الفهرس 
Androgenetic alopeciaOnly 14 pages are availabe for public view
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Abstract
Androgenetic alopecia is an androgen induced disorder that is characterized by hair loss in genetically predisposed men and women. It requires adequate androgens to be in circulation and a genetic predisposition. In AGA, androgens induce miniaturization in follicles that are genetically predisposed to baldness. Such miniaturization is observed in the frontotemporal area and vertex in men, and over the crown in women, as these areas are more sensitive to the effects of androgens. Androgenetic alopecia is the most common cause of hair loss that occurs after puberty. It affects approximately 40% and 50% of men at the ages 40 and 50 years, respectively. AGA is known to depend on the presence of the androgen DHT and on a genetic predisposition for this condition, but its pathophysiology has not been fully elucidated. Patients typically present with the progressive thinning and shortening of hair in affected areas. Insulin resistance can be defined as an impaired biological response to exogenous or endogenous insulin. It causes an insufficiency in insulin-stimulated glucose transport in the skeletal muscle and fat tissue, as well as a suppression of glucose production in the liver. The homeostasis model assessment HOMA method is performed with the help of a mathematical operation that allows for the quantitative assessment of insulin resistance. Previous studies have demonstrated an association between AGA and insulin resistance. Insulin resistance is a state in which a given concentration of insulin produces a less-than-expected biological effect. This is followed by increased insulin secretion with compensatory hyperinsulinemia, to maintain normal glucose and lipid homeostasis. The prevalence of coronary heart disease and myocardial infarction has been shown to be higher in cases with AGA than in individuals without AGA, and AGA is considered to be an additional risk factor for these diseases. Conversely, other studies have indicated that there is no correlation between CVD and AGA. A possible connection between insulin resistance and AGA has been the focus of several studies, but the correlation between insulin resistance as a primary factor responsible for the pathogenesis and AGA has not been studied. The aim of this work was to contrast insulin resistance-related features in young males and females with AGA, and to compare insulin resistance, using the HOMA-IR index, in AGA patients and controls. The present study was carried out on eighty AGA patients recruited from Dermatology outpatient clinic of Benha University Hospital. Patients with AGA were eligible for this work if their ages were 18-35 years old, with alopecia ≥ grade III in the Hamilton–Norwood classification for males and alopecia ≥ grade II in Ludwig’s classification for females. For comparison, a control group of eighty age - and weight - matched subjects without alopecia (case–control ratio 1 : 1), who were seen in the same outpatient clinic during the study period was enrolled. All studied individuals were subjected to history taking and clinical examination. Several biochemical parameters were assessed in this work. These parameters included, insulin, fasting blood glucose, cholesterol, TG, HDL-C, LDL-C, total testosterone and SHBG.The result of this work showed the following
1. Patients with AGA had significantly more insulin resistance than controls, also all patients subgroups had significantly more insulin resistance than all controls subgroups.
2. HOMA-IR index values were statistically different between AGA patients and controls and statistically different between patients and controls subgroups.
3. Among demographic variables, family history of AGA was found to be significantly different between patients and controls, and also between patients and controls subgroups.
4. Diastolic BP was found to be significantly different between AGA male patients and male controls.
5. Among demographic variables, family history of DM was found to be significantly different between patients and controls, female patients and female controls, and obese patients and obese controls.
6. Among biologic variables, serum level of cholesterol, TG, HDL-C, and LDL-C were found to be significantly different between patients and controls and between patients and controls subgroups, except HDL-C which was not statistically different between female patients and female controls and between obese patients and obese controls, and also TG which was not statistically different between non obese patients and non obese controls.
7. Among biologic variables, serum levels of insulin were found to be significantly different between patients and controls and between patients and controls subgroups.
8. In all demographic and anthropometric variables, there were positive significant correlations between HOMA-IR index values and weight, smoking and family history of DM in all patients groups.
9. In all biologic variables, there was positive significant correlation between HOMA-IR index values and serum levels of cholesterol in only male patients group.
10. In all biologic variables, there were positive significant correlations
between HOMA-IR index values and both serum levels of insulin and
fasting blood glucose levels in all patients groups.
11. Among biologic variables, there were no significant correlations
between HOMA-IR index values and both serum levels of SHBG and
serum levels of testosterone in all patients groups.