title: Alopecia and its association with coronary heart disease and cardiovascular risk factors: a meta-analysis.
abstract: BACKGROUND
  Alopecia has been associated with an increased risk of coronary heart disease as well as the following risk factors for cardiovascular disease: hyperinsulinaemia, insulin resistance, metabolic syndrome, dyslipidaemia, and hypertension. We performed a meta-analysis to quantitatively determine the level of risk of coronary heart disease and risk factors in individuals with alopecia.
  
  
  METHODS
  A systematic literature search was conducted using several databases. We calculated pooled odds ratios and 95% confidence intervals using a random effects model.
  
  
  RESULTS
  In total, 31 studies comprising 29,254 participants with alopecia were eligible for the meta-analysis and showed that alopecia is associated with an increased risk of coronary heart disease (OR 1.22, 95% CI: 1.07-1.39), hyperinsulinaemia (OR 1.97, 95% CI: 1.20-3.21), insulin resistance (OR 4.88, 95% CI: 2.05-11.64), and metabolic syndrome (OR 4.49, 95% CI: 2.36-8.53). Individuals with alopecia were also shown to be more likely compared to those without alopecia to have higher serum cholesterol levels (OR 1.60, 95% CI: 1.17-2.21), higher serum triglyceride levels (OR 2.07, 95% CI: 1.32-3.25), higher systolic blood pressures (OR 1.73, 95% CI: 1.29-2.33), and higher diastolic blood pressures (OR 1.59, 95% CI: 1.16-2.18).
  
  
  CONCLUSIONS
  Alopecia is associated with an increased risk of coronary heart disease, and there appears to be a dose-response relationship with degree of baldness whereby the greater the severity of alopecia, the greater the risk of coronary heart disease. Alopecia is also associated with an increased risk of hypertension, hyperinsulinaemia, insulin resistance, metabolic syndrome, and having elevated serum total cholesterol and triglyceride levels.
authors.affiliation: The Whiteley-Martin Research Centre, Discipline of Surgery, The University of Sydney, Nepean Hospital, Penrith, New South Wales, Australia.
authors.forename: Nelson
authors.initials: N
authors.lastname: Trieu
authors.affiliation: The Whiteley-Martin Research Centre, Discipline of Surgery, The University of Sydney, Nepean Hospital, Penrith, New South Wales, Australia. Electronic address: guy.eslick@sydney.edu.au.
authors.forename: Guy D
authors.initials: GD
authors.lastname: Eslick
mesh_terms: D000505:Alopecia / Q000175:diagnosis* / Q000453:epidemiology*; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000453:epidemiology; D016022:Case-Control Studies; D003327:Coronary Disease / Q000175:diagnosis* / Q000453:epidemiology*; D006801:Humans; D012307:Risk Factors
keywords: Alopecia; Coronary heart disease; Dyslipidaemia; Hypertension; Insulin resistance; Meta-analysis