The association of androgenetic alopecia and insulin resistance is independent of hyperandrogenemia: A case‐control study

Kartal, Demet; Borlu, Murat; Çınar, Salih Levent; Ferahbaş, Ayten; Ulaş, Yılmaz; Ünlühızarcı, Kürşad; Ukşal, Ümit; Keleştimur, Fahrettin

doi:10.1111/ajd.12285

Cited by 5 publications

(5 citation statements)

References 15 publications

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“…All the enrolled women were premenopausal, with an age distribution similar to other studies [4,[8][9][10][11]. This study's weight distribution pattern was more prevalent towards overweight and obesity, with no significant relationship to the FPHL severity.…”

Section: Discussionsupporting

confidence: 77%

“…Scores ≤8/36 is the currently accepted figure for Middle-Eastern women, including Iraqi women. The hirsutism severity was graded according to (mFG) to mild (mFG score≤15), moderate (mFG score [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25], and severe hirsutism (mFG score >25), or having no hirsutism (mFG score≤8) [6].…”

Section: Figure 1: Flow Chart Of the Inclusion And Exclusion Criteriamentioning

confidence: 99%

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Is There Any Association Between Clinical and Biochemical Hyperandrogenism in Women With Female Pattern Hair Loss?

Odhaib¹,

Hamdi²,

Mansour³

2020

Cureus

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Background The exact association between clinical and biochemical hyperandrogenism (HA) is heterogeneous and cannot be ascertained, especially in normoandrogenic women. Objectives Evaluate any association between clinical phenotypes and biochemical parameters of HA in premenopausal women with female pattern hair loss (FPHL). Materials and methods A cross-sectional observational study on 362 women, who were assessed for general characteristics, the different FPHL severities by Sinclair's score, hirsutism by modified Ferriman-Gallwey (mFG) score. Evaluation for biochemical HA included total, calculated free and bioavailable testosterone (TT), free testosterone (FT), and bioavailable testosterone (BT), respectively, and dehydroepiandrosterone sulfate. The variables of clinical HA were FPHL, hirsutism, and acne. Results The enrolled young premenopausal women's age range was (14-47 years). Around 78% were overweight or obese women. Eighty-percent of women had a mild FPHL, with a median of three years, where 2/3 of women had a duration <3 years with no significant relationship to FPHL severity. About 73% of women had either a mild to moderate hirsutism, and around 16% had acne. The biochemical HA was confirmed in around 52% of women (n=188), who show high levels of calculated FT. The calculated BT is high in 78.5% of women (n=284). The means of HA's biochemical indicators were in their reference ranges or slightly above, with no specific change pattern with the corresponding FPHL severity. None of these parameters had a significant relationship with the severity of FPHL. The FPHL duration was not affected by any presumed variable of clinical or biochemical HA. Conclusions FPHL severity was associated with other clinical HA signs like hirsutism and acne, but not to HA's biochemical parameter. Other parameters, like sex hormone-binding globulin (SHBG), and BMI, had no significant relation to the FPHL severity.

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Section: Discussionsupporting

confidence: 77%

Section: Figure 1: Flow Chart Of the Inclusion And Exclusion Criteriamentioning

confidence: 99%

Is There Any Association Between Clinical and Biochemical Hyperandrogenism in Women With Female Pattern Hair Loss?

Odhaib¹,

Hamdi²,

Mansour³

2020

Cureus

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“…reported a significantly raised BMI in women with hirsutism, both with and without FPHL, but BMI levels were not raised in non‐hirsute women with FPHL. A study from Turkey found an association between FPHL and insulin resistance that appeared to be independent of hyperandrogenaemia …”

Section: Comorbiditiesmentioning

confidence: 99%

Genetics and other factors in the aetiology of female pattern hair loss

Redler

Messenger

Betz

2017

Experimental Dermatology

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Pattern hair loss is the most common form of hair loss in both women and men. Male pattern hair loss, also termed male androgenetic alopecia (M-AGA), is an androgendependent trait that is predominantly genetically determined. Androgen-mediated mechanisms are probably involved in female pattern hair loss (FPHL) in some women but the evidence is less strong than in M-AGA; other non-androgenic pathways, including environmental influences, may contribute to the aetiology. Genome-wide association studies have identified several genetic loci for M-AGA and have provided better insight into the underlying biology. However, the role of heritable factors in and it has long been assumed that FPHL shares the same aetiology;hence, the term "female androgenetic alopecia" is often applied to this condition. However, the role of androgens in causing FPHL is less clear than in men. The genetic studies performed so far have not led to any firm conclusions but rather suggest different pathways for M-AGA and FPHL.In this review, we summarize what is known about the aetiology of FPHL and its relationship to M-AGA. Our main focus is on the results of genetic studies performed within the last decade. We also discuss the role of endocrine and other factors in the pathogenesis. | PREVALENCEPublished data on the prevalence of FPHL show some variation between studies, perhaps reflecting the difficulty in classifying mild forms of the condition. However, all show an increasing prevalence with age. Studies in women of white European ethnicity in the USA, [2] UK [3] and Australia [4] record a prevalence of 3%-12% in the third decade, rising to 14%-28% in the sixth decade and 29%-56%

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“…Prevalence of insulin resistance in patients with androgenetic alopecia is higher than in the general population matched with regard to sex and age [27,28]. HOMA-IR (Homeostatic Model Assessment of Insulin Resistance) index score, calculated from a blood glucose and insulin concentration determined on an empty stomach, is higher in patients with androgenetic alopecia [27].…”

Section: Insulin Resistancementioning

confidence: 99%

“…Częstość występowania insulinooporności u pacjentów z łysieniem androgenowym jest większa niż w populacji ogólnej dobranej pod względem płci i wieku [27,28]. Wartość wskaźnika insulinooporności HOMA-IR, wyliczanego z oznaczonego na czczo stężenia glukozy i insuliny we krwi, jest wyższa u pacjentów z łysieniem androgenowym [27].…”

Section: Obesityunclassified

Androgenetic alopecia as a cardiovascular risk factor

Wernicka¹,

Wyzgał²,

Waśkiel‐Burnat³

et al. 2018

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Androgenetic alopecia is the most common cause of chronic hair loss. The first reports indicating the relationship between androgenetic alopecia and cardiovascular diseases were published in the 1970s. Epidemiological studies confirmed a more frequent occurrence of ischaemic heart disease, development of atherosclerosis and an increased risk of cardiovascular death in this group of patients. Metabolic syndrome and the presence of its components: arterial hypertension, dyslipidemia, insulin resistance and visceral obesity are more frequent in androgenetic alopecia. The pathomechanism of co-occurring androgenetic alopecia and cardiovascular diseases includes several factors such as genetic (increased sensitivity to androgens and activity of 5α-reductase), hormonal (increased concentration of insulin, aldosterone, leptin) and inflammatory (cytokines, free oxygen radicals). Androgenetic alopecia, especially when it begins before the age of 30, has been identified as an independent cardiovascular risk factor. Women and men with pattern hair loss should be closely monitored for other risk factors to start prophylaxis. streszczenie Łysienie androgenowe stanowi najczęstszą przyczynę utraty włosów u kobiet i mężczyzn. W latach 70. XX wieku pojawiły się pierwsze doniesienia wskazujące na związek łysienia androgenowego z chorobami układu krążenia. Późniejsze badania epidemiologiczne potwierdziły częstsze występowanie w tej grupie pacjentów choroby niedokrwiennej serca, przyspieszony rozwój miażdżycy oraz większe ryzyko zgonu z przyczyn sercowo-naczyniowych. U osób z łysieniem androgenowym częściej stwierdza się zespół metaboliczny oraz obecność jego poszczególnych składowych, takich jak nadciśnienie tętnicze, dyslipidemia, insulinooporność i otyłość trzewna. Patomechanizm współwystępowania łysienia androgenowego i chorób sercowo-naczyniowych jest złożony i obejmuje czynniki genetyczne (zwiększona wrażliwość na androgeny i aktywność 5α-reduktazy), hormonalne (zwiększone stężenie insuliny, aldosteronu, leptyny) oraz zapalne (cytokiny, wolne rodniki tlenowe). Łysienie androgenowe, zwłaszcza rozpoczynające się przed 30. rokiem życia, uznano za niezależny czynnik ryzyka sercowo-naczyniowego. Kobiety i mężczyźni z androgenową utratą włosów powinni być okresowo monitorowani w celu poszukiwania innych czynników ryzyka, aby jak najszybciej rozpocząć działania profilaktyczne.

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The association of androgenetic alopecia and insulin resistance is independent of hyperandrogenemia: A case‐control study

Abstract: 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.

Cited by 5 publications

References 15 publications

Is There Any Association Between Clinical and Biochemical Hyperandrogenism in Women With Female Pattern Hair Loss?

Is There Any Association Between Clinical and Biochemical Hyperandrogenism in Women With Female Pattern Hair Loss?

Genetics and other factors in the aetiology of female pattern hair loss

Androgenetic alopecia as a cardiovascular risk factor

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