Hair Loss After Metabolic and Bariatric Surgery: a Systematic Review and Meta-analysis

Wen Zhang,Meiling Fan,Cunchuan Wang,Wah Yang,Weiju Chen,Kamal Mahawar,Chetan Parmar

doi:10.1007/s11695-021-05311-2

Abstract

BackgroundHair loss is a common complication after metabolic and bariatric surgery (MBS). There is a lack of published systematic review in the scientific literature on this topic. The aim of this study was to perform a systematic review and meta-analysis on hair loss after MBS in accordance with Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) guidelines.MethodsPubMed, CINAHL, EMBASE, Web of Science, SCOPUS, and four Chinese databases were searched. Data were pooled using Review Manager 5.3 and Stata 12.0, and subgroups were performed if necessary and feasible.ResultsA total of 18 studies (n = 2538) were included. The pooled results showed that the incidence of hair loss after MBS was 57% (95% CI 42–71%). It decreased with longer follow-up times. Hair loss was significantly more common in younger (mean difference (MD), − 2.45; 95% CI, − 4.26 to − 0.64; p = 0.008) women (OR, 3.87; 95% CI, 0.59 to 17.59; p = 0.08). Serum zinc (standardized mean difference (SMD), − 1.13; 95% CI, − 2.27 to 0.01, p = 0.05), folic acid (SMD = − 0.88, 95% CI − 1.29 to − 0.46, p < 0.0001), and ferritin levels (SMD, − 0.22; 95% CI, − 0.38 to − 0.05; p = 0.01), but not serum iron and vitamin B12, were associated with hair loss following MBS.ConclusionsHair loss is common after MBS especially in younger women, and those with low serum levels of zinc, folic acid, and ferritin. Prospective studies on larger cohorts are needed.

Highlights

MethodsThe prevalence of overweight and obesity has been increasing globally and it has become a major public health concern in many countries [1]
When we looked at the subgroup based on follow-up duration, a significant pooled result (35%, 95% confidence interval (CI) 33 to 37%, p
When we looked at the subgroup of procedures, both the two subgroups had significant pooled results, but the incidence of hair loss was similar in both groups, with SG surgery (51%, 95% CI 48 to 54%, p< 0.1, I2 = 94.2%) and RYGB surgery (59%, 95% CI 55 to 63%, p

Summary

Introduction

MethodsThe prevalence of overweight and obesity has been increasing globally and it has become a major public health concern in many countries [1]. Others have demonstrated that iron and zinc levels are associated with hair loss [5]. Hair loss is a common complication after metabolic and bariatric surgery (MBS). The pooled results showed that the incidence of hair loss after MBS was 57% (95% CI 42–71%). Serum zinc (standardized mean difference (SMD), − 1.13; 95% CI, − 2.27 to 0.01, p = 0.05), folic acid (SMD = − 0.88, 95% CI − 1.29 to − 0.46, p < 0.0001), and ferritin levels (SMD, − 0.22; 95% CI, − 0.38 to − 0.05; p = 0.01), but not serum iron and vitamin B12, were associated with hair loss following MBS

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