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Journal of the American Academy of Dermatology
Volume 63, n° 3
pages 420-429 (septembre 2010)
Doi : 10.1016/j.jaad.2009.10.018
accepted : 4 October 2009
Original Articles

Androgenetic alopecia and cardiovascular risk factors in men and women: A comparative study
 

Salvador Arias-Santiago, MD a, , María Teresa Gutiérrez-Salmerón, PhD a, Luisa Castellote-Caballero, MD b, Agustín Buendía-Eisman, PhD a, Ramón Naranjo-Sintes, PhD a
a Dermatology Unit, San Cecilio University Hospital, Granada, Spain 
b Radiology Unit, San Cecilio University Hospital, Granada, Spain 

Reprint requests: Salvador Arias Santiago, MD, San Cecilio University Hospital, Av Dr. Oloriz 16, Granada, 18012, Spain.
Abstract
Background

Numerous studies in recent decades have associated male androgenetic alopecia (AGA) with the risk of cardiovascular disease. However, only 3 studies have addressed this association in female patients. Most studies considered the risk of myocardial infarction or mortality as a result of heart disease, without analyzing cardiovascular risk factors.

Objectives

The objectives of this study were to analyze the presence of cardiovascular risk factors included in the Adult Treatment Panel-III criteria for metabolic syndrome, the prevalence of carotid atheromatosis, hormonal (aldosterone, insulin, testosterone, and sex hormone–binding globulin) factors, and acute phase reactant (C-reactive protein, fibrinogen, D-dimers, erythrocyte sedimentation rate) variables in male and female patients with AGA and in a control group, and to analyze differences among the groups.

Methods

This case-control study included 154 participants, 77 with early-onset AGA (40 male and 37 female) and 77 healthy control subjects (40 male and 37 female) from the dermatology department at a university hospital in Granada, Spain.

Results

Metabolic syndrome was diagnosed in 60% of male patients with AGA (odds ratio [OR] = 10.5, 95% confidence interval [CI] 3.3-32.5), 48.6% of female patients with AGA (OR = 10.73, 95% CI 2.7-41.2), 12.5% of male control subjects, and 8.1% of female control subjects (P < .0001). Atheromatous plaques were observed in 32.5% of male patients with AGA (OR = 5.93, 95% CI 1.5-22.9) versus 7.5% of male control subjects (P  = .005) and 27% of female patients with AGA (OR = 4.19, 95% CI 1.05-16.7) versus 8.1% of female control subjects (P  = .032). Aldosterone and insulin levels were significantly higher in the male and female patients with AGA versus their respective control subjects. Mean values of fibrinogen were significantly higher in male patients with AGA, whereas values of fibrogen, C-reactive protein, and D-dimers were significantly higher in female patients with AGA versus their respective control subjects.

Limitations

The study of a wider sample of patients with AGA would confirm these findings and allow a detailed analysis of the above factors as a function of the degree of alopecia or between menopausal and premenopausal women.

Conclusion

The determination of metabolic syndrome and ultrasound study of the carotid arteries may be useful screening methods to detect risk of developing cardiovascular disease in male and female patients with early-onset AGA and signal a potential opportunity for early preventive treatment.

The full text of this article is available in PDF format.

Key words : acute phase reactant, atheroma plaque, cardiovascular risk factors, hormonal study, male and female androgenetic alopecia, metabolic syndrome

Abbreviations used : AGA, ATP, BMI, BP, CI, CRP, DHT, HDL-C, HOMA-IR, MS, OR, PCOS, SHBG



 Funding sources: None.
 Conflicts of interest: None declared.



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