Early androgenetic alopecia as a possible indicator of diabetes mellitus and its link to cardiovascular risks: A cross-sectional study

Abstract

Background: Previous studies have reported inconsistent associations between androgenetic alopecia (AGA) and diabetes mellitus (DM).

Objectives: To assess AGA prevalence in Southern China and explore its link to cardiovascular risks.

Methods: A population-based cross-sectional study in Shenzhen was conducted. AGA was diagnosed by dermatologists. Logistic regression analyzed associations among AGA and obesity, DM, hypertension, dyslipidemia, and cerebrovascular diseases.

Results: Out of 11,968 participants, the AGA prevalence was 18.94%, higher in males (32.42%) than females (7.12%). AGA patients exhibited high rates of obesity, abdominal obesity, dyslipidemia, DM, and hypertension (All P < .05). Stratified analyses revealed a significantly higher DM prevalence in AGA patients aged 18∼49 years, but not in patients aged over 50 years. A significant negative age-DM interaction on AGA was observed (P_interact<.001). After rigorous adjustment, multivariable analyses in adults <45 years showed that AGA was associated with DM (OR = 1.66, 95% CI: 1.21∼2.27, P = .002), impaired fasting glucose (OR = 1.45, 95% CI: 1.11∼1.89, P = .006), fasting glucose ≥7.0 mmol/L (OR = 1.86, 95% CI: 1.27∼2.74, P = .002), and glycosylated hemoglobin, type A1C (HbA1c) ≥6.5% (OR = 1.65, 95% CI: 1.16∼2.34, P = .006). No associations were found in adults over 45 years.

Limitation: Cross-sectional design precludes causal inference.

Conclusion: Early-onset AGA may indicate DM risk in young and middle-aged adults, highlighting the need for early identification aimed at preventive strategies.

Keywords: androgenetic alopecia; cardiovascular risks; diabetes mellitus; early-onset.