Severe androgenetic alopecia as a proxy of metabolic syndrome in male psoriatic patients older than 59 years

Eur J Dermatol. 2014 May-Jun;24(3):356-60. doi: 10.1684/ejd.2014.2346.

Abstract

Background: Whereas several studies have underlined the association between severe psoriasis and metabolic syndrome (MetS), the association of androgenetic alopecia (AGA) and MetS have yielded inconsistent results.

Objective: To investigate the relationship between AGA and the components of MetS in a population of psoriatic male patients.

Methods: A non-interventional, cross-sectional, multicenter study was conducted in France. A standardized questionnaire was completed, including information on components of MetS and other possible risk factors. MetS was defined in this study as a combination of three or more of the four components of MetS: waist circumference, hyperlipidemia, diabetes mellitus and hypertension. In addition, a standardized simplified Norwood classification limited into 5 grades (0-4) was used.

Results: In a total of 1073 male patients, hypertension, high waist circumference, diabetes mellitus and hyperlipidemia were observed in 28%, 59%, 11%, and 31%, respectively. In age-adjusted multivariate analysis, severe AGA (grade 3-4 versus grade 0) was associated with the presence of at least one component of MetS. By groups of age, a statistically significant association of severe AGA and MetS was demonstrated in patients over 59 years. Severe AGA was also associated with a first degree familial history of major cardiovascular event in patients older than 59 years.

Conclusions: Our study, based on a simplified but stringent definition of MetS, confirmed the link between severe AGA and individual components of MetS in psoriatic patients. This argues for careful follow-up with regular screening in male psoriatic patients with severe AGA in order to early detect determinants of MetS.

Keywords: androgenetic alopecia; hypertension; metabolic syndrome; psoriasis.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Alopecia / complications*
  • Cross-Sectional Studies
  • Humans
  • Male
  • Metabolic Syndrome / complications*
  • Metabolic Syndrome / diagnosis
  • Middle Aged
  • Prospective Studies
  • Psoriasis / complications*
  • Severity of Illness Index