Androgenetic Alopecia and its Association with Metabolic Syndrome: A Systematic Review and Meta-analysis

Objectives. The study aimed to confirm the association between androgenetic alopecia (AGA) and Metabolic Syndrome (MetS). It also aimed to determine if early-onset AGA among males and AGA among females increases the risk of developing MetS, and if severity of AGA increases the odds of developing MetS. Methods. Observational studies from electronic databases were selected by the consensus of three independent review authors. The Newcastle-Ottawa Scale for assessing the quality of non-randomized studies in meta-analysis was used. Statistical analyses were accomplished using Review Manager software. Results. A total of 11 case-control studies, one prospective cohort study, and five cross-sectional studies were selected. In the meta-analysis of ten case-control studies and three cross-sectional studies (3840 participants), AGA was significantly correlated with MetS (OR 2.59, 95% CI 1.51 to 4.44; p<0.0005). Early-onset AGA among males (<35 years old) showed significant association (OR 3.69, 95% CI 2.15 to 6.33; p<0.00001). AGA among females also increased the odds of developing MetS (OR 5.59, 95% CI 2.06 to 15.12; p<0.0007). Moderate to severe AGA in males, Norwood-Hamilton IV or higher, was also significant (OR 1.65, 95% CI 1.12 to 2.42; p=0.01). The same trend was noted for females with Ludwig II and III (OR 5.82, 95% CI 2.54 to 13.34; p<0.00001). Conclusion. Although the pathophysiology still remains under investigation, the present study points to an association between AGA and MetS. It can be used as a marker to identify patients who should be screened for MetS and managed accordingly.