Frontiers in endocrinology · 2026
Prevalence of metabolic syndrome in patients with androgenetic alopecia: an analysis of current evidence.
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Xu Wan, Zhang Wen-Qing, Liang Xin, Fan Qian, Yu Hai-Dong, Li Xin
Аннотация
BACKGROUND: Androgenetic alopecia (AGA) is the most common non-scarring alopecia, and its prevalence increases with age. Previous meta-analyses of AGA and metabolic syndrome (MetS) have focused mainly on associations and risk estimates. We quantified the prevalence of MetS and its components among patients with AGA.
METHODS: PubMed, Embase, Web of Science, the Cochrane Library, CNKI, VIP, and WanFang Data were searched from inception to July 2026 for cross-sectional and cohort studies. Prevalence estimates were pooled using logit-transformed random-effects models with restricted maximum likelihood estimation. We report 95% confidence intervals (CIs), I², τ², and 95% prediction intervals (PIs) when estimable. Examined subgroups included region, sex, AGA severity, MetS definition, and study quality. Sensitivity analyses assessed robustness. Egger's test was performed to assess outcomes derived from ≥10 studies.
RESULTS: Twenty-eight studies were included. MetS prevalence was 23.7% (12 studies; 3,623 participants; 95% CI, 15.5%-34.5%; I² = 95.4%; 95% PI, 3.7%-71.7%). Prevalence estimates for abdominal obesity, hypertension or elevated blood pressure, diabetes mellitus, dyslipidemia, hypertriglyceridemia, elevated low-density lipoprotein cholesterol, and low high-density lipoprotein cholesterol were 36.0%, 30.7%, 13.3%, 24.5%, 23.6%, 30.0%, and 28.8%, respectively. Heterogeneity was substantial across outcomes; the elevated low-density lipoprotein cholesterol estimate was based on only two studies. MetS prevalence was 19.7%, 30.8%, and 44.2% in mild, moderate, and severe AGA, respectively, although grading systems varied. In leave-one-out analyses, the pooled MetS estimate ranged from 21.1% to 25.9%; other outcomes with at least seven studies were also broadly unchanged; however, heterogeneity persisted. Evidence from female patients was limited (4 studies, 765 participants).
CONCLUSION: MetS and several metabolic abnormalities are common among patients with AGA, although estimates vary substantially across studies. Early assessment may support comprehensive health management in this population.
METHODS: PubMed, Embase, Web of Science, the Cochrane Library, CNKI, VIP, and WanFang Data were searched from inception to July 2026 for cross-sectional and cohort studies. Prevalence estimates were pooled using logit-transformed random-effects models with restricted maximum likelihood estimation. We report 95% confidence intervals (CIs), I², τ², and 95% prediction intervals (PIs) when estimable. Examined subgroups included region, sex, AGA severity, MetS definition, and study quality. Sensitivity analyses assessed robustness. Egger's test was performed to assess outcomes derived from ≥10 studies.
RESULTS: Twenty-eight studies were included. MetS prevalence was 23.7% (12 studies; 3,623 participants; 95% CI, 15.5%-34.5%; I² = 95.4%; 95% PI, 3.7%-71.7%). Prevalence estimates for abdominal obesity, hypertension or elevated blood pressure, diabetes mellitus, dyslipidemia, hypertriglyceridemia, elevated low-density lipoprotein cholesterol, and low high-density lipoprotein cholesterol were 36.0%, 30.7%, 13.3%, 24.5%, 23.6%, 30.0%, and 28.8%, respectively. Heterogeneity was substantial across outcomes; the elevated low-density lipoprotein cholesterol estimate was based on only two studies. MetS prevalence was 19.7%, 30.8%, and 44.2% in mild, moderate, and severe AGA, respectively, although grading systems varied. In leave-one-out analyses, the pooled MetS estimate ranged from 21.1% to 25.9%; other outcomes with at least seven studies were also broadly unchanged; however, heterogeneity persisted. Evidence from female patients was limited (4 studies, 765 participants).
CONCLUSION: MetS and several metabolic abnormalities are common among patients with AGA, although estimates vary substantially across studies. Early assessment may support comprehensive health management in this population.