Sex hormone-binding globulin and risk of hyperglycemia in patients with androgenetic alopecia.
ABSTRACT Low circulating levels of sex hormone-binding globulin (SHBG) are a strong predictor of the risk of type 2 diabetes. Androgenetic alopecia (AGA) has been related to an increase in cardiovascular risk, but the mechanism of this association has not been elucidated. AGA can be associated with low levels of SHBG and insulin resistance, which could be related to hyperglycemia and type 2 diabetes.
The objective of this study was to evaluate SHBG and blood glucose levels in men and women with early-onset AGA and control subjects to determine whether low levels of SHBG are associated with hyperglycemia.
This case-control study included 240 patients consecutively admitted to the outpatient clinic (Dermatology Department of San Cecilio University Hospital, Granada, Spain), 120 with early-onset AGA (60 men and 60 women) and 120 control subjects (60 men and 60 women) with skin diseases other than alopecia.
Of patients with AGA, 39.1% presented with hyperglycemia (>110 mg/dL) versus 12.5% of controls (P < 0.0001). AGA patients with hyperglycemia or diabetes presented lower significant levels of SHBG than alopecic patients without hyperglycemia or type 2 diabetes, respectively. Patients with AGA and hyperglycemia presented significantly lower levels of SHBG than controls with hyperglycemia (22.3 vs 39.4 nmol/L for AGA patients and controls, respectively, P = .004). No significant differences in SHBG levels were noticed between patients and controls without hyperglycemia. Binary logistic regression showed a strong association between lower SHBG levels and glucose levels greater than 110 mg/dL in patients with AGA even after additional adjustment for sex, abdominal obesity, and free testosterone (odds ratio = 3.35; 95% confidence interval = 1.9-5.7; P < .001).
The study of a wider sample of AGA patients would confirm these findings and would permit analysis of the pathogenic mechanisms underlying the increase in cardiovascular risk in patients with AGA.
An association between early-onset AGA, hyperglycemia/diabetes, and low levels of SHBG was observed in the current study. Low levels of SHBG could be a marker of insulin resistance and hyperglycemia/diabetes in patients with AGA.
- Journal of the European Academy of Dermatology and Venereology 12/2011; · 2.69 Impact Factor
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ABSTRACT: BACKGROUND:: This study investigated the potential contribution of environmental factors and testosterone levels on androgenic alopecia (AGA) in women. METHODS:: Ninety-eight identical female twins were recruited from 2009 to 2011. Subjects were asked to complete a comprehensive questionnaire, provide a sputum sample for testosterone analysis, and pose for standardized digital photography. Frontal (FHL), temporal (THL), and vertex (VHL) hair loss were assessed from the photographs using Adobe Photoshop. Hair loss measures were then correlated with survey responses and testosterone levels between twin pairs. Two independent, blinded observers also rated the photographs for hair thinning. RESULTS:: Factors associated with increased FHL included multiple marriages (p=0.043), longer sleep duration (p=0.011), higher severity of stress (p=0.034), positive smoking history (p=0.021), higher income (p=0.023), absence of hat use (p=0.017), and history of diabetes mellitus (p=0.023), polycystic ovarian syndrome (p=0.002), and hypertension (p=0.001). Factors associated with increased THL included divorce or separation (p=0.034), multiple marriages (p =0.040), more children (p=0.005), longer sleep duration (p=0.006), and history of diabetes mellitus (p=0.008), and hypertension (p=0.027). Lack of sun protection (p=0.020), consuming less caffeine (p = 0.040), history of skin disease (p=0.048), and lack of exercise (p=0.012) were associated with increased VHL. Higher testosterone levels was associated with increased temporal and vertex hair loss patterns (p<0.039). Increased stress, increased smoking, having more children, and having a history of hypertension and cancer were all associated with increased hair thinning (p <0.05). CONCLUSIONS:: This study implicates several environmental risk factors in the pathophysiology of female alopecia. CLINICAL QUESTION/LEVEL OF EVIDENCE:: Prognostic/Risk, II.Plastic and reconstructive surgery 08/2012; · 2.74 Impact Factor
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ABSTRACT: BACKGROUND: Early-onset baldness has been linked to prostate cancer; however, little is known about this relationship in AfricanAmericans who are at elevated prostate cancer risk.METHODS: We recruited 219 African-American controls and 318 African-American prostate cancer cases. We determined age-stratified associations of baldness with prostate cancer occurrence and severity defined by high stage (T3/T4) or high grade (Gleason 7+.) Associations of androgen metabolism genotypes (CYP3A4, CYP3A5, CYP3A43, AR-CAG, SRD5A2 A49T, and SRD5A2 V89L), family history, alcohol intake, and smoking were examined by baldness status and age group by using multivariable logistic regression models.RESULTS: Baldness was associated with odds of prostate cancer [OR = 1.69; 95% confidence interval (CI), 1.05-2.74]. Frontal baldness was associated with high-stage (OR = 2.61; 95% CI, 1.10-6.18) and high-grade (OR = 2.20; 95% CI, 1.05-4.61) tumors. For men diagnosed less than the age of 60 years, frontal baldness was associated with high stage (OR = 6.51; 95% CI, 2.11-20.06) and high grade (OR = 4.23; 95% CI, 1.47-12.14). We also observed a suggestion of an interaction among smoking, median age, and any baldness (P = 0.02).CONCLUSIONS: We observed significant associations between early-onset baldness and prostate cancer in African-American men. Interactions with age and smoking were suggested in these associations. Studies are needed to investigate the mechanisms influencing the relationship between baldness and prostate cancer in African-American men.Impact: African-American men present with unique risk factors including baldness patterns that may contribute to prostate cancer disparities. Cancer Epidemiol Biomarkers Prev; 22(4); 1-8. ©2013 AACR.Cancer Epidemiology Biomarkers & Prevention 03/2013; · 4.56 Impact Factor