Association Between Trichoscopic Features and Serum Hormone Levels and Vitamin D Concentration in Patients with Androgenetic Alopecia in Eastern China: A Cross-Sectional Study

Abstract

Purpose Androgenetic alopecia (AGA) is a common dermatological condition, with reported associations between serum vitamin D and sex hormone levels. However, the relationship between these factors and the severity of hair loss remains unclear. Patients and Methods Our cross-sectional study included 310 AGA patients who visited the dermatology clinic and underwent trichoscopy examinations throughout 2021. We collected data on serum sex hormones and 25(OH)D levels during their consultations. TrichoScan analysis was used to characterize and quantify AGA severity based on hair density and vellus hair proportions in the central scalp area, which were then correlated with the collected indicators. Results The study findings reflect the basic demographic characteristics of AGA patients in the Chinese population. We discovered a significant negative correlation between serum SHBG levels and AGA severity in women, but no association was found in men. Serum testosterone, estradiol, dehydroepiandrosterone sulfate, and 25(OH)D levels showed no significant correlation with the severity of androgenetic alopecia, regardless of gender. Conclusion To our knowledge, this is the first study to investigate the relationship between serum sex hormones, vitamin D, and AGA severity using trichoscopic scalp hair features.

Short-Term Clinical Assessment of Treating Female Androgenetic Alopecia with Autologous Stem Cells Derived from Human Hair Follicles

“…In humans, the role of SHGB is to protect against excess endogenous and exogenic steroids by combining with them [40]. Among female patients, Chen et al found that low-serum SHGB correlated negatively with AGA severity [41]. Taken together with our observation, this seems to confirm SHGB's crucial involvement in the presentation of AGA in women.…”

The Hormonal Background of Hair Loss in Non-Scarring Alopecias

“…Interestingly, AGA severity in women is negatively correlated with serum SHBG levels, which is explained by the fact that higher SHBG concentrations bind more testosterone, lowering its free and active fraction. Consequently, this decreases the negative impact of T on hair growth [ 33 ]. For this reason, total T measurement should be performed only in line with the SHBG test, which helps estimate the amount of free testosterone.…”