Investigation And Meta-Analysis Of Risk Factors For Androgenetic Alopecia

Objective:This study aimed to investigate the risk factors for androgenetic alopecia(AGA)and to develop a predictive model,to understand the living quality among patients,to explore the relationship between metabolic syndrome(Met S)and AGA,and thus providing theoretical support for clinicians to offer appropriate clinical guidance to AGA patients.Methods:1.A matched case-control study was carried out in 536pairs of AGA case-control subjects by administrating a same questionnaire.Risk factors for AGA onset were analyzed using univariate and multivariate logistic regression.The nomogram model was drawn to predict the risk of AGA via R software.The effects of different factors on the quality of life of AGA patients were analyzed by multiple linear regression.2.Pub Med,EMBASE,Web of Science,The Cochrane Library,CNKI,Wanfang,Wipu and China Biomedical Literature Service databases were retrieved to collect case-control studies related to Met S and AGA.Literature was independently screened by two investigators.After extraction of data and evaluation of the quality of the included literature,a meta-analysis was performed using Stata 16.0 software.Results:1.Univariate conditional logistic regression analysis showed statistically significant differences between the two groups in body mass index,marital status,education level,skin type,family history(father),family history(mother),nature of occupation,consumption of spicy and irritating foods,areca nut and coffee,length of time on electronics,workout time,workout type,frequency of hair washing and irregular menstruation(p<0.05).The results of the multivariate conditional logistic regression analysis showed that body mass index≥24kg/m~2,unmarried,family history(father),family history(mother),occupational nature of mental work,frequent consumption of spicy and stimulating foods,frequent consumption of areca nut and frequency of hair washing≥1 time/day increased the risk of the disease(P<0.05).Frequent coffee consumption and participation in aerobic or anaerobic exercise reduced the risk of the disease(P<0.05).The C-index of the nomogram prediction model built by R software was 0.789,indicating that the model has a good predictive ability.Multiple linear regression showed that severity of the disease,medical coping modes and the cost of treating hair loss influenced the dermatology life quality index scores of patients(p<0.05).2.A total of 20 articles were eligible for inclusion in this meta-analysis,including 1,581 patients with AGA and 1,425 healthy controls.The results showed that Met S was a risk factor for AGA(OR=3.58,95%CI:2.52-5.09,P<0.001).The AGA patients were more closely related to Met S in female,early-onset and Asian population.Furthermore,patients with AGA had higher body mass index,waist circumference,triglyceride,fasting glucose,systolic and diastolic blood pressure,but lower high-density lipoprotein cholesterol levels than control group(P<0.05).Conclusions:1.Body mass index≥24 kg/m~2,unmarried,family history(father),family history(mother),occupational nature of mental work,frequent consumption of spicy and stimulating foods,frequent consumption of areca nut and frequency of hair washing≥1 time/day were risk factors for the development of AGA.Frequent coffee consumption and participation in aerobic or anaerobic exercise were protective factors for AGA.The quality of life of patients with AGA was closely related to severity of the disease,medical coping modes and the proportion of money spent on alopecia treatment.2.AGA was associated with a high risk of Met S and patients with AGA had a significantly worse metabolic profile.