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Changes in bone mineral density in women with early-onset androgenetik alopecia and their correlations with hair-loss stages: a cross-sectional study

Betul Tas, Gokhan Artar, Ramazan Albayrak, Isil Ustun, Mehmet Oncu, Saadet Pilten, Murat Altuntas

Androgenetic alopecia is a common cosmetical condition that accompany by some disorders with high androgen level. Evaluating the possible relationship between androgenetic alopecia and bone mineral density, and its relevance with hair-loss stages were aimed. A cross-sectional study including 106 alopecia patients who also had joint complaints, was conducted on screening of recorded data regarding hair loss stages, bone mineral density and fix and modifiable factors related with bone density, such as body mass index, daily consumptions of calcium, caffeine and alcohol, smoking, birth count, daily sun exposure, usual physical activity, and hormone values including free and total testosterone, dehydroepiandrosterone sulfate, androstenedione, sex hormone binding globulin, follicular stimulating hormone, leutinizing hormone, 25-hydroxy cholecalciferol, ionized calcium, inorganic phosphorus and alkaline phosphatase. Alopecia was classified by hair loss-scale of Ludwig. Bone mineral density in the hip and lumbar spine was measured by dual energy X-ray absorptiometry (Stratos dR 2D Fan-Beam). Data was analysed by Number Cruncher Statistical System, 2007. Results were compared to p<0.05. About 90% of the subjects were under the age of 35 and 60% of them were in the Ludwig stage-2. Osteopenia was detected in the rates of 34.90%, 36.79% and 23.58%, and osteoporosis was detected in the rates of 4.72%, 5.66% and 3.77% in femur-neck, total hip and lumbar spine T-scores, respectively. Z-scores were lower in the rates of 19.81%, 14.15% and 11.32 % in the same order, compare to the agematched reference values. Predisposing factors, laboratory test results and bone mineral density scores did not show any differences according to the Ludwig stages (each at p>0.05). We suggest that all women with early-onset androgenetic alopecia should be thoroughly investigated to the possibility of premature bone loss.