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Seo A, Chang AY. A systematic review of the social impact of diseases in Nordic countries. Scand J Public Health 2024:14034948231217365. [PMID: 38166481 DOI: 10.1177/14034948231217365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2024]
Abstract
BACKGROUND We review the literature on the social impacts of diseases, defined as the social consequences of having a disease on the people around the patient, such as spouses, caregivers and offspring. The two objectives of this study are to summarise the social outcomes commonly associated with diseases and to compare the social impact across a range of diseases. METHODS A systematic review of the social impact of disease in Nordic countries was conducted using PubMed, PsycINFO and Google Scholar (PROSPERO registration number CRD42022291796). All articles that met the inclusion criteria were reviewed. We tabulated all outcomes and diseases studied, and synthesised the evidence based on the perspectives of patients, spouse/caregiver and offspring. RESULTS A total of 135 studies met the eligibility criteria, covering 76 diseases and 39 outcomes. From the patient's perspective, diseases impact divorce and marriage rates, social functioning, likelihood of committing a crime and being a victim of crime. From the caregiver's perspective, diseases affect their health-related quality of life and physical and psychological health. From the offspring's perspective, diseases impact their development, health and social adversities in later life. Diseases generally had negative social impacts, but there were some diseases associated with positive impacts. CONCLUSIONS The review provides a useful summary and gross comparison of the social impact of different diseases. The social impact of diseases can be large and significant. Thus, it should be considered when policymakers are setting priorities across disease areas.
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Affiliation(s)
- Ahreum Seo
- Department of Public Health, University of Southern Denmark, Denmark
| | - Angela Y Chang
- Danish Institute for Advanced Study, University of Southern Denmark, Denmark
- Department of Clinical Research, University of Southern Denmark, Denmark
- Interdisciplinary Centre on Population Dynamics (CPop), University of Southern Denmark, Denmark
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Stephens TJ, Berkowitz S, Marshall T, Kogan S, Raymond I. A Prospective Six-month Single-blind Study Evaluating Changes in Hair Growth and Quality Using a Nutraceutical Supplement in Men and Women of Diverse Ethnicities. THE JOURNAL OF CLINICAL AND AESTHETIC DERMATOLOGY 2022; 15:21-26. [PMID: 35309272 PMCID: PMC8903234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
OBJECTIVE The goal of this study was to assess the perceived efficacy of a standardized nutraceutical to improve hair growth and quality in men and women of various ethnicities with self-perceived hair thinning. METHODS This prospective, single-blind study enrolled healthy men aged 20 to 55 years (n=47) and premenopausal women aged 20 to 45 years (n=51) with self-perceived, mild-to-moderate hair thinning and included African American, Asian, Hispanic Caucasian and Non-Hispanic Caucasian participants. The nutraceutical supplement (Nutrafol® Men or Women Capsules, Nutraceutical Wellness Inc., New York, New York) was taken daily for six months. Subjects were evaluated in the clinic at baseline and Weeks 12 and 24 with two self-assessments at Weeks 4 and 8. Study endpoints were standardized digital imaging and investigator rated assessments. Self-assessment questionnaires rated hair growth, hair satisfaction, and lifestyle factors. RESULTS Investigator ratings for baseline hair growth, coverage, density, and volume were significant at Weeks 12 and 24 for all subjects (for each, p<0.001). These significant improvements were seen in 83.7 percent of men and 79.5 percent of women at Week 24. Results were similar across ethnic subgroups with significant benefit at Weeks 12 and 24 (for each, p<0.05). All subjects reported significant improvements in baseline hair appearance/quality, volume/fullness, scalp coverage, thickness, and shedding at Weeks 4, 8, 12 and 24 (for each, p<0.01). CONCLUSION A standardized nutraceutical supplement improved visible hair growth with less notable shedding based on subjects' and investigators' overall perception of treatment benefit for men and women of various ethnic backgrounds.
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Affiliation(s)
- Thomas J Stephens
- Dr. Stephens is with SGS Stephens, Inc., in Richardson, Texas. Ms. Berkowitz and Drs. Marshall, Kogan, and Raymond are with Nutraceutical Wellness LLC in New York, New York
| | - Sheryl Berkowitz
- Dr. Stephens is with SGS Stephens, Inc., in Richardson, Texas. Ms. Berkowitz and Drs. Marshall, Kogan, and Raymond are with Nutraceutical Wellness LLC in New York, New York
| | - Tess Marshall
- Dr. Stephens is with SGS Stephens, Inc., in Richardson, Texas. Ms. Berkowitz and Drs. Marshall, Kogan, and Raymond are with Nutraceutical Wellness LLC in New York, New York
| | - Sophia Kogan
- Dr. Stephens is with SGS Stephens, Inc., in Richardson, Texas. Ms. Berkowitz and Drs. Marshall, Kogan, and Raymond are with Nutraceutical Wellness LLC in New York, New York
| | - Isabelle Raymond
- Dr. Stephens is with SGS Stephens, Inc., in Richardson, Texas. Ms. Berkowitz and Drs. Marshall, Kogan, and Raymond are with Nutraceutical Wellness LLC in New York, New York
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3
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Huang CH, Fu Y, Chi CC. Health-Related Quality of Life, Depression, and Self-esteem in Patients With Androgenetic Alopecia: A Systematic Review and Meta-analysis. JAMA Dermatol 2021; 157:963-970. [PMID: 34232264 DOI: 10.1001/jamadermatol.2021.2196] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance Androgenetic alopecia (AGA) is associated with trichodynia, anxiety, low self-esteem, and depression, which have implications for quality of life. However, no systematic evaluation has been performed on the association of AGA with health-related quality of life (HRQOL). Objective To systematically examine the association of AGA with HRQOL and psychiatric disorders. Data Sources Cochrane Library, PubMed, Embase, and WanFang databases were searched from inception through January 24, 2021. Study Selection Case series, case-control studies, cross-sectional studies, cohort studies, and randomized clinical trials that examined either HRQOL or psychiatric disorders in patients with AGA were included. Studies published in languages other than English and Mandarin were excluded. Data Extraction and Synthesis The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline was used. The risk of bias in included studies was assessed with the Risk of Bias in Non-randomized Studies of Intervention (ROBINS-I) tool. A random-effects model meta-analysis was performed to calculate the pooled effect on HRQOL. A subgroup analysis according to sex and geographic regions was also conducted. Main Outcomes and Measures The outcome was HRQOL of patients with AGA. Results A total of 41 studies involving 7995 patients was included. The pooled Dermatology Life Quality Index score was 8.16 (95% CI, 5.62-10.71). The pooled Hair-Specific Skindex-29 score indicated moderate impairment of emotions, with the meta-analysis showing a score of 29.22 (95% CI, 24.17-34.28) in the emotion dimension. The pooled Center for Epidemiologic Studies Depression Scale score did not indicate depression, with the meta-analysis showing a score of 14.98 (95% CI, 14.28-15.68). Factors that had a direct association with HRQOL included married or coupled status and receipt of medical treatments, whereas factors that had an inverse association with HRQOL included higher self-rated hair loss severity, lower visual analog scale score, and higher educational level. Conclusions and Relevance This systematic review and meta-analysis found a significant association of AGA with moderate impairment of HRQOL and emotions, but no association was found with depressive symptoms. The findings suggest that patients with AGA may need psychological and psychosocial support.
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Affiliation(s)
- Chun-Hsien Huang
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Yun Fu
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Ching-Chi Chi
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou, Taiwan.,School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
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Guerra-Tapia A, Buendía-Eisman A, Ferrando Barbera J, Barbera JF, Eisman AB, Tapia AG, Perurena AG, Casado YJ, Tejero DO, Nuñez DCC, Moreno HJM, Melwani PM, Mateu AV, Rossell LG, Andrés PDVC, Belloso RI, Diez MB, Ruiz AIB, Mendiaraz MU, Sánchez MA, Ferra AM, Llaneras MS, Redondo LA, Gómez-Calcerrada MR, Gil MH, Mortet CP, Diéguez MLC, Molina NS, Castrillón MP, Ortiz RA, Ruiz EM, Rodríguez AJG, Busquet EA, Santandreu MS, Delgado WE, Otero RM, Valimaña MP, Montesinos IN, Montero LC, Pérez ADA, Vila TO, Sava CV, Blanco MP, Carrero EB, Romero MC, Fernández VD, Martin MR, Dorado BAG, Maso MCG, Moya SEM, Bayo MDCV, Hermida MTA, Vorlicka K, Morel GESL, Álvarez SG, Valle OG, Lázaro MCF, Ramírez AR, Martínez JMB, Herrero MTDP, Cantalejo TEL, Sánchez RB, Morras PG, Ostiz SH, Olmo RMOD, Santiago SA, Polo ADM, Callizo CM, Paz NPMD, Doménech CR, Miralles JMV, Gallego FJA, Marrero FJDL, Cwiek MC, Martin ML, Narganes LMV, Muñiz JCSM, González MCM, Regaña MS, Portillo MR, Mas VA, Navarro JG, Sarrio MCD, Fernández JLG, Varela YC, Sarto MS, Díez-Canseco MTMU, Moreno BN, Gil ML, González MDH, Lax RS, Fernández MT, Plata MDG, Guerra EG, Campos JMP, Llord LP, González SDC, Calatayud AM, Dosil VML, García ME, Buezo GF, Niubó EM, Peinado CM, Montcusí JP. Fase final de la validación transcultural al español de la escala Hair Specific Skindex-29: sensibilidad al cambio y correlación con la escala SF-12. ACTAS DERMO-SIFILIOGRAFICAS 2019; 110:819-829. [DOI: 10.1016/j.ad.2019.06.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 06/26/2019] [Accepted: 06/30/2019] [Indexed: 10/26/2022] Open
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Guerra-Tapia A, Buendía-Eisman A, Ferrando Barbera J. Final Phase in the Validation of the Cross-Cultural Adaptation of the Hair-Specific Skindex-29 Questionnaire Into Spanish: Sensitivity to Change and Correlation With the 12-Item Short-Form Health Survey. ACTAS DERMO-SIFILIOGRAFICAS 2019. [DOI: 10.1016/j.adengl.2019.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Tas B, Kulacaoglu F, Belli H, Altuntas M. The tendency towards the development of psychosexual disorders in androgenetic alopecia according to the different stages of hair loss: a cross-sectional study. An Bras Dermatol 2018; 93:185-190. [PMID: 29723381 PMCID: PMC5916388 DOI: 10.1590/abd1806-4841.20185658] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Accepted: 01/09/2017] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Androgenetic alopecia is a common dermatological condition affecting both genders. OBJECTIVE To evaluate the tendency towards development of psychosexual disorders according to the clinical stages of androgenetic alopecia. METHODS A cross-sectional study was conducted including 353 patients of both sexes on different clinical stages of hair loss, and the patients were enquired about self-perception, self-esteem, sexual experiences, anxiety and depression states. Hair loss was classified by standardized hair loss scales, and psychological effects were assessed with questionnaires. Results were compared to p<0.05. RESULTS Negative effects on each psychological parameter of androgenetic alopecia in females were higher than in males. While overall comparisons according to hair loss stages for each parameter were significant in males, only sexual experiences, anxiety and depression values were significant in females. Sexual experiences and depression values were higher in Ludwig 3 than in 1&2, while anxiety was higher in Ludwig 3 than 1. Self-perception values in Norwood 2&2A were higher than 3A, 3V, 4 and 4A, while self-esteem values in 2A were higher than 3&4. Sexual experiences values in 2&2A were lower than 3, 3A, 3V, 4 and 4A, while 3&3A were lower than 4&4A. Depression was lower in 2A than 3, 3A, and 3V, and lower in 2A than 4A. Anxiety was lower in 2A than in 4&4A. STUDY LIMITATIONS Relatively small number of patients, who were from a single center. CONCLUSIONS In the management of androgenetic alopecia, it should be considered that patients may need psychological support according to the clinical stages, because of increased tendency to develop psychosexual disorders.
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Affiliation(s)
- Betul Tas
- Department of Dermatology, University of Health Sciences, Istanbul
Bagcilar Research and Training Hospital - Istanbul, Turkey
| | - Filiz Kulacaoglu
- Department of Psychiatry, University of Health Sciences, Istanbul
Bagcilar Research and Training Hospital - Istanbul, Turkey
| | - Hasan Belli
- Department of Psychiatry, University of Health Sciences, Istanbul
Bagcilar Research and Training Hospital - Istanbul, Turkey
| | - Murat Altuntas
- Department of Family Medicine, University of Health Sciences,
Istanbul Bagcilar Research and Training Hospital - Istanbul, Turkey
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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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8
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Noordam R, Gunn DA, van Drielen K, Westgate G, Slagboom PE, de Craen AJM, van Heemst D. Both low circulating insulin-like growth factor-1 and high-density lipoprotein cholesterol are associated with hair loss in middle-aged women. Br J Dermatol 2016; 175:728-34. [PMID: 26959288 DOI: 10.1111/bjd.14529] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/02/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND Multiple biomarkers have been associated with hair loss in women, but studies have shown inconsistent results. OBJECTIVES We investigated the associations between markers of cardiovascular disease risk (e.g. serum lipid levels and hypertension) and ageing [e.g. 25-hydroxyvitamin D and insulin-like growth factor (IGF)] with hair loss in a population of middle-aged women. METHODS In a random subgroup of 323 middle-aged women (mean age 61·5 years) from the Leiden Longevity Study, hair loss was graded by three assessors using the Sinclair scale; women with a mean score > 1·5 were classified as cases with hair loss. RESULTS Every 1 SD increase in high-density lipoprotein (HDL) cholesterol was associated with a 0·65-times lower risk [95% confidence interval (CI) 0·46-0·91] of hair loss. For IGF-1 the risk was 0·68 times lower (95% CI 0·48-0·97) per 1 SD increase, independently of the other studied variables. Women with both IGF-1 and HDL cholesterol levels below the medians of the study population had a 3·47-times higher risk (95% CI 1·30-9·25) of having hair loss. CONCLUSIONS Low HDL cholesterol and IGF-1 were associated with a higher risk of hair loss in women. However, further studies are required to infer causal relationships.
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Affiliation(s)
- R Noordam
- Department of Gerontology and Geriatrics, Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, The Netherlands
| | - D A Gunn
- Unilever Discover, Sharnbrook, Bedfordshire, U.K
| | - K van Drielen
- Department of Gerontology and Geriatrics, Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, The Netherlands
| | - G Westgate
- Westgate Consultancy Ltd, Stevington, Bedfordshire, U.K
| | - P E Slagboom
- Section of Molecular Epidemiology, Department of Medical Statistics and Bioinformatics, Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, The Netherlands
| | - A J M de Craen
- Department of Gerontology and Geriatrics, Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, The Netherlands
| | - D van Heemst
- Department of Gerontology and Geriatrics, Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, The Netherlands.
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Mareeva AN, Kondrakhina IN. Psycho-emotional conditions of patients with non-cicatrazing alopecia (circumsribed, androgenetic). VESTNIK DERMATOLOGII I VENEROLOGII 2015. [DOI: 10.25208/0042-4609-2015-91-6-50-56] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Most common psycho-emotional disorders are described with patients with circumsribed, androgenetic alopecia. Main identification methods presented. It was shown based on analysis of literary data and in order to upgrade the quality of medical help for this group of patients how important it is to identify the preoccupying, depressive and other pathological psychogenic conditions of patients chronic alopecia.
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Janković S, Perić J, Maksimović N, Ćirković A, Marinković J, Janković J, Reljić V, Medenica L. Quality of life in patients with alopecia areata: a hospital-based cross-sectional study. J Eur Acad Dermatol Venereol 2015; 30:840-6. [DOI: 10.1111/jdv.13520] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Accepted: 09/17/2015] [Indexed: 12/12/2022]
Affiliation(s)
- S. Janković
- Institute of Epidemiology; Faculty of Medicine; University of Belgrade; Belgrade Serbia
| | - J. Perić
- Clinic of Dermatovenereology; Clinical Center of Serbia; Belgrade Serbia
| | - N. Maksimović
- Institute of Epidemiology; Faculty of Medicine; University of Belgrade; Belgrade Serbia
| | - A. Ćirković
- Institute of Medical Statistics and Informatics; Faculty of Medicine; University of Belgrade; Belgrade Serbia
| | - J. Marinković
- Institute of Medical Statistics and Informatics; Faculty of Medicine; University of Belgrade; Belgrade Serbia
| | - J. Janković
- Institute of Social Medicine; Faculty of Medicine; University of Belgrade; Belgrade Serbia
| | - V. Reljić
- Clinic of Dermatovenereology; Clinical Center of Serbia; Belgrade Serbia
| | - L. Medenica
- Clinic of Dermatovenereology; Clinical Center of Serbia; Belgrade Serbia
- Department of Dermatovenereology; Faculty of Medicine; University of Belgrade; Belgrade Serbia
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11
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Kondrakhina IN, Mareeva AN. Evaluation of the quality of life in patients with alopecia areata and androgenetic alopecia. VESTNIK DERMATOLOGII I VENEROLOGII 2015. [DOI: 10.25208/0042-4609-2015-91-5-53-58] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
State Research Center of Dermatovenereology and Cosmetology, Ministry of Healthcare of the Russian Federation
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12
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Kartal D, Borlu M, Çınar SL, Ferahbaş A, Ulaş Y, Ünlühızarcı K, Ukşal Ü, Keleştimur F. The association of androgenetic alopecia and insulin resistance is independent of hyperandrogenemia: A case-control study. Australas J Dermatol 2015; 57:e88-92. [PMID: 25781062 DOI: 10.1111/ajd.12285] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Accepted: 10/27/2014] [Indexed: 11/28/2022]
Abstract
BACKGROUND/OBJECTIVES Androgenetic alopecia (AGA) occurs due to the effect of androgens and genetic predisposition. The association between hyperandrogenism and insulin resistance (IR) has been clearly documented. In recent years there have been reports supporting the presence of IR in AGA. The study aimed to investigate the presence of IR in women with AGA and discern whether or not it is associated with hyperandrogenism. METHODS Overall, 77 women with AGA were included in the study. Patients with Ludwig grades I-III AGA were enrolled in the study. Blood samples were drawn for measurements of hormone profile, basal insulin and fasting blood glucose (FBG). An oral glucose tolerance test was performed on another day. IR was assessed by the homeostasis model assessment score. RESULTS All IR parameters were significantly higher in the 75 study subjects without DM than in the control group (P < 0.05). After excluding five patients with IGT, the level of all IR parameters were still higher than in the control group (P < 0.05). Hyperandrogenemia was found in 30 (40%) patients. When this second group (n = 45) (excluding patients with hyperandrogenemia) was compared with the control group on IR, all parameters except for basal insulin were significantly higher in the second group than in the controls (P < 0.05). CONCLUSION Our results suggest a relation between IR and AGA in female patients. We showed for the first time that the association of AGA and IR is independent of hyperandrogenemia.
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Affiliation(s)
- Demet Kartal
- Department of Dermatology and Venereology, Erciyes University, Kayseri, Turkey
| | - Murat Borlu
- Department of Dermatology and Venereology, Erciyes University, Kayseri, Turkey
| | - Salih L Çınar
- Department of Dermatology and Venereology, Erciyes University, Kayseri, Turkey
| | - Ayten Ferahbaş
- Department of Dermatology and Venereology, Erciyes University, Kayseri, Turkey
| | - Yılmaz Ulaş
- Department of Dermatology and Venereology, Kayseri Education and Research Hospital, Kayseri, Turkey
| | - Kürşad Ünlühızarcı
- Department of Endocrinology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Ümit Ukşal
- Department of Dermatology and Venereology, Taksim Alman Hospital, İstanbul, Turkey
| | - Fahrettin Keleştimur
- Department of Endocrinology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
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13
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Choi EK, Kim IR, Chang O, Kang D, Nam SJ, Lee JE, Lee SK, Im YH, Park YH, Yang JH, Cho J. Impact of chemotherapy-induced alopecia distress on body image, psychosocial well-being, and depression in breast cancer patients. Psychooncology 2014; 23:1103-10. [DOI: 10.1002/pon.3531] [Citation(s) in RCA: 118] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2013] [Revised: 01/28/2014] [Accepted: 02/28/2014] [Indexed: 11/06/2022]
Affiliation(s)
- Eun Kyung Choi
- Cancer Education Center; Samsung Comprehensive Cancer Center; Samsung Medical Center; Sungkyunkwan University School of Medicine; Seoul Korea
| | - Im-Ryung Kim
- Cancer Education Center; Samsung Comprehensive Cancer Center; Samsung Medical Center; Sungkyunkwan University School of Medicine; Seoul Korea
| | - Oliver Chang
- Krieger School of Arts and Sciences; Johns Hopkins University; Baltimore MD USA
| | - Danbee Kang
- Department of Health Sciences and Technology, SAIHST; Sungkyunkwan University; Seoul Korea
| | - Seok-Jin Nam
- Department of Surgery; Samsung Medical Center; Sungkyunkwan University School of Medicine; Seoul Korea
| | - Jeong Eon Lee
- Department of Surgery; Samsung Medical Center; Sungkyunkwan University School of Medicine; Seoul Korea
| | - Se Kyung Lee
- Department of Surgery; Samsung Medical Center; Sungkyunkwan University School of Medicine; Seoul Korea
| | - Young-Hyuck Im
- Department of Hematology and Oncology; Samsung Medical Center; Sungkyunkwan University School of Medicine; Seoul Korea
| | - Yeon Hee Park
- Department of Hematology and Oncology; Samsung Medical Center; Sungkyunkwan University School of Medicine; Seoul Korea
| | - Jung-Hyun Yang
- Department of Surgery; Konkuk University Medical Center; Konkuk University School of Medicine; Seoul Korea
| | - Juhee Cho
- Cancer Education Center; Samsung Comprehensive Cancer Center; Samsung Medical Center; Sungkyunkwan University School of Medicine; Seoul Korea
- Department of Health Sciences and Technology, SAIHST; Sungkyunkwan University; Seoul Korea
- Department of Health, Behavior and Society; Johns Hopkins Bloomberg School of Public Health; Baltimore MD USA
- Department of Epidemiology; Johns Hopkins Bloomberg School of Public Health; Baltimore MD USA
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Tabolli S, Sampogna F, di Pietro C, Mannooranparampil TJ, Ribuffo M, Abeni D. Health status, coping strategies, and alexithymia in subjects with androgenetic alopecia: a questionnaire study. Am J Clin Dermatol 2013; 14:139-45. [PMID: 23413102 DOI: 10.1007/s40257-013-0010-3] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND Androgenic alopecia (AGA) is viewed as a relatively mild dermatologic condition; however, affected individuals feel that alopecia is a serious condition with major consequences in their life. OBJECTIVE The objective of this study was to assess the health status, the risk of anxiety/depression, the coping strategies, and alexithymia in subjects with AGA. METHODS Consecutive subjects referred to the outpatients department of the Istituto Dermopatico dell'Immacolata, Istituto di Ricovero e Cura a Carattere Scientifico (IDI IRCCS) dermatologic hospital with a diagnosis of AGA were enrolled. AGA was assessed using the Ludwig scale in female subjects and following Hamilton-Norwood's classification in male subjects. The questionnaires provided to the patient and collected before the visit were the Medical Outcomes Study Short Form-12 (SF-12), the 12-item General Health Questionnaire (GHQ-12), the Coping Orientations to Problems Experienced (COPE), and the Toronto Alexithymia Scale-20 (TAS-20). Multiple logistic regressions were performed to examine the relationship of sociodemographic variables and clinical characteristics with coping. RESULTS 351 subjects were enrolled during the study period. Sixty percent of female subjects with AGA were GHQ-12 positive (values ≥4) compared with 32 % of male subjects with AGA. AGA male and AGA female subjects had a statistically worse score than non-AGA male subjects for the physical component summary (PCS) and the mental component summary (MCS) of the SF-12, and for the GHQ-12. Compared with male subjects, AGA female subjects were more likely to adopt an 'active emotional coping' strategy according to COPE scores, and less likely to have 'externally oriented thinking,' and more 'difficulty identifying feelings' according to the TAS-20 scores. In a logistic regression model, including sex, MCS, total TAS-20, and the COPE scores as independent variables and the AGA severity as a dependent variable, only sex had a significant odds ratio (OR) [13.32; 95 % CI 4.77-38.58, p < 0.001]. Female subjects were almost 13 times more likely to have more severe AGA than male subjects. In three other models (i.e., one for each coping category) which included sex, AGA severity, MCS, and TAS-20, the 'problem-focused coping' strategy was negatively associated with alexithymia (OR 0.48; 95 % CI 0.27-0.86, p = 0.01), the 'active emotional coping' strategy was associated with gender (women had an OR of 2.69; 95 % CI 1.5-4.8, p = 0.001), and the 'avoidant coping' strategy was associated with alexithymia (OR 4.12; 95 % CI 2.23-7.58, p < 0.001) and with lower MCS values (OR 0.37; 95 % CI 0.22-0.64, p < 0.001). CONCLUSION The study confirmed the high prevalence of depression/anxiety in AGA subjects, with a significantly higher prevalence in AGA female than male subjects. It is interesting to observe that patients reactions to their AGA related more to the emotional and psychological states deriving from their alopecia than to the objective clinical rating. Avoidant coping strategies were selected more frequently by AGA subjects if they were GHQ-12 positive and had alexithymia. To have alexithymia modified all coping strategies in AGA female subjects but not in AGA male subjects. Physicians should be aware that the impact of AGA is not limited to symptoms, and should help people to deal with their emotional responses to alopecia, such as anger and worry, and their beliefs about the consequences of their condition, and how it will impact on their daily life.
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Factors associated with female pattern hair loss and its prevalence in Taiwanese women: a community-based survey. J Am Acad Dermatol 2012. [PMID: 23182061 DOI: 10.1016/j.jaad.2012.09.046] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
BACKGROUND Although female pattern hair loss (FPHL) has been considered simply the female counterpart of male pattern hair loss in men, the risk factors may differ. OBJECTIVE We sought to evaluate factors associated with FPHL and to estimate its prevalence in women. METHOD In total, 26,226 subjects aged 30 years and older participated in a cross-sectional survey. Ludwig and Norwood classifications were used to assess the degree of hair loss. Information on possible risk factors for FPHL was collected using a questionnaire interview. RESULTS The prevalence of FPHL (Ludwig grade >I) for all ages was 11.8% (95% CI 11.5%-12.2%), increasing with advancing age. After controlling for age and family history, statistically significant associations were noted between FPHL and high fasting glucose (odds ratio [OR] 1.15, 95% confidence interval [CI] 1.04-1.28), fewer childbirths (OR 1.24, 95% CI 1.12-1.38), breast-feeding (OR 0.88, 95% CI 0.78-0.98), oral contraceptive use (OR 1.21, 95% CI 1.01-1.45), and ultraviolet exposure more than 16 hours per week (OR 1.12, 95% CI 1.02-1.22). LIMITATIONS The validity and reliability of FPHL classification may be not perfect in this survey and may need to be verified. Information on family history may be still subject to recall bias. CONCLUSIONS Risk factors for FPHL and male androgenic alopecia may differ.
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Permanent impairment of insulin resistance from pregnancy to adulthood: The primary basic risk factor of chronic Western diseases. Med Hypotheses 2009; 73:670-81. [DOI: 10.1016/j.mehy.2009.04.047] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2009] [Revised: 04/23/2009] [Accepted: 04/25/2009] [Indexed: 01/21/2023]
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González-González JG, Mancillas-Adame LG, Fernández-Reyes M, Gómez-Flores M, Lavalle-González FJ, Ocampo-Candiani J, Villarreal-Pérez JZ. Androgenetic alopecia and insulin resistance in young men. Clin Endocrinol (Oxf) 2009; 71:494-9. [PMID: 19094069 DOI: 10.1111/j.1365-2265.2008.03508.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Epidemiological studies have associated androgenetic alopecia (AGA) with severe young-age coronary artery disease and hypertension, and linked it to insulin resistance. We carried out a case-control study in age- and weight-matched young males to study the link between AGA and insulin resistance using the homeostasis model assessment of insulin resistance (HOMA-IR) index or metabolic syndrome clinical manifestations. METHODS Eighty young males, 18-35 years old, with AGA > or = stage III in the Hamilton-Norwood classification, and 80 weight- and age-matched controls were included. Alopecia, glucose, serum insulin, HOMA-IR index, lipid profile and androgen levels, as well as metabolic syndrome criteria, were evaluated. RESULTS The HOMA-IR index was significantly higher in cases than controls. Nonobese cases had a higher mean diastolic blood pressure and a more frequent family history of AGA than nonobese controls. A borderline difference in the HOMA-IR index was found in obese AGA cases vs. obese controls [P = 0.055, 95% confidence interval (CI) 2.36-4.20 vs. 1.75-2.73]. Free testosterone values were significantly higher in controls than cases, regardless of body mass index (BMI). A statistically significant additive effect for obesity plus alopecia was found, with significant trends for insulin, the HOMA-IR index, lipids and free testosterone when BMI and alopecia status were used to classify the participants. CONCLUSIONS Our results support the recommendation for assessing insulin resistance and cardiovascular-related features and disorders in all young males with stage III or higher AGA, according to the Hamilton-Norwood classification.
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Affiliation(s)
- José Gerardo González-González
- Servicio de Endocrinologia, Dr Jose Eleuterio Gonzalez University Hospital, Facultad de Medicina, Universidad Autonoma de Nuevo Leon, Ave. Madero y Gonzalitos S/N, Monterrey, Mexico.
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Chavez AO, Gastaldelli A, Guardado-Mendoza R, Lopez-Alvarenga JC, Leland MM, Tejero ME, Sorice G, Casiraghi F, Davalli A, Bastarrachea RA, Comuzzie AG, DeFronzo RA, Folli F. Predictive models of insulin resistance derived from simple morphometric and biochemical indices related to obesity and the metabolic syndrome in baboons. Cardiovasc Diabetol 2009; 8:22. [PMID: 19389241 PMCID: PMC2674590 DOI: 10.1186/1475-2840-8-22] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2009] [Accepted: 04/23/2009] [Indexed: 12/13/2022] Open
Abstract
Background Non-human primates are valuable models for the study of insulin resistance and human obesity. In baboons, insulin sensitivity levels can be evaluated directly with the euglycemic clamp and is highly predicted by adiposity, metabolic markers of obesity and impaired glucose metabolism (i.e. percent body fat by DXA and HbA1c). However, a simple method to screen and identify obese insulin resistant baboons for inclusion in interventional studies is not available. Methods We studied a population of twenty baboons with the euglycemic clamp technique to characterize a population of obese nondiabetic, insulin resistant baboons, and used a multivariate linear regression analysis (adjusted for gender) to test different predictive models of insulin sensitivity (insulin-stimulated glucose uptake = Rd) using abdominal circumference and fasting plasma insulin. Alternatively, we tested in a separate baboon population (n = 159), a simpler model based on body weight and fasting plasma glucose to predict the whole-body insulin sensitivity (Rd/SSPI) derived from the clamp. Results In the first model, abdominal circumference explained 59% of total insulin mediated glucose uptake (Rd). A second model, which included fasting plasma insulin (log transformed) and abdominal circumference, explained 64% of Rd. Finally, the model using body weight and fasting plasma glucose explained 51% of Rd/SSPI. Interestingly, we found that percent body fat was directly correlated with the adipocyte insulin resistance index (r = 0.755, p < 0.0001). Conclusion In baboons, simple morphometric measurements of adiposity/obesity, (i.e. abdominal circumference), plus baseline markers of glucose/lipid metabolism, (i.e. fasting plasma glucose and insulin) provide a feasible method to screen and identify overweight/obese insulin resistant baboons for inclusion in interventional studies aimed to study human obesity, insulin resistance and type 2 diabetes mellitus.
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Affiliation(s)
- Alberto O Chavez
- Department of Medicine, Diabetes Division, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.
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