Androgenetic alopecia was associated with hyperlipidemia in both males and females and with obesity in females in a large US cohort, according to a study by Malak Husseinali, BSA, of Baylor College of Medicine in Houston, and colleagues.
In the cross-sectional, 1:2 propensity score–matched analysis of the All of Us Research Program, the investigators evaluated 1,015 patients with androgenetic alopecia and 2,030 matched controls with at least 1 year of electronic health record data. Matching was performed on age, sex, race, and ethnicity, and analyses were adjusted for smoking status, insurance coverage, household income, health care access, and marital status. Thirteen cardiovascular and metabolic conditions were assessed.
In unadjusted analyses, patients with androgenetic alopecia had higher prevalence of hyperlipidemia (61% vs 42%), obesity (38% vs 29%), hypertension (51% vs 44%), and valvular heart disease (17% vs 12%) compared with controls. No statistically significant differences were observed for coronary artery disease, myocardial infarction, stroke or transient ischemic attack, heart failure, peripheral artery disease, atrial fibrillation, venous thromboembolism, type 2 diabetes, or chronic kidney disease.
In adjusted analyses, hyperlipidemia remained associated with androgenetic alopecia in both males and females, corresponding to 2.3 times the odds in males and 2.6 times the odds in females. Obesity was associated with androgenetic alopecia in females, with approximately 1.5 times the odds, but not in males. Associations with hypertension and valvular heart disease did not persist following adjustment.
The cohort had a mean age of 60 years and was 68% female and 29% male. Patients with androgenetic alopecia were more likely to report higher income, have insurance, and have greater health care utilization than matched controls.
The study was limited by its cross-sectional design, which precluded causal inference, and by reliance on structured electronic health record data, which may have led to underreporting or misclassification. The investigators also lacked data on physical activity, dietary habits, and use of lipid-lowering or antiandrogenic medications, and they could not assess dose-response relationships because standardized grading of androgenetic alopecia severity was unavailable.
“These findings support the growing recognition that AGA may serve as a dermatologic window into cardiovascular risk,” the authors wrote.
Disclosures: The authors declared no conflicts of interest.
Source: Dermatology Online Journal
