title: Benign prostatic hyperplasia, metabolic syndrome and androgenic alopecia: Is there a possible relationship?
abstract: OBJECTIVE
  To evaluate the incidence of benign prostatic hyperplasia (BPH) and metabolic syndrome in patients with androgenetic alopecia (AGA) in comparison with those with no AGA, as several previous studies have reported inconsistent results of an association between metabolic syndrome and BPH with AGA.
  
  
  METHODS
  This cross-sectional study included 400 participants, divided into 300 patients diagnosed with AGA, with different grades according to Norwood-Hamilton classification, and 100 control subjects with no AGA. Criteria for diagnosis of metabolic syndrome according to Adult Treatment Panel-III criteria (waist circumference, blood pressure, fasting blood sugar, high-density lipoprotein and triglycerides), as well as criteria for diagnosis of BPH (prostatic volume, urine flow, and prostate-specific antigen) were assessed in all patients and compared with the control subjects.
  
  
  RESULTS
  There were significant differences between the AGA and no-AGA groups for the following variables: waist circumference, body mass index, fibrinogen level, fasting blood sugar, cholesterol, C-reactive protein, erythrocyte sedimentation rate, and glycosylated haemoglobin. There was a significant difference in number of patients with AGA manifesting criteria of metabolic syndrome (51% vs 28%), as well as BPH diagnostic criteria (36% vs 6.8%) compared with the control subjects. Both BPH and metabolic syndrome were shown to be significant independent variables associated with AGA.
  
  
  CONCLUSIONS
  Dermatologists, urologists, and primary care physicians should monitor patients with early onset AGA for the development of urinary symptoms, to permit an earlier diagnosis of BPH; and for metabolic syndrome symptoms, to permit early diagnosis of cardiovascular risk factors.
authors.affiliation: Department of Dermatology, Faculty of Medicine, Alexandria University, Egypt.
authors.forename: Naglaa F
authors.initials: NF
authors.lastname: Agamia
authors.affiliation: Department of Urology, Faculty of Medicine, Alexandria University, Egypt.
authors.forename: Tamer
authors.initials: T
authors.lastname: Abou Youssif
authors.affiliation: Department of Clinical Pathology, Faculty of Medicine, Alexandria University, Egypt.
authors.forename: Abeer
authors.initials: A
authors.lastname: El-Hadidy
authors.affiliation: Deparment of Radiology, Faculty of Medicine, Alexandria University, Egypt.
authors.forename: Amr
authors.initials: A
authors.lastname: El-Abd
keywords: AGA, androgenetic alopecia; Androgenetic alopecia; BMI, body mass index; Benign prostatic hyperplasia; CRP, C-reactive protein; CVD, cardiovascular disease; Cardiovascular risk; DHT, dihydrotestosterone; ESR, erythrocyte sedimentation rate; FBS, fasting blood sugar; HDL, high-density lipoprotein; HbA1c, glycosylated haemoglobin; Metabolic syndrome