Androgenetic alopecia and insulin resistance in young men: Androgenetic alopecia and insulin resistance (original) (raw)

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 ≥ 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.

Figures (3)

Table 1. Demographic and anthropometric values and first-degree family history of the population categorized by obesity and alopecia FH, history ofa first-degree relative; CHD, coronary heart disease. Values given as mean (SD) or % prevalence. *Significant at a P-level of 0-05, ANOVA or x’, between-group differences. +Significant at a P-level of 0:05, ANOVA or y° for trends as appropriate. §Groups 1 and 2 were different from groups 3 and 4 by Bonferroni’s post hoc test. {Group 1 was different from groups 2, 3 and 4. Group 2 was different only from group 1 by Bonferroni’s post hoc t

Table 1. Demographic and anthropometric values and first-degree family history of the population categorized by obesity and alopecia FH, history ofa first-degree relative; CHD, coronary heart disease. Values given as mean (SD) or % prevalence. *Significant at a P-level of 0-05, ANOVA or x’, between-group differences. +Significant at a P-level of 0:05, ANOVA or y° for trends as appropriate. §Groups 1 and 2 were different from groups 3 and 4 by Bonferroni’s post hoc test. {Group 1 was different from groups 2, 3 and 4. Group 2 was different only from group 1 by Bonferroni’s post hoc t

IDF, International Diabetes Federation; RR, relative risk; CI, confidence interval. *y° or Fisher’s exact test to compare groups 1 and 2, or groups 3 and 4. +Not carried out because none of them were free of metabolic syndrome features. Table 3. Metabolic syndrome expression by cases and controls

IDF, International Diabetes Federation; RR, relative risk; CI, confidence interval. *y° or Fisher’s exact test to compare groups 1 and 2, or groups 3 and 4. +Not carried out because none of them were free of metabolic syndrome features. Table 3. Metabolic syndrome expression by cases and controls

Loading...

Loading Preview

Sorry, preview is currently unavailable. You can download the paper by clicking the button above.

References (36)

  1. Paus, R. & Cotsarelis, G. (1999) The biology of hair follicles. New England Journal of Medicine, 341, 491-497.
  2. Zouboulis, C.C., Chen, W.C., Thornton, M.J. et al. (2007) Sexual hormones in human skin. Hormone and Metabolic Research, 39, 85- 95.
  3. Ohnemus, U., Uenalan, M., Inzunza, J. et al. (2006) The hair follicle as an estrogen target and source. Endocrine Reviews, 27, 677-706.
  4. Ohnemus, U., Uenalan, M., Conrad, F. et al. (2005) Hair cycle control by estrogens: catagen induction via estrogen receptor (ER)-alpha is checked by ER beta signaling. Endocrinology, 146, 1214-1225.
  5. Labrie, F., Luu-The, V., Labrie, C. et al. (2000) Intracrinology and the skin. Hormone Research, 54, 218-229.
  6. Otberg, N., Finner, A.M. & Shapiro, J. (2007) Androgenetic alopecia. Endocrinology and Metabolism Clinics of North America, 36, 379-398.
  7. Chumlea, W.C., Rhodes, T., Girman, C.J. et al. (2004) Family history and risk of hair loss. Dermatology, 209, 33-39.
  8. Hoffmann, R. & Happle, R. (2000) Current understanding of androgenetic alopecia. Part I: Etiopathogenesis. European Journal of Dermatology, 10, 319-327.
  9. 9 Tosti, A., Piraccini, B.M., Iorizzo, M. et al. (2005) The natural history of androgenetic alopecia. Journal of Cosmetic Dermatology, 4, 41- 43.
  10. Rebora, A. (2004) Pathogenesis of androgenetic alopecia. Journal of the American Academy of Dermatology, 50, 777-779.
  11. Severi, G., Sinclair, R., Hopper, J.L. et al. (2003) Androgenetic alopecia in men aged 40-69 years: prevalence and risk factors. British Journal of Dermatology, 149, 1207-1213.
  12. Su, L.H. & Chen, T.H. (2007) Association of androgenetic alopecia with smoking and its prevalence among Asian men: a community- based survey. Archives of Dermatology, 143, 1401-1406.
  13. Chen, W., Yang, C.C., Chen, G.Y. et al. (2004) Patients with a large prostate show a higher prevalence of androgenetic alopecia. Archives of Dermatological Research, 296, 245-249.
  14. Giles, G.G., Severi, G., Sinclair, R. et al. (2002) Androgenetic alopecia and prostate cancer: findings from an Australian case-control study. Cancer Epidemiology Biomarkers and Prevention, 11, 549- 553.
  15. Matilainen, V.A., Makinen, P.K. & Keinanen-Kiukaanniemi, S.M. (2001) Early onset of androgenetic alopecia associated with early severe coronary heart disease: a population-based, case-control study. Journal of Cardiovascular Risk, 8, 147-151.
  16. Sasmaz, S., Senol, M., Ozcan, A. et al. (1999) The risk of coronary heart disease in men with androgenetic alopecia. Journal of the European Academy of Dermatology and Venereology, 12, 123-125.
  17. Rebora, A. (2001) Baldness and coronary artery disease: the derma- tologic point of view of a controversial issue. Archives of Dermatology, 137, 943-947.
  18. Ahouansou, S., Le Toumelin, P., Crickx, B. et al. (2007) Association of androgenetic alopecia and hypertension. European Journal of Dermatology, 17, 220-222.
  19. Hirsso, P., Laakso, M., Matilainen, V. et al. (2006) Association of insulin resistance linked diseases and hair loss in elderly men. Finnish population-based study. Central European Journal of Public Health, 14, 78-81.
  20. Hirsso, P., Rajala, U., Hiltunen, L. et al. (2007) Obesity and low-grade inflammation among young Finnish men with early-onset alopecia. Dermatology, 214, 125-129.
  21. Hirsso, P., Rajala, U., Laakso, M. et al. (2005) Health-related quality of life and physical well-being among a 63-year-old cohort of women with androgenetic alopecia; a Finnish population-based study. Health and Quality of Life Outcomes, 3, 49.
  22. Kashyap, S.R. & Defronzo, R.A. (2007) The insulin resistance syndrome: physiological considerations. Diabetes and Vascular Disease Research, 4, 13-19.
  23. Nishimura, M., Tokoro, T., Nishida, M. et al. (2008) Association of insulin resistance with de novo coronary stenosis after percutaneous coronary artery intervention in hemodialysis patients. Nephron Clinical Practice, 109, c9-c17.
  24. Lautt, W.W. (2007) Postprandial insulin resistance as an early predictor of cardiovascular risk. Therapeutics and Clinical Risk Management, 3, 761-770.
  25. Sourij, H., Schmoelzer, I., Dittrich, P. et al. (2008) Insulin resistance as a risk factor for carotid atherosclerosis: a comparison of the Homeostasis Model Assessment and the short insulin tolerance test. Stroke, 39, 1349-1351.
  26. Kurzrock, R. & Cohen, P.R. (2007) Polycystic ovary syndrome in men: Stein-Leventhal syndrome revisited. Medical Hypotheses, 68, 480-483.
  27. Matilainen, V., Koskela, P. & Keinanen-Kiukaanniemi, S. (2000) Early androgenetic alopecia as a marker of insulin resistance. Lancet, 356, 1165-1166.
  28. Norwood, O.T. (1975) Male pattern baldness: classification and incidence. Southern Medical Journal, 68, 1359-1365.
  29. Matthews, D.R., Hosker, J.P., Rudenski, A.S. et al. (1985) Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia, 28, 412-419.
  30. Hanley, A.J., Williams, K., Stern, M.P. et al. (2002) Homeostasis model assessment of insulin resistance in relation to the incidence of cardiovascular disease: the San Antonio Heart Study. Diabetes Care, 25, 1177-1184.
  31. Alberti, K.G., Zimmet, P. & Shaw, J. (2006) Metabolic syndrome - a new world-wide definition. A Consensus Statement from the International Diabetes Federation. Diabetic Medicine, 23, 469- 480.
  32. Grossmann, M., Thomas, M.C., Panagiotopoulos, S. et al. (2008) Low testosterone levels are common and associated with insulin resistance in men with diabetes. Journal of Clinical Endocrinology and Metabolism, 93, 1834-1840.
  33. Kupelian, V., Page, S.T., Araujo, A.B. et al. (2006) Low sex hormone- binding globulin, total testosterone, and symptomatic androgen deficiency are associated with development of the metabolic syndrome in nonobese men. Journal of Clinical Endocrinology and Metabolism, 91, 843-850.
  34. Kupelian, V., Hayes, F.J., Link, C.L. et al. (2008) Inverse association of testosterone and the metabolic syndrome in men is consistent across race and ethnic groups. Journal of Clinical Endocrinology and Metabolism, 93, 3403-3410.
  35. Starka, L., Duskova, M., Cermakova, I. et al. (2005) Premature androgenic alopecia and insulin resistance. Male equivalent of polycystic ovary syndrome? Endocrine Regulations, 39, 127-131.
  36. Yilmaz, M., Bukan, N., Ersoy, R. et al. (2005) Glucose intolerance, insulin resistance and cardiovascular risk factors in first degree relatives of women with polycystic ovary syndrome. Human Reproduction, 20, 2414-2420.