Posts Tagged ‘Polycystic Ovarian Syndrome’

Types of Alopecia and Overlap in their Causes

Sunday, January 2nd, 2011

Alopecia can strike anyone for any variety of reasons.  Even newborn babies can be born with this condition.  There are five most common types of hair loss, several other types of alopecia exist, the first five being the most common ones:

  • The most common form of baldness is a progressive hair thinning condition, so called Androgenic alopecia or male pattern baldness (MPB).
  • Female pattern baldness. The equivalent of MPB, and often is related to Polycystic Ovarian Syndrome (PCOS), malnutrition or wheat/gluten intolerance.
  • Alopecia areata, involves the loss of some of the hair from the head, Those with alopecia areata have scattered bald spots all over the head, or one large bald spot confined to one section of the head. It is known as “spot baldness”, it can result in hair loss ranging from just one location (Alopecia areata monolocularis) to every hair on the entire body (Alopecia areata universalis). Alopecia areata, is typically associated with sudden hair loss, sometimes related to trauma, or illness, stress, abusive hair styling such as tight braids and pony tails, wigs, hairpieces or chemicals used on the hair. Alopecia areata is an autoimmune disorder. *4
  • Alopecia totalis, involves the loss of all of the head hair, typically be characterized by the complete loss of hair on the head.  The shedding of normal hair will usually occur over a certain amount of time. The sufferers of alopecia totalis will sometime have a small amount of soft Lanugo hair left over after the normal hair has completely fallen out. *7
  • Alopecia universalis, which involves the loss of all of the hair from the head and the body, from the top of the head to the legs and feet including eye brows.  Alopecia universalis is the rarest condition of the five most common forms of alopecia. It is thought that alopecial universalis is an autoimmune condition. *5

The following are are thought of as being less common, these can be confused as female/male pattern baldness:

Traction alopecia is most commonly found in people with ponytails or cornrows who pull on their hair with excessive force.

Trichotillomania is the loss of hair caused by compulsive pulling and bending of the hairs. It tends to occur more in children than in adults. In this condition the hairs are not absent from the scalp but are broken. Where they break near the scalp they cause typical, short, “exclamation mark” hairs.

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Free-IGF-1 lowers SHBG | Acne, Polycystic Ovarian Syndrome, Hyperinsulinemia and Diet

Sunday, November 21st, 2010

1)

Arch Dermatol. 2002 Dec;138(12):1584-90.
Acne vulgaris: a disease of Western civilization.

Cordain L, Lindeberg S, Hurtado M, Hill K, Eaton SB, Brand-Miller J.
Department of Health and Exercise Science, Colorado State University, Fort Collins, CO 80523, USA. cordain@cahs.colostate.edu
Comment in:
* Arch Dermatol. 2002 Dec;138(12):1591-2.
* Arch Dermatol. 2003 Jul;139(7):941; author reply 942-3.
* Arch Dermatol. 2003 Jul;139(7):941-2; author reply 942-3.

Abstract

BACKGROUND: In westernized societies, acne vulgaris is a nearly universal skin disease afflicting 79% to 95% of the adolescent population. In men and women older than 25 years, 40% to 54% have some degree of facial acne, and clinical facial acne persists into middle age in 12% of women and 3% of men. Epidemiological evidence suggests that acne incidence rates are considerably lower in nonwesternized societies. Herein we report the prevalence of acne in 2 nonwesternized populations: the Kitavan Islanders of Papua New Guinea and the Aché hunter-gatherers of Paraguay. Additionally, we analyze how elements in nonwesternized environments may influence the development of acne.

OBSERVATIONS: Of 1200 Kitavan subjects examined (including 300 aged 15-25 years), no case of acne (grade 1 with multiple comedones or grades 2-4) was observed. Of 115 Aché subjects examined (including 15 aged 15-25 years) over 843 days, no case of active acne (grades 1-4) was observed.

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CONCLUSIONS: The astonishing difference in acne incidence rates between nonwesternized and fully modernized societies cannot be solely attributed to genetic differences among populations but likely results from differing environmental factors. Identification of these factors may be useful in the treatment of acne in Western populations.

PMID: 12472346 [PubMed - indexed for MEDLINE]

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Insulin Resistance Disorders and Androgenetic Alopecia

Tuesday, November 9th, 2010

 

There is a link between hair loss (balding) and high insulin levels in blood.  Multiple studies have shown that men who experience early balding (i.e under the age of 35) tend to have high blood insulin levels. There is a strong prevalence of insulin resistance with androgenetic alopecia (AGA), and more troublesome, there’s an association of androgenetic alopecia (AGA) with insulin-resistance-related disorders such as ischemic heart disease and serious cardiovascular events.

The above is not only true in men. An association between AGA and anthropometric abnormalities (linked with insulin resistance and heredity) was found in women aged 63 years. Female AGA has usually been linked with hyper-androgenism and hirsutism and, most recently, also with polycystic ovarian syndrome (PCOS). Polycystic ovarian syndrome is quite common among Caucasian women, and its association with insulin resistance is well documented.

Further, epidemiological studies have associated androgenetic alopecia (AGA) with severe young-age coronary artery disease and hypertension, and linked it to insulin resistance

The following studies show that AGA and high blood insulin levels are connected. The first dated Sept 2000, then June 2003, June 2006, and Oct 2009.

Lancet. 2000 Sep 30;356(9236):1165-6 “Early androgenetic alopecia as a marker of insulin resistance” Found that men under the age of 35 with an early onset of alopecia aged showed a “strikingly increased risk of hyperinsulinaemia and insulin-resistance-associated disorders” (i.e obesity, hypertension, and dyslipidemia). That early androgenetic alopecia could be a clinical marker of insulin resistance.

J Cardiovasc Risk. 2003 Jun;10(3):227-31. “Hair loss, insulin resistance, and heredity in middle-aged women…” Found that female with some markers of insulin resistance have significantly increased risk for female AGA. Paternal history of alopecia seemed to be more common in female AGA compared to women with normal or minimal loss of hair.

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Insulin Resistance Article – Archived

Thursday, August 19th, 2010

-::- Note: The below is published here for archival purposes -::-
Thanks to medscape.com for this invaluable article

Insulin Resistance

Background

Insulin resistance is a state in which a given concentration of insulin produces a less-than-expected biological effect. Insulin resistance has also been arbitrarily defined as the requirement of 200 or more units of insulin per day to attain glycemic control and to prevent ketosis.

The syndromes of insulin resistance actually make up a broad clinical spectrum, which includes obesity, glucose intolerance, diabetes, and the metabolic syndrome, as well as an extreme insulin-resistant state. Many of these disorders are associated with various endocrine, metabolic, and genetic conditions. These syndromes may also be associated with immunological diseases and may exhibit distinct phenotypic characteristics.

The metabolic syndrome —a state of insulin-resistance that is also known as either syndrome X or the dysmetabolic syndrome—has drawn the greatest attention because of its public health importance.

In an effort to clinically identify patients with insulin resistance, various organizations have developed diagnostic criteria. The most commonly used criteria in the United States are those of the National Cholesterol Education Program/Adult Treatment Panel III (NCEP/ATP III).

  • NCEP/ATP III criteria for the diagnosis of the metabolic syndrome include the following (diagnosis is made when 3 or more are present):
    • Waist circumference of more than 102 cm in men or more than 88 cm in women
    • Fasting triglyceride level of 150 mg/dL or higher
    • Blood pressure level of 130/85 mm Hg or higher
    • High-density lipoprotein cholesterol (HDL-C) level of less than 40 mg/dL in men or less than 50 mg/dL in women
    • Fasting glucose level of 110 mg/dL or higher (which has been changed to 100 mg/dL to reflect revised criteria for impaired fasting glucose [IFG])

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J Cardiovasc Risk. 2003 Jun;10(3):227-31. “Hair loss, insulin resistance, and heredity in middle-aged women…”

Tuesday, August 17th, 2010

-::- Note: The below is published here for archival purposes -::-

J Cardiovasc Risk. 2003 Jun;10(3):227-31.

Hair loss, insulin resistance, and heredity in middle-aged women. A population-based study.

Matilainen V, Laakso M, Hirsso P, Koskela P, Rajala U, Keinänen-Kiukaanniemi S.

Department of Public Health Science and General Practice, University of Oulu and Unit of General Practice, Central University Hospital of Oulu, Finland.

Abstract

CONTEXT: The association of androgenic alopecia (AGA) with insulin resistance, coronary artery disease and hypercholesterolemia has been previously reported in men, but no such association has been reported in women with female androgenic alopecia (AGA). Female AGA has usually been linked with hyper-androgenism and hirsutism and, most recently, also with polycystic ovarian syndrome (PCOS), even though epidemiological documentation of the latter association is scanty. Polycystic ovarian syndrome is quite common among Caucasian women, and its association with insulin resistance is well documented.

OBJECTIVES AND DESIGN: The aim of this study was to obtain a more precise estimation of the prevalence on female AGA and to describe its possible connections with insulin resistance linked parameters and with paternal and maternal family history of alopecia. A cross-sectional population based cohort survey was carried out in the City of Oulu, Finland in 1998.

SETTING AND PARTICIPANTS: As a part of a population based cohort study the hair status of 324 women aged 63 years was assessed by a modification of Ludwig’s scale. The background data consisting of anthropometric measures (weight, height, body mass index, waist, hip and neck circumferences), smoking status, chronic diseases and their medication as well as the family history of AGA were collected by questionnaires and interviews made by study nurses and in clinical examination. Blood samples for laboratory tests were taken on the same occasion.

RESULTS: The prevalence of extensive loss of hair (at least grade II or III on Ludwig’s scale) was quite high (31.2%). The insulin resistance associated parameters, such as waist and neck circumferences, abdominal obesity measured by waist-to-hip ratio, mean insulin concentration (11.3 mU/l versus 9.95 mU/l, p=0.02) or urinary albumin-to-creatinine ratio (1.80 versus 1.58, p=0.01), were significantly higher in women with extensive hair loss compared to those with normal hair or only minimal hair loss (grade I on Ludwig’s scale). The women belonging to the highest quintiles of neck or waist circumferences had significantly increased risk for extensive hair loss compared to those with normal hair or minimal hair loss, the unadjusted ORs being 2.25 (95% CI, 1.26-4.03) and 1.75 (95% CI, 1.00-3.07), respectively. Similarly in women with hyperinsulinemia (fs-insulin >10 mU/l), microalbuminuria (urinary albumin-to-creatinine ratio exceeding the highest microalbuminuria decile (>2.5 mg/mmol) and paternal history of AGA the ORs for alopecia were increased being 1.65 (95% CI, 1.02-2.67), 2.39 (95% CI, 1.21-4.73) and 2.08 (95% CI, 1.26-3.44). All of these ORs, except those for highest quintiles of waist and neck circumferences remained significant in multiple adjusted models.

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