Publication: Erken Başlangıçlı Androgenetik Alopesili Erkek Hastalarda Serum Adipokinleri (Leptin, Adiponektin), İnsülin Direnci ve Metabolik Sendrom Arasındaki İlişkinin Araştırılması
Abstract
Giriş ve Amaç: Androgenetik alopesi (AGA), oluşumunda genetik ve hormonal faktörlerin etkili olduğu yaygın bir saç dökülmesi tipidir. Son zamanlarda AGA gelişiminde metabolik sendrom (MS) ve insülin direncinin de rol oynayabileceği belirtilmektedir. İnsülin direncinin metabolik disfonksiyon ve kıl folikülü gelişimi üzerine etkileri gösterilmektedir. Adipokinler ise adipoz doku tarafından üretilen ve metabolizma üzerine etkileri olan moleküllerdir. Adipokinlerin kıl üzerine olan etkileri net olmamakla birlikte, MS ve insülin direnci durumunda serum seviyeleri değişebilmektedir. Çalışmamızda MS, insülin direnci varlığı ve adipokin düzeyleri açısından erken başlangıçlı AGA'lı bireyler ile sağlıklı kontrol grubunun karşılaştırılması ve insülin direncine sekonder meydana gelebilecek adipokin değişimlerinin kıl üzerine olan etkilerinin tespit edilmesi hedeflenmiştir. Gereç ve Yöntem: Araştırmaya Ondokuz Mayıs Üniversitesi Tıp Fakültesi Hastanesi Deri ve Zührevi Hastalıkları Departmanına başvuran 18-35 yaş arası AGA tanısı konulmuş 60 erkek hasta ve hasta grubu ile yaş ve vücut kitle indeksi (VKİ) yönünden eşleştirilmiş 60 erkek sağlıklı kontrol dahil edildi. Hastalık şiddetini belirlemek için Hamilton-Norwood (H-N) ölçeği kullanıldı. Her iki gruptaki bireylerin bel çevresi, tansiyon/arteryel ölçümleri yapıldı ve VKİ değerleri hesaplandı. Glukoz, lipit paneli, insülin, leptin, adiponektin laboratuvar değerleri ölçüldü. MS varlığının tespiti için NCEP ATP III 2005 ve IDF 2009 kriterleri kullanıldı, insülin direncinin belirlenmesi için HOMA formülünden yararlanıldı. Çalışmamız ile elde ettiğimiz verilerin istatistiksel değerlendirmesi, IBM SPSS (sürüm 26.0) yazılımı aracılığıyla yapıldı. Bulgular: MS bileşenlerinden glukoz ve diyastolik kan basıncı hasta grubunda kontrol grubuna göre istatistiksel olarak daha yüksek bulundu (p<0,05). Diğer MS bileşenleri açısından iki grup arasında istatistiksel anlamlı fark yoktu (p>0,05). NCEP ATP III 2005 kriterlerine göre hasta grubunda 6 (%10), kontrol grubunda 2 (%3,3), IDF 2009 kriterlerine göre ise hasta grubunda 11 (%18,4), kontrol grubunda 3 (%5) kişide MS saptandı. İki grup arasında NCEP ATP III 2005 kriterlerine göre MS varlığı için istatistiksel olarak anlamlı fark tespit edilmezken(p>0,05), IDF 2009 kriterlerine göre istatistiksel olarak anlamlı fark tespit edildi (p<0,05). İki grup arasında insülin ve HOMA değeri ortalaması açısından istatistiksel anlamlı fark tespit edilmedi (p>0,05). HOMA ≥2,5 olanlar insülin direnci var olarak kabul edildiğinde hasta grubunda 16 (%26,7), kontrol grubunda ise 8 (%13,3) kişide insülin direnci tespit edildi. İki grup arasında insülin direnci varlığı açısından istatistiksel fark izlenmedi (p>0,05). Hasta grubunda istatistiksel olarak anlamlı leptin yüksekliği mevcuttu (p<0,05). Adiponektin ortanca değeri açısından iki grup arasında istatistiksel anlamlı fark yoktu (p>0,05). Hasta grubunda adiponektin/leptin oranı ortanca değeri istatistiksel açıdan anlamlı düşük bulundu (p<0,05). Hastalık evresi ile leptin, adiponektin, adiponektin/leptin oranı arasında pozitif ya da negatif yönde istatistiksel açıdan anlamlı korelasyon saptanamadı (p>0,05). Tartışma ve Sonuçlar: Bu çalışma MS'nin, insülin direncinin ve yüksek leptin düzeyi gibi adipokinlerin AGA gelişiminde önemli bir rol oynayabileceğini göstermektedir. Bu sebeple AGA tanılı bireyler metabolik hadiseler açısından taranmalı ve metabolik disfonksiyon tespit edilirse erken dönemde müdahale edilmelidir. Adipokinlerin dermatolojik hastalıklar üzerine etki mekanizmaları net olmamakla birlikte daha fazla araştırmaya ihtiyaç vardır. Anahtar Kelimeler: Alopesi, İnsülin, Metabolik Sendrom, Adipokin
Introduction and Aim: Androgenetic Alopecia (AGA) is a common type of hair loss in which genetic and hormonal factors play a significant role. Recently, it has been suggested that metabolic syndrome (MS) and insulin resistance may also contribute to the development of AGA. The effects of insulin resistance on metabolic dysfunction and hair follicle development have been demonstrated. Adipokines are molecules produced by adipose tissue that influence metabolism. Although the effects of adipokines on hair are not fully understood, their serum levels may change in cases of MS and insulin resistance. The aim of our study is to compare individuals with early-onset AGA with a healthy control group in terms of MS, insulin resistance, and adipokine levels, and to identify the effects of adipokine changes secondary to insulin resistance on hair. Materials and Methods: The study included 60 male patients aged 18-35 who were diagnosed with AGA and applied to the Department of Dermatology and Venereology at Ondokuz Mayıs University Medical Faculty Hospital, as well as 60 healthy male controls matched for age and body mass index (BMI). The severity of the disease was determined using the Hamilton-Norwood (H-N) scale. Waist circumference, blood pressure/arterial measurements, and BMI values were measured for individuals in both groups. Laboratory values, including glucose, lipid panel, insulin, leptin, and adiponectin, were assessed. The presence of metabolic syndrome (MS) was determined using the NCEP ATP III 2005 and IDF 2009 criteria, while insulin resistance was assessed using the HOMA formula. The statistical analysis of the data obtained in this study was performed using IBM SPSS (version 26.0) software. Results: Among the components of metabolic syndrome (MS), glucose and diastolic blood pressure were found to be statistically higher in the patient group compared to the control group (p<0.05). There was no statistically significant difference between the two groups for other MS components (p>0.05). According to the NCEP ATP III 2005 criteria, MS was detected in 6 patients (10%) in the patient group and in 2 (3.3%) in the control group. According to the IDF 2009 criteria, MS was detected in 11 patients (18.4%) in the patient group and in 3 (5%) in the control group. No statistically significant difference was found between the two groups based on the NCEP ATP III 2005 criteria for the presence of MS (p>0.05), while a statistically significant difference was found based on the IDF 2009 criteria (p<0.05). No statistically significant difference was observed between the two groups in terms of mean insulin levels and HOMA values (p>0.05). When HOMA ≥2.5 was considered indicative of insulin resistance, insulin resistance was detected in 16 patients (26.7%) in the patient group and in 8 (13.3%) in the control group. There was no statistically significant difference between the two groups regarding the presence of insulin resistance (p>0.05). In the patient group, a statistically significant increase in leptin levels was observed (p<0.05). No statistically significant difference was found between the two groups regarding the median adiponectin value (p>0.05). The median adiponectin/leptin ratio in the patient group was found to be statistically significantly lower (p<0.05). No statistically significant correlation was detected between disease stage and leptin, adiponectin, or adiponectin/leptin ratio (p>0.05). Discussion and Conclusions: This study suggests that metabolic syndrome (MS), insulin resistance, and adipokines such as elevated leptin levels may play an important role in the development of AGA. Therefore, individuals diagnosed with AGA should be screened for metabolic abnormalities, and if metabolic dysfunction is detected, early intervention should be considered. Although the mechanisms by which adipokines affect dermatological diseases are not fully understood, further research is needed in this area. Key words: Alopecia, İnsulin, Metabolic Syndrome, Adipokines
Introduction and Aim: Androgenetic Alopecia (AGA) is a common type of hair loss in which genetic and hormonal factors play a significant role. Recently, it has been suggested that metabolic syndrome (MS) and insulin resistance may also contribute to the development of AGA. The effects of insulin resistance on metabolic dysfunction and hair follicle development have been demonstrated. Adipokines are molecules produced by adipose tissue that influence metabolism. Although the effects of adipokines on hair are not fully understood, their serum levels may change in cases of MS and insulin resistance. The aim of our study is to compare individuals with early-onset AGA with a healthy control group in terms of MS, insulin resistance, and adipokine levels, and to identify the effects of adipokine changes secondary to insulin resistance on hair. Materials and Methods: The study included 60 male patients aged 18-35 who were diagnosed with AGA and applied to the Department of Dermatology and Venereology at Ondokuz Mayıs University Medical Faculty Hospital, as well as 60 healthy male controls matched for age and body mass index (BMI). The severity of the disease was determined using the Hamilton-Norwood (H-N) scale. Waist circumference, blood pressure/arterial measurements, and BMI values were measured for individuals in both groups. Laboratory values, including glucose, lipid panel, insulin, leptin, and adiponectin, were assessed. The presence of metabolic syndrome (MS) was determined using the NCEP ATP III 2005 and IDF 2009 criteria, while insulin resistance was assessed using the HOMA formula. The statistical analysis of the data obtained in this study was performed using IBM SPSS (version 26.0) software. Results: Among the components of metabolic syndrome (MS), glucose and diastolic blood pressure were found to be statistically higher in the patient group compared to the control group (p<0.05). There was no statistically significant difference between the two groups for other MS components (p>0.05). According to the NCEP ATP III 2005 criteria, MS was detected in 6 patients (10%) in the patient group and in 2 (3.3%) in the control group. According to the IDF 2009 criteria, MS was detected in 11 patients (18.4%) in the patient group and in 3 (5%) in the control group. No statistically significant difference was found between the two groups based on the NCEP ATP III 2005 criteria for the presence of MS (p>0.05), while a statistically significant difference was found based on the IDF 2009 criteria (p<0.05). No statistically significant difference was observed between the two groups in terms of mean insulin levels and HOMA values (p>0.05). When HOMA ≥2.5 was considered indicative of insulin resistance, insulin resistance was detected in 16 patients (26.7%) in the patient group and in 8 (13.3%) in the control group. There was no statistically significant difference between the two groups regarding the presence of insulin resistance (p>0.05). In the patient group, a statistically significant increase in leptin levels was observed (p<0.05). No statistically significant difference was found between the two groups regarding the median adiponectin value (p>0.05). The median adiponectin/leptin ratio in the patient group was found to be statistically significantly lower (p<0.05). No statistically significant correlation was detected between disease stage and leptin, adiponectin, or adiponectin/leptin ratio (p>0.05). Discussion and Conclusions: This study suggests that metabolic syndrome (MS), insulin resistance, and adipokines such as elevated leptin levels may play an important role in the development of AGA. Therefore, individuals diagnosed with AGA should be screened for metabolic abnormalities, and if metabolic dysfunction is detected, early intervention should be considered. Although the mechanisms by which adipokines affect dermatological diseases are not fully understood, further research is needed in this area. Key words: Alopecia, İnsulin, Metabolic Syndrome, Adipokines
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