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Evaluation of lipid levels in androgenetic alopecia


Evaluation of lipid levels in androgenetic alopecia in comparison with control group

Journal of the European Academy of Dermatology and Venereology

Several studies have determined relatively increased risk of coronary heart disease (CHD) in men with vertex type androgenetic alopecia (AGA). 1–5 Most of these considered this association independent of CHD risk factors, 1–4,6 whereas some others revealed a meaningful association between AGA and hyperlipidemia. 7,8 Androgens and genetic susceptibility are essential for the development of AGA. In this study, data were collected from June 2005 to August 2007 from men who attending to dermatologic clinics affiliated to Ilam University of medical science.

Study group:
50 men with vertex type AGA (grade vertex or more, according to Hamilton-Norwood classification).

Control group:
50 men with normal hair status matched with study group concerning age, body mass index (BMI) and habit of smoking.

After a 12-h fasting period, venous blood was taken for analysing triglyceride (TG), total cholesterol and high-density lipoprotein (HDL)-cholesterol and low-density lipoprotein (LDL)-cholesterol was calculated by the CHOD-PAP method.

Mean age was 40.6 ± 9.5 years with mean rank of 52.1 in the study group and 39.5 ± 8.7 years with mean rank of 48.9 in the control group. Mean of BMI was 24.3 ± 2.62 kg/m2 in the study group and 24.2 ± 2.3 kg/m2 in the control group. There was no statistically significant difference between two groups about above-mentioned factors.

Results :
There were statistically significant differences in triglyceride and HDL-cholesterol levels and total cholesterol/HDL-cholesterol ratio between two groups so that triglyceride and total cholesterol/HDL-cholesterol ratio were higher in the study group, but HDL-cholesterol was lower in the study group (in all findings, P < 0.01).

Total cholesterol and LDL-cholesterol levels also were higher in the study group, but the difference was not significant.

According to MEDLINE search, there are few studies directly evaluating AGA and hyperlipidemia relationship.

Guzzo et al. have evaluated lipid profile of 50 men with AGA grade 3, 4 vertex. These values have been compared with randomly obtained serum lipid profiles of 37 age-matched men referring to reference laboratory. 9 Although there has not been statistically meaningful difference in lipid indices between two groups, their finding is questioned because of ignoring confounding factors affecting serum lipid profiles (secondary hyperlipidemia and familial hyperlipidemia).

Our study attended to confounding factors in relationship between AGA and hyperlipidemia.

There are some noticeable points about CHD and lipid profile relationship in interpretation of our findings: Nevertheless, increased LDL-cholesterol/HDL-cholesterol ratio have already been considered as a sensitive predictor of CHD risk in men, total cholesterol/HDL-cholesterol ratio has been found a better predictor metabolic index for CHD risk in large study done by ‘Quebec’ Heart Institute thereafter.

In our study, total cholesterol/HDL-cholesterol ratio has been meaningfully higher in men with AGA (P < 0.01), suggesting a greater susceptibility to CHD in these patients.

In our study, patient with vertex-type AGA showed lower HDL-cholesterol level (P < 0.01) and higher triglyceride level (P < 0.01) than the control group, further supporting evidence suggesting a greater susceptibility to CHD in these patients.

According to mentioned findings, vertex-type AGA can be used as a marker of increased probability of CHD in the context of hyperlipidemia. It is recommended to evaluate serum lipid indices in these patients.