Department of Dermatology, Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu, China.
Institute of Regenerative Medicine, Jiangsu University, Zhenjiang, Jiangsu, China.
PLoS One. 2024 Mar 7;19(3):e0299212. doi: 10.1371/journal.pone.0299212. eCollection 2024.
Early-onset androgenetic alopecia (AGA) has been associated with various chronic conditions, including metabolic syndrome (MetS). Gaining a deep understanding of early-onset AGA may enable earlier intervention in individuals at high risks. This scoping review aims to explore the risk factors and etiology, associated conditions, and adverse effects on wellbeing in early-onset AGA.
Electronic literature searches were conducted in MEDLINE, EMBASE and CENTRIAL. Eligible studies included case-control, cohort, cross-sectional, and meta-analysis studies. Selected studies needed to clearly define early-onset AGA cases or include only cases starting before the age of 40 and compare them with appropriate controls. The exclusion criteria comprised editorials, commentaries, case series, and non-systematic reviews, among others. Data extraction involved collecting study characteristics, methodologies, main outcomes, and findings. Descriptive tables were used to summarize key information and relevant variables when necessary.
Among the 65 eligible articles, 67.69% were case-control studies and 78.46% evaluated only male patients. "Early-onset" was defined as cases developing before the age of 30 years in 43.08% of the studies. The Hamilton-Norwood scale was the most frequently used method for evaluating the severity of alopecia in men (69.23%). Reported risk factors for early-onset AGA included a family history of AGA, cigarette smoking, unhealthy dietary habits, and a high body mass index. Early-onset AGA may also be associated with hormonal profiles, 5α-reductase enzyme activity, androgen receptor genes, and some susceptibility loci. Comorbidities investigated included MetS, cardiovascular disease, insulin resistance, dyslipidemia, and Parkinson's disease. Men with early-onset AGA may have reduced treatment efficacy with drug like rosuvastatin, metformin or lisinopril for dyslipidemia, prediabetes, or hypertension. Additionally, young men with AGA tended to suffer from psychological issues such as anxiety and low self-esteem compared to those without hair loss.
Early-onset AGA is a complex condition with various risk factors and etiology, associated comorbidities, and potential implications for treatment response and psychological health.
早发性雄激素性脱发（AGA）与多种慢性疾病有关，包括代谢综合征（MetS）。深入了解早发性 AGA 可能使处于高风险的个体更早地接受干预。本范围综述旨在探讨早发性 AGA 的危险因素和病因、相关疾病以及对幸福感的不良影响。
在 MEDLINE、EMBASE 和 CENTRIAL 中进行电子文献检索。纳入的研究包括病例对照、队列、横断面和荟萃分析研究。选择的研究需要明确界定早发性 AGA 病例，或仅纳入 40 岁前发病的病例，并将其与适当的对照组进行比较。排除标准包括社论、评论、病例系列和非系统评价等。数据提取包括收集研究特征、方法、主要结局和发现。必要时使用描述性表格总结关键信息和相关变量。
在 65 篇合格文章中，67.69%为病例对照研究，78.46%仅评估男性患者。43.08%的研究将“早发性”定义为病例在 30 岁前发病。在男性中，最常使用 Hamilton-Norwood 量表评估脱发严重程度（69.23%）。早发性 AGA 的报告危险因素包括 AGA 家族史、吸烟、不健康的饮食习惯和高体重指数。早发性 AGA 还可能与激素谱、5α-还原酶活性、雄激素受体基因和一些易感基因座有关。研究的合并症包括代谢综合征、心血管疾病、胰岛素抵抗、血脂异常和帕金森病。早发性 AGA 男性可能对药物如瑞舒伐他汀、二甲双胍或赖诺普利治疗血脂异常、糖尿病前期或高血压的疗效降低。此外，与没有脱发的男性相比，患有 AGA 的年轻男性往往更容易出现焦虑和自尊心低等心理问题。
早发性 AGA 是一种复杂的疾病，具有多种危险因素和病因、相关合并症以及对治疗反应和心理健康的潜在影响。
