Association of androgenetic alopecia with metabolic syndrome in men: a community-based survey

Association of Obesity and Bariatric Surgery on Hair Health

Obesity and obesity-related conditions today constitute a public health problem worldwide. Obesity is an "epidemic" chronic disorder, which is defined by the WHO as normal or excessive fat accumulation that may impair health. It is also defined for adults as a BMI that is greater than or equal to 30. The most common obesity-related diseases are type 2 diabetes mellitus, cardiovascular diseases, metabolic syndrome, chronic kidney disease, hyperlipidemia, hypertension, nonalcoholic fatty liver disease, and certain types of cancer. It has been also proven that obesity can have a negative effect on hair. It can lead to hair thinning. Patients with obesity can undergo bariatric surgery if they meet the inclusion criteria. The four common types of weight loss surgery include a duodenal switch with biliopancreatic diversion, laparoscopic adjustable gastric banding, Roux-en-Y gastric bypass, and sleeve gastrectomy. Bariatric surgery can affect skin and hair and is associated with telogen effluvium due to weight loss, microelement deficiency, anesthesia, low calorie intake, and low protein intake. Patients who undergo bariatric surgery can experience post-bariatric surgery depression. Hair loss can have a major impact on self-esteem, negatively affecting one's self-image. The purpose of this narrative review is to critically review how obesity, obesity-related diseases, and bariatric surgery affect hair health in general and the hair development cycle, and how they influence hair loss.

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

BACKGROUND

Androgenetic alopecia (AGA) is a common cause of hair loss in both genders that may be associated with disturbed systemic metabolism. Irisin is a hormone-like myokine that greatly influences systemic metabolism and is linked to cardiovascular diseases.

AIM

To detect irisin role in AGA and its associated metabolic syndrome (MetS) and cardiovascular risk.

PATIENTS/METHODS

This case-control study included 44 AGA patients of both genders and 22 healthy individuals. Serum irisin level was measured using ELISA and scalp biopsy was taken to detect irisin immunohistochemically. Carotid Doppler ultrasonography was performed to measure carotid intima media thickness (CIMT).

RESULTS

Higher serum irisin was significantly detected in AGA patients (p ˂ 0.001), and in males (p = 0.01) particularly severe cases (p ˂ 0.001). It was significantly higher in AGA patients presenting with MetS and those suffering from dyslipidemia (p ˂ 0.001 for both). Multivariate regression analysis proved BMI (p = 0.01) and serum irisin (p = 0.02) as independent predictors of CIMT abnormality among AGA patients. Regarding cutaneous irisin expression, the epidermal H-score was significantly higher in AGA patients with MetS compared to those without (p = 0.04). Epidermal H-score ˃100 was significantly associated with male gender (p = 0.05), severe AGA (p = 0.02), MetS (p = 0.03), dyslipidemia (p = 0.03), and abnormal CIMT (p = 0.03).

CONCLUSION

High serum irisin and upregulated epidermal irisin expression are associated with the incidence of MetS, dyslipidemia, and CIMT abnormality among AGA patients. This may indicate resistance to irisin, which hinders its favorable cardiometabolic actions. Further studies are warranted to investigate the concept of irisin resistance in AGA patients, which was uniquely discussed in the present study.

Recent Advances in Understanding of the Etiopathogenesis, Diagnosis, and Management of Hair Loss Diseases

Hair-loss diseases comprise heterogenous conditions with respective pathophysiology and clinicopathological characteristics. Major breakthroughs in hair follicle biology and immunology have led to the elucidation of etiopathogenesis of non-scarring alopecia (e.g., alopecia areata, AA) and cicatricial alopecia (e.g., lichen planopilaris, LPP). High-throughput genetic analyses revealed molecular mechanism underlying the disease susceptibility of hair loss conditions, such as androgenetic alopecia (AGA) and female pattern hair loss (FPHL). Hair loss attracted public interest during the COVID-19 pandemic. The knowledge of hair loss diseases is robustly expanding and thus requires timely updates. In this review, the diagnostic and measurement methodologies applied to hair loss diseases are updated. Of note, novel criteria and classification/scoring systems published in the last decade are reviewed, highlighting their advantages over conventional ones. Emerging diagnostic techniques are itemized with clinical pearls enabling efficient utilization. Recent advances in understanding the etiopathogenesis and management for representative hair diseases, namely AGA, FPHL, AA, and major primary cicatricial alopecia, including LPP, are comprehensively summarized, focusing on causative factors, genetic predisposition, new disease entity, and novel therapeutic options. Lastly, the association between COVID-19 and hair loss is discussed to delineate telogen effluvium as the predominating pathomechanism accounting for this sequela.

Lactobacillus paracasei HY7015 and Lycopus lucidus Turcz. Extract Promotes Human Dermal Papilla Cell Cytoprotective Effect and Hair Regrowth Rate in C57BL/6 Mice

Hair loss is a disease that requires accurate diagnosis and type-specific medical treatment. Many hair loss treatments have some side effects, such as hormone-related effects, so there is a need for safe and effective hair loss treatment. In this study, we investigated the effects of Lactobacillus paracasei HY7015 (HY7015) and Lycopus lucidus Turcz. (LT) extract on hair regrowth and protection. In vitro experiments were conducted to assess the effects of HY7015 and/or LT extract on human follicle dermal papilla cells (HFDPC) of cytoprotective functions such as proliferations, antioxidants, anti-inflammatory, and growth factor expressions. In animal experiments, we investigated hair regrowth rate, hair follicle formation and secretion of growth factors in telogenic C57BL/6 mice. We confirmed the cytoprotective effects of HY7015 and LT through regulations of proliferation, SOD and IL-1β in HFDPC. In mouse experiments, oral administration of HY7015 and LT promoted hair regrowth as well as hair follicle maturation in the dermal skin of C57BL/6 mice, and upregulated VEGF and IGF-1 growth factor levels in mouse serum. In summary, our data demonstrate that ingestions of HY7015 and LT can promote hair regrowth by enhancing cytoprotective effects and expressions of growth factors.

Pediatric androgenetic alopecia: a retrospective review of clinical characteristics, hormonal assays and metabolic syndrome risk factors in 23 patients

BACKGROUND

Androgenetic alopecia in the pediatric population is rarely discussed in the literature. Although the prevalence of the metabolic syndrome is increased in patients with early-onset androgenetic alopecia, the presence of metabolic syndrome risk factors in pediatric androgenetic alopecia is unknown.

OBJECTIVE

To evaluate the demographics, medical and family histories, clinical and trichoscopic features, androgenic hormones, and metabolic syndrome risk factors in pediatric androgenetic alopecia.

METHODS

The medical reports of pediatric patients with androgenetic alopecia were reviewed.

RESULTS

The study included 23 patients (12 females and 11 males) with a mean age of 15,3 ± 2,1 years. Sixteen patients had adolescent androgenetic alopecia and seven, had childhood alopecia. Nine patients reported a family history, all of whom had adolescent androgenetic alopecia. Hyperandrogenism was noted in three patients with adolescent androgenetic alopecia. The most common hair loss pattern was diffuse thinning at the crown with preservation of the frontal hairline which was noted in 10 patients (43.5%), six of whom were males. Fourteen patients (60.9%) had at least one metabolic syndrome risk factor. The most common risk factor was obesity or overweight (47.8%) followed by insulin resistance (21.7%), high fasting blood glucose (13%), high blood pressure (4.4%) and lipid abnormalities (4.4%).

STUDY LIMITATIONS

Retrospective study; lack of a control group.

CONCLUSION

Pediatric androgenetic alopecia is often associated with metabolic syndrome risk factors. Therefore, androgenetic alopecia in the pediatric population may indicate a future metabolic syndrome which warrants an accurate and prompt diagnosis for early screening and treatment.

A study on relationship between androgenetic alopecia and cardiovascular risk using high sensitivity C-reactive protein and galectin-3 in men with early onset baldness

OBJECTIVE

In this study, the objective was to evaluate the cardiovascular and metabolic effects in men with male pattern alopecia beginning before 30 years of age.

METHODS

Total of 81 people (41 androgenetic alopecia (AGA) and 40 healthy individuals) were included in the study. Twenty-four-hour ambulatory blood pressure (ABP) measurement, high sensitive C-reactive protein (hsCRP), galectin-3 were studied. Hamilton-Norwood scale (HNS) was used to determine the AGA types of the cases.

RESULTS

The mean age in the AGA and control groups was 30.3 ± 7.5 and 30.8 ± 6.0, respectively. Twenty-four-hour ABP measurements, hsCRP, and galectin-3 were similar in both groups. There was a positive correlation between HNS grade with age, BMI, triglyceride levels and fasting blood glucose levels in individuals with AGA. Similarly, there was a positive correlation between HNS grade with daytime pulse wave velocity and night-time reflection magnitude. A significant positive correlation was determined between hsCRP with BMI and waist circumference, and between galectin-3 with BMI, waist circumference, hip circumference, HOMA-IR in individuals with AGA.

CONCLUSIONS

This study shows that AGA patients are similar to the normal population in terms of insulin resistance or metabolic syndrome components. However, hsCRP and galectin-3 appear to be associated with cardiovascular disease risk factors in individuals with AGA.

Skin and Metabolic Syndrome: An Evidence Based Comprehensive Review

Metabolic syndrome is currently considered to be a global epidemic, causing a significant increase in the cost of health care, apart from deteriorating the quality of life. Skin serves as a mirror of underlying metabolic sinister. Various dermatological conditions like psoriasis, acanthosis nigricans, lichen planus, acne vulgaris, acrochordons, atopic dermatitis, etc. have been reported to be associated with metabolic syndrome. We hereby present an evidence-based review of the various dermatological conditions and their association with the development of metabolic syndrome.

Evaluation of serum G protein-coupled estrogen receptor 1 (GPER-1) levels in patients with androgenetic alopecia

The effect of oestrogens in androgenetic alopecia (AGA) pathophysiology has not been clearly understood. However, they are considered to have a place in the AGA pathogenesis as the androgens do. The effects of estrogen occur via the estrogen receptors alpha and beta, and the recently discovered G protein-coupled estrogen receptor 1 (GPER-1). Aim of this study is to examine serum GPER-1 levels of AGA patients and to evaluate the place of them in AGA pathogenesis for the first time through the literature. 40 AGA patients with clinical AGA stage 2-3-4 diagnoses according to the Hamilton-Norwood classification for males, and AGA stage 2 according to Ludwig system for females and with normal serum dihydroepiandrosterone sulfate, estradiol, total testosterone, progesterone, follicle stimulating hormone and luteinizing hormone were included in the study in addition to 40 healthy controls with similar characteristics by means of age and gender. We received the medical history and performed the physical examinations. We measured serum GPER-1 levels. Serum GPER-1 levels of AGA patients and the control group were 30.43 ± 3.83 ng/mL and 14.18 ± 3.61 ng/mL (mean ± SD), respectively. The levels were detected as significantly increased in AGA group compared with the control group (p = 0.007). No serum GPER-1 level differences were found among female and male patients (p = 0.101). Significantly high levels of serum GPER-1 levels in AGA patients without any relationship between gender and GPER-1 Levels compared with healthy controls reminded us that GPER-1 might have a role in AGA pathogenesis independent from the gender.

A Community Based Study to Estimate Prevalence and Determine Correlates of Premature Graying of Hair among Young Adults in Srinagar, Uttarakhand, India

Background

There are several ways by which aging is identified, of which graying of hair is perhaps the most common way. Nowadays, graying of hairs, which was expected to occur after 40s, can be easily observed among younger age group, even before 20s. The present study aims to estimate the prevalence of graying of hairs and its correlates among young adults in Srinagar, Uttarakhand, India.

Methodology

A community-based cross-sectional study was conducted among 384 young adults between 15 and 30-year age group in the urban area of Srinagar tehsil of Pauri district. Graying of hair was assessed on the basis of the number of white hairs on examination of scalp.

Results

The prevalence of premature graying of hairs (PMGHs) was found to be 27.3%. Binary logistic regression analysis showed that a paternal history of PMGH, history of smoking, maternal history of PMGH, sunlight exposure, and body mass index were significant predictors of PMGH.

Limitations

The factors found associated could be better determined through a follow-up study which could not be done in the current study. The present study was carried in a tehsil of one district of Uttarakhand therefore has limited external validity.

Conclusion

The present study highlights the importance of maintaining a healthy lifestyle as well as adequate exposure to sunlight in preventing PMGH.

Early-onset androgenetic alopecia in China: a descriptive study of a large outpatient cohort

Objective

Methods

Results

Conclusions

Metabolic syndrome in androgenetic alopecia patients; Is serum regulated on activation, normal T-cell expressed and secreted the missing link?

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.

Association of Baldness with Coronary Artery Disease and Its Severity

BACKGROUND

The pivotal role of baldness as a potential risk factor for cardiovascular disorders remains a debate, and the small body of literature has generated inconsistent findings. We aimed to assess the association between baldness and the risk for coronary artery disease (CAD) and its severity in a sample of Iranian men.

MATERIALS AND METHODS

This cross-sectional study was performed on 105 consecutive patients suspected to CAD and scheduled for elective coronary angiography. The severity of CAD was determined according to the number of involved coronary vessels. For assessing the severity of baldness, the Hamilton-Norwood scale for grading of androgenetic alopecia in males was used.

RESULTS

The overall frequency of CAD in the groups with and without baldness was 88.9% and 72.5%, respectively, indicating a significant difference (P=0.033). Similarly, patients with the family history of baldness suffered more from CAD as compared to those without history (93.3% vs.76.0%). However, no significant association was found between the baldness and non-baldness groups with regard to the severity of CAD (P=0.291). According to the multivariable logistic regression model, the presence of baldness could predict the increased likelihood of CAD (or=3.037, P=0.046).

CONCLUSION

Along with traditional risk factors for CAD, the presence of baldness and positive family history of this phenotype could be considered as the primary determinant for the increasing likelihood of CAD.

Male Equivalent Polycystic Ovarian Syndrome: Hormonal, Metabolic, and Clinical Aspects

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.

YKL-40 A Sensitive Biomarker for Early Androgenetic Alopecia and Early Hidden Metabolic Syndrome

Background:

Androgenetic alopecia (AGA) is a common dermatological problem, Does the onset of the AGA matters in the general health? YKL 40 may have role in the pathogenesis of early AGA and associated metabolic syndrome (MS). YKL 40, released by many inflammatory cells and its biological role is not well known.

Aim of the Work:

The estimation of serum level of YKL-40 in patients with AGA to detect its role in AGA and MS pathogenesis, onset and severity.

Materials and Methods:

This case–control study, 100 individuals were enrolled in our study; 70 AGA patients and 30 healthy controls. We obtained an informed written consent from each individual prior the participation. AGA was diagnosed clinically, and onset was evaluated as early onset alopecia (by the age of 30 years or earlier), YKL-40 level was measured by ELISA technique.

Results:

Patients showed highly significant higher serum YKL-40 level more than that of the healthy subjects (P < 0.001). There was highly significant increase in YKL-40 level among early onset male and female cases compared to late onset cases (P < 0.001 each). There was significant increase in MS elements in AGA cases than controls (P < 0.05), and highly significant increase in MS associations and severity among early onset male and female cases compared to late onset cases (P < 0.001 each). AGA patients with MS showed highly significant higher serum YKL-40 level more than that without (P < 0.001). There was highly significant increase in YKL-40 level among early onset AGA with MS compared to late onset cases with MS (P < 0.001 each).

Conclusions:

High serum YKL-40 considered not only a biomarker of early onset AGA but also considered a potential sensitive predictor for early onset MS development and severity in patients with early onset AGA.

Increased DHEAS and Decreased Total Testosterone Serum Levels in a Subset of Men with Early-Onset Androgenetic Alopecia: Does a Male PCOS-Equivalent Exist?

BACKGROUND

Increased dehydroepiandrosterone sulfate (DHEAS) levels have been reported in men with early-onset (<35 years) androgenetic alopecia (AGA). It has been suggested that a male polycystic ovarian syndrome- (PCOS-) equivalent, defined as an endocrine syndrome with a metabolic background and a PCOS-like hormonal pattern, predisposing to type II diabetes mellitus (DM II), cardiovascular and prostate diseases later in life, may occur in at least a part of these men. The gonadal function, including sperm parameters and total testosterone (TT) levels, has been investigated in a low number of these men.

OBJECTIVE

The aim of the study was to assess gonadal and adrenal function in a subset of men with early-onset AGA and controls.

METHODS

43 men with early-onset AGA and 36 controls were screened for DHEAS, TT, glycaemia, insulin, gonadotropins, 17α-hydroxyprogesterone (17α-hydroxyprogesterone (17n = 21), as those with at least one of the following parameters: body mass index (BMI) >25 kg/m², insulin resistance (IR), and/or SHBG <25 nmol/l.

RESULTS

Patients with early-onset AGA had higher mean (±SD) BMI (25.5 ± 3.8 vs. 23.7 ± 3.0 kg/m²; P < 0.05) and 17α-hydroxyprogesterone (17P < 0.05) and 17P < 0.05) and 17P < 0.05) and 17P < 0.05) and 17μg/dl; P < 0.05) and 17P < 0.05) and 17P < 0.05) and 17P < 0.05) and 17.

CONCLUSION

Men with early-onset AGA and at least one among BMI >25 kg/m², IR, and SHBG <25 nmol/l have increased DHEAS levels and a worse gonadal steroidogenesis. They might have a greater risk to develop gonadal dysfunction later in life. These criteria may be used to define male PCOS-equivalent.

Clinical, trichoscopic, and folliscopic identification of the impact of metabolic syndrome on the response to intradermal dutasteride 0.02% injection in patients with female pattern hair loss: a prospective cohort study

BACKGROUND

No studies investigating the impact of metabolic syndrome (MetS) in treatment response of female pattern hair loss (FPHL).

OBJECTIVE

In this prospective cohort study, we studied the impact of MetS in response to intradermal dutasteride 0.02% injection in patients with FPHL.

METHODS

Fifty-one adult participants with FPHL were classified into study cohorts: with MetS and comparison cohorts without MetS. Both groups underwent clinical, trichoschopic, and digital folliscopic evaluation. Treatment was scheduled over a period of 3 months as four weekly sessions, followed by another four bimonthly sessions. Response was evaluated by digital folliscopy, investigator's, and patient's self assessments at 1 and 3 months post-treatment. Side effects were evaluated.

RESULTS

In participants with MetS, there was a significant reduction of the mean percentage of terminal hair with significant increase of the mean percentage of vellus hair (p = .003, .006, respectively) compared with participants without MetS at 1 month after treatment. These significant differences persisted at 3 months after treatment; for terminal and vellus hair (p = .000) with significant reduction in the mean hair thickness (p = .002) compared with participants without MetS.

CONCLUSIONS

MetS negatively impacted FPHL in terms of response to intradermal injection of dutasteride 0.02% and severity. Further studies are still needed.

Physiopathology and current treatments of androgenetic alopecia: Going beyond androgens and anti-androgens

Androgenetic alopecia (AGA) is the most diagnosed hair loss dysfunction. Its physiopathology comprises a genetic predisposition affording an exacerbated response of the hair follicles cells to androgens aggravated by scalp inflammation and extrinsic factors. This paper presents a review of the mechanisms and extrinsic factors involved in the AGA physiopathology as well as its conventional and emerging treatments. The research focused on reports regarding AGA physiopathology and treatments published between January 2001 and July 2019 in medical and related journals. The most used medical treatments for AGA-minoxidil and finasteride-present non satisfactory results in some cases. Currently, the low-level laser therapy is recognized as a safe and effective treatment for AGA. Some minimally invasive techniques-mesotherapy, microneedling, carboxytherapy, and platelet-rich plasma-are also used to stimulate hair growth. Pharmaceutical substances with mechanisms differing from the anti-androgen activity are under current investigation and many of them have botanical origins; however, formulations with higher performance are required, and the hair follicles ability of being a drug and nanoparticle reservoir has been researched. The association of different strategies, that is, substances with synergic mechanisms and the use of advantageous technologies associated with lifestyle changes could improve the treatment outcomes.

Metabolic Syndrome and Skin Diseases

The increasing prevalence of Metabolic syndrome (MetS) is a worldwide health problem, and the association between MetS and skin diseases has recently attracted growing attention. In this review, we summarize the associations between MetS and skin diseases, such as psoriasis, acne vulgaris, hidradenitis suppurativa, androgenetic alopecia, acanthosis nigricans, and atopic dermatitis. To discuss the potential common mechanisms underlying MetS and skin diseases, we focus on insulin signaling and insulin resistance, as well as chronic inflammation including adipokines and proinflammatory cytokines related to molecular mechanisms. A better understanding of the relationship between MetS and skin diseases contributes to early diagnosis and prevention, as well as providing clues for developing novel therapeutic strategies.

Annurca Apple Polyphenols Ignite Keratin Production in Hair Follicles by Inhibiting the Pentose Phosphate Pathway and Amino Acid Oxidation

Patterned hair loss (PHL) affects around 50% of the adult population worldwide. The negative impact that this condition exerts on people’s life quality has boosted the appearance of over-the-counter products endowed with hair-promoting activity. Nutraceuticals enriched in polyphenols have been recently shown to promote hair growth and counteract PHL. Malus pumila Miller cv. Annurca is an apple native to Southern Italy presenting one of the highest contents of Procyanidin B2. We have recently shown that oral consumption of Annurca polyphenolic extracts (AAE) stimulates hair growth, hair number, hair weight and keratin content in healthy human subjects. Despite its activity, the analysis of the molecular mechanism behind its hair promoting effect is still partially unclear. In this work we performed an unprecedented metabolite analysis of hair follicles (HFs) in mice topically treated with AAE. The metabolomic profile, based on a high-resolution mass spectrometry approach, revealed that AAE re-programs murine HF metabolism. AAE acts by inhibiting several NADPH dependent reactions. Glutaminolysis, pentose phosphate pathway, glutathione, citrulline and nucleotide synthesis are all halted in vivo by the treatment of HFs with AAE. On the contrary, mitochondrial respiration, β-oxidation and keratin production are stimulated by the treatment with AAE. The metabolic shift induced by AAE spares amino acids from being oxidized, ultimately keeping them available for keratin biosynthesis.

Thiosulfate promotes hair growth in mouse model

The present study describes the hair growth-promoting effects of sodium thiosulfate (STS), a widely used compound, in mice. STS accelerated hair growth in the "telogen model", suggesting that it stimulates telogen hair follicles to reenter the anagen phase of hair growth. In the same model, STS potentiated hair growth in an additive manner with minoxidil (MXD), a drug used for the treatment of androgenic alopecia. Furthermore, in the "anagen model", STS promoted hair growth, probably by promoting hair follicle proliferation. Since STS elevated the skin surface temperature, its hair growth-promoting activity may be partly due to vasorelaxation, similar to MXD. In addition, STS is known to generate a gaseous mediator, H₂S, which has vasorelaxation and anti-inflammatory/anti-oxidative stress activities. Therefore, STS and/or provisionally its metabolite, H₂S, may aid the hair growth process. Collectively, these results suggest that salts of thiosulfate may represent a novel and beneficial remedy for hair loss.

Bayesian measurement-error-driven hidden Markov regression model for calibrating the effect of covariates on multistate outcomes: Application to androgenetic alopecia

Multistate Markov regression models used for quantifying the effect size of state‐specific covariates pertaining to the dynamics of multistate outcomes have gained popularity. However, the measurements of multistate outcome are prone to the errors of classification, particularly when a population‐based survey/research is involved with proxy measurements of outcome due to cost consideration. Such a misclassification may affect the effect size of relevant covariates such as odds ratio used in the field of epidemiology. We proposed a Bayesian measurement‐error‐driven hidden Markov regression model for calibrating these biased estimates with and without a 2‐stage validation design. A simulation algorithm was developed to assess various scenarios of underestimation and overestimation given nondifferential misclassification (independent of covariates) and differential misclassification (dependent on covariates). We applied our proposed method to the community‐based survey of androgenetic alopecia and found that the effect size of the majority of covariate was inflated after calibration regardless of which type of misclassification. Our proposed Bayesian measurement‐error‐driven hidden Markov regression model is practicable and effective in calibrating the effects of covariates on multistate outcome, but the prior distribution on measurement errors accrued from 2‐stage validation design is strongly recommended.

Gender-specific risk factors for androgenetic alopecia in the Korean general population: Associations with medical comorbidities and general health behaviors

BACKGROUND

The relationships between androgenetic alopecia (AGA) and various factors related to metabolic syndrome have been demonstrated in previous studies. However, it remains unclear because of inconsistent results. We investigated the associations between AGA and various risk factors related to metabolic syndrome according to gender.

METHODS

We conducted a population-based cross-sectional survey of 2028 Koreans (1050 men, 978 women). The basic and specific (BASP) classification was used for diagnosis of AGA. We collected information on risk factors though questionnaires and medical records.

RESULTS

AGA was significantly associated with age, family history of AGA, hypertension, diabetes mellitus, and waist circumference in both genders. Female subjects with AGA were more likely to have cerebrovascular disease, dyslipidemia, and obesity; however, these associations were not observed in the male subjects. When multiple regression analysis was applied, there was a significant relationship between hypertension and AGA in male subjects. However, there was no statistically significant association in female subjects.

CONCLUSION

The different results according to gender might arise from different mechanisms of AGA. There was a significant relationship between hypertension and AGA in male subjects. Evaluation of blood pressure in male patients with AGA might facilitate interventions for hypertension.

Does a male polycystic ovarian syndrome equivalent exist?

The occurrence of a genetic background in the etiology of polycystic ovarian syndrome (PCOS) represents the rational basis to postulate the existence of a male PCOS equivalent. Hormonal and metabolic abnormalities have been described in male relatives of women with PCOS. These males also have a higher prevalence of early onset (<35 years) androgenetic alopecia (AGA). Hence, this feature has been proposed as a clinical sign of the male PCOS equivalent. Clinical evidence has shown that men with early onset AGA have hormonal and metabolic abnormalities. Large cohort studies have clearly shown a higher prevalence of type II diabetes mellitus (DM II) and cardiovascular diseases (CVDs) in elderly men with early onset AGA. In addition, prostate cancer, benign prostate hyperplasia (BPH) and prostatitis have been described. These findings support the existence of the male PCOS equivalent, which may represent an endocrine syndrome with a metabolic background, and might predispose to the development of DM II, CVDs, prostate cancer, BPH and prostatitis later in life. Its acknowledgment would be helpful for the prevention of these long-term complications.

Mediterranean diet: fresh herbs and fresh vegetables decrease the risk of Androgenetic Alopecia in males

It is well established that Androgenetic Alopecia (AGA) occurs in genetically predisposed individuals but little is known of its non-genetic risk factors. The aim of the study was to investigate the role of the Mediterranean diet in determining the risk of AGA. A hospital-based case-control study was conducted in the outpatient clinics of the hospital "Istituto Dermopatico dell'Immacolata, Rome, Italy". We included 104 males and 108 controls not affected by AGA. Controls were frequency matched to cases. Information on socio-demographic characteristics, medical history, smoking and diet were collected for all patients. Logistic regression was used to estimate odds ratio and 95% confidence intervals. After controlling for age, education, body mass index and family history of AGA, protective effects for AGA were found for high consumption (≥ 3 times weekly) of raw vegetables (OR 0.43; 95% CI 0.21-0.89) and high consumption of fresh herbs (3 or more regularly) (OR 0.44; 95% CI 0.22-0.87). We suggest that some foods of the Mediterranean diet, say fresh herbs and salad, may reduce the risk of AGA onset.

Frequency, severity and related factors of androgenetic alopecia in dermatology outpatient clinic: hospital-based cross-sectional study in Turkey

BACKGROUND:

Androgenetic alopecia (AGA) is a patterned hair loss occurring due to systemic androgen and genetic factors. It is the most common cause of hair loss in both genders. In recent years, many studies investigating the relation between systemic diseases and androgenetic alopecia presented controversial results.

OBJECTIVES:

In this study we aimed to investigate the frequency of androgenetic alopecia, the presence of accompanying systemic diseases, the relation between body mass index and androgenetic alopecia severity and the association of hyperandrogenemia signs with androgenetic alopecia in patients who referred to our outpatient clinic.

METHODS:

Patients who referred to our clinic between October 2013 and May 2014 were included in the study. Diagnosis of androgenetic alopecia was made upon clinical findings. Presence of seborrhea and acne in both genders, and hirsutism in women, were examined. Age, gender, smoking habit and alcohol consumption, age of onset of androgenetic alopecia, family history, accompanying systemic diseases and abnormalities of menstrual cycle were recorded.

RESULTS:

954 patients (535 women, 419 men) were included in the study. Androgenetic alopecia prevalence found was 67.1% in men and 23.9% in women. Androgenetic alopecia prevalence and severity were correlated with age in both genders (p=0,0001). Frequency of accompanying systemic diseases were not significantly different between patients with and without androgenetic alopecia (p=0,087), except for hypertension, which was significantly more frequent in men with androgenetic alopecia aged between 50 and 59 years. Study limitations: Despite the exclusion of other causes of alopecia, differentiation of Ludwig grade 1 AGA from telogen effluvium based on clinical features alone is difficult.

CONCLUSIONS:

In our study the rate of androgenetic alopecia was found to be higher than the other studies made in Asian and Caucasian populations.

Alopecia and the metabolic syndrome

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.

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

Hormonal and metabolic abnormalities have been reported in men with early-onset androgenetic alopecia (AGA). Although this has been ascribed to the existence of a male polycystic ovary syndrome (PCOS)-equivalent, data on this topic are inconsistent and this syndrome has not been already acknowledged. To evaluate if, already before the age of 35 years, any difference occurs in the glycolipid and hormonal profiles and in the body weight in men with AGA compared to age-matched controls, we performed a comprehensive meta-analysis of all the available observational case-control studies of literature, using MEDLINE, Google Schoolar and Scopus databases. Among 10596 papers retrieved, seven studies were finally included, enrolling a total of 1009 participants. Our findings demonstrate that young men with AGA have a slightly but significantly worse glycolipid profile compared to controls and a hormonal pattern resembling those of women with PCOS, already before the age of 35 years. Therefore, early-onset AGA might represent a phenotypic sign of the male PCOS-equivalent. The acknowledgement of this syndrome would be of importance to prevent the long-term consequences on health in the affected men. The glycolipid profile and the body weight should be monitored in men with AGA starting from the second decade of life.

Inflammatory markers and Lp(a) levels as cardiovascular risk factors in androgenetic alopecia

It is not well-established whether patients with androgenetic alopecia (AGA) show a higher cardiovascular risk and higher prevalence of metabolic syndrome (MS). Therefore, we aimed to analyze the cardiovascular risk and the prevalence of MS by means of a case-control study. We determined lipidic, inflammatory, hormonal and insulin resistance parameters with conventional laboratory methods in 50 male early-onset AGA patients and 50 controls. AGA patients did not show statistical differences for insulin resistance (glucose, insulin, C peptide, HOMA), lipids (total-cholesterol, HDL-cholesterol, tryglicerides) or hormonal parameters (testosterone, free androgen index, sex hormone-binding globulin) P >  0.05, respectively. No differences between groups were observed in prevalence of MS or its components (P >  0.05). AGA patients showed higher levels of fibrinogen, C-reactive protein (CRP) and lipoprotein(a) (Lp(a)) (P = 0.016, P = 0.019 and P = 0.032, respectively). In the unadjusted logistic regression analyses, PCR >4 mg/L, fibrinogen >395 mg/dL and Lp(a) >59 mg/dL increased the risk of AGA, but in the adjusted logistic regression analyses, only PCR >4 mg/L and Lp(a) >59 mg/dL independently increased this risk (OR = 5.83, 95% CI 1.33-25.59 P = 0.020; OR = 3.94 CI 95% 1.08-14.43 P = 0.038). The present study indicates that AGA patients do not show differences in either insulin resistance or prevalence of MS. However, AGA patients show a higher cardiovascular risk characterised by an increase in inflammatory parameters and Lp(a) levels.

Isolation and Quantification of Glycosaminoglycans from Human Hair Shaft

Background

There is evidence that glycosaminoglycans (GAGs) are present in the hair shaft within the follicle but there are no studies regarding GAGs isolation and measurement in the human hair shaft over the scalp surface, it means, in the free hair shaft.

Objective

The purpose of our research was to isolate and measure the total GAGs from human free hair shaft.

Methods

Seventy-five healthy individuals participated in the study, 58 adults, men and women over the age of 50 and 17 children (aged 4~9). GAGs in hair samples, received from the parietal and the occipital areas, were isolated with 4 M guanidine HCl and measured by the uronic acid-carbazole reaction assay.

Results

GAGs concentration was significantly higher in the occipital area than in the parietal area, in all study groups. GAG levels from both areas were significantly higher in children than in adults. GAG levels were not associated with gender, hair color or type.

Conclusion

We report the presence of GAGs in the human free hair shaft and the correlation of hair GAG levels with the scalp area and participants' age.

Female sexual dysfunction in androgenetic alopecia: Case-control study

INTRODUCTION

We sought to evaluate the association of female sexual dysfunction (FSD) with androgenetic alopecia (AGA) and metabolic syndrome (MetS) in premenopausal women.

METHODS

From December 2013 to June 2015, we performed a case-control, prospective study of 115 patients with AGA and 97 age-matched control patients without AGA from among premenopausal women who visited dermatology clinics of the two reference hospitals. Comprehensive history, anthropometric measurements, and questionnaire administration were performed for each of the total of 212 women. The Female Sexual Function Index (FSFI) was used to assess the key dimensions of female sexual function. AGA was assessed and graded by an experienced dermatologist according to Ludwig's classification. The MetS assessment was made according to the NCEP-ATP III criteria.

RESULTS

In univariate analysis, age, weight, waist circumference, hip circumference, waist-to-hip ratio, body mass index (BMI), AGA, MetS, cardiovascular event, marital status, hypertension, high fasting plasma glucose, high triglyceride, large waist, total testosterone, and free testosterone were associated with presence of FSD. In logistic regression analysis, age (odds ratio [OR] 1.21, 95% confidence interval [CI] 1.13-1.30; p<0.001), AGA (OR 3.42, 95% CI 1.31-8.94; p=0.017), MetS (OR 5.39, 95% CI 1.34-21.62; p=0.012), and free testosterone (OR 0.18, 95% CI 0.09-0.37; p<0.001) were independently associated with FSD.

CONCLUSIONS

Our study suggests that age, AGA, MetS, and free testosterone may have strong impact on sexual function in premenopausal women. Further studies with population-based and longitudinal design should be conducted to confirm this finding.

[New populations at increased cardiovascular risk: Cardiovascular disease in dermatological diseases]

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.

Association of metabolic syndrome with female pattern hair loss in women: A case-control study

BACKGROUND

Several studies have addressed the association of metabolic syndrome (MetS) with androgenetic alopecia (AGA) in men with few reports focusing on this association in females. The aim of this work was to investigate the association of MetS among Egyptian women with different stages of female pattern hair loss (FPHL) and to compare the results with age- and sex-matched controls.

METHODS

This study included 90 female participants, 45 cases with different stages of FPHL classified according to the Ludwig scale and 45 healthy control participants that were age- and sex-matched with the cases. Assessment of MetS components was done according to the Adult Treatment Panel III criteria.

RESULTS

Compared to the control group, a statistically significant association was found between FPHL and the presence of MetS with a tendency to increase with the severity of FPHL being greater in stage III > stage II > stage I. Among metabolic syndrome components, waist circumference (WC) (OR 5.6, 95% CI 2.2 -13.9, P = 0.0002) and hypertension (HTN) (OR 3.5, 95% CI 1.3-8.9, P = 0.008) were revealed as the most important factors associated with FPHL. WC also tended to increase with the severity of FPHL.

CONCLUSIONS

We demonstrated a significant association between MetS and FPHL. Women with FPHL, particularly if associated with an increased WC or hypertension, should be screened for MetS criteria for early identification and management.

Relationship between androgenetic alopecia and cardiovascular risk factors according to BASP classification in Koreans

There have been many studies on the relationship between androgenetic alopecia (AGA) and cardiovascular risk factors, but the study results were inconsistent and research on AGA in Asians remains insufficient. This study investigated the relationship between Korean AGA and various cardiovascular risk factors, considering life habits, type of hair loss and sex. We investigated subjects who visited a hospital for public or industrial health medical examinations between October 2012 and December 2014. A questionnaire as well as anthropometric measurements and a blood test were performed. Among the 1884 total subjects, 52.6% had AGA. AGA patients displayed a significantly higher prevalence rate of cardiovascular diseases, smoking rate, fasting glucose and triglyceride, and a significantly lower high-density lipoprotein cholesterol level than did the non-AGA group. The results of the subgroup analysis showed higher prevalence rates of hypertension, stroke, metabolic syndrome and smoking in male AGA patients. The more severe the AGA, the higher the incidences of hypertension, diabetes and smoking were observed. According to the analysis results by BASP classification, the F-type AGA patients displayed a higher body mass index, waist circumference and diastolic blood pressure, and had a significantly higher prevalence rate of hypertension. As a result of the large population-based study, modifications in lifestyle and early screening for cardiovascular disease, as well as hypertension and diabetes, are suggested.

Is Early Onset Androgenic Alopecia a Marker of Metabolic Syndrome and Carotid Artery Atherosclerosis in Young Indian Male Patients?

BACKGROUND

Androgenic alopecia (AGA) is a common cosmetically and psychosocially distressing condition. High androgen level contributes to the development of atherosclerosis, thrombosis leading to hypertension and hypercholesterolemia.

OBJECTIVES

To study the clinico-epidemiological profile of AGA and the presence of metabolic syndrome (MetS) and carotid artery atherosclerosis in male patients with early onset AGA as compared to controls.

MATERIALS AND METHODS

In this case-control study, 100 male patients of age 18-35 years with AGA and an equal number of age-matched healthy controls attending skin and STD OPD were included. Assessment of the degree of hair loss, evaluation of MetS and carotid artery color Doppler for the atherosclerotic plaque was done in all patients.

RESULTS

Statistically significant number of patients with early onset AGA 22/100 (22%) (P < 0.05) fulfilled the criteria for MetS compared to 8/100 (8%) in the control group. There were statistically significant differences in mean values of waist circumference, serum triglycerides, serum cholesterol, systolic blood pressure, diastolic blood pressure, fasting glucose concentration, and very low-density lipoprotein (LDL). However, no significant differences were observed in the mean values of high-density lipoprotein cholesterol and LDL cholesterol. The atherosclerotic plaque was found in two patients of the study group, and no plaque was found in control patients.

CONCLUSION

We suggest that all men with AGA should be thoroughly investigated, and lifestyle changes should be started in the early period of life so as to reduce the risk of various problems associated with MetS. AGA can be considered as an early marker for MetS.

Study of the International Epidemiology of Androgenetic Alopecia in Young Caucasian Men Using Photographs From the Internet

BACKGROUND

The epidemiological evaluation of androgenetic alopecia (AGA) is based mainly on direct observation and questionnaires. The international epidemiology and environmental risk factors of AGA in young Caucasian men remain unknown.

AIM

To use photographs and data from the Internet to evaluate severe AGA and generate greater understanding of the international epidemiology of the disorder in young Caucasian men.

MATERIALS AND METHODS

A population-based cross-sectional study design was used. The sample included 26,340 Caucasian men aged 30 to 40 years who had uploaded profiles to two dating websites. Their photographs were evaluated for AGA and graded as follows: severe AGA (Norwood type VI-VII), non-severe AGA, and unknown. Epidemiological data were collected from the sites. Logistic regression was used to analyze the effect of risk factors on the prevalence of severe AGA.

RESULTS

The overall success rate for identifying severe AGA by indirect evaluation of Internet photographs was 94%. The prevalence of severe AGA was 15.33% overall and varied significantly by geographical region. The risk of having severe AGA was increased by 1.092 for every year of age between 30 and 40 years. Severe AGA was more prevalent in subjects with higher body mass index.

CONCLUSIONS

Photographs from the Internet can be used to evaluate severe AGA in epidemiological studies. The prevalence of severe AGA in young Caucasian men increases with age and varies by geographical region. Body mass index is an environmental risk factor for severe AGA.

Oxidative stress-associated senescence in dermal papilla cells of men with androgenetic alopecia

Dermal papilla cells (DPCs) taken from male androgenetic alopecia (AGA) patients undergo premature senescence in vitro in association with the expression of p16(INK4a), suggesting that DPCs from balding scalp are more sensitive to environmental stress than nonbalding cells. As one of the major triggers of senescence in vitro stems from the cell "culture shock" owing to oxidative stress, we have further investigated the effects of oxidative stress on balding and occipital scalp DPCs. Patient-matched DPCs from balding and occipital scalp were cultured at atmospheric (21%) or physiologically normal (2%) O2. At 21% O2, DPCs showed flattened morphology and a significant reduction in mobility, population doubling, increased levels of reactive oxygen species and senescence-associated β-Gal activity, and increased expression of p16(INK4a) and pRB. Balding DPCs secreted higher levels of the negative hair growth regulators transforming growth factor beta 1 and 2 in response to H2O2 but not cell culture-associated oxidative stress. Balding DPCs had higher levels of catalase and total glutathione but appear to be less able to handle oxidative stress compared with occipital DPCs. These in vitro findings suggest that there may be a role for oxidative stress in the pathogenesis of AGA both in relation to cell senescence and migration but also secretion of known hair follicle inhibitory factors.

Association of premature androgenetic alopecia and metabolic syndrome in a young Indian population

Context:

Although evidences for association of androgenetic alopecia (AGA) with metabolic syndrome (MetS) are accruing, inconclusiveness with respect to the gender specificity and differential association of MetS with increasing severity of AGA continues to persist. Furthermore, data specific to Indian settings are relatively sparse.

Aims:

The present study aimed at assessing the frequency of MetS in individuals with early AGA in Indian settings.

Settings and Design:

A case-control study was conducted at a trichology clinic in Bengaluru between April 2012 and September 2012 with a total of 85 cases of AGA and 85 age-matched controls.

Materials and Methods:

The Norwood-Hamilton classification was used to assess the grade of AGA. MetS was defined according to the National Cholesterol Education Program Adult Treatment Panel III criteria. Blood pressure, blood glucose, lipid parameters, and body mass index along with anthropometric measurements were assessed in all study participants.

Statistical Analysis Used:

Chi-square test was used to compare proportions between groups. Means were compared between groups using Student's t-test.

Results:

MetS was seen in a higher proportion of patients with AGA (43.5%) as compared to the control group (2.4%) and the differences were statistically significant (P < 0.001). As compared to controls, patients with AGA had higher triglycerides (P < 0.001), systolic blood pressure (P < 0.001), diastolic blood pressure (P < 0.001) along with significantly lower high-density lipoprotein cholesterol levels (P < 0.001). Severity of AGA was not associated with MetS.

Conclusions:

AGA is associated with MetS in male Indian patients aged <30 years. Studies with large sample sizes may be required to conclusively define any putative associations between AGA grades and MetS.

Androgenetic alopecia, metabolic syndrome, and insulin resistance: Is there any association? A case-control study

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.

Alopecia and its association with coronary heart disease and cardiovascular risk factors: a meta-analysis

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.

Hormonal profile in Indian men with premature androgenetic alopecia

Introduction:

Alopecia in male is considered as a genetically determined disorder characterized by increased level of local androgen metabolite and increase androgen receptor binding in balding areas. Frequent deviations of hormones from normal values have been reported in men diagnosed with premature androgenetic alopecia (AGA) especially for androgens, gonadotropins and sex hormone binding globulin (SHBG). Different studies in the past have inferred that premature baldness before the age of thirty in males could be considered equivalent to the polycystic ovary syndrome (PCOS) in female.

Materials and Methods:

Hormonal profile of 50 men with severe premature balding before 30 years of age were compared with same numbers of age matched controls. The serum concentrations of total testosterone, dehydroepiandrosterone sulfate, luteinizing hormone, follicle stimulating hormone, SHBG, insulin and fasting blood sugar were estimated. Statistical analysis was performed with paired Student's t-test for cases and controls.

Results:

Decreased levels of SHBG with high free androgen index were found in cases when compared with the controls.

Conclusion:

Though altered hormonal profile may coexist in some of men with premature AGA it can’t be considered as male equivalent to PCOS in female or the metabolic syndrome.

HSL Attenuates the Follicular Oxidative Stress and Enhances the Hair Growth in ob/ob Mice

Summary:

We demonstrated enhanced hair regeneration following topical administration of N-(3-oxododecanoyl)-l-homoserine lactone (HSL) in ob/ob mice. The ob/ob mice showed delayed hair regeneration (more than 6 wk) after depilation, which rapidly induced transition to anagen in the hair cycle in wild-type mice. Vehicle and HSL solutions were applied to the depilated dorsal skin of ob/ob mice. The depilated skin of the HSL-treated mice was fully covered with hair, whereas no macroscopic alteration was observed in vehicle-treated group by the fourth week after depilation. Oxidative stress was drastically decreased and the expression of the antioxidative enzymes PON1 and PON3 was increased in the HSL-treated skin with highly proliferative anagen follicles. These results suggest that HSL is a candidate therapeutic agent for alopecia in metabolic syndrome.

Metabolic syndrome and skin: psoriasis and beyond

Metabolic syndrome (Met S) is a clustering of risk factors comprising of abdominal obesity, dyslipidemia, elevated blood pressure, and abnormal glucose tolerance. The prevalence of Met S has been increasing in the last few years throughout the world. Psoriasis has consistently been associated with Met S as well as its various components. However, the association is no longer limited to psoriasis alone. Various dermatological conditions such as lichen planus, androgenetic alopecia, systemic lupus erythematosus, skin tags, acanthosis nigricans, and even cutaneous malignancies have also been found to be associated with this syndrome. Though chronic inflammation is thought to be the bridging link, the role of oxidative stress and endocrine abnormalities has recently been proposed in bringing them together.