the MTHFR protein leads to a high levels of SH. Our hypothesis was that this polymorphism and SH level are risk factors for CHD in Patients with AGA. METHODS A total of 106 patients with AGA and 100 well-matched healthy controls were enrolled in the study. SH levels were estimated. DNA was extracted and polymerase chain reaction amplification, followed by restriction enzyme digestion for MTHFR (C677T) gene, was conducted. RESULTS SH levels were significantly higher in the patient group and highest in those with the TT genotype. The mutant T allele was associated with hyperhomocysteinemia and an increased risk of CHD in patients with AGA. CONCLUSIONS AGA is associated with a higher risk of developing CHD due to the associated higher level of SH that, in turn, depends on and is correlated with mutant MTHFR genotypes. Cardiac evaluation and follow-up of patients with AGA is recommended for early detection and treatment of CHD to avoid an overall detrimental course.
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Affiliation(s)
- Fawzia A Saafan
- Department of Dermatology, Andrology and STDs, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Ayman Z Elsamanoudy
- Department of Medical Biochemistry and Molecular Biology Department Faculty of Medicine, Mansoura University, Mansoura, Egypt; Department of Clinical Biochemistry Department, Faculty of Medicine, King Abdulaziz University, Saudi Arabia
| | - Dalia Shaalan
- Department of Medical Biochemistry and Molecular Biology Department Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Nanees Zeidan
- Department of Dermatology, Andrology and STDs, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Mohammad A Gaballah
- Department of Dermatology, Andrology and STDs, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
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12
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Mustafa AI, Abel Halim WAE, Eman F, Doaa EH. Metabolic syndrome in androgenetic alopecia patients; Is serum regulated on activation, normal T-cell expressed and secreted the missing link? J Cosmet Dermatol 2020; 20:2270-2276. [PMID: 33128431 DOI: 10.1111/jocd.13802] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 10/01/2020] [Accepted: 10/07/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Androgenetic alopecia (AGA) is the most common cause of hair loss affecting both men and women. There are many conflicting results about the relationship between AGA and metabolic syndrome, (MetS) and the pathogenesis of the metabolic disorders in AGA patients is not completely elucidated. AIMS Evaluation of the prevalence of MetS and the possible role of RANTES in pathogenesis of the MS among AGA patients. METHODS A total of 160 subjects were enrolled in this work; included 100 patients clinically diagnosed with AGA and 60 apparently healthy control subjects. They were evaluated for MS components according to National Cholesterol Education Program (NCEP) adult treatment panel 3 (ATP3) and measurement of serum RANTES level using ELISA kits. RESULTS Metabolic syndrome was present in 30.0% of AGA patients and in 10.0% of the control group (P = .038), Studied AGA patients showed significantly higher serum RANTES when compared to control group (P value < .001). Moreover, serum RANTES levels were significantly positively correlated with BMI, FBG, TC, and LDL-c levels in AGA patients with MetS. CONCLUSION Metabolic syndrome components were prevalent among AGA patients. Serum RANTES level was significantly higher in all AGA patients and specifically in those with MS as it was significantly positively correlated with some MetS components which reflects its possible role in pathogenesis of MetS in AGA patients.
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Affiliation(s)
- Amany Ibraim Mustafa
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Benha University, Benha, Egypt
| | | | - Fawzy Eman
- Department of laboratory Medicine, Mansoura Fever Hospital, Ministry of Health and Population, Benha, Egypt
| | - El-Habbak Doaa
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Benha University, Benha, Egypt
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Di Guardo F, Ciotta L, Monteleone M, Palumbo M. Male Equivalent Polycystic Ovarian Syndrome: Hormonal, Metabolic, and Clinical Aspects. INTERNATIONAL JOURNAL OF FERTILITY & STERILITY 2020; 14:79-83. [PMID: 32681618 PMCID: PMC7382675 DOI: 10.22074/ijfs.2020.6092] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 12/31/2019] [Indexed: 12/04/2022]
Abstract
Recent studies identified the presence of a male polycystic ovarian syndrome (PCOS), which mainly affects men
whose female relatives are afflicted with PCOS, caused by genes responsible for the susceptibility of this syndrome in women.
Similar hormonal, metabolic, and clinical alterations occurring in PCOS women have also been reported in their male
relatives, suggesting a association between the male and female forms of the syndrome. Although the remarkable
clinical manifestation of the male equivalent PCOS is diagnosed by the early-onset androgenetic alopecia, characterized by hair recession, pronounced hypertrichosis, insulin resistance, biochemical and hormonal abnormalities, the
hormonal/metabolic profile is still controversial. Men affected by early-onset androgenetic alopecia (AGA) are at risk
of developing hyperinsulinemia, insulin-resistance, dyslipidaemia, and cardiovascular diseases. However, there is no
consensus on the association of male equivalent PCOS with hypertension and obesity. Moreover, reduced levels of
sex hormone-binding globulin have been detected in these male patients, accompanied by increased free androgens.
Conversely, literature reported lower concentrations of testosterone in male equivalent PCOS when compared with the
normal range, indicating a crucial role for the conversion of cortical androgens. Finally, further studies are warranted
to investigate a possible link among AGA, metabolic/hormonal alterations, and acne. Our study assessed the hormo-
nal, metabolic and clinical aspects of male equivalent PCOS syndrome reported in the literature to evaluate similar
and divergent elements involved in the female version of the syndrome.
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Affiliation(s)
- Federica Di Guardo
- Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy.Electronic Address:
| | - Lilliana Ciotta
- Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy
| | - Morena Monteleone
- Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy
| | - Marco Palumbo
- Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy
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Ma J, Sheng Y, Lao Z, Zhao J, Yang Q. Hyperuricemia is associated with androgenetic alopecia in men: A cross-sectional case-control study. J Cosmet Dermatol 2020; 19:3122-3126. [PMID: 32281237 DOI: 10.1111/jocd.13401] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 03/16/2020] [Indexed: 12/01/2022]
Abstract
BACKGROUND Early androgenetic alopecia (AGA) is patterned hair loss occurring before 30 years. Early AGA is frequently reported in men and carries the risk of obesity, metabolic syndrome, and cardiovascular diseases. Hyperuricemia used to be a minor component of metabolic syndrome. Recently, increasing number of studies has proved that hyperuricemia is an independent risk factor for many cardiovascular diseases and psoriasis. However, none of these studies have examined the relationship between hyperuricemia and AGA. AIMS To determine the association between hyperuricemia and AGA in men. METHODS A cross-sectional case-control study was conducted. The medical charts and photographs of men with a clinical diagnosis of AGA were reviewed. The clinical and laboratory data of AGA and control groups were compared. RESULTS Men with AGA (n = 1312) had higher mean uric acid level (6.25 mg/dL vs 5.97 mg/dL; P < .001) and higher prevalence of hyperuricemia (25.0% vs 15.6%; P < .001) than those without AGA (n = 2624). There was no statistically significant association between AGA severity and hyperuricemia (P = .295). CONCLUSIONS Men with early AGA have a higher prevalence of hyperuricemia.
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Affiliation(s)
- Jingwen Ma
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Youyu Sheng
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Zhengyin Lao
- Health Management Center, Huashan Hospital, Fudan University, Shanghai, China
| | - Jun Zhao
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Qinping Yang
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
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15
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Starace M, Orlando G, Alessandrini A, Piraccini BM. Female Androgenetic Alopecia: An Update on Diagnosis and Management. Am J Clin Dermatol 2020; 21:69-84. [PMID: 31677111 DOI: 10.1007/s40257-019-00479-x] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Female androgenetic alopecia (FAGA) is a common cause of non-scarring alopecia in women. The onset may be at any age following puberty and the frequency increases with age. Clinically, it shows a diffuse hair thinning over the central scalp, while the frontal hairline is usually retained. FAGA can have a significant psychological impact, leading to anxiety and depression. For this reason, early diagnosis is very important to stop the progression of the disease. The sex hormonal milieu is the main pathogenetic mechanism studied in FAGA. The role of androgens is not clearly defined and only one-third of women with FAGA show abnormal androgen levels. Endocrinological diseases with hyperandrogenism associated with FAGA comprise polycystic ovarian syndrome (PCOS), hyperprolactinemia, adrenal hyperplasia and, rarely, ovarian and adrenal tumours. Usually the diagnosis of FAGA is made clinically. A complete clinical examination and a blood examination can reveal other signs of hyperandrogenism. Trichoscopy shows the typical hair miniaturization. A scalp biopsy can be useful when the clinical evaluation does not provide a definitive diagnosis or when cicatricial alopecias with hair loss in the distribution of FAGA or alopecia areata are suspected. FAGA is a slowly progressive disease. The goal of therapy is to stop the progression and to induce a cosmetically acceptable hair regrowth. The most important drugs are topical minoxidil and oral anti-androgens. The purpose of this review is to provide an update on FAGA and to create a guideline on diagnosis and management of this frequent hair disease, not always easily recognizable from cicatricial alopecias with a similar distribution.
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Affiliation(s)
- Michela Starace
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, V. Massarenti 1, 40138, Bologna, Italy
| | - Gloria Orlando
- Unit of Dermatology, Department of Medicine-DIMED, University of Padova, Padua, Italy
| | - Aurora Alessandrini
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, V. Massarenti 1, 40138, Bologna, Italy
| | - Bianca Maria Piraccini
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, V. Massarenti 1, 40138, Bologna, Italy.
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Vora RV, Kota RKSK, Singhal RR, Anjaneyan G. Clinical Profile of Androgenic Alopecia and Its Association with Cardiovascular Risk Factors. Indian J Dermatol 2019; 64:19-22. [PMID: 30745630 PMCID: PMC6340244 DOI: 10.4103/ijd.ijd_526_16] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Context: Androgenic alopecia (AGA) is a hereditary androgen-dependent disorder, characterized by gradual conversion of terminal hair into miniaturized hair and defined by various patterns. Common age group affected is between 30 and 50 years. Metabolic syndrome (MetS) is a cluster of cardiovascular risk factors that include diabetes and prediabetes, abdominal obesity, dyslipidemia, and hypertension. The relationship between androgenic alopecia and MetS is still poorly understood. Aim: The aim was to study the clinical profile of androgenic alopecia and its association with cardiovascular risk factors. Materials and Methods: This was a hospital-based cross-sectional study done on men in the age group of 25–40 years. Fifty clinically diagnosed cases with early-onset androgenic alopecia of Norwood Grade III or above and fifty controls without androgenic alopecia were included in the study. Data collected included anthropometric measurements, blood pressure, family history of androgenic alopecia, history of alcohol, smoking; fasting blood sugar, and lipid profile were done. MetS was diagnosed as per the new International Diabetes Federation criteria. Chi-square and Student's t-test were used for statistical analysis. Results: MetS was seen in 5 (10%) cases and 1 (2%) control (P=0.092). Abdominal obesity, hypertension, and lowered high-density lipoprotein were significantly higher in patients with androgenic alopecia when compared to that of the controls. Conclusion: A higher prevalence of cardiovascular risk factors was seen in men with early-onset androgenic alopecia. Early screening for MetS and its components may be beneficial in patients with early-onset androgenic alopecia.
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Affiliation(s)
- Rita V Vora
- Department of Skin and VD, Shree Krishna Hospital, Anand, Gujarat, India
| | | | - Rochit R Singhal
- Department of Skin and VD, Shree Krishna Hospital, Anand, Gujarat, India
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17
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Chung HC, Choe SJ, Lee S, Oh SS, Lee WS. Medical Comorbidities and the Onset of Androgenetic Alopecia: A Population-Based, Case-Control Study. Ann Dermatol 2018; 30:251-252. [PMID: 29606834 PMCID: PMC5839908 DOI: 10.5021/ad.2018.30.2.251] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Revised: 05/03/2017] [Accepted: 05/15/2017] [Indexed: 11/17/2022] Open
Affiliation(s)
- Hee-Chul Chung
- Department of Dermatology, Institute of Hair & Cosmetic Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Sung Jay Choe
- Department of Dermatology, Institute of Hair & Cosmetic Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Solam Lee
- Department of Dermatology, Institute of Hair & Cosmetic Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Sung-Soo Oh
- Department of Occupational and Environmental Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Won-Soo Lee
- Department of Dermatology, Institute of Hair & Cosmetic Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
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Abstract
Hair loss is a common condition that affects most people at some point in their lives. It can exist as an isolated problem or with other diseases and conditions. Androgenetic alopecia (AGA) and its association with the metabolic syndrome (MetS) have received increasing interest since 1972, when the first link between cardiovascular risk factors and hair loss was raised. We have reviewed studies concerning the relationship between alopecia and MetS. Many studies have investigated the relationship among AGA and MetS and its individual components, particularly in men, where a disproportionately large number of these studies supports this association. AGA has also been associated with other metabolic-related conditions, including coronary artery disease, polycystic ovary syndrome, and Cushing syndrome, as well as several nutritional deficiencies, all of which have led to many clinicians advocating for the screening of MetS and cardiovascular risk factors in patients who present with AGA.
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Abstract
The relationship of sex hormones to obesity and inflammation has been extensively studied. Research on endogenous and exogenous sex steroids, including studies on animal models of metabolic syndrome (MetS), has indicated that sex hormones are involved in metabolic pathways relevant to MetS. Lower testosterone levels in men and higher levels in women increase risks of MetS and type 2 diabetes mellitus (T2DM). Lower levels of sex hormone-binding globulin increase risks of MetS and T2DM in both sexes. Skin diseases that are sex hormone mediated, such as polycystic ovary syndrome, acanthosis nigricans, acne vulgaris, and pattern alopecia, have been associated with insulin resistance. Insulin resistance increases the risk for metabolic and potentially cardiovascular complications, and patients with such skin diseases should be followed for a prolonged time to determine whether they develop these complications. Early intervention may help delay or prevent the onset of T2DM and decrease cardiovascular risks.
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Affiliation(s)
| | - Nicholas Leader
- Chicago Medical School at Rosalind Franklin University of Medicine and Science, North Chicago, IL
| | - George Kroumpouzos
- Department of Dermatology,Warren Alpert Medical School of Brown University, Providence, RI; Department of Dermatology, Medical School of Jundiaí, Jundiaí, SP, Brazil, Brazil* GK Dermatology, South Weymouth, MA.
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20
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Redler S, Messenger AG, Betz RC. Genetics and other factors in the aetiology of female pattern hair loss. Exp Dermatol 2017; 26:510-517. [DOI: 10.1111/exd.13373] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/24/2017] [Indexed: 12/19/2022]
Affiliation(s)
- Silke Redler
- Institute of Human Genetics; University Clinic Düsseldorf; Heinrich-Heine-University; Düsseldorf Germany
| | | | - Regina C. Betz
- Institute of Human Genetics; University of Bonn; Bonn Germany
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21
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C K, M E, G K, O K, Ag E, Th E, Gi K, T D, T K, E B. The Relationship between Lichen Planus and Carotid Intima Media Thickness. ACTA CARDIOLOGICA SINICA 2016; 32:738-743. [PMID: 27899862 DOI: 10.6515/acs20160224a] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
BACKGROUND Lichen planus (LP) is a chronic inflammatory disease. Although the association between chronic inflammation and subclinical atherosclerosis has been reported in the literature, the relationship between LP and carotid intima media thickness (CIMT) has not been previously investigated. The aim of this study was to investigate the relationship between LP and CIMT. METHODS One hundred eleven LP patients and 105 controls were enrolled in the study. Then, CIMT examination was performed with an ultrasonography device. Cross-sectional associations of LP with CIMT were analyzed using linear regression models adjusted for related confounders. RESULTS No statistical difference was found between LP and the controls except for the female gender, white blood cell, LDL cholesterol and triglycerides (p = 0.046, p = 0.019, p = 0.011 and p = 0.013, respectively). Significant difference was found between the groups in terms of CIMT (0.90 ± 0.2 mm vs. 0.61 ± 0.3 mm, p = 0.001). CIMT was correlated with longevity of the LP, but we did not find LP to be an independent predictor of increased CIMT in logistic regression analysis (r = 0.449, p < 0.001, β = -0.117, p = 0.092; respectively). CONCLUSIONS The results of our study suggested that LP was associated with increased mean CIMT, and furthermore that CIMT was correlated with longevity of LP. However, LP was not an independent predictor of increased CIMT.
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Affiliation(s)
- Koseoglu C
- Deparment of Cardiology, Ankara Training and Research Hospital
| | - Erdogan M
- Department of Cardiology, Ataturk Training and Research Hospital
| | - Koseoglu G
- Department of Dermatology, Ankara University Faculty of Medicine, Ankara
| | - Kurmus O
- Department of Cardiology, Tarsus State Hospital, Mersin
| | - Ertem Ag
- Department of Cardiology, Ataturk Training and Research Hospital
| | | | - Kurmus Gi
- Department of Dermatology, Dıskapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Durmaz T
- Department of Cardiology, Ataturk Training and Research Hospital
| | - Keles T
- Department of Cardiology, Ataturk Training and Research Hospital
| | - Bozkurt E
- Department of Cardiology, Ataturk Training and Research Hospital
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22
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Triantafyllidi H, Grafakos A, Ikonomidis I, Pavlidis G, Trivilou P, Schoinas A, Lekakis J. Severity of Alopecia Predicts Coronary Changes and Arterial Stiffness in Untreated Hypertensive Men. J Clin Hypertens (Greenwich) 2016; 19:51-57. [DOI: 10.1111/jch.12871] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Revised: 05/04/2016] [Accepted: 05/09/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Helen Triantafyllidi
- 2nd Department of Cardiology Medical School; Attikon Hospital; University of Athens; Athens Greece
| | - Agis Grafakos
- 2nd Department of Cardiology Medical School; Attikon Hospital; University of Athens; Athens Greece
| | - Ignatios Ikonomidis
- 2nd Department of Cardiology Medical School; Attikon Hospital; University of Athens; Athens Greece
| | - George Pavlidis
- 2nd Department of Cardiology Medical School; Attikon Hospital; University of Athens; Athens Greece
| | - Paraskevi Trivilou
- 2nd Department of Cardiology Medical School; Attikon Hospital; University of Athens; Athens Greece
| | - Antonis Schoinas
- 2nd Department of Cardiology Medical School; Attikon Hospital; University of Athens; Athens Greece
| | - John Lekakis
- 2nd Department of Cardiology Medical School; Attikon Hospital; University of Athens; Athens Greece
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Godoy-Gijón E, Meseguer-Yebra C, Palacio-Aller L, Godoy-Rocati DV, Lahoz-Rallo C. [New populations at increased cardiovascular risk: Cardiovascular disease in dermatological diseases]. CLINICA E INVESTIGACION EN ARTERIOSCLEROSIS : PUBLICACION OFICIAL DE LA SOCIEDAD ESPANOLA DE ARTERIOSCLEROSIS 2016; 28:143-153. [PMID: 26383179 DOI: 10.1016/j.arteri.2015.08.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Revised: 08/03/2015] [Accepted: 08/04/2015] [Indexed: 06/05/2023]
Abstract
The increased cardiovascular risk in some dermatological diseases has been demonstrated in recent decades. Diseases such as psoriasis and systemic lupus erythematosus are currently included in the guidelines for prevention of cardiovascular disease. Other diseases such as androgenic alopecia, polycystic ovary syndrome, hidradenitis suppurativa or lichen planus have numerous studies that point to an increased risk, however, they have not been included in these guidelines. In this article we review the evidence supporting this association, in order to alert the clinician to the need for greater control in cardiovascular risk factors in these patients.
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Affiliation(s)
- Elena Godoy-Gijón
- Servicio de Dermatología, Hospital Clínico Universitario de Valladolid, Valladolid, España.
| | - Carmen Meseguer-Yebra
- Servicio de Dermatología, Hospital Virgen de la Concha, Complejo Asistencial de Zamora, Zamora, España
| | | | | | - Carlos Lahoz-Rallo
- Unidad de Lípidos y Riesgo Vascular, Servicio de Medicina Interna, Hospital Carlos III, Madrid, España
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Is There Really Relationship between Androgenetic Alopecia and Metabolic Syndrome? Dermatol Res Pract 2015; 2015:980310. [PMID: 26617635 PMCID: PMC4649068 DOI: 10.1155/2015/980310] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2015] [Revised: 10/20/2015] [Accepted: 10/22/2015] [Indexed: 01/30/2023] Open
Abstract
Background. There are several studies investigating the relationship between androgenetic alopecia (AGA) and metabolic syndrome (MS) with conflicting results. Objective. We sought to investigate whether there is a relationship between AGA and MS. Methods. A case-control study including 74 male patients with AGA and 42 male controls was conducted. Age, duration of AGA, AGA onset age, anthropometric measures, body mass index, lipid parameters, fasting blood glucose, blood pressure, and presence of MS were recorded. Results. Of the 74 male AGA patients (age range 20–50 years, mean 32.14), 24 were in stage 2, 26 were in stage 3, 17 were in stage 3V, 1 was in stage 5, and 6 were in stage 7. There was no significant difference in the rate of MS between AGA and control groups (P = 0.135). Among the evaluated parameters, only systolic blood pressure in AGA group was significantly higher than control group. Conclusion. In contrast to the most of the previous studies, our study does not support the link between AGA and MS. To exclude confounding factors such as advanced age and therefore metabolic disturbances, further studies are needed with large group of AGA patients including different age groups and varying severity.
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25
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Bakry OA, El Farargy SM, Ghanayem N, Soliman A. Atherogenic index of plasma in non-obese women with androgenetic alopecia. Int J Dermatol 2015; 54:e339-44. [PMID: 26096895 DOI: 10.1111/ijd.12783] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2014] [Revised: 05/28/2014] [Accepted: 06/04/2014] [Indexed: 12/20/2022]
Abstract
BACKGROUND Androgenetic alopecia (AGA) is characterized by the local and gradual transformation of terminal scalp hair into vellus hair, which has a shorter and thinner shaft. Several studies have analyzed the relationship between AGA and cardiovascular disease in males, and few were conducted in females. The current study aimed to investigate lipid profile and atherogenic index of plasma in non-obese females with AGA. METHODS Forty non-obese females with early-onset AGA were selected with 40 age- and gender-matched healthy subjects as a control group. Total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and triglycerides were measured, and the atherogenic index of plasma was calculated for all cases and control subjects. RESULTS Mean values of total cholesterol (P < 0.001), low-density lipoprotein cholesterol (P = 0.03), and triglycerides (P = 0.001) were significantly higher in cases than controls. Mean value of high-density lipoprotein cholesterol was significantly lower in cases than controls (P = 0.008). The atherogenic index of plasma was significantly higher in cases than controls (P < 0.001). CONCLUSION Current findings support the relationship between early-onset AGA and unfavorable lipid profile and cardiovascular risk in affected females. Assessment and follow-up of these cases will allow early intervention to avoid cardiovascular complications.
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Affiliation(s)
- Ola A Bakry
- Department of Dermatology, Andrology and STDs, Faculty of Medicine, Menoufiya University, Shibeen El Koom, Egypt
| | - Shawky M El Farargy
- Department of Dermatology, Andrology and STDs, Faculty of Medicine, Menoufiya University, Shibeen El Koom, Egypt
| | - Naglaa Ghanayem
- Department of Medical Biochemistry, Faculty of Medicine, Menoufiya University, Shibeen El Koom, Egypt
| | - Amal Soliman
- Department of Dermatology, Andrology and STDs, Faculty of Medicine, Menoufiya University, Shibeen El Koom, Egypt
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Bakry OA, Shoeib MAM, El Shafiee MK, Hassan A. Androgenetic alopecia, metabolic syndrome, and insulin resistance: Is there any association? A case-control study. Indian Dermatol Online J 2014; 5:276-81. [PMID: 25165643 PMCID: PMC4144211 DOI: 10.4103/2229-5178.137776] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
CONTEXT Although several previous studies have investigated the association of metabolic syndrome (MS) and insulin resistance (IR) with androgenetic alopecia (AGA), the results have been inconsistent. AIM We attempted to assess the presence of MS and IR in patients with AGA. This may help to detect if AGA can be considered as a clue for underlying serious systemic diseases. MATERIALS AND METHODS One hundred male patients with stages III-VII AGA, in Hamilton-Norwood classification, and 100 normal, gender- and age-matched control subjects were included. Anthropometric measures, blood pressure, fasting glucose, fasting insulin, high-density lipoprotein cholesterol, and triglycerides were measured for the all participants. The presence of MS and IR was evaluated. RESULTS There were statistically significant differences regarding mean values of body weight (P < 0.001), height (P = 0.002), waist circumference (P < 0.001), body mass index (P < 0.001), systolic (P < 0.001), and diastolic blood pressure (P < 0.001), fasting glucose (P < 0.001), triglycerides (P < 0.001), high-density lipoprotein cholesterol (P < 0.01), fasting insulin (P = 0.02) and homeostasis model assessment of insulin resistance (P < 0.001) between cases and controls. A statistically significant association was found between AGA and MS (P = 0.002) and between AGA and IR (P < 0.001). Multiple logistic regression analysis revealed that waist circumference (>102 cm) was the most significant risk factor for developing MS. It increased the risk of MS by 1.25-folds (95% CI = 1.10-1.42, P < 0.001). CONCLUSION Our results support the recommendation for assessing MS and IR in all young males with stage III or higher AGA. Early intervention is critical to reduce the risk and complications of cardiovascular disease and type 2 diabetes mellitus later in life.
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Affiliation(s)
- Ola Ahmed Bakry
- Departments of Dermatology, Andrology and STDs, Faculty of Medicine, Menoufiya University, Menoufiya, Egypt
| | | | | | - Ahmed Hassan
- Departments of Dermatology, Andrology and STDs, Faculty of Medicine, Menoufiya University, Menoufiya, Egypt
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Trieu N, Eslick GD. Alopecia and its association with coronary heart disease and cardiovascular risk factors: a meta-analysis. Int J Cardiol 2014; 176:687-95. [PMID: 25150481 DOI: 10.1016/j.ijcard.2014.07.079] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2014] [Accepted: 07/24/2014] [Indexed: 11/25/2022]
Abstract
BACKGROUND Alopecia has been associated with an increased risk of coronary heart disease as well as the following risk factors for cardiovascular disease: hyperinsulinaemia, insulin resistance, metabolic syndrome, dyslipidaemia, and hypertension. We performed a meta-analysis to quantitatively determine the level of risk of coronary heart disease and risk factors in individuals with alopecia. METHODS A systematic literature search was conducted using several databases. We calculated pooled odds ratios and 95% confidence intervals using a random effects model. RESULTS In total, 31 studies comprising 29,254 participants with alopecia were eligible for the meta-analysis and showed that alopecia is associated with an increased risk of coronary heart disease (OR 1.22, 95% CI: 1.07-1.39), hyperinsulinaemia (OR 1.97, 95% CI: 1.20-3.21), insulin resistance (OR 4.88, 95% CI: 2.05-11.64), and metabolic syndrome (OR 4.49, 95% CI: 2.36-8.53). Individuals with alopecia were also shown to be more likely compared to those without alopecia to have higher serum cholesterol levels (OR 1.60, 95% CI: 1.17-2.21), higher serum triglyceride levels (OR 2.07, 95% CI: 1.32-3.25), higher systolic blood pressures (OR 1.73, 95% CI: 1.29-2.33), and higher diastolic blood pressures (OR 1.59, 95% CI: 1.16-2.18). CONCLUSIONS Alopecia is associated with an increased risk of coronary heart disease, and there appears to be a dose-response relationship with degree of baldness whereby the greater the severity of alopecia, the greater the risk of coronary heart disease. Alopecia is also associated with an increased risk of hypertension, hyperinsulinaemia, insulin resistance, metabolic syndrome, and having elevated serum total cholesterol and triglyceride levels.
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Affiliation(s)
- Nelson Trieu
- The Whiteley-Martin Research Centre, Discipline of Surgery, The University of Sydney, Nepean Hospital, Penrith, New South Wales, Australia
| | - Guy D Eslick
- The Whiteley-Martin Research Centre, Discipline of Surgery, The University of Sydney, Nepean Hospital, Penrith, New South Wales, Australia.
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The female pattern hair loss: review of etiopathogenesis and diagnosis. BIOMED RESEARCH INTERNATIONAL 2014; 2014:767628. [PMID: 24812631 PMCID: PMC4000932 DOI: 10.1155/2014/767628] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2013] [Accepted: 01/14/2014] [Indexed: 11/24/2022]
Abstract
Female pattern hair loss (FPHL) is the most common hair loss disorder in women. Initial signs may develop during teenage years leading to a progressive hair loss with a characteristic pattern distribution. The condition is characterized by progressive replacement of terminal hair follicles over the frontal and vertex regions by miniaturized follicles, that leads progressively to a visible reduction in hair density. Women diagnosed with FPHL may undergo significant impairment of quality of life. FPHL diagnosis is mostly clinical. Depending on patient history and clinical evaluation, further diagnostic testing may be useful. The purpose of the paper is to review the current knowledge about epidemiology, pathogenesis, clinical manifestations, and diagnosis of FPHL.
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Wang E, Chong K, Yu M, Akhoundsadegh N, Granville DJ, Shapiro J, McElwee KJ. Development of autoimmune hair loss disease alopecia areata is associated with cardiac dysfunction in C3H/HeJ mice. PLoS One 2013; 8:e62935. [PMID: 23658656 PMCID: PMC3637254 DOI: 10.1371/journal.pone.0062935] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2012] [Accepted: 03/26/2013] [Indexed: 02/08/2023] Open
Abstract
Alopecia areata (AA) is a chronic autoimmune hair loss disease that affects several million men, women and children worldwide. Previous studies have suggested a link between autoimmunity, stress hormones, and increased cardiovascular disease risk. In the current study, histology, immunohistology, quantitative PCR (qPCR) and ELISAs were used to assess heart health in the C3H/HeJ mouse model for AA and heart tissue response to adrenocorticotropic hormone (ACTH) exposure. Mice with AA exhibited both atrial and ventricular hypertrophy, and increased collagen deposition compared to normal-haired littermates. QPCR revealed significant increases in Il18 (4.6-fold), IL18 receptor-1 (Il18r1; 2.8-fold) and IL18 binding protein (Il18bp; 5.2-fold) in AA hearts. Time course studies revealed a trend towards decreased Il18 in acute AA compared to controls while Il18r1, Il18bp and Casp1 showed similar trends to those of chronic AA affected mice. Immunohistochemistry showed localization of IL18 in chronic AA mouse atria. ELISA indicated cardiac troponin-I (cTnI) was elevated in the serum and significantly increased in AA heart tissue. Cultures of heart atria revealed differential gene expression between AA and control mice in response to ACTH. ACTH treatment induced significant increase in cTnI release into the culture medium in a dose-dependent manner for both AA and control mice. In conclusion, murine AA is associated with structural, biochemical, and gene expression changes consistent with cardiac hypertrophy in response to ACTH exposure.
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Affiliation(s)
- Eddy Wang
- Department of Dermatology and Skin Science, University of British Columbia, Vancouver, BC, Canada
| | - Katy Chong
- University of British Columbia, Vancouver, BC, Canada
| | - Mei Yu
- Department of Dermatology and Skin Science, University of British Columbia, Vancouver, BC, Canada
| | - Noushin Akhoundsadegh
- Department of Dermatology and Skin Science, University of British Columbia, Vancouver, BC, Canada
| | - David J. Granville
- Department of Pathology and Laboratory Medicine, James Hogg Research Centre, Institute for Heart and Lung Health, University of British Columbia, Vancouver, BC, Canada
| | - Jerry Shapiro
- Department of Dermatology and Skin Science, Vancouver General Hospital, Vancouver, BC, Canada
| | - Kevin J. McElwee
- Department of Dermatology and Skin Science, University of British Columbia, Vancouver, BC, Canada
- * E-mail:
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Arrabal-Polo MÁ, Arias-Santiago S, López-Carmona Pintado F, Merino-Salas S, Lahoz-García C, Zuluaga-Gómez A, Arrabal-Martin M. Metabolic syndrome, hormone levels, and inflammation in patients with erectile dysfunction. ScientificWorldJournal 2012; 2012:272769. [PMID: 22973171 PMCID: PMC3438735 DOI: 10.1100/2012/272769] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2012] [Accepted: 08/12/2012] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND The end point of this study was to investigate the prevalence of MS in patients with ED in comparison with control subjects and to analyse the association with acute phase reactants (CRP, ESR) and hormone levels. METHODS This case-control study included 65 patients, 37 with erectile dysfunction, according to the International Index of Erectile Function (IIEF) from the Urology Department of San Cecilio University Hospital, Granada (Spain) and 28 healthy controls. The prevalence of metabolic syndrome was calculated according to ATP-III criteria. Hormone levels and acute phase parameters were studied in samples drawn. RESULTS The ATP-III criteria for MS were met by 64.9% of the patients with ED and only 9.5% of the controls (P < 0.0001, OR = 17.53, 95% CI: 3.52-87.37). Binary logistic regression analysis showed a strong association between patients with ED and MS, even after additional adjustment for confounding factors (OR = 20.05, 95% CI: 1.24-32.82, P < 0.034). Patients with hypogonadism presented a significantly higher prevalence of metabolic syndrome. Multiple linear regression analysis showed that systolic BP and CRP predicted 0.46 (model R²) of IIEF changes. CONCLUSION Chronic inflammation found in patients with ED might explain the association between ED and metabolic syndrome.
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Affiliation(s)
- Miguel Ángel Arrabal-Polo
- Urology Department, San Cecilio University Hospital, Camino de Ronda street, 143, 18003 Granada, Spain
| | | | | | - Sergio Merino-Salas
- Urology Department, San Cecilio University Hospital, Camino de Ronda street, 143, 18003 Granada, Spain
| | - Clara Lahoz-García
- Urology Department, San Cecilio University Hospital, Camino de Ronda street, 143, 18003 Granada, Spain
| | - Armando Zuluaga-Gómez
- Urology Department, San Cecilio University Hospital, Camino de Ronda street, 143, 18003 Granada, Spain
| | - Miguel Arrabal-Martin
- Urology Department, San Cecilio University Hospital, Camino de Ronda street, 143, 18003 Granada, Spain
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Arrabal-Polo MÁ, Arias-Santiago S, López-Carmona F, Merino-Salas S, Lahoz-García C, Zuluaga-Gómez A, Arrabal-Martín M. [Metabolic syndrome and hormone profile in patients with erectile dysfunction]. Actas Urol Esp 2012; 36:222-7. [PMID: 21959064 DOI: 10.1016/j.acuro.2011.07.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2011] [Accepted: 07/25/2011] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To demonstrate the existence of relation between metabolic syndrome and erectile dysfunction and to analyze the hormone profile of these patients regarding a healthy population group. MATERIAL AND METHODS A case-control study was designed with 65 men divided into 2 groups according to presence or non-presence of erectile dysfunction. Group A was made up of 37 men with erectile dysfunction and group B by 28 healthy men without erectile dysfunction. Ages ranged from 40 to 65 years. The presence of metabolic syndrome according to the ATPIII definition, performance of physical exercise, smoking habit, body mass index and complete hormone profile including testosterone -total, free and bioavailability, were studied. RESULTS Greater presence of metabolic syndrome was detected among men of Group A (72.9%) versus those of group B (17.8%) (p=0.0001). Among the parameters that make up the metabolic syndrome, there are differences between both groups in systolic and diastolic blood pressure, fast blood sugar and abdominal circumference, all these differences being significant. After performing multivariate analysis between the metabolic syndrome and erectile dysfunction adjusted for age, BMI, International Index for Erectile Function (IIEF), physical exercise and smoking habit, we have observed an independent significant relation between the metabolic syndrome and erectile dysfunction. We have not found differences between both groups in any hormone parameter. CONCLUSION A relationship is found between metabolic syndrome and erectile dysfunction. Thus, it seems recommendable to perform the metabolic profile and cardiovascular risk study in these patients.
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Affiliation(s)
- M Á Arrabal-Polo
- Servicio de Urología, Hospital Universitario San Cecilio, Granada, España.
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Arias-Santiago S, Arrabal-Polo MA, Buendía-Eisman A, Arrabal-Martín M, Gutiérrez-Salmerón MT, Girón-Prieto MS, Jimenez-Pacheco A, Calonje JE, Naranjo-Sintes R, Zuluaga-Gomez A, Serrano Ortega S. Androgenetic alopecia as an early marker of benign prostatic hyperplasia. J Am Acad Dermatol 2011; 66:401-8. [PMID: 21835498 DOI: 10.1016/j.jaad.2010.12.023] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2010] [Revised: 12/11/2010] [Accepted: 12/22/2010] [Indexed: 10/17/2022]
Abstract
BACKGROUND Androgenetic alopecia (AGA) and benign prostatic hyperplasia are both androgen-dependent entities that respond to the blocking of 5-alpha-reductase. OBJECTIVES The objective of this study was to determine whether prostatic volumes and urinary flow changes were higher in patients with early-onset AGA than in healthy control subjects. METHODS This was an observational case-control study of 87 men: 45 with early-onset AGA diagnosed in the dermatology department and 42 control subjects. End-point variables were prostatic volume, measured by transrectal ultrasound, and urinary flow, measured by urinary flowmetry. A hormone study was performed on all participants, and the International Prostate Symptom Score and International Index of Erectile Function score were determined. RESULTS The groups did not significantly differ in mean age (cases, 52.7 years vs control subjects, 49.8 years; P = .12). Patients with AGA had significantly higher mean prostate volume (29.65 vs 20.24 mL, P < .0001), International Prostate Symptom Score (4.93 vs 1.23, P < .0001), and prostate-specific antigen value (1.53 vs 0.94 ng/mL, P < .0001) and significantly lower maximum urinary flow (14.5 vs 22.45 mL/s, P < .0001) versus control subjects. Binary logistic regression analysis showed a strong association between the presence of AGA and benign prostatic hyperplasia after adjusting for age, urinary volume, urination time, International Prostate Symptom Score, abdominal obesity, glucose levels, systolic blood pressure, insulin levels, fibrinogen, and C-reactive protein (odds ratio = 5.14, 95% confidence interval 1.23-47.36, P = .041). LIMITATIONS The study of larger sample sizes would facilitate stratified analyses according to the Ebling type of androgenetic alopecia. CONCLUSION There is a relationship between the presence of AGA and prostate growth-associated urinary symptoms, likely attributable to their pathophysiological similarity. This study suggests that early-onset AGA may be an early marker of urinary/prostatic symptomatology. Future studies may clarify whether treatment of patients with AGA may benefit the concomitant benign prostatic hypertrophy, which would be present at an earlier stage in its natural evolution.
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Arias-Santiago S, Gutiérrez-Salmerón MT, Buendía-Eisman A, Girón-Prieto MS, Naranjo-Sintes R. Sex hormone-binding globulin and risk of hyperglycemia in patients with androgenetic alopecia. J Am Acad Dermatol 2011; 65:48-53. [PMID: 21511365 DOI: 10.1016/j.jaad.2010.05.002] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2010] [Revised: 04/25/2010] [Accepted: 05/02/2010] [Indexed: 11/18/2022]
Abstract
BACKGROUND Low circulating levels of sex hormone-binding globulin (SHBG) are a strong predictor of the risk of type 2 diabetes. Androgenetic alopecia (AGA) has been related to an increase in cardiovascular risk, but the mechanism of this association has not been elucidated. AGA can be associated with low levels of SHBG and insulin resistance, which could be related to hyperglycemia and type 2 diabetes. OBJECTIVE The objective of this study was to evaluate SHBG and blood glucose levels in men and women with early-onset AGA and control subjects to determine whether low levels of SHBG are associated with hyperglycemia. METHODS This case-control study included 240 patients consecutively admitted to the outpatient clinic (Dermatology Department of San Cecilio University Hospital, Granada, Spain), 120 with early-onset AGA (60 men and 60 women) and 120 control subjects (60 men and 60 women) with skin diseases other than alopecia. RESULTS Of patients with AGA, 39.1% presented with hyperglycemia (>110 mg/dL) versus 12.5% of controls (P < 0.0001). AGA patients with hyperglycemia or diabetes presented lower significant levels of SHBG than alopecic patients without hyperglycemia or type 2 diabetes, respectively. Patients with AGA and hyperglycemia presented significantly lower levels of SHBG than controls with hyperglycemia (22.3 vs 39.4 nmol/L for AGA patients and controls, respectively, P = .004). No significant differences in SHBG levels were noticed between patients and controls without hyperglycemia. Binary logistic regression showed a strong association between lower SHBG levels and glucose levels greater than 110 mg/dL in patients with AGA even after additional adjustment for sex, abdominal obesity, and free testosterone (odds ratio = 3.35; 95% confidence interval = 1.9-5.7; P < .001). LIMITATIONS The study of a wider sample of AGA patients would confirm these findings and would permit analysis of the pathogenic mechanisms underlying the increase in cardiovascular risk in patients with AGA. CONCLUSION An association between early-onset AGA, hyperglycemia/diabetes, and low levels of SHBG was observed in the current study. Low levels of SHBG could be a marker of insulin resistance and hyperglycemia/diabetes in patients with AGA.
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Arias-Santiago S, Buendía-Eisman A, Aneiros-Fernández J, Girón-Prieto MS, Gutiérrez-Salmerón MT, Mellado VG, Naranjo-Sintes R. Cardiovascular risk factors in patients with lichen planus. Am J Med 2011; 124:543-8. [PMID: 21605731 DOI: 10.1016/j.amjmed.2010.12.025] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2010] [Revised: 12/18/2010] [Accepted: 12/27/2010] [Indexed: 10/18/2022]
Abstract
BACKGROUND Chronic inflammation was found to play an important role in the development of cardiovascular risk factors. Recently a case-control study found that lichen planus was associated with dyslipidemia in a large series of patients. However, no data were presented about lipid values, glucose levels, or blood pressure. OBJECTIVE The objective of this case-control study was to evaluate cardiovascular risk factors included in Adult Treatment Panel III criteria for metabolic syndrome in men and women with lichen planus and in healthy controls. PATIENTS AND METHODS This case-control study included 200 patients, 100 with lichen planus (50 men and 50 women) and 100 controls consecutively admitted to the outpatient clinic in Dermatology departments in Granada, Spain. RESULTS Analysis of metabolic syndrome parameters revealed a higher significant prevalence of dyslipidemia in patients with lichen planus. No significant differences were observed in glucose levels, abdominal obesity, or blood pressure. Elevated levels of C-reactive protein, erythrocyte sedimentation rate, and fibrinogen were noted in patients with lichen planus. Adjusted odds ratio for dyslipidemia in patients with lichen planus was 2.85 (95% confidence interval, 1.33-5.09; P=.001). CONCLUSION Chronic inflammation in patients with lichen planus may explain the association with dyslipidemia. Lipid levels screening in men or women with lichen planus may be useful to detect individuals at risk and start preventive treatment against the development of cardiovascular disease.
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Arias-Santiago S, Buendía-Eisman A, Aneiros-Fernández J, Girón-Prieto M, Gutiérrez-Salmerón M, García-Mellado V, Cutando A, Naranjo-Sintes R. Lipid levels in patients with lichen planus: a case-control study. J Eur Acad Dermatol Venereol 2011; 25:1398-401. [DOI: 10.1111/j.1468-3083.2011.03983.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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