Premature Androgenetic Alopecia Research Articles

GLP-1 agonists and hair loss: a call for further investigation.

The widespread adoption of glucagon-like peptide-1 (GLP-1) agonists in treating type 2 diabetes mellitus (T2DM) and obesity has sparked investigations into their impact on hair health, an area characterized by diverse conjectures. Some propose potential risks such as disrupted hair growth cycles or premature androgenetic alopecia (AGA), while others suggest benefits linked to improved insulin sensitivity and enhanced scalp blood circulation. However, despite these theoretical underpinnings, clinical evidence linking GLP-1 agonists to hair loss remains sparse. The necessity for vigilant patient monitoring and collaborative efforts cannot be overstressed in comprehensively addressing any potential consequences of GLP-1 agonist therapy on hair health as their use continues to expand.

Bioinformatic analysis of gene expression data reveals Src family protein tyrosine kinases as key players in androgenetic alopecia.

Androgenetic alopecia (AGA) is a common progressive scalp hair loss disorder that leads to baldness. This study aimed to identify core genes and pathways involved in premature AGA through an in-silico approach. Gene expression data (GSE90594) from vertex scalps of men with premature AGA and men without pattern hair loss was downloaded from the Gene Expression Omnibus database. Differentially expressed genes (DEGs) between the bald and haired samples were identified using the limma package in R. Gene ontology and Reactome pathway enrichment analyses were conducted separately for the up-regulated and down-regulated genes. The DEGs were annotated with the AGA risk loci, and motif analysis in the promoters of the DEGs was also carried out. STRING Protein-protein interaction (PPI) and Reactome Functional Interaction (FI) networks were constructed using the DEGs, and the networks were analyzed to identify hub genes that play could play crucial roles in AGA pathogenesis. The in-silico study revealed that genes involved in the structural makeup of the skin epidermis, hair follicle development, and hair cycle are down-regulated, while genes associated with the innate and adaptive immune systems, cytokine signaling, and interferon signaling pathways are up-regulated in the balding scalps of AGA. The PPI and FI network analyses identified 25 hub genes namely CTNNB1, EGF, GNAI3, NRAS, BTK, ESR1, HCK, ITGB7, LCK, LCP2, LYN, PDGFRB, PIK3CD, PTPN6, RAC2, SPI1, STAT3, STAT5A, VAV1, PSMB8, HLA-A, HLA-F, HLA-E, IRF4, and ITGAM that play crucial roles in AGA pathogenesis. The study also implicates that Src family tyrosine kinase genes such as LCK, and LYN in the up-regulation of the inflammatory process in the balding scalps of AGA highlighting their potential as therapeutic targets for future investigations.

STUDY OF VITAMIN D LEVELS IN MEN WITH PREMATURE ANDROGENETIC ALOPECIA

Androgenetic alopecia is common dermatological problem among the young to middle aged population.Androgenetic alopecia is labeled as 'premature' or 'Early' androgenetic alopecia when the onset of disease is before 30 years of age. There is very little data available regarding the role of vitamin D in the Premature androgenetic alopecia. Vitamin D deficiency is diagnosed when the levels of vitamin D in the serum is <30 ng/ml. This study focuses on establishing association between serum vitamin D levels and severity of premature androgenetic alopecia. Conclusion:Vitamin D plays a major role in premature onset of androgenetic alopecia.

Androgenetic alopecia: Prevalence and clinical characteristics in a South-West Nigerian population

Introduction: Androgenetic alopecia (AGA) is a type of nonscarring alopecia with prevalence, pattern, and severity that have not been documented extensively in Nigeria and Africa. This study aimed to document AGA's prevalence and clinical characteristics among adults in Ogbomoso, Southwestern Nigeria. Methods: A community-based cross-sectional study of 260 consenting adults with AGA and 260 age- and sex-matched controls through a multistage sampling method. The survey for AGA was done using a pretested questionnaire. Data were analyzed with IBM SPSS version 20. Results: The overall prevalence of AGA was 29.95%, with a gender prevalence of 24.88% and 5.06% for men and women, respectively. The mean age of AGA was 51.32 ± 16.31 years, with a range of 24–90 years and male-to-female ratio of 4.9:1. The prevalence of premature AGA was 0.38%. Grade II vertex (13.8%) and VI (10.4%) were the most frequent male androgenetic alopecia severity grades, while grade IVa was the least common. Ludwig I was the most frequent female androgenetic alopecia severity grade (7.7%), followed by Ludwig II (6.9%) and III (2.3%). The mixed type of baldness was the most common (73.6%) phenotype, followed by frontal (20.8%), and vertex (4.2%) in men. Conclusion: Overall prevalence of AGA was 29.95%. The prevalence varies with location, age and gender with paternal family history as a significant risk factor. The mixed type of baldness is the most common phenotype.

Study of serum vitamin D levels in men with premature androgenetic alopecia.

Vitamin D deficiency had been associated with various hair loss disorders, such as telogen effluvium, alopecia areata, and female pattern hair loss. However, previous studies have not found a correlation between serum vitamin D levels and the severity of androgenetic alopecia. A case-control study was conducted for a period of one year in a public tertiary care hospital. Fifty males clinically diagnosed with androgenetic alopecia and 50 age-matched healthy controls were recruited. Serum vitamin D levels in both cases and controls were measured by radioimmunoassay technique, and the results were compared. A total of 50 cases and 50 controls were recruited and analyzed. The mean age of the cases was 23years and that of controls was 24.2years. The mean levels of serum vitamin D significantly decreased in cases, compared to controls (20.10 vs. 29.34ng/mL; P≤0.001). Eighty-six percent of the cases had deficiency of vitamin D (<30nmol/L), while 14% had insufficient vitamin D levels (31-50nmol/L). There was a positive correlation between vitamin D deficiency and severity of androgenetic alopecia (AGA), which was statistically significant (P≤0.5). However, there was no correlation between the duration of sun exposure and serum vitamin D levels (2.36±1.2 in cases and 3.23±1.6 in controls, P value=0.98). Our study showed a significant correlation between vitamin D deficiency and the severity of androgenetic alopecia. This suggests that vitamin D may play a role in the premature onset of androgenetic alopecia. However, further studies on a larger population and the effect of vitamin D supplementation on the progression of androgenetic alopecia are required to validate the above findings.

The Association of Metabolic Syndrome and Insulin Resistance in Early-Onset Androgenetic Alopecia in Males: A Case-Control Study.

Background:Men with premature androgenetic alopecia (AGA) are found to be susceptible to cardiovascular diseases, metabolic syndrome (MS), diabetes mellitus and hypertension, and also premature baldness can have a definite negative impact on self-image and self-esteem in these patients. The aim of this study was to assess the strength of association between MS and/or insulin resistance (IR) in males with early-onset AGA.Methods:A total of 50 male patients with premature AGA and equal number of age-matched controls were enrolled in the study. Anthropometric measures, blood pressure, fasting glucose, fasting insulin, high-density lipoprotein cholesterol, and triglycerides were measured for all the participants. Association of IR and MS was evaluated.Results:Most common grade of hair loss was Grade IIIa (32%) of Hamilton–Norwood Scale of hair loss. Five out of 50 cases (10%) and 2 out of 50 controls (4%) had shown association with IR and the difference between the groups was statistically insignificant (P=0.23). Fifteen out of 50 cases (30%) and 4 out of 50 controls had shown association with MS and the difference between the groups was statistically significant (P=0.005).Conclusion:Male patients with early-onset AGA were not associated with IR. MS was associated with male patients with early-onset AGA. The results observed in our study may raise awareness in susceptible individuals that lifestyle changes in early life can reduce the risk of coronary heart diseases in the long term.

A study of the association of premature androgenetic alopecia with metabolic syndrome and coronary artery disease

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; &lt;span lang="EN-IN"&gt;Androgenetic alopecia (AGA) is a common form of patterned hair loss characterized by transformation of terminal hair of the scalp to vellous hair mediated mainly by androgens. Premature androgenetic alopecia can be defined as androgenetic alopecia developing before 35 years of age and presenting with at least stage 2 of Norwood-Hamilton classification. Premature AGA not only adds to psychological stress but is also reported as a risk factor for cardiovascular diseases, metabolic syndrome and carcinoma prostrate. In many subsequent studies, AGA has been shown to be associated with several diseases such as insulin resistance (IR), abnormal serum lipid profiles and obesity.&lt;/span&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; &lt;span lang="EN-IN"&gt;Various parameters of metabolic syndrome were measured in 75 male patients of AGA in the department of dermatology, Safdarjung hospital from June 2015 to April 2016. ECG and echocardiography was done in all patients to look for any evidence of premature coronary artery disease&lt;/span&gt;.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; &lt;span lang="EN-IN"&gt;In our study grade III and IV of AGA were the most common types (32% each). We found the prevalence of metabolic syndrome to be 8% in our patients with premature androgenetic alopecia in accordance with the NCEP ATP III guidelines. There was a significant positive correlation between grade of androgenetic alopecia and metabolic syndorme in our patients (p=0.049). &lt;/span&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; &lt;span lang="EN-IN"&gt;The prevalence of metabolic syndrome was not increased as compared to general population.&lt;/span&gt;&lt;/p&gt;

Study of gene expression alteration in male androgenetic alopecia: evidence of predominant molecular signalling pathways.

Male androgenetic alopecia (AGA) is the most common form of hair loss in men. It is characterized by a distinct pattern of progressive hair loss starting from the frontal area and the vertex of the scalp. Although several genetic risk loci have been identified, relevant genes for AGA remain to be defined. To identify biomarkers associated with AGA. Molecular biomarkers associated with premature AGA were identified through gene expression analysis using cDNA generated from scalp vertex biopsies of hairless or bald men with premature AGA, and healthy volunteers. This monocentric study reveals that genes encoding mast cell granule enzymes, inflammatory mediators and immunoglobulin-associated immune mediators were significantly overexpressed in AGA. In contrast, underexpressed genes appear to be associated with the Wnt/β-catenin and bone morphogenic protein/transforming growth factor-β signalling pathways. Although involvement of these pathways in hair follicle regeneration is well described, functional interpretation of the transcriptomic data highlights different events that account for their inhibition. In particular, one of these events depends on the dysregulated expression of proopiomelanocortin, as confirmed by polymerase chain reaction and immunohistochemistry. In addition, lower expression of CYP27B1 in patients with AGA supports the notion that changes in vitamin D metabolism contributes to hair loss. This study provides compelling evidence for distinct molecular events contributing to alopecia that may pave the way for new therapeutic approaches.

Free Androgen Index (FAI): Marker of Premature Androgenetic Alopecia in Men

Introduction: Premature androgenetic alopecia (AGA) in men is alopecia occurring before the age of 30 years. We conducted this study to evaluate various androgenic hormones in men with premature androgenetic alopecia and to assess if free androgen index (FAI) can be used as a marker of hyperandrogenism in these men. Materials and methods: 57 men with premature AGA (defined as grade 3 or more on Hamilton-Norwood scale) were taken as subjects. The serum concentrations of Testosterone, DHEAS, and SHBG were measured and Free androgen index (FAI) was calculated and compared with age and sex matched controls. Results: There were significant differences in the mean values of all the three indicators for androgen status (FAI, DHEAS and testosterone) in cases as compared to the controls. The statistical significance was higher for FAI and DHEAS than that for testosterone. FAI appeared to be a better predictor of hyperandrogenism than DHEAS and testosterone. Conclusion: FAI is the best marker of a person’s androgen status and can be considered as the marker of premature AGA. Taking into consideration the technical limitations of the currently available methods for measuring free testosterone, and the diagnostic importance of using FAI as indicator of androgen status, it is recommended to implement these parameters in the routine investigation and assessment of men with AGA.

Assessment of semen quality in patients with androgenetic alopecia in an infertility clinic

Abstract Background Androgenetic alopecia (AGA) is a common cause of hair loss in men. It is associated with the risk of cardiovascular disease and metabolic syndrome. Additionally, it is suggested that premature AGA could be considered equivalent to that of polycystic ovary syndrome in women. Objective The aim of this study was to examine the relation between AGA and the quality of semen. Methods The semen specimens were collected from 203 young adult men included in the study. AGA was classified according to the Hamilton baldness scale, modified by Norwood. All participants were classified into two categories: normal to mild AGA (equivalent to Norwood types I–II) as Group I and moderate to severe AGA (equivalent to Norwood types III–VII) as Group II to assess the difference in the quality of sperms between the two groups. Results There were no statistically significant differences in the men's age and body mass index scores among the groups. For both Groups I and II, the history of smoking and varicocele was not statistically different ( p = 0.62 and p = 0.11, respectively). All parameters of sperm including volume, density, motility, and morphology were significantly lower in participants with moderate to severe AGA than those with normal to mild AGA ( p p p p Conclusion This study showed that young adult men with moderate to severe AGA have poor quality of semen compared with those who have normal to mild AGA.

Association of premature androgenetic alopecia and metabolic syndrome in a young Indian population.

Context:Although evidences for association of androgenetic alopecia (AGA) with metabolic syndrome (MetS) are accruing, inconclusiveness with respect to the gender specificity and differential association of MetS with increasing severity of AGA continues to persist. Furthermore, data specific to Indian settings are relatively sparse.Aims:The present study aimed at assessing the frequency of MetS in individuals with early AGA in Indian settings.Settings and Design:A case-control study was conducted at a trichology clinic in Bengaluru between April 2012 and September 2012 with a total of 85 cases of AGA and 85 age-matched controls.Materials and Methods:The Norwood-Hamilton classification was used to assess the grade of AGA. MetS was defined according to the National Cholesterol Education Program Adult Treatment Panel III criteria. Blood pressure, blood glucose, lipid parameters, and body mass index along with anthropometric measurements were assessed in all study participants.Statistical Analysis Used:Chi-square test was used to compare proportions between groups. Means were compared between groups using Student's t-test.Results:MetS was seen in a higher proportion of patients with AGA (43.5%) as compared to the control group (2.4%) and the differences were statistically significant (P < 0.001). As compared to controls, patients with AGA had higher triglycerides (P < 0.001), systolic blood pressure (P < 0.001), diastolic blood pressure (P < 0.001) along with significantly lower high-density lipoprotein cholesterol levels (P < 0.001). Severity of AGA was not associated with MetS.Conclusions:AGA is associated with MetS in male Indian patients aged <30 years. Studies with large sample sizes may be required to conclusively define any putative associations between AGA grades and MetS.

Hormonal profile in Indian men with premature androgenetic alopecia

Introduction:Alopecia in male is considered as a genetically determined disorder characterized by increased level of local androgen metabolite and increase androgen receptor binding in balding areas. Frequent deviations of hormones from normal values have been reported in men diagnosed with premature androgenetic alopecia (AGA) especially for androgens, gonadotropins and sex hormone binding globulin (SHBG). Different studies in the past have inferred that premature baldness before the age of thirty in males could be considered equivalent to the polycystic ovary syndrome (PCOS) in female.Materials and Methods:Hormonal profile of 50 men with severe premature balding before 30 years of age were compared with same numbers of age matched controls. The serum concentrations of total testosterone, dehydroepiandrosterone sulfate, luteinizing hormone, follicle stimulating hormone, SHBG, insulin and fasting blood sugar were estimated. Statistical analysis was performed with paired Student's t-test for cases and controls.Results:Decreased levels of SHBG with high free androgen index were found in cases when compared with the controls.Conclusion:Though altered hormonal profile may coexist in some of men with premature AGA it can’t be considered as male equivalent to PCOS in female or the metabolic syndrome.

Early-onset androgenetic alopecia and endocrine disruptors

Androgenetic alopecia (AGA) is the most common acquired non scarring alopecia in humans caused by androgen hormones in the setting of a genetic predisposition. Usually AGA starts after puberty, but recently it has been observed also in adolescents. Their mean age was 13 years with a slight prevalence in males. The premature AGA may be caused by environmental, alimentary (meat and milk) or cosmetics overexposure to sexual hormones or to endocrine disrupters (EDs). EDs are "exogenous substances that interfere with the synthesis, secretion, transport, binding, action, or elimination of natural hormones in the body causing adverse effects to human health" and they are able bind to the steroid hormone receptors. Early onset AGA may be linked to the well known phenomenon of early puberty caused in some cases by hormones contained in food or by environmental chemicals. Therefore it is likely that the EDs may play a role also in the pathogenesis of early-onset AGA.

The influence of low dose finasteride, a type II 5α-reductase inhibitor, on circulating neuroactive steroids.

Finasteride is a 5α-reductase inhibitor that has received clinical approval for the treatment of human benign prostatic hyperplasia and androgenetic alopecia. The treatment is practically without side effects, although some occasional cases of depression syndrome have been reported. 5α-Reductase is an enzyme responsible for the reduction of testosterone, progesterone or deoxycorticosterone to their 5α-reduced derivatives possessing anticonvulsant, antidepressant, and anxiolytic activity. Therefore, the formation of GABAergic neuroactive steroids is likely to be impacted by finasteride. The objective of the study was to show how the treatment of premature androgenetic alopecia with low doses (1mg/day) of finasteride influences the broad spectrum of steroids with potential neuroactivity. A group of 12 men with premature androgenetic alopecia participated in the present study. The steroid hormone profile was determined for all individuals. Finasteride was administered for 4 months at a daily dose of 1mg. After the treatment, the same hormonal profile was determined again. 5α-Reduced steroids, e.g., 5α-dihydrotestosterone, androsterone, epiandrosterone, 5α-androstene-3α,17β-diol, allopregnanolone, isopregnaolone, and some 5-ene steroids, such as dehydroepiandrosterone and pregnenolone, decreased gradually during treatment. The decrease of 5α-reduced steroids, especially of allopregnanediol, dihydrotestosterone, and pregnenolone, is probably one of the factors responsible for the increased occurrence of depression in men treated with finasteride, even at low doses.