Male-pattern baldness and incident coronary heart disease and risk factors in the Heinz Nixdorf Recall Study.

Amir A Mahabadi,Markus M Nöthen,Raimund Erbel,Lara M Hochfeld,Stefanie Heilmann-Heimbach,Susanne Moebus,Sonali Pechlivanis,Chun Shing Kwok,Karl-Heinz Jöckel

doi:10.1371/journal.pone.0225521

Abstract

Male-pattern baldness (MPB) is characterized by a progressive hair loss from the frontal and vertex scalp that affects about 80% of men at the age of 80 years. Epidemiological studies show positive associations between MPB and coronary heart disease (CHD) and CHD related risk factors such as blood pressure (BP), diabetes mellitus (DM) or elevated blood lipid levels. The results however vary with regard to the pattern of hair loss (i.e. moderate, severe, frontal or vertex). Further, no study has investigated for a shared genetic determinant between MPB and CHD as well as CHD related risk factors. Using the longitudinal data from the population-based Heinz Nixdorf Recall study we aimed to systematically investigate the association between MPB and incident CHD and CHD risk factors on (i) an epidemiological (N = 1,673 males) and (ii) a genetic (N = 1,357 males) level. The prevalence of any baldness in our study population was 88% (mean age ± SD: 64±7.5 years). Compared to men with ‘no baldness’, in men with any kind of baldness a slightly increased risk for CHD (Hazard ratio [95% confidence interval (95%CI)] = 1.2 [0.8; 1.9]), a slightly higher extend of coronary artery calcification (CAC) (Beta [95%CI] = 0.2 [-0.1; 0.6]), a moderately increased risk for DM (prevalence ratio [95%CI] = 1.4 [0.9; 2.0]) and higher body mass index (BMI) (Beta [95%CI] = 0.6 [0.00003; 1.2]) seem to be indicated in the adjusted model. In contrast, the MPB genetic risk score did not show any association with CHD or CHD risk factors. Taken together, the results of our study suggest a weak association between MPB and a few CHD risk factors (CAC, DM and BMI) but do not point to MPB as a strong surrogate measure for CHD and CHD risk factors in general.

Highlights

Male-pattern baldness (MPB) is the most common form of hair loss among men and is characterized by a progressive hair loss from the frontal and vertex scalp
Models: the adjustment sets for each phenotype are indicated in the S1 Table
While we did not detect any genetic associations between MPB and coronary heart disease (CHD) or related phenotypes, our epidemiological data point towards an increased risk for CHD in men with baldness

Summary

Introduction

Male-pattern baldness (MPB) is the most common form of hair loss among men and is characterized by a progressive hair loss from the frontal and vertex scalp. No study has so far tried to systematically break down the generally observed association between MPB and CHD to specific CHD risk factors neither on an epidemiological nor at genetic level. The aim of our study was to systematically investigate the associations between (i) MPB and CHD and (ii) MPB and risk factors associated with CHD both at an epidemiological and at a genetic level and thereby gain insights into the associated disease mechanisms. To this end, we used the comprehensive, longitudinally assessed phenotypic and genotypic data for a subset of 1,673 male participants of the German Heinz Nixdorf Recall Study

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Conclusion