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Cuevas-Diaz Duran R, Martinez-Ledesma E, Garcia-Garcia M, Bajo Gauzin D, Sarro-Ramírez A, Gonzalez-Carrillo C, Rodríguez-Sardin D, Fuentes A, Cardenas-Lopez A. The Biology and Genomics of Human Hair Follicles: A Focus on Androgenetic Alopecia. Int J Mol Sci 2024; 25:2542. [PMID: 38473791 DOI: 10.3390/ijms25052542] [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: 01/16/2024] [Revised: 02/16/2024] [Accepted: 02/18/2024] [Indexed: 03/14/2024] Open
Abstract
Androgenetic alopecia is a highly prevalent condition mainly affecting men. This complex trait is related to aging and genetics; however, multiple other factors, for example, lifestyle, are also involved. Despite its prevalence, the underlying biology of androgenetic alopecia remains elusive, and thus advances in its treatment have been hindered. Herein, we review the functional anatomy of hair follicles and the cell signaling events that play a role in follicle cycling. We also discuss the pathology of androgenetic alopecia and the known molecular mechanisms underlying this condition. Additionally, we describe studies comparing the transcriptional differences in hair follicles between balding and non-balding scalp regions. Given the genetic contribution, we also discuss the most significant risk variants found to be associated with androgenetic alopecia. A more comprehensive understanding of this pathology may be generated through using multi-omics approaches.
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Affiliation(s)
- Raquel Cuevas-Diaz Duran
- Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey 64710, NL, Mexico
- CapilarFix®, Monterrey 66220, NL, Mexico
| | - Emmanuel Martinez-Ledesma
- Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey 64710, NL, Mexico
- Tecnologico de Monterrey, Institute for Obesity Research, Monterrey 64849, NL, Mexico
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Peng H, Mao C, Zhang J, Wang F, Jiang H, Zhang Y, Zhu Z, Zhong C, Xu F, Liu CF, Zhang Y. Cohort Profile: Heart and Brain Investigation in Taicang (HABIT) study. Int J Epidemiol 2024; 53:dyad192. [PMID: 38205861 DOI: 10.1093/ije/dyad192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Accepted: 12/27/2023] [Indexed: 01/12/2024] Open
Affiliation(s)
- Hao Peng
- Department of Epidemiology, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, Suzhou, China
| | - Chengjie Mao
- Department of Neurology and Clinical Research Center of Neurological Disease, Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Jianan Zhang
- Department of Chronic Disease, Taicang Center of Disease Prevention and Control, Suzhou, China
| | - Fenchun Wang
- Department of Chronic Disease, Taicang Center of Disease Prevention and Control, Suzhou, China
| | - Hai Jiang
- Department of Chronic Disease, Taicang Center of Disease Prevention and Control, Suzhou, China
| | - Yingchun Zhang
- Department of Ultrasound, Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Zhengbao Zhu
- Department of Epidemiology, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, Suzhou, China
| | - Chongke Zhong
- Department of Epidemiology, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, Suzhou, China
| | - Feng Xu
- Department of Chronic Disease, Taicang Center of Disease Prevention and Control, Suzhou, China
| | - Chun-Feng Liu
- Department of Neurology and Clinical Research Center of Neurological Disease, Second Affiliated Hospital of Soochow University, Suzhou, China
- Institutes of Neuroscience, Soochow University, Suzhou, China
| | - Yonghong Zhang
- Department of Epidemiology, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, Suzhou, China
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Karasu YÖ, Orbak R, Kaşalı K, Berker E, Kantarci A. Association between androgenetic alopecia and periodontitis. J Periodontal Res 2023; 58:1105-1111. [PMID: 37571914 DOI: 10.1111/jre.13175] [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: 04/21/2023] [Revised: 08/01/2023] [Accepted: 08/03/2023] [Indexed: 08/13/2023]
Abstract
AIM Androgenic alopecia (AGA) is men's most common form of hair loss. It is affected by changes in the expression and activity of 5αR and the metabolism of testosterone and DHT. There is an association between AGA and systemic inflammatory diseases. We hypothesized that there is an association between AGA and periodontal disease, as inflamed gingiva and periodontal fibroblasts have been shown to express more 5αR. Thus, this study aimed to evaluate the relationship between periodontal disease and AGA and the potential effect of aging on this association. MATERIALS AND METHODS Out of a cohort of 1088 individuals, 385 white males aged 25-65 with similar socioeconomic levels and without systemic disease were included. Periodontitis was defined using NHANES data. AGA was evaluated using the Norwood-Hamilton scale. The relationship between AGA, periodontal disease severity, and age was assessed. RESULTS There was a correlation between age and baldness (r = .421, p < .001). There was a significant correlation between AGA and periodontal disease in younger patients aged 25-34 and 35-44. (p < .042 and p < .036, respectively). There was no significant correlation between AGA and periodontal disease in the 45-54 and 55-65 age groups (p > .05). CONCLUSION There may be a relationship between periodontal disease and AGA in the 25-44 age range, suggesting that this association starts at an early age in adulthood.
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Affiliation(s)
- Yerda Özkan Karasu
- The Forsyth Institute, Cambridge, Massachusetts, USA
- Department of Periodontology, Faculty of Dentistry, Ataturk University, Erzurum, Turkey
| | - Recep Orbak
- Department of Periodontology, Faculty of Dentistry, Ataturk University, Erzurum, Turkey
| | - Kamber Kaşalı
- Department of Biostatistics, Faculty of Medicine, Ataturk University, Erzurum, Turkey
| | - Ezel Berker
- Department of Periodontology, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
| | - Alpdogan Kantarci
- The Forsyth Institute, Cambridge, Massachusetts, USA
- School of Dental Medicine, Harvard University, Boston, Massachusetts, USA
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Henne SK, Nöthen MM, Heilmann-Heimbach S. Male-pattern hair loss: Comprehensive identification of the associated genes as a basis for understanding pathophysiology. MED GENET-BERLIN 2023; 35:3-14. [PMID: 38835416 PMCID: PMC10842561 DOI: 10.1515/medgen-2023-2003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2024]
Abstract
Male-pattern hair loss (MPHL) is a highly heritable and prevalent condition that is characterized by progressive hair loss from the frontotemporal and vertex scalp. This androgen-dependent hair loss may commence during puberty, and up to 80 % of European men experience some degree of MPHL during their lifetime. Current treatment options for MPHL have limited efficacy, and improved understanding of the underlying biological causes is required to facilitate novel therapeutic approaches. To date, molecular genetic studies have identified 389 associated genomic regions, have implicated numerous genes in these regions, and suggested pathways that are likely to contribute to key pathophysiological mechanisms in MPHL. This review provides an overview of the current status of MPHL genetic research. We discuss the most significant achievements, current challenges, and anticipated developments in the field, as well as their potential to advance our understanding of hair (loss) biology, and to improve hair loss prediction and treatment.
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Affiliation(s)
- Sabrina K Henne
- University Hospital of Bonn & University of Bonn Institute of Human Genetics Bonn Germany
| | - Markus M Nöthen
- University Hospital of Bonn & University of Bonn Institute of Human Genetics Bonn Germany
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Sözen M, Baldane S, Abusoglu S, Kebapcılar L, Kebapcılar A, Tunçez Akyürek F, Ünlü A, İpekci SH. A study on relationship between androgenetic alopecia and cardiovascular risk using high sensitivity C-reactive protein and galectin-3 in men with early onset baldness. Biomarkers 2021; 27:71-78. [PMID: 34852684 DOI: 10.1080/1354750x.2021.2013539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE In this study, the objective was to evaluate the cardiovascular and metabolic effects in men with male pattern alopecia beginning before 30 years of age. METHODS Total of 81 people (41 androgenetic alopecia (AGA) and 40 healthy individuals) were included in the study. Twenty-four-hour ambulatory blood pressure (ABP) measurement, high sensitive C-reactive protein (hsCRP), galectin-3 were studied. Hamilton-Norwood scale (HNS) was used to determine the AGA types of the cases. RESULTS The mean age in the AGA and control groups was 30.3 ± 7.5 and 30.8 ± 6.0, respectively. Twenty-four-hour ABP measurements, hsCRP, and galectin-3 were similar in both groups. There was a positive correlation between HNS grade with age, BMI, triglyceride levels and fasting blood glucose levels in individuals with AGA. Similarly, there was a positive correlation between HNS grade with daytime pulse wave velocity and night-time reflection magnitude. A significant positive correlation was determined between hsCRP with BMI and waist circumference, and between galectin-3 with BMI, waist circumference, hip circumference, HOMA-IR in individuals with AGA. CONCLUSIONS This study shows that AGA patients are similar to the normal population in terms of insulin resistance or metabolic syndrome components. However, hsCRP and galectin-3 appear to be associated with cardiovascular disease risk factors in individuals with AGA.
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Affiliation(s)
- Mehmet Sözen
- Department of Internal Medicine, Selcuk University Faculty of Medicine, Konya, Turkey
| | - Süleyman Baldane
- Department Endocrinology and Metabolism, Selcuk University Faculty of Medicine, Konya, Turkey
| | - Sedat Abusoglu
- Department of Biochemistry, Selcuk University Faculty of Medicine, Konya, Turkey
| | - Levent Kebapcılar
- Department Endocrinology and Metabolism, Selcuk University Faculty of Medicine, Konya, Turkey
| | - Ayşegül Kebapcılar
- Department of Obstetrics and Gynecology, Selcuk University Faculty of Medicine, Konya, Turkey
| | | | - Ali Ünlü
- Department of Biochemistry, Selcuk University Faculty of Medicine, Konya, Turkey
| | - Süleyman Hilmi İpekci
- Department Endocrinology and Metabolism, Selcuk University Faculty of Medicine, Konya, Turkey
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Wang YX, Chen XW, Wang SB, Gu LF, Li YF, Ma Y, Wang H, Wang LS. Association Between Androgenic Alopecia and Coronary Artery Disease: A Cross-Sectional Study of Han Chinese Male Population. Int J Gen Med 2021; 14:4809-4818. [PMID: 34475775 PMCID: PMC8406423 DOI: 10.2147/ijgm.s326812] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Accepted: 08/13/2021] [Indexed: 12/17/2022] Open
Abstract
Purpose This research aimed to investigate the correlation between androgenic alopecia (AGA) and coronary artery disease (CAD) and analyze its value in predicting the severity of coronary atherosclerosis in the Han Chinese male population. Patients and Methods A total of 402 Han Chinese male patients aged 28-75 years were enrolled and performed coronary angiography (CAG) after admission. According to the BASP classification, the participants were divided into mild, moderate and severe AGA. CAD was determined via CAG and defined as stenosis of ≥50% in at least one major coronary artery, and the Gensini score was calculated to evaluate the severity of coronary atherosclerosis. Results In this study, CAD status (P = 0.002), dyslipidemia status (P = 0.002), age (P = 0.003) and coronary atherosclerosis severity (P < 0.001) were different in patients with different levels of AGA. Multivariate logistic regression analysis revealed that severe AGA was independently correlated to CAD risk (OR, 2.111; 95% CI 1.152 to 3.870, P = 0.016), while the relative CAD risk of early-onset AGA was 2.292 (OR, 2.292; 95% CI 1.132 to 4.640, P = 0.021). AGA status (OR, 2.247; 95% CI 1.396 to 3.617, P = 0.001), severe AGA (OR, 2.360; 95% CI 1.506 to 3.699, P < 0.001) and early-onset AGA (OR, 3.474; 95% CI 2.069 to 5.832, P < 0.001) were all independently associated with the severity of coronary atherosclerosis. The area under the receiver operating characteristic (ROC) curve plotted using severe AGA was 0.601, which is predictive of severe coronary atherosclerosis. Moreover, the presence of severe AGA increases the risk of developing CAD associated with obesity (SI = 1.663, SIM = 1.222, AP = 0.289), diabetes (SI = 2.239, SIM = 1.149, AP = 0.503) and dyslipidemia (SI = 1.062, SIM = 0.646, AP = 0.045). Conclusion This study suggested that AGA is independently associated with CAD in a Han Chinese male population. AGA may be a simple and feasible method for screening CAD and indicative of the severity of coronary atherosclerosis.
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Affiliation(s)
- Ya-Xin Wang
- Department of Cardiology, Jiangsu Province People's Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, 210029, People's Republic of China
| | - Xiao-Wen Chen
- Department of Cardiology, Jiangsu Province People's Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, 210029, People's Republic of China
| | - Si-Bo Wang
- Department of Cardiology, Jiangsu Province People's Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, 210029, People's Republic of China
| | - Ling-Feng Gu
- Department of Cardiology, Jiangsu Province People's Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, 210029, People's Republic of China
| | - Ya-Fei Li
- Department of Cardiology, Jiangsu Province People's Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, 210029, People's Republic of China
| | - Yao Ma
- Department of Cardiology, Jiangsu Province People's Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, 210029, People's Republic of China
| | - Hao Wang
- Department of Cardiology, Jiangsu Province People's Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, 210029, People's Republic of China
| | - Lian-Sheng Wang
- Department of Cardiology, Jiangsu Province People's Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, 210029, People's Republic of China
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Aversa A, La Vignera S, Rago R, Gambineri A, Nappi RE, Calogero AE, Ferlin A. Fundamental Concepts and Novel Aspects of Polycystic Ovarian Syndrome: Expert Consensus Resolutions. Front Endocrinol (Lausanne) 2021. [PMID: 32849300 DOI: 10.3389/fendo.2020.00516.pmid:32849300;pmcid:pmc7431619] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/24/2023] Open
Abstract
Polycystic ovary syndrome (PCOS) is a very common endocrine and metabolic disorder with the involvement of both genetic and environmental factors. Although much has been clarified on its pathogenesis, diagnosis, clinical manifestations, and therapy, there are still areas of uncertainty. To address fundamental concepts, novel aspects and hypotheses, and future perspectives, including the possible additional benefits of treatment with nutraceuticals, an expert consensus panel formed by endocrinologists and gynecologists was established. After an independent review of the literature, the panel convened electronically on February 3, 2020, and six resolutions were created, debated, and agreed upon discussion, and finally approved in their final form in a consensus livestream meeting held on April 15. The summary of the resolutions are: (1) PCOS is a well-established medical condition that negatively affects reproduction, general health, sexual health, and quality of life; (2) the symptoms and signs of PCOS appear early in life especially in female newborns from PCOS carriers; (3) women with PCOS have significantly increased risk of pregnancy-related complications including gestational diabetes mellitus; (4) a male PCOS equivalent exists, and it may impact on metabolic health and probably on reproduction; (5) the evidence supports that medical therapy for PCOS is effective, rational, and evidence-based; (6) the evidence supports a major research initiative to explore possible benefits of nutraceutical therapy for PCOS. The proposed resolutions may be regarded as points of agreement based on the current scientific evidence available.
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Affiliation(s)
- Antonio Aversa
- Department of Experimental and Clinical Medicine, University "Magna Graecia", Catanzaro, Italy
| | - Sandro La Vignera
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Rocco Rago
- Physiopathology of Reproduction and Andrology Unit, Sandro Pertini Hospital, Rome, Italy
| | - Alessandra Gambineri
- Department of Medical and Surgical Science, University Alma Mater Studiorum, Bologna, Italy
| | - Rossella E Nappi
- Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause, IRCCS San Matteo Foundation, University of Pavia, Pavia, Italy
| | - Aldo E Calogero
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Alberto Ferlin
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
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Ata Korkmaz HA. Relationship between androgenic alopecia and white matter hyperintensities in apparently healthy subjects. Brain Imaging Behav 2021; 14:527-533. [PMID: 31250269 DOI: 10.1007/s11682-019-00147-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
A healthy brain is essential for living a longer and fuller life. Detecting asymptomatic white matter hyperintensities (WMHs) may be clinically important in terms of treatment and prognostic evaluation. WMHs in brain may reflect brain aging. Androgenic alopecia (AGA) is associated with significant cardiovascular risk factors that also have a negative impact on brain aging. The main purpose of present study was to know whether alopecia might provide predictive information of WMHs that may be considered as a surrogate marker of cerebral small vessel disease which is related to arteriolosclerosis and vascular risk factors. From January 2017 to March 2018, 256 cases were enrolled consecutively. Patients under 18 years old, older than 90 years old, known to be affected by neurodegenerative diseases, demyelinating disorders or stroke and/or a brain tumor, were excluded from the study. A 4-point cerebral white matter Magnetic Resonance Imaging (MRI) hyperintensities scoring system, the Fazekas scale, was used to evaluate brain aging. Presence of AGA was evaluated with inspection according to Hamilton-Norwood classification system (grade I to VII). Two hundred eleven (82%) of individuals had mild alopecia (grade I, II, III), 28 (11%) had moderate alopecia (grade IV, V) and 17 (7%) had severe alopecia (grade VI, VII). Frequency of abnormal WMHs was significantly higher in patients with AGA compared to the without AGA. Hypertension (HT) (95% confidence interval [CI]: 1.873-9.487, p < 0.001) and the AGA (95% CI: 2.989-12.916, p < 0.0001) were independent determinants of abnormal WMHs. AGA may be regarded as a surrogate marker of asymptomatic WMHs which is related to arteriolosclerosis and vascular risk factors that has a significant impact on people's life.
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Affiliation(s)
- Hatice Ayca Ata Korkmaz
- Department of Radiology, University of Health Science, Kanuni Research and Education Hospital, Trabzon, Turkey.
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Cannarella R, Condorelli RA, Barbagallo F, La Vignera S, Calogero AE. Endocrinology of the Aging Prostate: Current Concepts. Front Endocrinol (Lausanne) 2021; 12:554078. [PMID: 33692752 PMCID: PMC7939072 DOI: 10.3389/fendo.2021.554078] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 01/05/2021] [Indexed: 12/11/2022] Open
Abstract
Benign prostate hyperplasia (BPH), one of the most common diseases in older men, adversely affects quality-of-life due to the presence of low urinary tract symptoms (LUTS). Numerous data support the presence of an association between BPH-related LUTS (BPH-LUTS) and metabolic syndrome (MetS). Whether hormonal changes occurring in MetS play a role in the pathogenesis of BPH-LUTS is a debated issue. Therefore, this article aimed to systematically review the impact of hormonal changes that occur during aging on the prostate, including the role of sex hormones, insulin-like growth factor 1, thyroid hormones, and insulin. The possible explanatory mechanisms of the association between BPH-LUTS and MetS are also discussed. In particular, the presence of a male polycystic ovarian syndrome (PCOS)-equivalent may represent a possible hypothesis to support this link. Male PCOS-equivalent has been defined as an endocrine syndrome with a metabolic background, which predisposes to the development of type II diabetes mellitus, cardiovascular diseases, prostate cancer, BPH and prostatitis in old age. Its early identification would help prevent the onset of these long-term complications.
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CLOUDED LEOPARD ( NEOFELIS NEBULOSA) MORBIDITY AND MORTALITY IN CAPTIVE-BRED POPULATIONS: A COMPREHENSIVE RETROSPECTIVE STUDY OF MEDICAL DATA FROM 271 INDIVIDUALS IN EUROPEAN, ASIAN, AND AUSTRALIAN ZOOS. J Zoo Wildl Med 2020; 51:150-158. [PMID: 32212558 DOI: 10.1638/2019-0048] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/04/2019] [Indexed: 11/21/2022] Open
Abstract
The clouded leopard (Neofelis nebulosa) is classified as vulnerable on the International Union for the Conservation of Nature Red List of Threatened Species. However, diseases affecting this species across zoo populations are not well documented. The primary objective of this retrospective study was to identify common and significant causes of morbidity and mortality in captive-bred clouded leopards from European, Asian, and Australian institutions. Medical records from 44 zoological parks that held 271 clouded leopards from 1934 to 2017 were reviewed. Major causes of mortality in the dead leopards (n = 141) were respiratory disease (17%), maternal neglect and starvation (12%), generalized infectious disease (10%), digestive disease (10%), and trauma (10%). Six animals lived more than 20 yr and two were older than 22 yr. Diseases were recorded 344 times (average of two per leopard) in 166 living leopards. The body systems most frequently affected by disease in these 166 individuals were, in order of frequency, integumentary (prevalence = 21%), digestive (21%), respiratory (16%), musculoskeletal (12%), and urinary (10%) systems. Neoplasia (7%) was less frequent, followed by cardiovascular (5%), genital (3%), and viral (3%) disorders. Extensive, self-induced alopecia on the tail and dorsum was the most frequently reported dermatological disease, which is proposed to be called the "clouded leopard alopecia syndrome." The most common neoplasm was pheochromocytoma (1%), followed by squamous cell carcinoma of the paw pads, pleural mesothelioma and multicentric lymphomas (<1% each). Dilated cardiomyopathy (2%) was the most common cardiovascular disease. Bronchopneumonia (7%), enteritis (4%), and nephritis (4%) were the most frequently reported respiratory, digestive, and renal diseases, respectively. Diagnosed disease incidence was significantly higher in Europe. This paper reports the results of a comprehensive study of the causes of morbidity and mortality in European, Asian, and Australian clouded leopard zoo populations.
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Danesh-Shakiba M, Poorolajal J, Alirezaei P. Androgenetic Alopecia: Relationship to Anthropometric Indices, Blood Pressure and Life-Style Habits. Clin Cosmet Investig Dermatol 2020; 13:137-143. [PMID: 32104040 PMCID: PMC7008189 DOI: 10.2147/ccid.s231940] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2019] [Accepted: 01/20/2020] [Indexed: 11/30/2022]
Abstract
Purpose The association of androgenetic alopecia (AGA) with cardiovascular risk factors including hypertension, smoking and high body mass index (BMI) has been investigated in several studies. However, the results are discrepant. The aim of the present study was to evaluate the association of AGA with anthropometrics, blood pressure and lifestyle habits. Patients and Methods In this case-control study, 256 men with AGA and 256 age-matched healthy controls were evaluated. Systolic and diastolic blood pressures, as well as anthropometric indices were measured. Data on lifestyle habits including smoking, hookah use and alcohol consumption were also collected. Results Patients with AGA had significantly lower BMI and lower waist to hip ratio as compared to controls (p = 0.012 and p = 0.002, respectively). Other anthropometrics as well as mean systolic and diastolic blood pressures were not significantly different between the two groups. There was no significant difference between patients and controls in terms of lifestyle habits. Patients with severe AGA (Norwood-Hamilton classification type IV-VII) had significantly higher systolic and diastolic blood pressures as compared to those with mild to moderate AGA (Norwood-Hamilton classification type II, III), but the mean age of the former group was also significantly higher (p < 0.001). Conclusion In contrast to some previous studies, our findings did not show a significant association between certain cardiovascular risk factors (such as hypertension and smoking) and AGA. Although lower BMI and lower waist to hip ratio were observed in the patient group, these values were within normal limits and therefore not biologically significant.
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Affiliation(s)
| | - Jalal Poorolajal
- Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran.,Modeling of Noncommunicable Diseases Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Pedram Alirezaei
- Psoriasis Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
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12
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Aversa A, La Vignera S, Rago R, Gambineri A, Nappi RE, Calogero AE, Ferlin A. Fundamental Concepts and Novel Aspects of Polycystic Ovarian Syndrome: Expert Consensus Resolutions. Front Endocrinol (Lausanne) 2020; 11:516. [PMID: 32849300 PMCID: PMC7431619 DOI: 10.3389/fendo.2020.00516] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 06/26/2020] [Indexed: 12/24/2022] Open
Abstract
Polycystic ovary syndrome (PCOS) is a very common endocrine and metabolic disorder with the involvement of both genetic and environmental factors. Although much has been clarified on its pathogenesis, diagnosis, clinical manifestations, and therapy, there are still areas of uncertainty. To address fundamental concepts, novel aspects and hypotheses, and future perspectives, including the possible additional benefits of treatment with nutraceuticals, an expert consensus panel formed by endocrinologists and gynecologists was established. After an independent review of the literature, the panel convened electronically on February 3, 2020, and six resolutions were created, debated, and agreed upon discussion, and finally approved in their final form in a consensus livestream meeting held on April 15. The summary of the resolutions are: (1) PCOS is a well-established medical condition that negatively affects reproduction, general health, sexual health, and quality of life; (2) the symptoms and signs of PCOS appear early in life especially in female newborns from PCOS carriers; (3) women with PCOS have significantly increased risk of pregnancy-related complications including gestational diabetes mellitus; (4) a male PCOS equivalent exists, and it may impact on metabolic health and probably on reproduction; (5) the evidence supports that medical therapy for PCOS is effective, rational, and evidence-based; (6) the evidence supports a major research initiative to explore possible benefits of nutraceutical therapy for PCOS. The proposed resolutions may be regarded as points of agreement based on the current scientific evidence available.
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Affiliation(s)
- Antonio Aversa
- Department of Experimental and Clinical Medicine, University “Magna Graecia”, Catanzaro, Italy
| | - Sandro La Vignera
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Rocco Rago
- Physiopathology of Reproduction and Andrology Unit, Sandro Pertini Hospital, Rome, Italy
| | - Alessandra Gambineri
- Department of Medical and Surgical Science, University Alma Mater Studiorum, Bologna, Italy
| | - Rossella E. Nappi
- Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause, IRCCS San Matteo Foundation, University of Pavia, Pavia, Italy
| | - Aldo E. Calogero
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Alberto Ferlin
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
- *Correspondence: Alberto Ferlin
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Pechlivanis S, Heilmann-Heimbach S, Erbel R, Mahabadi AA, Hochfeld LM, Jöckel KH, Nöthen MM, Moebus S. Male-pattern baldness and incident coronary heart disease and risk factors in the Heinz Nixdorf Recall Study. PLoS One 2019; 14:e0225521. [PMID: 31743359 PMCID: PMC6863534 DOI: 10.1371/journal.pone.0225521] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Accepted: 11/06/2019] [Indexed: 12/14/2022] Open
Abstract
Male-pattern baldness (MPB) is characterized by a progressive hair loss from the frontal and vertex scalp that affects about 80% of men at the age of 80 years. Epidemiological studies show positive associations between MPB and coronary heart disease (CHD) and CHD related risk factors such as blood pressure (BP), diabetes mellitus (DM) or elevated blood lipid levels. The results however vary with regard to the pattern of hair loss (i.e. moderate, severe, frontal or vertex). Further, no study has investigated for a shared genetic determinant between MPB and CHD as well as CHD related risk factors. Using the longitudinal data from the population-based Heinz Nixdorf Recall study we aimed to systematically investigate the association between MPB and incident CHD and CHD risk factors on (i) an epidemiological (N = 1,673 males) and (ii) a genetic (N = 1,357 males) level. The prevalence of any baldness in our study population was 88% (mean age ± SD: 64±7.5 years). Compared to men with ‘no baldness’, in men with any kind of baldness a slightly increased risk for CHD (Hazard ratio [95% confidence interval (95%CI)] = 1.2 [0.8; 1.9]), a slightly higher extend of coronary artery calcification (CAC) (Beta [95%CI] = 0.2 [-0.1; 0.6]), a moderately increased risk for DM (prevalence ratio [95%CI] = 1.4 [0.9; 2.0]) and higher body mass index (BMI) (Beta [95%CI] = 0.6 [0.00003; 1.2]) seem to be indicated in the adjusted model. In contrast, the MPB genetic risk score did not show any association with CHD or CHD risk factors. Taken together, the results of our study suggest a weak association between MPB and a few CHD risk factors (CAC, DM and BMI) but do not point to MPB as a strong surrogate measure for CHD and CHD risk factors in general.
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Affiliation(s)
- Sonali Pechlivanis
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital Essen, Essen, Germany
- * E-mail: (SP); (SHH)
| | - Stefanie Heilmann-Heimbach
- Institute of Human Genetics, University of Bonn, Bonn, Germany
- Department of Genomics, Life & Brain GmbH, University of Bonn, Bonn, Germany
- * E-mail: (SP); (SHH)
| | - Raimund Erbel
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital Essen, Essen, Germany
| | - Amir A. Mahabadi
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center, University Hospital Essen, Essen, Germany
| | - Lara M. Hochfeld
- Institute of Human Genetics, University of Bonn, Bonn, Germany
- Department of Genomics, Life & Brain GmbH, University of Bonn, Bonn, Germany
| | - Karl-Heinz Jöckel
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital Essen, Essen, Germany
| | - Markus M. Nöthen
- Institute of Human Genetics, University of Bonn, Bonn, Germany
- Department of Genomics, Life & Brain GmbH, University of Bonn, Bonn, Germany
| | - Susanne Moebus
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital Essen, Essen, Germany
- Centre for Urbane Epidemiology, University Hospital Essen, Essen, Germany
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Di Guardo F, Cerana MC, D'urso G, Genovese F, Palumbo M. Male PCOS equivalent and nutritional restriction: Are we stepping forward? Med Hypotheses 2019; 126:1-3. [PMID: 31010486 DOI: 10.1016/j.mehy.2019.03.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 02/17/2019] [Accepted: 03/04/2019] [Indexed: 01/30/2023]
Abstract
Polycystic ovarian syndrome (PCOS) is an endocrine disorder characterized by alteration of menses, polycystic ovaries, clinical and or biochemical signs of hyper-androgenism in the context of metabolic abnormalities such as obesity and insulin resistance that play a fundamental role in pathogenesis of the disease as well as in development of long-term complications including cardiovascular disease (CVD) and type II diabetes mellitus (DM II). Latest evidence supports the hypothesis of a genetic component in the aetiology of PCOS that seems to be inherited through an oligo-genic mechanism and cluster in families. Recent studies identified the existence of a male PCOS correspondent syndrome in which the genes responsible for PCOS susceptibility in women may be inherited by male relatives of women with PCOS. The same hormonal, clinical and metabolic alterations of women with PCOS have been found in their male relatives suggesting a relation between the syndrome in its male equivalent. Considering clinical manifestations of male PCOS equivalent, the early onset andro-genetic alopecia (AGA) is considered a clinical marker of insulin resistance, supported by the findings of a case-control study that reported an increased prevalence of hyperinsulinemia and insulin-resistance-associated disorders such as dyslipidaemia, hypertension and obesity, in men with early onset of alopecia (<35), compared with age-matched controls. Moreover, AGA and insulin resistance show higher levels of active androgens, highlighting that low SHBG levels occur in both the diseases and that the two conditions may concur to a worsening of the disease. With regards to the existence of a male PCOS equivalent syndrome, in particular with refer to its phenotypic hallmark of early onset AGA, our hypothesis supposes a beneficial effect of diet restriction used for PCOS as therapy for male patients affected by PCOS equivalent syndrome. Several observational studies and some randomized trials reported that modest reductions of body weight decrease the risk of development of many diseases, including diabetes and cardiovascular disease and contributes to increase insulin sensitivity in PCOS women. Weight reduction may be adopted for men affected by PCOS equivalent syndrome in order to reduce both levels of circulating androgens, insulin resistance and related-complications such as CVD and DM II.
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Affiliation(s)
- Federica Di Guardo
- Department of Medical Surgical Specialties, University of Catania, Via Tindaro 2, 95124 Catania, Italy.
| | - Maria Cecilia Cerana
- Department of Internal Medicine, The University of Connecticut, 263 Farmington Ave, Farmington, CT 06030, United States
| | - Gisella D'urso
- Department of Medical Surgical Specialties, University of Catania, Via Tindaro 2, 95124 Catania, Italy
| | - Fortunato Genovese
- Department of Medical Surgical Specialties, University of Catania, Via Tindaro 2, 95124 Catania, Italy
| | - Marco Palumbo
- Department of Medical Surgical Specialties, University of Catania, Via Tindaro 2, 95124 Catania, Italy
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Kim BK, Choe SJ, Chung HC, Oh SS, Lee WS. Gender-specific risk factors for androgenetic alopecia in the Korean general population: Associations with medical comorbidities and general health behaviors. Int J Dermatol 2018; 57:183-192. [PMID: 29330930 DOI: 10.1111/ijd.13843] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 10/18/2017] [Accepted: 10/23/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND The relationships between androgenetic alopecia (AGA) and various factors related to metabolic syndrome have been demonstrated in previous studies. However, it remains unclear because of inconsistent results. We investigated the associations between AGA and various risk factors related to metabolic syndrome according to gender. METHODS We conducted a population-based cross-sectional survey of 2028 Koreans (1050 men, 978 women). The basic and specific (BASP) classification was used for diagnosis of AGA. We collected information on risk factors though questionnaires and medical records. RESULTS AGA was significantly associated with age, family history of AGA, hypertension, diabetes mellitus, and waist circumference in both genders. Female subjects with AGA were more likely to have cerebrovascular disease, dyslipidemia, and obesity; however, these associations were not observed in the male subjects. When multiple regression analysis was applied, there was a significant relationship between hypertension and AGA in male subjects. However, there was no statistically significant association in female subjects. CONCLUSION The different results according to gender might arise from different mechanisms of AGA. There was a significant relationship between hypertension and AGA in male subjects. Evaluation of blood pressure in male patients with AGA might facilitate interventions for hypertension.
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Affiliation(s)
- Bo-Kyung Kim
- Department of Dermatology and Institute of Hair and Cosmetic Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Sung Jay Choe
- Department of Dermatology and Institute of Hair and Cosmetic Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Hee-Chul Chung
- Department of Dermatology and Institute of Hair and Cosmetic Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Sung-Soo Oh
- Department of Occupational and Environmental Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Won-Soo Lee
- Department of Dermatology and Institute of Hair and Cosmetic Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
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Cannarella R, Condorelli RA, Mongioì LM, La Vignera S, Calogero AE. Does a male polycystic ovarian syndrome equivalent exist? J Endocrinol Invest 2018; 41:49-57. [PMID: 28711970 DOI: 10.1007/s40618-017-0728-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Accepted: 07/02/2017] [Indexed: 01/06/2023]
Abstract
The occurrence of a genetic background in the etiology of polycystic ovarian syndrome (PCOS) represents the rational basis to postulate the existence of a male PCOS equivalent. Hormonal and metabolic abnormalities have been described in male relatives of women with PCOS. These males also have a higher prevalence of early onset (<35 years) androgenetic alopecia (AGA). Hence, this feature has been proposed as a clinical sign of the male PCOS equivalent. Clinical evidence has shown that men with early onset AGA have hormonal and metabolic abnormalities. Large cohort studies have clearly shown a higher prevalence of type II diabetes mellitus (DM II) and cardiovascular diseases (CVDs) in elderly men with early onset AGA. In addition, prostate cancer, benign prostate hyperplasia (BPH) and prostatitis have been described. These findings support the existence of the male PCOS equivalent, which may represent an endocrine syndrome with a metabolic background, and might predispose to the development of DM II, CVDs, prostate cancer, BPH and prostatitis later in life. Its acknowledgment would be helpful for the prevention of these long-term complications.
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Affiliation(s)
- R Cannarella
- Department of Clinical and Experimental Medicine, University of Catania, Policlinico "G. Rodolico", via S. Sofia 78, 95123, Catania, Italy
| | - R A Condorelli
- Department of Clinical and Experimental Medicine, University of Catania, Policlinico "G. Rodolico", via S. Sofia 78, 95123, Catania, Italy
| | - L M Mongioì
- Department of Clinical and Experimental Medicine, University of Catania, Policlinico "G. Rodolico", via S. Sofia 78, 95123, Catania, Italy
| | - S La Vignera
- Department of Clinical and Experimental Medicine, University of Catania, Policlinico "G. Rodolico", via S. Sofia 78, 95123, Catania, Italy
| | - A E Calogero
- Department of Clinical and Experimental Medicine, University of Catania, Policlinico "G. Rodolico", via S. Sofia 78, 95123, Catania, Italy.
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English RS. A hypothetical pathogenesis model for androgenic alopecia: clarifying the dihydrotestosterone paradox and rate-limiting recovery factors. Med Hypotheses 2017; 111:73-81. [PMID: 29407002 DOI: 10.1016/j.mehy.2017.12.027] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 11/25/2017] [Accepted: 12/28/2017] [Indexed: 12/30/2022]
Abstract
Androgenic alopecia, also known as pattern hair loss, is a chronic progressive condition that affects 80% of men and 50% of women throughout a lifetime. But despite its prevalence and extensive study, a coherent pathology model describing androgenic alopecia's precursors, biological step-processes, and physiological responses does not yet exist. While consensus is that androgenic alopecia is genetic and androgen-mediated by dihydrotestosterone, questions remain regarding dihydrotestosterone's exact role in androgenic alopecia onset. What causes dihydrotestosterone to increase in androgenic alopecia-prone tissues? By which mechanisms does dihydrotestosterone miniaturize androgenic alopecia-prone hair follicles? Why is dihydrotestosterone also associated with hair growth in secondary body and facial hair? Why does castration (which decreases androgen production by 95%) stop pattern hair loss, but not fully reverse it? Is there a relationship between dihydrotestosterone and tissue remodeling observed alongside androgenic alopecia onset? We review evidence supporting and challenging dihydrotestosterone's causal relationship with androgenic alopecia, then propose an evidence-based pathogenesis model that attempts to answer the above questions, account for additionally-suspected androgenic alopecia mediators, identify rate-limiting recovery factors, and elucidate better treatment targets. The hypothesis argues that: (1) chronic scalp tension transmitted from the galea aponeurotica induces an inflammatory response in androgenic alopecia-prone tissues; (2) dihydrotestosterone increases in androgenic alopecia-prone tissues as part of this inflammatory response; and (3) dihydrotestosterone does not directly miniaturize hair follicles. Rather, dihydrotestosterone is a co-mediator of tissue dermal sheath thickening, perifollicular fibrosis, and calcification - three chronic, progressive conditions concomitant with androgenic alopecia progression. These conditions remodel androgenic alopecia-prone tissues - restricting follicle growth space, oxygen, and nutrient supply - leading to the slow, persistent hair follicle miniaturization characterized in androgenic alopecia. If true, this hypothetical model explains the mechanisms by which dihydrotestosterone miniaturizes androgenic alopecia-prone hair follicles, describes a rationale for androgenic alopecia progression and patterning, makes sense of dihydrotestosterone's paradoxical role in hair loss and hair growth, and identifies targets to further improve androgenic alopecia recovery rates: fibrosis, calcification, and chronic scalp tension.
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18
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Abstract
Hair loss is a common condition that affects most people at some point in their lives. It can exist as an isolated problem or with other diseases and conditions. Androgenetic alopecia (AGA) and its association with the metabolic syndrome (MetS) have received increasing interest since 1972, when the first link between cardiovascular risk factors and hair loss was raised. We have reviewed studies concerning the relationship between alopecia and MetS. Many studies have investigated the relationship among AGA and MetS and its individual components, particularly in men, where a disproportionately large number of these studies supports this association. AGA has also been associated with other metabolic-related conditions, including coronary artery disease, polycystic ovary syndrome, and Cushing syndrome, as well as several nutritional deficiencies, all of which have led to many clinicians advocating for the screening of MetS and cardiovascular risk factors in patients who present with AGA.
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19
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A genomic approach to susceptibility and pathogenesis leads to identifying potential novel therapeutic targets in androgenetic alopecia. Genomics 2017; 109:165-176. [DOI: 10.1016/j.ygeno.2017.02.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Revised: 02/03/2017] [Accepted: 02/25/2017] [Indexed: 02/07/2023]
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20
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Fortes C, Mastroeni S, Mannooranparampil TJ, Ribuffo M. The combination of overweight and smoking increases the severity of androgenetic alopecia. Int J Dermatol 2017; 56:862-867. [DOI: 10.1111/ijd.13652] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Revised: 03/29/2017] [Accepted: 04/17/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Cristina Fortes
- Epidemiology Unit; Istituto Dermopatico dell'Immacolata (IDI-IRCCS-FLMM); Rome Italy
| | - Simona Mastroeni
- Epidemiology Unit; Istituto Dermopatico dell'Immacolata (IDI-IRCCS-FLMM); Rome Italy
| | | | - Marcella Ribuffo
- Dermatology Unit; Istituto Dermopatico dell'Immacolata (IDI-IRCCS-FLMM); Rome Italy
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21
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Kim M, Shin I, Yoon H, Cho S, Park H. Lipid profile in patients with androgenetic alopecia: a meta-analysis. J Eur Acad Dermatol Venereol 2016; 31:942-951. [DOI: 10.1111/jdv.14000] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Accepted: 09/14/2016] [Indexed: 11/29/2022]
Affiliation(s)
- M.W. Kim
- Department of Dermatology; Seoul National University Boramae Hospital; Seoul Korea
| | - I.S. Shin
- Department of Education; College of Education; Jeonju University; Jeonju Korea
| | - H.S. Yoon
- Department of Dermatology; Seoul National University Boramae Hospital; Seoul Korea
| | - S. Cho
- Department of Dermatology; Seoul National University Boramae Hospital; Seoul Korea
| | - H.S. Park
- Department of Dermatology; Seoul National University Boramae Hospital; Seoul Korea
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22
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Robison JI, Kline G. Surviving “Risk Factor Frenzy”: The Perils of Incorrectly Applying Epidemiological Research in Health Education and Promotion. INTERNATIONAL QUARTERLY OF COMMUNITY HEALTH EDUCATION 2016. [DOI: 10.2190/drcm-3pcg-90at-nr2l] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
In health education and promotion, “risk factors” for disease gathered from epidemiological research form the basis from which the majority of recommendations to individuals for lifestyle change are made. Unfortunately, many health practitioners are unaware that this type of research was never intended to be applied to individuals. The result is ongoing public confusion and anxiety concerning health recommendations and a loss of credibility for health professionals. This article: 1) briefly reviews the most commonly encountered limitations inherent in epidemiological research; 2) explores the problems and potential negative consequences of incorrectly applying epidemiological research in health education and promotion; and 3) makes recommendations to help health practitioners more skillfully interpret and incorporate into their work findings from epidemiological research.
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23
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Triantafyllidi H, Grafakos A, Ikonomidis I, Pavlidis G, Trivilou P, Schoinas A, Lekakis J. Severity of Alopecia Predicts Coronary Changes and Arterial Stiffness in Untreated Hypertensive Men. J Clin Hypertens (Greenwich) 2016; 19:51-57. [DOI: 10.1111/jch.12871] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Revised: 05/04/2016] [Accepted: 05/09/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Helen Triantafyllidi
- 2nd Department of Cardiology Medical School; Attikon Hospital; University of Athens; Athens Greece
| | - Agis Grafakos
- 2nd Department of Cardiology Medical School; Attikon Hospital; University of Athens; Athens Greece
| | - Ignatios Ikonomidis
- 2nd Department of Cardiology Medical School; Attikon Hospital; University of Athens; Athens Greece
| | - George Pavlidis
- 2nd Department of Cardiology Medical School; Attikon Hospital; University of Athens; Athens Greece
| | - Paraskevi Trivilou
- 2nd Department of Cardiology Medical School; Attikon Hospital; University of Athens; Athens Greece
| | - Antonis Schoinas
- 2nd Department of Cardiology Medical School; Attikon Hospital; University of Athens; Athens Greece
| | - John Lekakis
- 2nd Department of Cardiology Medical School; Attikon Hospital; University of Athens; Athens Greece
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Abstract
Background: Topical minoxidil solution (TMS) is widely used for androgenetic alopecia (AGA), and this is the first report of a large safety trial. Objectives: The aim of the study was to evaluate the safety profile of TMS by comparing hospitalization and death rates among subjects using TMS with controls. Cardiovascular safety and pregnancy outcomes were evaluated, and usage patterns were described. Methods: All subjects were followed at baseline, 3, 6, 9, and 12 months. Usage patterns, pregnancy status, overnight hospital stays, and cardiovascular risk factors were evaluated. Subjects rated effectiveness of TMS in the treatment of AGA. Statistical analyses were conducted to determine if TMS was associated with an increased risk of death or hospitalization. Results: TMS is a safe and effective treatment for AGA. There were no increases in cardiovascular events and no apparent increased risk for adverse pregnancy outcomes. Conclusions: This large, prospective study demonstrated the overall safety of TMS in the treatment of AGA.
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Affiliation(s)
- Jerry Shapiro
- Division of Dermatology, Department of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada.
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25
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Godoy-Gijón E, Meseguer-Yebra C, Palacio-Aller L, Godoy-Rocati DV, Lahoz-Rallo C. [New populations at increased cardiovascular risk: Cardiovascular disease in dermatological diseases]. CLINICA E INVESTIGACION EN ARTERIOSCLEROSIS : PUBLICACION OFICIAL DE LA SOCIEDAD ESPANOLA DE ARTERIOSCLEROSIS 2016; 28:143-153. [PMID: 26383179 DOI: 10.1016/j.arteri.2015.08.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Revised: 08/03/2015] [Accepted: 08/04/2015] [Indexed: 06/05/2023]
Abstract
The increased cardiovascular risk in some dermatological diseases has been demonstrated in recent decades. Diseases such as psoriasis and systemic lupus erythematosus are currently included in the guidelines for prevention of cardiovascular disease. Other diseases such as androgenic alopecia, polycystic ovary syndrome, hidradenitis suppurativa or lichen planus have numerous studies that point to an increased risk, however, they have not been included in these guidelines. In this article we review the evidence supporting this association, in order to alert the clinician to the need for greater control in cardiovascular risk factors in these patients.
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Affiliation(s)
- Elena Godoy-Gijón
- Servicio de Dermatología, Hospital Clínico Universitario de Valladolid, Valladolid, España.
| | - Carmen Meseguer-Yebra
- Servicio de Dermatología, Hospital Virgen de la Concha, Complejo Asistencial de Zamora, Zamora, España
| | | | | | - Carlos Lahoz-Rallo
- Unidad de Lípidos y Riesgo Vascular, Servicio de Medicina Interna, Hospital Carlos III, Madrid, España
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26
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Heilmann-Heimbach S, Hochfeld LM, Paus R, Nöthen MM. Hunting the genes in male-pattern alopecia: how important are they, how close are we and what will they tell us? Exp Dermatol 2016; 25:251-7. [DOI: 10.1111/exd.12965] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/29/2016] [Indexed: 12/14/2022]
Affiliation(s)
- Stefanie Heilmann-Heimbach
- Institute of Human Genetics; University of Bonn; Bonn Germany
- Department of Genomics; Life & Brain Center; University of Bonn; Bonn Germany
| | - Lara M. Hochfeld
- Institute of Human Genetics; University of Bonn; Bonn Germany
- Department of Genomics; Life & Brain Center; University of Bonn; Bonn Germany
| | - Ralf Paus
- Dermatology Research Centre; Institute of Inflammation and Repair; University of Manchester; Manchester UK
- Department of Dermatology; University of Münster; Münster Germany
| | - Markus M. Nöthen
- Institute of Human Genetics; University of Bonn; Bonn Germany
- Department of Genomics; Life & Brain Center; University of Bonn; Bonn Germany
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27
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Park SY, Oh SS, Lee WS. Relationship between androgenetic alopecia and cardiovascular risk factors according to BASP classification in Koreans. J Dermatol 2016; 43:1293-1300. [PMID: 27028221 DOI: 10.1111/1346-8138.13355] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Accepted: 02/02/2016] [Indexed: 11/29/2022]
Abstract
There have been many studies on the relationship between androgenetic alopecia (AGA) and cardiovascular risk factors, but the study results were inconsistent and research on AGA in Asians remains insufficient. This study investigated the relationship between Korean AGA and various cardiovascular risk factors, considering life habits, type of hair loss and sex. We investigated subjects who visited a hospital for public or industrial health medical examinations between October 2012 and December 2014. A questionnaire as well as anthropometric measurements and a blood test were performed. Among the 1884 total subjects, 52.6% had AGA. AGA patients displayed a significantly higher prevalence rate of cardiovascular diseases, smoking rate, fasting glucose and triglyceride, and a significantly lower high-density lipoprotein cholesterol level than did the non-AGA group. The results of the subgroup analysis showed higher prevalence rates of hypertension, stroke, metabolic syndrome and smoking in male AGA patients. The more severe the AGA, the higher the incidences of hypertension, diabetes and smoking were observed. According to the analysis results by BASP classification, the F-type AGA patients displayed a higher body mass index, waist circumference and diastolic blood pressure, and had a significantly higher prevalence rate of hypertension. As a result of the large population-based study, modifications in lifestyle and early screening for cardiovascular disease, as well as hypertension and diabetes, are suggested.
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Affiliation(s)
- Sang-Yeon Park
- Department of Dermatology and Institute of Hair and Cosmetic Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Sung Soo Oh
- Department of Occupational and Environmental Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Won-Soo Lee
- Department of Dermatology and Institute of Hair and Cosmetic Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
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28
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Ertas R, Orscelik O, Kartal D, Dogan A, Ertas SK, Aydogdu EG, Ascioglu O, Borlu M. Androgenetic alopecia as an indicator of metabolic syndrome and cardiovascular risk. Blood Press 2015; 25:141-8. [PMID: 26585114 DOI: 10.3109/08037051.2015.1111021] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Numerous studies have investigated a probable association between androgenetic alopecia (AGA) and cardiovascular disease (CVD) by researching limited and dispersed parameters. We aimed to evaluate both traditional and non-traditional cardiovascular risk factors in male patients with early-onset AGA. This case-control study included 68 participants: 51 male patients with early-onset AGA and 17 healthy male controls. Patients with AGA were classified into three groups according to the Hamilton-Norwood scale and the presence of vertex hair loss. Traditional and non-traditional cardiovascular risk factors were examined in all study subjects. Metabolic syndrome was diagnosed in 25 patients with AGA and in two control subjects (p < 0.05). The carotid intima-media thickness values were found to be significantly higher in patients with vertex pattern AGA than in patients without vertex baldness and controls (p < 0.05). The pulse-wave velocity values were also found to be significantly higher in patients (p < 0.001). A limitation of this study was the small study population. In conclusion, vertex pattern AGA appears to be a marker for early atherosclerosis. This finding supports the hypothesis that early-onset AGA alone could be an independent risk factor for CVD and metabolic syndrome.
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Affiliation(s)
- Ragip Ertas
- a Department of Dermatology and Venereology , Kayseri Education and Research Hospital , Kayseri , Turkey
| | - Ozcan Orscelik
- b Department of Cardiology , Sivas State Hospital , Sivas , Turkey
| | - Demet Kartal
- c Department of Dermatology and Venereology , Erciyes University Faculty of Medicine , Kayseri , Turkey
| | - Ali Dogan
- d Department of Cardiology , Erciyes University Faculty of Medicine , Kayseri , Turkey
| | - Sule Ketenci Ertas
- e Department of Internal Medicine , Erciyes University Faculty of Medicine , Kayseri , Turkey
| | - Ebru Guler Aydogdu
- f Department of Dermatology and Venereology , Elazığ Education and Research Hospital , Elazığ , Turkey
| | - Ozcan Ascioglu
- c Department of Dermatology and Venereology , Erciyes University Faculty of Medicine , Kayseri , Turkey
| | - Murat Borlu
- c Department of Dermatology and Venereology , Erciyes University Faculty of Medicine , Kayseri , Turkey
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Banger HS, Malhotra SK, Singh S, Mahajan M. Is Early Onset Androgenic Alopecia a Marker of Metabolic Syndrome and Carotid Artery Atherosclerosis in Young Indian Male Patients? Int J Trichology 2015; 7:141-7. [PMID: 26903742 PMCID: PMC4738480 DOI: 10.4103/0974-7753.171566] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Androgenic alopecia (AGA) is a common cosmetically and psychosocially distressing condition. High androgen level contributes to the development of atherosclerosis, thrombosis leading to hypertension and hypercholesterolemia. OBJECTIVES To study the clinico-epidemiological profile of AGA and the presence of metabolic syndrome (MetS) and carotid artery atherosclerosis in male patients with early onset AGA as compared to controls. MATERIALS AND METHODS In this case-control study, 100 male patients of age 18-35 years with AGA and an equal number of age-matched healthy controls attending skin and STD OPD were included. Assessment of the degree of hair loss, evaluation of MetS and carotid artery color Doppler for the atherosclerotic plaque was done in all patients. RESULTS Statistically significant number of patients with early onset AGA 22/100 (22%) (P < 0.05) fulfilled the criteria for MetS compared to 8/100 (8%) in the control group. There were statistically significant differences in mean values of waist circumference, serum triglycerides, serum cholesterol, systolic blood pressure, diastolic blood pressure, fasting glucose concentration, and very low-density lipoprotein (LDL). However, no significant differences were observed in the mean values of high-density lipoprotein cholesterol and LDL cholesterol. The atherosclerotic plaque was found in two patients of the study group, and no plaque was found in control patients. CONCLUSION We suggest that all men with AGA should be thoroughly investigated, and lifestyle changes should be started in the early period of life so as to reduce the risk of various problems associated with MetS. AGA can be considered as an early marker for MetS.
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Affiliation(s)
| | | | - Sohan Singh
- Department of Radiology, Government Medical College, Amritsar, Punjab, India
| | - Mridula Mahajan
- Department of Biochemistry, Government Medical College, Amritsar, Punjab, India
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Parkin Kullmann JA, Hayes S, Wang MX, Pamphlett R. Designing an Internationally Accessible Web-Based Questionnaire to Discover Risk Factors for Amyotrophic Lateral Sclerosis: A Case-Control Study. JMIR Res Protoc 2015; 4:e96. [PMID: 26239255 PMCID: PMC4705359 DOI: 10.2196/resprot.4840] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Accepted: 07/13/2015] [Indexed: 12/12/2022] Open
Abstract
Background Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease with a typical survival of three to five years. Epidemiological studies using paper-based questionnaires in individual countries or continents have failed to find widely accepted risk factors for the disease. The advantages of online versus paper-based questionnaires have been extensively reviewed, but few online epidemiological studies into human neurodegenerative diseases have so far been undertaken. Objective To design a Web-based questionnaire to identify environmental risk factors for ALS and enable international comparisons of these risk factors. Methods A Web-based epidemiological questionnaire for ALS has been developed based on experience gained from administering a previous continent-wide paper-based questionnaire for this disease. New and modified questions have been added from our previous paper-based questionnaire, from literature searches, and from validated ALS questionnaires supplied by other investigators. New criteria to allow the separation of familial and sporadic ALS cases have been included. The questionnaire addresses many risk factors that have already been proposed for ALS, as well as a number that have not yet been rigorously examined. To encourage participation, responses are collected anonymously and no personally identifiable information is requested. The survey is being translated into a number of languages which will allow many people around the world to read and answer it in their own language. Results After the questionnaire had been online for 4 months, it had 379 respondents compared to only 46 respondents for the same initial period using a paper-based questionnaire. The average age of the first 379 web questionnaire respondents was 54 years compared to the average age of 60 years for the first 379 paper questionnaire respondents. The questionnaire is soon to be promoted in a number of countries through ALS associations and disease registries. Conclusions Web-based questionnaires are a time- and resource-efficient method for performing large epidemiological studies of neurodegenerative diseases such as ALS. The ability to compare risk factors between different countries using the same analysis tool will be of particular value for finding robust risk factors that underlie ALS.
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Association of male pattern baldness with angiographic coronary artery disease severity and collateral development. Neth Heart J 2015; 23:265-74. [PMID: 25911010 PMCID: PMC4409596 DOI: 10.1007/s12471-015-0688-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2014] [Indexed: 10/31/2022] Open
Abstract
OBJECTIVE We aimed to investigate whether there is an association between male pattern baldness and angiographic coronary artery disease (CAD) severity and collateral development, which has not been reported previously. METHODS Coronary arteriograms, CAD risk factors, lipid parameters and presence and severity of baldness in 511 male patients were prospectively evaluated. Baldness was classified into five groups. Severity of CAD was evaluated with the Gensini scoring system and collateral development with Rentrop scores. RESULTS Although subjects with a higher Gensini score had more frequent and severe baldness, they were older than the group with lower Gensini scores. Bald patients had a higher Gensini score when compared with their non-bald counterparts. In univariate analysis, age more than 60, body mass index more than 30, smoking and baldness were predictors of high Gensini scores. In multivariate analysis, only age more than 60, body mass index more than 30 and smoking were independent predictors of a high Gensini score. There were no differences in terms of presence and severity of baldness in subjects with and without adequate collateral development. CONCLUSIONS There was no relation between presence, severity and age of occurrence of male pattern baldness and Gensini and Rentrop scores, which are important measures of presence and severity of CAD.
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Zhou CK, Littman AJ, Levine PH, Hoffman HJ, Cleary SD, White E, Cook MB. Male pattern baldness in relation to prostate cancer risks: an analysis in the VITamins and lifestyle (VITAL) cohort study. Prostate 2015; 75:415-23. [PMID: 25492530 PMCID: PMC4293210 DOI: 10.1002/pros.22927] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2014] [Accepted: 09/30/2014] [Indexed: 11/08/2022]
Abstract
BACKGROUND Male pattern baldness and prostate cancer may share common pathophysiological mechanisms in terms of advancing age, heritability, and endogenous hormones. Results from previous epidemiologic studies are inconsistent. Therefore, we investigated the association of prostate cancer risks with male pattern baldness at age 30 years, age 45 years, and baseline (median age = 60.5 years) in the VITamins And Lifestyle (VITAL) cohort study. METHODS We included 32,583 men who were aged 50-76 years and without prior cancer diagnosis (excluding non-melanoma skin cancer) at the start of follow-up. First primary incident prostate cancers were ascertained via linkage to the western Washington Surveillance, Epidemiology, and End Results (SEER) program. Hazard ratios (HRs) and 95% confidence intervals (95% CIs) were estimated using Cox proportional hazards regressions with adjustment for potential confounders. RESULTS During follow-up (median = 9 years), 2,306 incident prostate cancers were diagnosed. Male pattern baldness at age 30 years, age 45 years, and baseline were not statistically significantly associated with overall or subtypes of prostate cancer. CONCLUSION This study did not provide support for the hypothesis that male pattern baldness may be a marker for subsequent prostate cancer. Previous evidence indicates that a distinct class of frontal with vertex balding may be associated with increased risk of aggressive prostate cancer, but all such balding classes were captured as a single exposure category by the VITAL cohort questionnaire. Prostate 75:415-423, 2015. © 2014 Wiley Periodicals, Inc.
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Affiliation(s)
- Cindy Ke Zhou
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, MD
- Department of Epidemiology and Biostatistics, George Washington University, Washington, D.C
| | - Alyson J. Littman
- Department of Epidemiology, University of Washington, Seattle, WA
- Seattle Epidemiologic Research and Information Center, Veterans Affairs Puget Sound Health Care System, Seattle, WA
| | - Paul H. Levine
- Department of Epidemiology and Biostatistics, George Washington University, Washington, D.C
| | - Heather J. Hoffman
- Department of Epidemiology and Biostatistics, George Washington University, Washington, D.C
| | - Sean D. Cleary
- Department of Epidemiology and Biostatistics, George Washington University, Washington, D.C
| | - Emily White
- Department of Epidemiology, University of Washington, Seattle, WA
- Cancer Prevention Program, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Michael B. Cook
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, MD
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Zhou CK, Pfeiffer RM, Cleary SD, Hoffman HJ, Levine PH, Chu LW, Hsing AW, Cook MB. Relationship between male pattern baldness and the risk of aggressive prostate cancer: an analysis of the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial. J Clin Oncol 2014; 33:419-25. [PMID: 25225425 DOI: 10.1200/jco.2014.55.4279] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
PURPOSE Male pattern baldness and prostate cancer appear to share common pathophysiologic mechanisms. However, results from previous studies that assess their relationship have been inconsistent. Therefore, we investigated the association of male pattern baldness at age 45 years with risks of overall and subtypes of prostate cancer in a large, prospective cohort—the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial. METHODS We included 39,070 men from the usual care and screening arms of the trial cohort who had no cancer diagnosis (excluding nonmelanoma skin cancer) at the start of follow-up and recalled their hair-loss patterns at age 45 years. Hazard ratios (HRs) and 95% CIs were estimated by using Cox proportional hazards regression models with age as the time metric. RESULTS During follow-up (median, 2.78 years), 1,138 incident prostate cancer cases were diagnosed, 571 of which were aggressive (biopsy Gleason score ≥ 7, and/or clinical stage III or greater, and/or fatal). Compared with no baldness, frontal plus moderate vertex baldness at age 45 years was not significantly associated with overall (HR, 1.19; 95% CI, 0.98 to 1.45) or nonaggressive (HR, 0.97; 95% CI, 0.72 to 1.30) prostate cancer risk but was significantly associated with increased risk of aggressive prostate cancer (HR, 1.39; 95% CI, 1.07 to 1.80). Adjustment for covariates did not substantially alter these estimates. Other classes of baldness were not significantly associated with overall or subtypes of prostate cancer. CONCLUSION Our analysis indicates that frontal plus moderate vertex baldness at age 45 years is associated with an increased risk of aggressive prostate cancer and supports the possibility of common pathophysiologic mechanisms.
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Affiliation(s)
- Cindy Ke Zhou
- Cindy Ke Zhou, Ruth M. Pfeiffer, and Michael B. Cook, National Cancer Institute, Bethesda, MD; Cindy Ke Zhou, Sean D. Cleary, Heather J. Hoffman, and Paul H. Levine, George Washington University, Washington, DC; and Lisa W. Chu and Ann W. Hsing, Cancer Prevention Institute of California, Fremont, CA
| | - Ruth M Pfeiffer
- Cindy Ke Zhou, Ruth M. Pfeiffer, and Michael B. Cook, National Cancer Institute, Bethesda, MD; Cindy Ke Zhou, Sean D. Cleary, Heather J. Hoffman, and Paul H. Levine, George Washington University, Washington, DC; and Lisa W. Chu and Ann W. Hsing, Cancer Prevention Institute of California, Fremont, CA
| | - Sean D Cleary
- Cindy Ke Zhou, Ruth M. Pfeiffer, and Michael B. Cook, National Cancer Institute, Bethesda, MD; Cindy Ke Zhou, Sean D. Cleary, Heather J. Hoffman, and Paul H. Levine, George Washington University, Washington, DC; and Lisa W. Chu and Ann W. Hsing, Cancer Prevention Institute of California, Fremont, CA
| | - Heather J Hoffman
- Cindy Ke Zhou, Ruth M. Pfeiffer, and Michael B. Cook, National Cancer Institute, Bethesda, MD; Cindy Ke Zhou, Sean D. Cleary, Heather J. Hoffman, and Paul H. Levine, George Washington University, Washington, DC; and Lisa W. Chu and Ann W. Hsing, Cancer Prevention Institute of California, Fremont, CA
| | - Paul H Levine
- Cindy Ke Zhou, Ruth M. Pfeiffer, and Michael B. Cook, National Cancer Institute, Bethesda, MD; Cindy Ke Zhou, Sean D. Cleary, Heather J. Hoffman, and Paul H. Levine, George Washington University, Washington, DC; and Lisa W. Chu and Ann W. Hsing, Cancer Prevention Institute of California, Fremont, CA
| | - Lisa W Chu
- Cindy Ke Zhou, Ruth M. Pfeiffer, and Michael B. Cook, National Cancer Institute, Bethesda, MD; Cindy Ke Zhou, Sean D. Cleary, Heather J. Hoffman, and Paul H. Levine, George Washington University, Washington, DC; and Lisa W. Chu and Ann W. Hsing, Cancer Prevention Institute of California, Fremont, CA
| | - Ann W Hsing
- Cindy Ke Zhou, Ruth M. Pfeiffer, and Michael B. Cook, National Cancer Institute, Bethesda, MD; Cindy Ke Zhou, Sean D. Cleary, Heather J. Hoffman, and Paul H. Levine, George Washington University, Washington, DC; and Lisa W. Chu and Ann W. Hsing, Cancer Prevention Institute of California, Fremont, CA
| | - Michael B Cook
- Cindy Ke Zhou, Ruth M. Pfeiffer, and Michael B. Cook, National Cancer Institute, Bethesda, MD; Cindy Ke Zhou, Sean D. Cleary, Heather J. Hoffman, and Paul H. Levine, George Washington University, Washington, DC; and Lisa W. Chu and Ann W. Hsing, Cancer Prevention Institute of California, Fremont, CA.
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Sharma KH, Jindal A. Association between androgenetic alopecia and coronary artery disease in young male patients. Int J Trichology 2014; 6:5-7. [PMID: 25114445 PMCID: PMC4124697 DOI: 10.4103/0974-7753.136747] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Background: Several studies have demonstrated an association between androgenetic alopecia (AGA) and cardiovascular disease. Still controversies exist regarding the association. Are they truly associated? Objective: The purpose of the present study was to assess the prevalence of AGA and establish its association in young (<45 years) Asian Indian Gujarati male patients having coronary artery disease (CAD). Materials and Methods: Case-control prospective multicentric study was carried out on 424 men. Case group consisted of 212 male subjects having CAD (Group 1) and another 212, either sibling or first degree male relative of the case subjects (having no evidence of CAD) were considered as the control group (Group 2). Age, total cholesterol, incidence of diabetes mellitus, and hypertension were similar in both groups. The degree of alopecia was assessed using the Norwood-Hamilton scale for men. Statistical analysis was performed using Chi-square test. Results: AGA was found in 80 (37.73%) young CAD patients (Group 1), whereas 44 (20.7%) of patients had alopecia in the control group (Group 2). There was statistically significant association between male AGA and CAD (P = 0.001). Odds ratio was 2.70 (95% confidence interval [CI], 1.72 ± 4.26). Statistically significant association was found between high grade baldness (Grades IV-VII) and CAD in young men (P < 0.05). Odds ratio = 2.36 (95% CI, 1.108 ± 5.033). There is statistically significant association of AGA in young Asian Gujarati male with CAD and the prevalence of AGA in young CAD patient is 37.73%. Conclusion: This study implies early onset AGA in male is independently associated with CAD, though mechanisms need to be investigated.
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Affiliation(s)
- Kamal H Sharma
- Department of Cardiology, U. N. Mehta Institute of Cardiology, B. J. Medical College, Civil Hospital, Ahmedabad, Gujarat, India
| | - Anchal Jindal
- Department of Dermatology, Sanjay Gandhi Memorial Hospital, New Delhi, India
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Trieu N, Eslick GD. Alopecia and its association with coronary heart disease and cardiovascular risk factors: a meta-analysis. Int J Cardiol 2014; 176:687-95. [PMID: 25150481 DOI: 10.1016/j.ijcard.2014.07.079] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2014] [Accepted: 07/24/2014] [Indexed: 11/25/2022]
Abstract
BACKGROUND Alopecia has been associated with an increased risk of coronary heart disease as well as the following risk factors for cardiovascular disease: hyperinsulinaemia, insulin resistance, metabolic syndrome, dyslipidaemia, and hypertension. We performed a meta-analysis to quantitatively determine the level of risk of coronary heart disease and risk factors in individuals with alopecia. METHODS A systematic literature search was conducted using several databases. We calculated pooled odds ratios and 95% confidence intervals using a random effects model. RESULTS In total, 31 studies comprising 29,254 participants with alopecia were eligible for the meta-analysis and showed that alopecia is associated with an increased risk of coronary heart disease (OR 1.22, 95% CI: 1.07-1.39), hyperinsulinaemia (OR 1.97, 95% CI: 1.20-3.21), insulin resistance (OR 4.88, 95% CI: 2.05-11.64), and metabolic syndrome (OR 4.49, 95% CI: 2.36-8.53). Individuals with alopecia were also shown to be more likely compared to those without alopecia to have higher serum cholesterol levels (OR 1.60, 95% CI: 1.17-2.21), higher serum triglyceride levels (OR 2.07, 95% CI: 1.32-3.25), higher systolic blood pressures (OR 1.73, 95% CI: 1.29-2.33), and higher diastolic blood pressures (OR 1.59, 95% CI: 1.16-2.18). CONCLUSIONS Alopecia is associated with an increased risk of coronary heart disease, and there appears to be a dose-response relationship with degree of baldness whereby the greater the severity of alopecia, the greater the risk of coronary heart disease. Alopecia is also associated with an increased risk of hypertension, hyperinsulinaemia, insulin resistance, metabolic syndrome, and having elevated serum total cholesterol and triglyceride levels.
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Affiliation(s)
- Nelson Trieu
- The Whiteley-Martin Research Centre, Discipline of Surgery, The University of Sydney, Nepean Hospital, Penrith, New South Wales, Australia
| | - Guy D Eslick
- The Whiteley-Martin Research Centre, Discipline of Surgery, The University of Sydney, Nepean Hospital, Penrith, New South Wales, Australia.
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Affiliation(s)
- Menelaos L Batrinos
- Professor Emeritus of Endocrinology, Athens University Medical School, Athens, Greece
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Agac MT, Bektas H, Korkmaz L, Cetin M, Erkan H, Gurbak I, Hatem E, Celik S. Androgenetic alopecia is associated with increased arterial stiffness in asymptomatic young adults. J Eur Acad Dermatol Venereol 2014; 29:26-30. [PMID: 24628808 DOI: 10.1111/jdv.12424] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2013] [Accepted: 01/25/2014] [Indexed: 11/29/2022]
Abstract
BACKGROUND Association of androgenetic alopecia (AGA) with increased incidence of hypertension, a strong risk factor for coronary artery disease, has been suggested. However, there are no data on arterial stiffness measures of asymptomatic young adults with AGA. OBJECTIVE In this study, we aimed to investigate the association of the AGA with arterial stiffness assessed by cardio-ankle vascular index (CAVI), in asymptomatic young men. METHODS A total of 162 asymptomatic men aged between 18 and 45 years were consecutively enrolled to the study. Subjects were considered to have AGA if they have ≥3 grade vertex alopecia according to Hamilton-Norwood scale. Arterial stiffness was assessed by CAVI and defined as abnormal if CAVI is ≥8. RESULTS Frequency of abnormal CAVI was higher in patients with AGA (29.3% vs. 10.0%, P = 0.003). Subjects with AGA had higher mean CAVI than subjects without AGA (7.56 ± 0.93 vs. 7.15 ± 0.79, P = 0.004). Binary logistic regression analysis demonstrated that presence of AGA (OR, 5.6; 95% CI, 1.7-20.0, P = 0.006), age (OR, 1.1; 95% CI, 1.0-1.2, P = 0.03) and diastolic blood pressure (OR, 1.1; 95% CI, 1.0-1.3, P = 0.005) were independently associated with abnormal CAVI. CONCLUSION We concluded that, AGA might be an indicator of arterial stiffness in asymptomatic young adults.
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Affiliation(s)
- M T Agac
- Department of Cardiology, Ahi Evren Cardiovascular and Thoracic Surgery Training and Research Hospital, Trabzon, Turkey
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Christoffersen M, Frikke-Schmidt R, Schnohr P, Jensen GB, Nordestgaard BG, Tybjærg-Hansen A. Visible Age-Related Signs and Risk of Ischemic Heart Disease in the General Population. Circulation 2014; 129:990-8. [DOI: 10.1161/circulationaha.113.001696] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background—
Cardiovascular disease is 1 of the most common age-related diseases, and also 1 of the most common causes of death in the general population. We tested the hypothesis that visible age-related signs associate with risk of ischemic heart disease (IHD), myocardial infarction (MI), and death in the general population, independent of chronological age.
Methods and Results—
10,885 individuals aged 20 to 93 years free of IHD were followed from 1976 through 1978 until June 2011 with 100% complete follow-up. During these 35 years of follow-up, 3401 participants developed IHD and 1708 developed MI. Presence of frontoparietal baldness, crown top baldness, earlobe crease, and xanthelasmata was associated with increased risk of IHD or MI after multifactorial adjustment for chronological age and well-known cardiovascular risk factors. The risk of IHD and MI increased stepwise with increasing number of age-related signs with multifactorially adjusted hazard ratios up to 1.40 (95% confidence interval, 1.20–1.62) for IHD and 1.57 (1.28–1.93) for MI, in individuals with 3 to 4 versus no age-related signs at baseline (
P
for trend <0.001). In all age groups in both women and men, absolute 10-year risk of IHD and MI increased with increasing number of visible age-related signs.
Conclusions—
Male pattern baldness, earlobe crease, and xanthelasmata—alone or in combination—associate with increased risk of ischemic heart disease and myocardial infarction independent of chronological age and other well-known cardiovascular risk factors. This is the first prospective study to show that looking old for your age is a marker of poor cardiovascular health.
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Affiliation(s)
- Mette Christoffersen
- From the Department of Clinical Biochemistry, Rigshospitalet, Copenhagen, Denmark (M.C., R.F.-S.,A.T.-H.); The Copenhagen City Heart Study, Frederiksberg Hospital, Copenhagen, Denmark (P.S., G.B.J., B.G.N., A.T.-H.); the Department of Cardiology, Hvidovre Hospital, Hvidovre, Denmark (G.B.J.); Department of Clinical Biochemistry, Herlev Hospital, Copenhagen, Denmark (B.G.N.); and Copenhagen University Hospitals and Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark (M.C., R.F
| | - Ruth Frikke-Schmidt
- From the Department of Clinical Biochemistry, Rigshospitalet, Copenhagen, Denmark (M.C., R.F.-S.,A.T.-H.); The Copenhagen City Heart Study, Frederiksberg Hospital, Copenhagen, Denmark (P.S., G.B.J., B.G.N., A.T.-H.); the Department of Cardiology, Hvidovre Hospital, Hvidovre, Denmark (G.B.J.); Department of Clinical Biochemistry, Herlev Hospital, Copenhagen, Denmark (B.G.N.); and Copenhagen University Hospitals and Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark (M.C., R.F
| | - Peter Schnohr
- From the Department of Clinical Biochemistry, Rigshospitalet, Copenhagen, Denmark (M.C., R.F.-S.,A.T.-H.); The Copenhagen City Heart Study, Frederiksberg Hospital, Copenhagen, Denmark (P.S., G.B.J., B.G.N., A.T.-H.); the Department of Cardiology, Hvidovre Hospital, Hvidovre, Denmark (G.B.J.); Department of Clinical Biochemistry, Herlev Hospital, Copenhagen, Denmark (B.G.N.); and Copenhagen University Hospitals and Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark (M.C., R.F
| | - Gorm B. Jensen
- From the Department of Clinical Biochemistry, Rigshospitalet, Copenhagen, Denmark (M.C., R.F.-S.,A.T.-H.); The Copenhagen City Heart Study, Frederiksberg Hospital, Copenhagen, Denmark (P.S., G.B.J., B.G.N., A.T.-H.); the Department of Cardiology, Hvidovre Hospital, Hvidovre, Denmark (G.B.J.); Department of Clinical Biochemistry, Herlev Hospital, Copenhagen, Denmark (B.G.N.); and Copenhagen University Hospitals and Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark (M.C., R.F
| | - Børge G. Nordestgaard
- From the Department of Clinical Biochemistry, Rigshospitalet, Copenhagen, Denmark (M.C., R.F.-S.,A.T.-H.); The Copenhagen City Heart Study, Frederiksberg Hospital, Copenhagen, Denmark (P.S., G.B.J., B.G.N., A.T.-H.); the Department of Cardiology, Hvidovre Hospital, Hvidovre, Denmark (G.B.J.); Department of Clinical Biochemistry, Herlev Hospital, Copenhagen, Denmark (B.G.N.); and Copenhagen University Hospitals and Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark (M.C., R.F
| | - Anne Tybjærg-Hansen
- From the Department of Clinical Biochemistry, Rigshospitalet, Copenhagen, Denmark (M.C., R.F.-S.,A.T.-H.); The Copenhagen City Heart Study, Frederiksberg Hospital, Copenhagen, Denmark (P.S., G.B.J., B.G.N., A.T.-H.); the Department of Cardiology, Hvidovre Hospital, Hvidovre, Denmark (G.B.J.); Department of Clinical Biochemistry, Herlev Hospital, Copenhagen, Denmark (B.G.N.); and Copenhagen University Hospitals and Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark (M.C., R.F
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Narad S, Pande S, Gupta M, Chari S. Hormonal profile in Indian men with premature androgenetic alopecia. Int J Trichology 2014; 5:69-72. [PMID: 24403767 PMCID: PMC3877475 DOI: 10.4103/0974-7753.122961] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Introduction: Alopecia in male is considered as a genetically determined disorder characterized by increased level of local androgen metabolite and increase androgen receptor binding in balding areas. Frequent deviations of hormones from normal values have been reported in men diagnosed with premature androgenetic alopecia (AGA) especially for androgens, gonadotropins and sex hormone binding globulin (SHBG). Different studies in the past have inferred that premature baldness before the age of thirty in males could be considered equivalent to the polycystic ovary syndrome (PCOS) in female. Materials and Methods: Hormonal profile of 50 men with severe premature balding before 30 years of age were compared with same numbers of age matched controls. The serum concentrations of total testosterone, dehydroepiandrosterone sulfate, luteinizing hormone, follicle stimulating hormone, SHBG, insulin and fasting blood sugar were estimated. Statistical analysis was performed with paired Student's t-test for cases and controls. Results: Decreased levels of SHBG with high free androgen index were found in cases when compared with the controls. Conclusion: Though altered hormonal profile may coexist in some of men with premature AGA it can’t be considered as male equivalent to PCOS in female or the metabolic syndrome.
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Affiliation(s)
- Smita Narad
- Department of Biochemistry, NKP Salve Institute of Medical Sciences and Research Center, Nagpur, Maharashtra, India
| | - Sushil Pande
- Department of Dermatology, NKP Salve Institute of Medical Sciences and Research Center, Nagpur, Maharashtra, India
| | - Madhur Gupta
- Department of Biochemistry, NKP Salve Institute of Medical Sciences and Research Center, Nagpur, Maharashtra, India
| | - Suresh Chari
- Department of Biochemistry, NKP Salve Institute of Medical Sciences and Research Center, Nagpur, Maharashtra, India
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Lai CH, Chu NF, Chang CW, Wang SL, Yang HC, Chu CM, Chang CT, Lin MH, Chien WC, Su SL, Chou YC, Chen KH, Wang WM, Liou SH. Androgenic alopecia is associated with less dietary soy, lower [corrected] blood vanadium and rs1160312 1 polymorphism in Taiwanese communities. PLoS One 2013; 8:e79789. [PMID: 24386074 PMCID: PMC3875420 DOI: 10.1371/journal.pone.0079789] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2013] [Accepted: 09/25/2013] [Indexed: 12/23/2022] Open
Abstract
Background Although the genetic basis of androgenic alopecia has been clearly established, little is known about its non-genetic causes, such as environmental and lifestyle factors. Objective This study investigated blood and urine heavy metals concentrations, environmental exposure factors, personal behaviors, dietary intakes and the genotypes of related susceptibility genes in patients with androgenic alopecia (AGA). Design Age, AGA level, residence area, work hours, sleep patterns, cigarette usage, alcohol consumption, betel nut usage, hair treatments, eating habits, body heavy metals concentrations and rs1998076, rs913063, rs1160312 and rs201571 SNP genotype data were collected from 354 men. Logistic regression analysis was performed to examine whether any of the factors displayed odds ratios (ORs) indicating association with moderate to severe AGA (≧IV). Subsequently, Hosmer-Lemeshow, Nagelkerke R2 and accuracy tests were conducted to help establish an optimal model. Results Moderate to severe AGA was associated with the AA genotype of rs1160312 (22.50, 95% CI 3.99–126.83), blood vanadium concentration (0.02, 95% CI 0.01–0.04), and regular consumption of soy bean drinks (0.23, 95% CI 0.06–0.85), after adjustment for age. The results were corroborated by the Hosmer-Lemeshow test (P = 0.73), Nagelkerke R2 (0.59), accuracy test (0.816) and area under the curve (AUC; 0.90, 0.847–0.951) analysis. Conclusions Blood vanadium and frequent soy bean drink consumption may provide protect effects against AGA. Accordingly, blood vanadium concentrations, the AA genotype of rs1160312 and frequent consumption of soy bean drinks are associated with AGA.
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Affiliation(s)
- Ching-Huang Lai
- Department of Epidemiology, School of Public Health, National Defense Medical Center, Taipei, Taiwan
| | - Nain-Feng Chu
- Department of Epidemiology, School of Public Health, National Defense Medical Center, Taipei, Taiwan
- Taitung Hospital, Department of Health, Executive Yuan, Taiwan
| | - Chi-Wen Chang
- School of Nursing, College of Medicine, Chang-Gung University, Taoyuan, Taiwan
| | - Shu-Li Wang
- Division of Environmental Health and Occupational Medicine, National Health Research Institutes, MiaoLi, Taiwan
| | - Hsin-Chou Yang
- Institute of Statistical Science Academia Sinica, Taipei, Taiwan
| | - Chi-Ming Chu
- Department of Epidemiology, School of Public Health, National Defense Medical Center, Taipei, Taiwan
- * E-mail:
| | - Chu-Ting Chang
- Department of Epidemiology, School of Public Health, National Defense Medical Center, Taipei, Taiwan
| | - Ming-Huang Lin
- Department of Epidemiology, School of Public Health, National Defense Medical Center, Taipei, Taiwan
| | - Wu-Chien Chien
- Department of Epidemiology, School of Public Health, National Defense Medical Center, Taipei, Taiwan
| | - Sui-Lung Su
- Department of Epidemiology, School of Public Health, National Defense Medical Center, Taipei, Taiwan
| | - Yu-Ching Chou
- Department of Epidemiology, School of Public Health, National Defense Medical Center, Taipei, Taiwan
| | - Kang-Hua Chen
- School of Nursing, College of Medicine, Chang-Gung University, Taoyuan, Taiwan
| | - Wei-Ming Wang
- Department of Dermatology, Tri-Service General Hospital, Taipei, Taiwan
| | - Saou-Hsing Liou
- Department of Epidemiology, School of Public Health, National Defense Medical Center, Taipei, Taiwan
- Division of Environmental Health and Occupational Medicine, National Health Research Institutes, MiaoLi, Taiwan
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Schooling CM. Androgen activity, ischaemic heart disease and risk factors among men in NHANES III. Eur J Clin Invest 2013; 43:1273-81. [PMID: 24117250 DOI: 10.1111/eci.12174] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2013] [Accepted: 08/31/2013] [Indexed: 12/18/2022]
Abstract
AIM Observationally, low serum testosterone among men is associated with cardiovascular diseases and its risk factors, but it is unclear whether raising endogenous androgens would be protective. To clarify the role of androgens, the association of two different androgen biomarkers (serum testosterone and androstanediol glucuronide) with cardiovascular disease risk factors and mortality was examined in a nationally representative sample of US men. RESEARCH DESIGN AND METHODS Multivariable linear and proportion hazards regression were used to examine the adjusted associations of serum testosterone and androstanediol glucuronide with cardiovascular disease risk factors and death from major cardiovascular diseases in 1460 men from NHANES III phase 1 (1988-1991) followed-up through 2006. RESULTS Serum testosterone and androstanediol glucuronide were weakly correlated (0·13). Serum testosterone was associated with healthier values of most cardiovascular disease risk factors but not with death from ischaemic heart disease or stroke, adjusted for age, education, race/ethnicity, smoking and alcohol use. Similarly adjusted, androstanediol glucuronide was associated with unhealthier values of some cardiovascular risk factors and death from ischaemic heart disease (hazard ratio 1·16, 95% confidence interval 1·003-1·33 per standard deviation). CONCLUSIONS Androgen biomarkers had inconsistent associations with cardiovascular disease risk factors and ischaemic heart disease. Androstanediol glucuronide, rather than serum testosterone, had associations with cardiovascular disease risk factors more similar to those seen in randomized controlled trials of testosterone therapy, with corresponding implications for raising androgens.
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Abstract
Metabolic syndrome (Met S) is a clustering of risk factors comprising of abdominal obesity, dyslipidemia, elevated blood pressure, and abnormal glucose tolerance. The prevalence of Met S has been increasing in the last few years throughout the world. Psoriasis has consistently been associated with Met S as well as its various components. However, the association is no longer limited to psoriasis alone. Various dermatological conditions such as lichen planus, androgenetic alopecia, systemic lupus erythematosus, skin tags, acanthosis nigricans, and even cutaneous malignancies have also been found to be associated with this syndrome. Though chronic inflammation is thought to be the bridging link, the role of oxidative stress and endocrine abnormalities has recently been proposed in bringing them together.
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Affiliation(s)
- Tanmay Padhi
- Department of Dermatology and Venereology, VSS Medical College, Sambalpur, Odisha, India
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Affiliation(s)
- Dilip Gude
- Department of Internal Medicine/Critical Care, Princess Durru Shehvar Children's and General Hospital, Purani Haveli, Hyderabad, Andhra Pradesh, India
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Westgate GE, Botchkareva NV, Tobin DJ. The biology of hair diversity. Int J Cosmet Sci 2013; 35:329-36. [PMID: 23363384 DOI: 10.1111/ics.12041] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2012] [Accepted: 01/23/2013] [Indexed: 12/17/2022]
Affiliation(s)
- Gillian E Westgate
- Centre for Skin Sciences; School of Life Sciences; University of Bradford; Richmond Road Bradford West Yorkshire BD7 1DP UK
- Westgate Consultancy Ltd; Court Lane Stevington Bedfordshire MK43 7QT UK
| | - Natalia V Botchkareva
- Centre for Skin Sciences; School of Life Sciences; University of Bradford; Richmond Road Bradford West Yorkshire BD7 1DP UK
| | - Desmond J Tobin
- Centre for Skin Sciences; School of Life Sciences; University of Bradford; Richmond Road Bradford West Yorkshire BD7 1DP UK
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Yamada T, Hara K, Umematsu H, Kadowaki T. Male pattern baldness and its association with coronary heart disease: a meta-analysis. BMJ Open 2013; 3:bmjopen-2012-002537. [PMID: 23554099 PMCID: PMC3641488 DOI: 10.1136/bmjopen-2012-002537] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To confirm the association between male pattern baldness and coronary heart disease (CHD). DESIGN Meta-analysis of observational studies. DATA SOURCES Medline and the Cochrane Library were searched for articles published up to November 2012 using keywords that included both 'baldness' and 'coronary heart disease' and the reference lists of those studies identified were also searched. STUDY SELECTION Observational studies were identified that reported risk estimates for CHD related to baldness. Two observers independently assessed eligibility, extracted data and assessed the possibility of bias. DATA SYNTHESIS The adjusted relative risk (RR) and 95% CI were estimated using the DerSimonian-Laird random-effect model. RESULTS 850 possible studies, 3 cohort studies and 3 case-control studies were selected (36 990 participants). In the cohort studies, the adjusted RR of men with severe baldness for CHD was 1.32 (95% CI 1.08 to 1.63, p=0.008, I(2)=25%) compared to those without baldness. Analysis of younger men (<55 or ≤60 years) showed a similar association of CHD with severe baldness (RR 1.44, 95% CI 1.11 to 1.86, p=0.006, I(2)=0%). In three studies employing the modified Hamilton scale, vertex baldness was associated with CHD and the relation depended on the severity of baldness (severe vertex: RR 1.48 (1.04 to 2.11, p=0.03); moderate vertex: RR 1.36 (1.16 to 1.58, p<0.001); mild vertex: RR 1.18 (1.04 to 1.35, p<0.001)). However, frontal baldness was not associated with CHD (RR 1.11 (0.92 to 1.32, p=0.28)). CONCLUSIONS Vertex baldness, but not frontal baldness, is associated with an increased risk of CHD. The association with CHD depends on the severity of vertex baldness and also exists among younger men. Thus, vertex baldness might be more closely related to atherosclerosis than frontal baldness, but the association between male pattern baldness and CHD deserves further investigation.
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Affiliation(s)
- Tomohide Yamada
- Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
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Factors associated with female pattern hair loss and its prevalence in Taiwanese women: a community-based survey. J Am Acad Dermatol 2012. [PMID: 23182061 DOI: 10.1016/j.jaad.2012.09.046] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
BACKGROUND Although female pattern hair loss (FPHL) has been considered simply the female counterpart of male pattern hair loss in men, the risk factors may differ. OBJECTIVE We sought to evaluate factors associated with FPHL and to estimate its prevalence in women. METHOD In total, 26,226 subjects aged 30 years and older participated in a cross-sectional survey. Ludwig and Norwood classifications were used to assess the degree of hair loss. Information on possible risk factors for FPHL was collected using a questionnaire interview. RESULTS The prevalence of FPHL (Ludwig grade >I) for all ages was 11.8% (95% CI 11.5%-12.2%), increasing with advancing age. After controlling for age and family history, statistically significant associations were noted between FPHL and high fasting glucose (odds ratio [OR] 1.15, 95% confidence interval [CI] 1.04-1.28), fewer childbirths (OR 1.24, 95% CI 1.12-1.38), breast-feeding (OR 0.88, 95% CI 0.78-0.98), oral contraceptive use (OR 1.21, 95% CI 1.01-1.45), and ultraviolet exposure more than 16 hours per week (OR 1.12, 95% CI 1.02-1.22). LIMITATIONS The validity and reliability of FPHL classification may be not perfect in this survey and may need to be verified. Information on family history may be still subject to recall bias. CONCLUSIONS Risk factors for FPHL and male androgenic alopecia may differ.
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Fabijanić D, Čulić V. Diagonal ear lobe crease and coronary artery disease. Am J Cardiol 2012; 110:1385-6. [PMID: 23059390 DOI: 10.1016/j.amjcard.2012.08.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2012] [Revised: 08/01/2012] [Accepted: 08/06/2012] [Indexed: 11/17/2022]
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HONG H, JI JH, LEE Y, KANG H, CHOI GS, LEE WS. Reliability of the pattern hair loss classifications: A comparison of the basic and specific and Norwood-Hamilton classifications. J Dermatol 2012; 40:102-6. [DOI: 10.1111/1346-8138.12024] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2012] [Accepted: 09/15/2012] [Indexed: 11/26/2022]
Affiliation(s)
- Hannah HONG
- Department of Dermatology; Institute of Hair and Cosmetic Medicine; Yonsei University Wonju College of Medicine; Wonju
| | - Jae Hong JI
- Department of Dermatology; Institute of Hair and Cosmetic Medicine; Yonsei University Wonju College of Medicine; Wonju
| | - Yoonhee LEE
- Department of Dermatology; Institute of Hair and Cosmetic Medicine; Yonsei University Wonju College of Medicine; Wonju
| | - Hoon KANG
- College of Medicine; The Catholic University of Korea; Seoul
| | | | - Won-Soo LEE
- Department of Dermatology; Institute of Hair and Cosmetic Medicine; Yonsei University Wonju College of Medicine; Wonju
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