Dyslipidemia in patients with early onset androgenetic alopecia and risk of coronary artery disease

The Gulf Journal of Dermatology and Venereology INTRODUCTION Androgenetic alopecia (AGA) is a hereditary and androgen-dependent progressive thinning of the scalp hair in a defined pattern. It is a common dermatological disorder affecting more men and occasionally women, with significant negative impact on their social and psychological well being. AGA commonly begins by 20 years of age and affects nearly 50% of men by the age of 50 years.1,2 Its etiopathogenesis is mainly androgendependent and modulated via the testosterone metabolite (dihydrotestosterone), the expression of hair follicle-related androgen receptor and genetic factors also have been implicated.3 Coronary artey disease (CAD) is a major cause of death and disability worldwide.4 Advanced obstructive CAD can exist in patients with minimal or no symptoms and can progress rapidly, so early detection is extremely important.5 Several studies have shown that baldness is associated with the risk of CAD. These studies have generally found a positive association between baldness and CAD, ABSTRACT Background: The association between androgenetic alopecia (AGA) and coronary artery disease (CAD) has been explored in serious studies. Aim of the work: This study was designed to evaluate lipid profile in male patients with early onset AGA. Patients and methods: This study included 60 male patients with AGA as case group and 40 males with a normal hair status as control group. The age of both groups ranged from 20-35. Lipid profile including total cholesterol (TC), triglyceride (TG), high density lipoprotein (HDL), low density lipoprotein (LDL), lipoprotein-a (Lp-a), apolipoprotein A1 (Apo A1), and apolipoprotein B (Apo B) were measured in both groups. Results: There was a significant difference in serum LDL between patients and controls(147.40 ± 58.12 versus 100.20 ± 35.62, P < 0.05). Also, there was a significant difference in serum lipoprotein-a between patients and controls ((48.10 ± 52.53 versus 16.49 ± 12.12, P < 0.05 ). The difference in other lipid parameters between two groups was not significant. The family history of androgenic alopecia and coronary heart disease was significantly higher in the cases than the controls (51 (85%) versus 15 (37.5%),18(30%) versus 4(10%), P < 0.05). Conclusion: Disorder of lipid profile, especially low density lipoprotein and lipoprotein-a can be considered as a risk factor for coronary artery disease in patients with early onset AGA. Investigation of lipid profile mainly low density lipoprotein and lipoprotein-a should be done for every patient with early onset androgenetic alopecia. Early therapy with lipid lowering drugs and follow up with cardiologist is useful to reduce the risk of coronary artery disease.