Androgenetic alopecia is associated with increased arterial stiffness in asymptomatic young adults

Long-lived proteins and DNA as candidate predictive biomarkers for tissue associated diseases

Protein turnover is an important mechanism to maintain proteostasis. Long-lived proteins (LLPs) are vulnerable to lose their function due to time-accumulated damages. In this study we employed in vivo stable isotope labeling in mice from birth to postnatal day 89. Quantitative proteomics analysis of ten tissues and plasma identified 2113 LLPs, including widespread and tissue-specific ones. Interestingly, a significant percentage of LLPs was detected in plasma, implying a potential link to age-related cardiovascular diseases. LLPs identified in brains were related to neurodegenerative diseases. In addition, the relative quantification of DNA-derived deoxynucleosides from the same tissues provided information about cellular DNA renewal and showed good correlation with LLPs in the brain. The combined data reveal tissue-specific maps of mouse LLPs that may be involved in pathology due to a low renewal rate and an increased risk of damage. Tissue-derived peripheral LLPs hold promise as biomarkers for aging and age-related diseases.

Serum uric acid level in male patients with androgenetic alopecia: A prospective study in China

BACKGROUND

The aim of this study was to investigate the serum level of uric acid (UA) in male patients with androgenetic alopecia (AGA) and to compare the level with that of men without AGA. In addition, the comparison of the serum level of uric acid (UA) before and after treatment with finasteride was performed.

METHOD

A total of 120 male patients with AGA and 120 males without AGA were enrolled in this prospective study. Patients with AGA were randomized into two groups: 60 patients were given 1 mg finasteride orally every day for 6 months, and 60 patients were given placebo. Serum UA level was detected at the first visit and after the 6-month treatment by colorimetric analysis.

RESULTS

Before treatment, the mean serum UA level in patients with AGA was higher than that in the control group (401.52±83.27 umol/L vs 362.67±60.88 umol/L, P<0.050), and a higher proportion of hyperuricemia was found in patients with AGA (2 9.17% vs 15.00%, P<0.050). After treatment, the mean serum UA level in the finasteride group decreased significantly, from 405.87±87.12 umol/L to 381.84±82.50 umol/L (P<0.050), and from 397.17±79.73 to 394.18±78.09 umol/L in the placebo group (P = 0.370). Patients with AGA with hyperuricemia had a higher BMI (25.38±3.43 kg/m2) when compared to the patients without hyperuricemia (23.88±2.64 kg/m2). For every unit of BMI increase in patients with AGA, the risk of hyperuricemia increased by 30.5% (P = 0.030). Furthermore, the levels of UA were different in the finasteride group before and after treatment (P = 0.049, 95%CI, 0.080, 47.970).

CONCLUSIONS

We found that AGA has a relationship with hyperuricemia, and the level of serum UA can decrease with the treatment of finasteride.

Circulating and/or cutaneous irisin resistance: A novel link among androgenetic alopecia, comorbid metabolic syndrome and cardiovascular risks

BACKGROUND

Androgenetic alopecia (AGA) is a common cause of hair loss in both genders that may be associated with disturbed systemic metabolism. Irisin is a hormone-like myokine that greatly influences systemic metabolism and is linked to cardiovascular diseases.

AIM

To detect irisin role in AGA and its associated metabolic syndrome (MetS) and cardiovascular risk.

PATIENTS/METHODS

This case-control study included 44 AGA patients of both genders and 22 healthy individuals. Serum irisin level was measured using ELISA and scalp biopsy was taken to detect irisin immunohistochemically. Carotid Doppler ultrasonography was performed to measure carotid intima media thickness (CIMT).

RESULTS

Higher serum irisin was significantly detected in AGA patients (p ˂ 0.001), and in males (p = 0.01) particularly severe cases (p ˂ 0.001). It was significantly higher in AGA patients presenting with MetS and those suffering from dyslipidemia (p ˂ 0.001 for both). Multivariate regression analysis proved BMI (p = 0.01) and serum irisin (p = 0.02) as independent predictors of CIMT abnormality among AGA patients. Regarding cutaneous irisin expression, the epidermal H-score was significantly higher in AGA patients with MetS compared to those without (p = 0.04). Epidermal H-score ˃100 was significantly associated with male gender (p = 0.05), severe AGA (p = 0.02), MetS (p = 0.03), dyslipidemia (p = 0.03), and abnormal CIMT (p = 0.03).

CONCLUSION

High serum irisin and upregulated epidermal irisin expression are associated with the incidence of MetS, dyslipidemia, and CIMT abnormality among AGA patients. This may indicate resistance to irisin, which hinders its favorable cardiometabolic actions. Further studies are warranted to investigate the concept of irisin resistance in AGA patients, which was uniquely discussed in the present study.

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

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.

YKL-40 A Sensitive Biomarker for Early Androgenetic Alopecia and Early Hidden Metabolic Syndrome

Background:

Androgenetic alopecia (AGA) is a common dermatological problem, Does the onset of the AGA matters in the general health? YKL 40 may have role in the pathogenesis of early AGA and associated metabolic syndrome (MS). YKL 40, released by many inflammatory cells and its biological role is not well known.

Aim of the Work:

The estimation of serum level of YKL-40 in patients with AGA to detect its role in AGA and MS pathogenesis, onset and severity.

Materials and Methods:

This case–control study, 100 individuals were enrolled in our study; 70 AGA patients and 30 healthy controls. We obtained an informed written consent from each individual prior the participation. AGA was diagnosed clinically, and onset was evaluated as early onset alopecia (by the age of 30 years or earlier), YKL-40 level was measured by ELISA technique.

Results:

Patients showed highly significant higher serum YKL-40 level more than that of the healthy subjects (P < 0.001). There was highly significant increase in YKL-40 level among early onset male and female cases compared to late onset cases (P < 0.001 each). There was significant increase in MS elements in AGA cases than controls (P < 0.05), and highly significant increase in MS associations and severity among early onset male and female cases compared to late onset cases (P < 0.001 each). AGA patients with MS showed highly significant higher serum YKL-40 level more than that without (P < 0.001). There was highly significant increase in YKL-40 level among early onset AGA with MS compared to late onset cases with MS (P < 0.001 each).

Conclusions:

High serum YKL-40 considered not only a biomarker of early onset AGA but also considered a potential sensitive predictor for early onset MS development and severity in patients with early onset AGA.

Androgenetic Alopecia: Relationship to Anthropometric Indices, Blood Pressure and Life-Style Habits

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.

Gender-specific risk factors for androgenetic alopecia in the Korean general population: Associations with medical comorbidities and general health behaviors

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.

Mediterranean diet: fresh herbs and fresh vegetables decrease the risk of Androgenetic Alopecia in males

It is well established that Androgenetic Alopecia (AGA) occurs in genetically predisposed individuals but little is known of its non-genetic risk factors. The aim of the study was to investigate the role of the Mediterranean diet in determining the risk of AGA. A hospital-based case-control study was conducted in the outpatient clinics of the hospital "Istituto Dermopatico dell'Immacolata, Rome, Italy". We included 104 males and 108 controls not affected by AGA. Controls were frequency matched to cases. Information on socio-demographic characteristics, medical history, smoking and diet were collected for all patients. Logistic regression was used to estimate odds ratio and 95% confidence intervals. After controlling for age, education, body mass index and family history of AGA, protective effects for AGA were found for high consumption (≥ 3 times weekly) of raw vegetables (OR 0.43; 95% CI 0.21-0.89) and high consumption of fresh herbs (3 or more regularly) (OR 0.44; 95% CI 0.22-0.87). We suggest that some foods of the Mediterranean diet, say fresh herbs and salad, may reduce the risk of AGA onset.

[New populations at increased cardiovascular risk: Cardiovascular disease in dermatological diseases]

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.

The Relation of Androgenetic Alopecia Severity with Epicardial Fat Thickness

Background

Androgenetic alopecia (AGA) is the most commonly encountered baldness pattern in men. Epicardial fat tissue is found on the cardiac surface between the myocardium and visceral pericardium. Both AGA and epicardial fat thickness (EFT) are related to coronary artery disease, which is also reflected by an increase in carotid intima media thickness (CIMT).

Objective

The purpose of this study was to investigate the relation of AGA severity with EFT.

Methods

One hundred twenty-six male patients with AGA aged 18 to 55 years without histories of chronic disease were enrolled. Subjects were divided into three groups (mild, moderate, and severe) on the basis of the Hamilton baldness scale as modified by Norwood. Maximum EFT was measured at end-systole on the midventricular free wall of the right ventricle. CIMT was also recorded for all patients.

Results

The groups did not have statistically significant differences with respect to age, height, weight, body mass index, left ventricular ejection fraction, or left atrial diameter (p>0.05 for all comparisons), but the severe group had a higher EFT compared with the moderate (p<0.001; z score, -7.040) and mild groups (p<0.001; z score, -6.667). The moderate group also had higher EFT than the mild group (p<0.001; z score, -5.931). Mean CIMT value in the severe group was significantly higher compared with the value in the other groups.

Conclusion

The study showed that subjects in advanced stages of AGA had increased EFT, which was measured via echocardiography.

Xanthelasma palpebrarum associated with increased cardio-ankle vascular index in asymptomatic subjects

BACKGROUND

Xanthelasma palpebrarum (XP) is associated with increased risk of ischemic heart disease and myocardial infarction independent of other well-known cardiovascular risk factors. Cardio-ankle vascular index (CAVI) is a novel index of arterial stiffness and important marker of subclinical atherosclerosis. The purpose of this study was to investigate the association between XP and CAVI in asymptomatic subjects.

METHODS

Consecutive 50 subjects with XP and age-gender matched 50 control subjects were enrolled. Patients with known atherosclerotic vascular disease were excluded. Arterial stiffness was assessed by CAVI and defined as abnormal if CAVI is ≥ 8.

RESULTS

Subjects with XP had higher mean CAVI than control subjects (8.05 ± 1.72 vs. 6.76 ± 1.18, p < 0.001). Frequency of abnormal CAVI was higher in subjects with XP (n = 27) compared to those without XP (n = 9, 54 vs. 18 %, p < 0.001). There was a significant correlation between XP and CAVI (r = 0.42, p < 0.001). Conditional logistic regression analysis showed that XP (odds ratio OR 8.80, 95 % confidence interval CI 2.63-29.49, p < 0.001) and age (OR 1.17, 95 % CI 1.08-1.26, p < 0.001) were independent predictors for abnormal CAVI.

CONCLUSION

The study suggests that XP is associated with increased arterial stiffness in asymptomatic subjects.

Visible aging signs as risk markers for ischemic heart disease: Epidemiology, pathogenesis and clinical implications

Association of common aging signs (i.e., male pattern baldness, hair graying, and facial wrinkles) as well as other age-related appearance factors (i.e., arcus corneae, xanthelasmata, and earlobe crease) with increased risk of ischemic heart disease was initially described in anecdotal reports from clinicians observing trends in the physical appearance of patients with ischemic heart disease. Following these early observations numerous epidemiological studies have reported these associations. Since the prevalences of both visible aging signs and ischemic heart disease have a strong correlation with increasing age, it has been extensively debated whether the observed associations could be entirely explained by a common association with age. Furthermore, the etiologies of the visible aging signs are rarely fully understood, and pathophysiological explanations for these associations remain controversial, and are mostly speculative. As a consequence of inconsistent findings and lack of mechanistic explanations for the observed associations with ischemic heart disease, consensus on the clinical importance of these visible aging signs has been lacking. The aim of this review is for each of the visible aging signs to (i) review the etiology, (ii) to discuss the current epidemiological evidence for an association with risk of ischemic heart disease, and (iii) to present possible pathophysiological explanations for these associations. Finally this review discusses the potential clinical implications of these findings.

Association of premature androgenetic alopecia and metabolic syndrome in a young Indian population

Context:

Although evidences for association of androgenetic alopecia (AGA) with metabolic syndrome (MetS) are accruing, inconclusiveness with respect to the gender specificity and differential association of MetS with increasing severity of AGA continues to persist. Furthermore, data specific to Indian settings are relatively sparse.

Aims:

The present study aimed at assessing the frequency of MetS in individuals with early AGA in Indian settings.

Settings and Design:

A case-control study was conducted at a trichology clinic in Bengaluru between April 2012 and September 2012 with a total of 85 cases of AGA and 85 age-matched controls.

Materials and Methods:

The Norwood-Hamilton classification was used to assess the grade of AGA. MetS was defined according to the National Cholesterol Education Program Adult Treatment Panel III criteria. Blood pressure, blood glucose, lipid parameters, and body mass index along with anthropometric measurements were assessed in all study participants.

Statistical Analysis Used:

Chi-square test was used to compare proportions between groups. Means were compared between groups using Student's t-test.

Results:

MetS was seen in a higher proportion of patients with AGA (43.5%) as compared to the control group (2.4%) and the differences were statistically significant (P < 0.001). As compared to controls, patients with AGA had higher triglycerides (P < 0.001), systolic blood pressure (P < 0.001), diastolic blood pressure (P < 0.001) along with significantly lower high-density lipoprotein cholesterol levels (P < 0.001). Severity of AGA was not associated with MetS.

Conclusions:

AGA is associated with MetS in male Indian patients aged <30 years. Studies with large sample sizes may be required to conclusively define any putative associations between AGA grades and MetS.