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Burgos-Blasco P, Gonzalez-Cantero A, Hermosa-Gelbard A, Jiménez-Cahue J, Buendía-Castaño D, Berna-Rico E, de Aragon CAJ, Vañó-Galván S, Saceda-Corralo D. Subclinical Atherosclerosis in Alopecia Areata: Usefulness of Arterial Ultrasound for Disease Diagnosis and Analysis of Its Relationship with Cardiometabolic Parameters. J Clin Med 2024; 13:4264. [PMID: 39064304 PMCID: PMC11278048 DOI: 10.3390/jcm13144264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2024] [Revised: 06/09/2024] [Accepted: 06/14/2024] [Indexed: 07/28/2024] Open
Abstract
Background/Objectives: Chronic systemic inflammation is a risk factor that increases the development of atherosclerosis and predisposes to cardiovascular diseases (CVDs). The systemic inflammatory profile of alopecia areata (AA) regarding IFNγ and Th1 cytokine dysregulation has previously been described, suggesting an increased incidence of CVDs in this population. No previous studies investigated the possible relationship between atherosclerosis and AA by cardiovascular imaging techniques. To determine the prevalence, distribution and burden of subclinical atherosclerosis in AA. METHODS We conducted a case-control study in 62 participants, including 31 patients with severe AA (SALT > 75) and 31 healthy controls, matched for age, sex and body mass index (BMI). The participants underwent a detailed history assessment and were subjected to the measurement of weight, height, abdominal circumference and blood pressure. A fasting blood sample was also collected. Subclinical atherosclerosis was evaluated by ultrasonography of the bilateral femoral and carotid arteries. RESULTS The AA patients had an increased prevalence of subclinical atherosclerosis (54.7%) compared to the healthy controls (22.6%, p = 0.010). The prevalence of atheroma plaques was significantly higher in the carotid arteries (41.90% vs. 12.9%, p = 0.009), while no significant differences were found in femoral plaque prevalence. The AA patients with atherosclerotic plaques were older (p < 0.001) and had a longer time since AA diagnosis (p = 0.11) and increased serum levels of glycated hemoglobin (p = 0.029) and triglycerides (p = 0.009). In a regression analysis, duration of disease and neutrophil/lymphocyte ratio were the main predictors of atherosclerosis. CONCLUSIONS AA patients have an increased prevalence of carotid subclinical atherosclerosis. The duration of AA, systemic inflammation and insulin resistance appear to play a role in the development of subclinical atherosclerosis in this population.
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Affiliation(s)
- Patricia Burgos-Blasco
- Servicio de Dermatología, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Carretera Colmenar Viejo km 9.100, 28034 Madrid, Spain; (A.H.-G.); (J.J.-C.); (D.B.-C.); (E.B.-R.); (C.A.-J.d.A.); (S.V.-G.); (D.S.-C.)
- Hair Disorders Unit, Grupo Pedro Jaén, 28006 Madrid, Spain
| | - Alvaro Gonzalez-Cantero
- Servicio de Dermatología, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Carretera Colmenar Viejo km 9.100, 28034 Madrid, Spain; (A.H.-G.); (J.J.-C.); (D.B.-C.); (E.B.-R.); (C.A.-J.d.A.); (S.V.-G.); (D.S.-C.)
- Faculty of Medicine, Universidad Francisco de Vitoria, 28223 Pozuelo de Alarcón, Spain
| | - Angela Hermosa-Gelbard
- Servicio de Dermatología, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Carretera Colmenar Viejo km 9.100, 28034 Madrid, Spain; (A.H.-G.); (J.J.-C.); (D.B.-C.); (E.B.-R.); (C.A.-J.d.A.); (S.V.-G.); (D.S.-C.)
- Hair Disorders Unit, Grupo Pedro Jaén, 28006 Madrid, Spain
| | - Juan Jiménez-Cahue
- Servicio de Dermatología, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Carretera Colmenar Viejo km 9.100, 28034 Madrid, Spain; (A.H.-G.); (J.J.-C.); (D.B.-C.); (E.B.-R.); (C.A.-J.d.A.); (S.V.-G.); (D.S.-C.)
- Hair Disorders Unit, Grupo Pedro Jaén, 28006 Madrid, Spain
| | - Diego Buendía-Castaño
- Servicio de Dermatología, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Carretera Colmenar Viejo km 9.100, 28034 Madrid, Spain; (A.H.-G.); (J.J.-C.); (D.B.-C.); (E.B.-R.); (C.A.-J.d.A.); (S.V.-G.); (D.S.-C.)
- Hair Disorders Unit, Grupo Pedro Jaén, 28006 Madrid, Spain
| | - Emilio Berna-Rico
- Servicio de Dermatología, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Carretera Colmenar Viejo km 9.100, 28034 Madrid, Spain; (A.H.-G.); (J.J.-C.); (D.B.-C.); (E.B.-R.); (C.A.-J.d.A.); (S.V.-G.); (D.S.-C.)
| | - Carlota Abbad-Jaime de Aragon
- Servicio de Dermatología, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Carretera Colmenar Viejo km 9.100, 28034 Madrid, Spain; (A.H.-G.); (J.J.-C.); (D.B.-C.); (E.B.-R.); (C.A.-J.d.A.); (S.V.-G.); (D.S.-C.)
| | - Sergio Vañó-Galván
- Servicio de Dermatología, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Carretera Colmenar Viejo km 9.100, 28034 Madrid, Spain; (A.H.-G.); (J.J.-C.); (D.B.-C.); (E.B.-R.); (C.A.-J.d.A.); (S.V.-G.); (D.S.-C.)
- Hair Disorders Unit, Grupo Pedro Jaén, 28006 Madrid, Spain
- Departamento de Biología de Sistemas, Facultad de Medicina, Universidad de Alcalá, 28801 Alcalá de Henares, Spain
| | - David Saceda-Corralo
- Servicio de Dermatología, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Carretera Colmenar Viejo km 9.100, 28034 Madrid, Spain; (A.H.-G.); (J.J.-C.); (D.B.-C.); (E.B.-R.); (C.A.-J.d.A.); (S.V.-G.); (D.S.-C.)
- Hair Disorders Unit, Grupo Pedro Jaén, 28006 Madrid, Spain
- Departamento de Biología de Sistemas, Facultad de Medicina, Universidad de Alcalá, 28801 Alcalá de Henares, Spain
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Najafi MT, Abedini R, Ghandi N, Seraji S, Sadeghi Y. Is the severity of alopecia areata associated with arterial stiffness? JOURNAL OF RESEARCH IN MEDICAL SCIENCES : THE OFFICIAL JOURNAL OF ISFAHAN UNIVERSITY OF MEDICAL SCIENCES 2023; 28:80. [PMID: 38292334 PMCID: PMC10826848 DOI: 10.4103/jrms.jrms_375_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 07/20/2023] [Accepted: 08/16/2023] [Indexed: 02/01/2024]
Abstract
Background This study aimed to evaluate the severity of alopecia areata (AA) associations with metabolic syndrome, body composition evaluated by bioimpedance techniques, and arterial stiffness based on pulse-wave velocity analysis. Materials and Methods This cross-sectional study was conducted on patients referred to AA Clinic at Razi Hospital in 2021 and 2022. Patients with AA with the Severity of Alopecia Tool (SALT) score above 20% and receiving no systemic therapy were included. Patient demographic and clinical information, symptoms of metabolic syndrome, and bioimpedance factors were collected, and the relationship between disease severity, metabolic syndrome, and bioimpedance indicators was evaluated. Results In this study, 59 patients were examined, with 26 (44.07%) being female and 33 (55.93%) being male. The mean age of the patients was 37.42 years (standard deviation [SD] =11.28). The severity of the disease was assessed using the SALT score, with the mean severity in terms of the percentage being 69.83% (SD = 28.57%). In the regression model, SALT score was independently related to the severity of vascular stiffness after adjusting for the effect of other variables (beta = 0.033, 95% CI = 0.009-0.057, P = 0.046). Moreover, SALT score was significantly related to metabolic syndrome after adjusting for the effect of other variables (OR = 1.035, 95% CI = 1.012-1.059, P = 0.002). Conclusion This study found that AA severity is associated with a higher chance of having metabolic syndrome and arterial stiffness which may lead to cardiovascular diseases in patients with AA, and screening patients regarding cardiometabolic diseases is mandated.
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Affiliation(s)
| | - Robabeh Abedini
- Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Narges Ghandi
- Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Shadab Seraji
- Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Yasaman Sadeghi
- Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Tehranchinia Z, Abdollahimajd F, Haghighatkhah H, Talebi A, Yarahmadi A, Zoghi G. The frequency of fatty liver in patients with alopecia areata: A case-control study. J Cosmet Dermatol 2023; 22:2579-2583. [PMID: 37017934 DOI: 10.1111/jocd.15754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 02/03/2023] [Accepted: 03/21/2023] [Indexed: 04/06/2023]
Abstract
BACKGROUND Alopecia areata (AA) is an immune-mediated nonscarring hair loss disorder with multiple subtypes, including alopecia universalis (AU). Previous studies have shown a link between serum lipid profile and alopecia. We aimed to investigate the frequency of fatty liver in patients with AU and patchy alopecia areata (PAA) compared to a control group. METHODS This case-control study included patients with AU and PAA referred to a dermatology clinic from September 23, 2019 to September 23, 2020. A group of individuals without hair loss disorders attending the same clinic were selected as controls. Participants' general information, including age, sex, weight, height, and waist circumference (WC), was recorded. Body mass index (BMI) was calculated for all participants. Also, hyperlipidemia and statin use were noted and liver enzymes were evaluated. For AU and PAA patients, disease duration and the Severity of Alopecia Tool (SALT) score were also recorded. Then, all subjects underwent ultrasound to assess fatty liver and its grade. RESULTS Overall, 32 patients were included in each group. All three groups were comparable in age, sex, weight, height, BMI, WC, hyperlipidemia, abnormal liver enzymes, and statin use. Disease duration and SALT score were significantly higher in the AU than in the PAA group (p = 0.009 and p < 0.001, respectively). The frequency of fatty liver was the highest in AU patients (40.6%), followed by 34.4% in PAA patients, and 21.9% in controls (p = 0.263). This was also the case for grade-1 fatty liver, while grade-2 was more common in PAA patients, and grade-3 was only observed in one patient from the AU group (p = 0.496). CONCLUSIONS Fatty liver was more frequent in AU and PAA patients than controls, without statistically significant differences. There might be an association between fatty liver and AA, particularly the AU subtype.
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Affiliation(s)
- Zohreh Tehranchinia
- Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fahimeh Abdollahimajd
- Department of Dermatology, Shohada-e-Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamidreza Haghighatkhah
- Radiology Department of Diagnosis Imaging, Shohada-e-Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Atefeh Talebi
- Colorectal Research Center, Rasool Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Amin Yarahmadi
- Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ghazal Zoghi
- Endocrinology and Metabolism Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
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Diotallevi F, Campanati A, Martina E, Radi G, Paolinelli M, Marani A, Molinelli E, Candelora M, Taus M, Galeazzi T, Nicolai A, Offidani A. The Role of Nutrition in Immune-Mediated, Inflammatory Skin Disease: A Narrative Review. Nutrients 2022; 14:591. [PMID: 35276950 PMCID: PMC8840467 DOI: 10.3390/nu14030591] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 01/23/2022] [Accepted: 01/27/2022] [Indexed: 11/16/2022] Open
Abstract
Immune-mediated inflammatory skin diseases are characterized by a complex multifactorial etiology, in which genetic and environmental factors interact both in genesis and development of the disease. Nutrition is a complex and fascinating scenario, whose pivotal role in induction, exacerbation, or amelioration of several human diseases has already been well documented. However, owing to the complexity of immune-mediated skin disease clinical course and breadth and variability of human nutrition, their correlation still remains an open debate in literature. It is therefore important for dermatologists to be aware about the scientific basis linking nutrition to inflammatory skin diseases such as psoriasis, atopic dermatitis, hidradenitis suppurativa, bullous diseases, vitiligo, and alopecia areata, and whether changes in diet can influence the clinical course of these diseases. The purpose of this narrative review is to address the role of nutrition in immune-mediated inflammatory skin diseases, in light of the most recent and validate knowledge on this topic. Moreover, whether specific dietary modifications could provide meaningful implementation in planning a therapeutic strategy for patients is evaluated, in accordance with regenerative medicine precepts, a healing-oriented medicine that considers the whole person, including all aspects of the lifestyle.
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Affiliation(s)
- Federico Diotallevi
- Dermatological Clinic, Department of Clinical and Molecular Sciences, Polytechnic Marche University, 60100 Ancona, Italy; (F.D.); (A.C.); (G.R.); (M.P.); (A.M.); (E.M.); (M.C.); (A.O.)
| | - Anna Campanati
- Dermatological Clinic, Department of Clinical and Molecular Sciences, Polytechnic Marche University, 60100 Ancona, Italy; (F.D.); (A.C.); (G.R.); (M.P.); (A.M.); (E.M.); (M.C.); (A.O.)
| | - Emanuela Martina
- Dermatological Clinic, Department of Clinical and Molecular Sciences, Polytechnic Marche University, 60100 Ancona, Italy; (F.D.); (A.C.); (G.R.); (M.P.); (A.M.); (E.M.); (M.C.); (A.O.)
| | - Giulia Radi
- Dermatological Clinic, Department of Clinical and Molecular Sciences, Polytechnic Marche University, 60100 Ancona, Italy; (F.D.); (A.C.); (G.R.); (M.P.); (A.M.); (E.M.); (M.C.); (A.O.)
| | - Matteo Paolinelli
- Dermatological Clinic, Department of Clinical and Molecular Sciences, Polytechnic Marche University, 60100 Ancona, Italy; (F.D.); (A.C.); (G.R.); (M.P.); (A.M.); (E.M.); (M.C.); (A.O.)
| | - Andrea Marani
- Dermatological Clinic, Department of Clinical and Molecular Sciences, Polytechnic Marche University, 60100 Ancona, Italy; (F.D.); (A.C.); (G.R.); (M.P.); (A.M.); (E.M.); (M.C.); (A.O.)
| | - Elisa Molinelli
- Dermatological Clinic, Department of Clinical and Molecular Sciences, Polytechnic Marche University, 60100 Ancona, Italy; (F.D.); (A.C.); (G.R.); (M.P.); (A.M.); (E.M.); (M.C.); (A.O.)
| | - Matteo Candelora
- Dermatological Clinic, Department of Clinical and Molecular Sciences, Polytechnic Marche University, 60100 Ancona, Italy; (F.D.); (A.C.); (G.R.); (M.P.); (A.M.); (E.M.); (M.C.); (A.O.)
| | - Marina Taus
- Dietetic Unit and Clinical Nutrition, United Hospitals of Ancona, 60100 Ancona, Italy; (M.T.); (A.N.)
| | - Tiziana Galeazzi
- Department of Pediatrics, Marche Polytechnic University, 60100 Ancona, Italy;
| | - Albano Nicolai
- Dietetic Unit and Clinical Nutrition, United Hospitals of Ancona, 60100 Ancona, Italy; (M.T.); (A.N.)
| | - Annamaria Offidani
- Dermatological Clinic, Department of Clinical and Molecular Sciences, Polytechnic Marche University, 60100 Ancona, Italy; (F.D.); (A.C.); (G.R.); (M.P.); (A.M.); (E.M.); (M.C.); (A.O.)
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