baldness
Hyperinsulinemia is common in family members of women with polycystic ovary syndrome.

Norman RJ, Masters S, Hague W.

Reproductive Medicine Unit, University of Adelaide, Queen Elizabeth Hospital, Woodville, Australia.

OBJECTIVE: To determine whether disorders of insulin secretion are common in male and female family members of subjects with polycystic ovary syndrome (PCOS). DESIGN: Family study of siblings and parents of PCOS subjects (five families). All proband cases met the criteria of polycystic ovaries (PCO) by ultrasound (US) and hyperandrogenism. SETTING: University Reproductive Medicine Unit. PATIENT(S): Family members of PCOS subjects. INTERVENTION(S): Oral glucose tolerance testing (OGTT), insulin, and lipids were measured. Clinical examination including assessment of premature baldness in men and US of ovaries in female members. MAIN OUTCOME MEASURE(S): Insulin, lipids, and clinical parameters. RESULT(S): Hyperinsulinemia (69%) and hypertriglyceridemia (56%) was common in family members as were PCO in 79% of 24 females and premature baldness in men in 88% of eight subjects. CONCLUSION(S): Hyperinsulinemia is a potential metabolic and genetic marker for subjects who may be carriers of a familial tendency for PCO.

Online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8941059&dopt=Abstract baldness, alopecia, hair loss



baldness
Serum androgens: associations with prostate cancer risk and hair patterning.

Demark-Wahnefried W, Lesko SM, Conaway MR, Robertson CN, Clark RV, Lobaugh B, Mathias BJ, Strigo TS, Paulson DF.

Division of Urology, Duke University Medical Center, Durham, North Carolina 27710, USA.

Cancer of the prostate is the leading cancer among American men, yet few risk factors have been established. Hair growth and development are influenced by androgens, and it has long been suspected that prostate cancer also is responsive to these hormones. A blinded, case-control study was undertaken to determine if hair patterning is associated with risk of prostate cancer, as well as specific hormonal profiles. The study accrued 315 male subjects who were stratified with regard to age, race, and case-control status (159 prostate cancer cases/156 controls). Hair-patterning classification and serum levels of total and free testosterone (T), sex hormone binding globulin, and dihydrotestosterone (DHT) were performed. Data indicate that hair patterning did not differ between prostate cancer cases and controls; however, significant hormonal differences were detected between the two groups. Free T was greater among cases than in controls (16.4 +/- 6.1 vs. 14.9 +/- 4.8 pg/ml, P = 0.02). Conversely, DHT-related ratios were greater among controls (P = 0.03 for DHT/T and P = 0.01 for DHT/free T). Several strong associations also were found between hormone levels and hair patterning. Men with vertex and frontal baldness had higher levels of free T (16.5 +/- 5.5 and 16.2 +/- 8.0 pg/ml, respectively) when compared to men with either little or no hair loss (14.8 +/- 4.7 pg/ml) (P = 0.01). Data suggest that increased levels of free T may be a risk factor for prostatic carcinoma. In addition, although no differences in hair patterning were detected between cases and controls within this older population, further research (i.e., prospective trials or case-control studies among younger men) may be necessary to determine if hair patterning serves as a viable biomarker for this disease, especially given the strong association between free T levels and baldness.

Online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9349747&dopt=Abstract baldness, alopecia, hair loss



baldness
Effect of finasteride on human testicular steroidogenesis.

Castro-Magana M, Angulo M, Fuentes B, Canas A, Sarrantonio M, Arguello R, Vitollo P.

Department of Pediatrics, Winthrop-University Hospital, Mineola, New York 11501, USA.

We studied the testicular function and some androgen-mediated events in 22 males (16-30 years of age) with male pattern baldness that was treated with finasteride (10 mg once daily) for 2 years. Patients were evaluated every 3 months. Prostatic volume was determined in six subjects by endorectal ultrasound scans. Serum gonadotropin, prostate-specific antigen (PSA), and sex hormone levels were determined basally and periodically during the treatment period. Fourteen subjects underwent gonadal stimulation with human chorionic gonadotropin (hCG), and the gonadotropin response to gonadotropin releasing hormone (GnRH) was determined in eight subjects, prior to and after 2 years of therapy. Finasteride treatment resulted in an improvement in the male pattern baldness and prostatic shrinkage that was associated with an increase in serum testosterone levels (17.2 +/- 2.5 vs. 26.3 +/- 1.7 nmol/L) and a decrease in dihydrotestosterone (DHT) levels (1.45 +/- 0.41 vs. 0.38 +/- 0.10 nmol/L), causing a marked increase in that testosterone/DHT ratio. A significant increase in the serum levels of androstenedione (3.67 +/- 0.49 vs. 7.05 +/- 0.70 nmol/L) and estradiol (132 +/- 44 vs. 187 +/- 26 pmol/L) was also noted, whereas androstanediol glucoronide (33.3 +/- 6.4 vs. 10.7 +/- 4.5 pmol) and PSA (1.6 +/- 0.6 vs. 0.4 +/- 0.1 ng/ml) were significantly decreased. No changes in basal or stimulated levels of gonadotropin were observed. There was a significant increase in the testosterone response to hCG during finasteride therapy (delta: 16.7 vs. 35.5 nmol/L) that could be explained, at least in part, by the reduction of testosterone metabolism resulting from the blockage induced by finasteride. The decrease in the androstenedione to testosterone and estrone to estradiol ratios observed after hCG treatment, however, strongly suggests increased activity of the 17-ketosteroid reductase enzyme and an improvement of the testicular capacity for testosterone production.

Online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8957695&dopt=Abstract baldness, alopecia, hair loss



baldness
Baldness and other correlates of sex hormones in relation to testicular cancer.

Petridou E, Roukas KI, Dessypris N, Aravantinos G, Bafaloukos D, Efraimidis A, Papacharalambous A, Pektasidis D, Rigatos G, Trichopoulos D.

Department of Hygiene and Epidemiology, Athens University Medical School, Greece. epetrid atlas.uoa.ariadne-t.gr

There is evidence that sex hormones and intrauterine factors are involved in the etiology of testicular cancer. We evaluated the importance of perinatal and adult life correlates of sex hormones as risk factors for testicular cancer in a case control study of 97 incident, histologically confirmed cases, residents of the Greater Athens area and environs, who were diagnosed in the 3 specialized cancer hospitals and the major General Hospital in Athens during the 2 year period 1993-94. Cases were age-matched to 2 healthy controls from the same study base. Both cases and controls as well as their mothers were interviewed by the same investigator and the data were analyzed through conditional logistic regression. The odds ratio for testicular cancer was elevated among persons born after a pregnancy characterized by severe nausea. Among the adult life factors, higher body mass was associated with reduced risk, as was evidence of baldness. To the extent that nausea during pregnancy reflects higher levels of pregnancy estrogens on the one hand, and baldness is linked to androgens on the other, our data suggest that estrogens in the intrauterine life and androgens at later stages may have sequential opposing effects for the development of testicular cancer.

Online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9185701&dopt=Abstract baldness, alopecia, hair loss



baldness
Chronic telogen effluvium.

Whiting DA.

Department of Dermatology and Pediatrics, University of Texas, Southwestern Medical Center at Dallas, USA.

Chronic telogen effluvium is not uncommon. It is a form of diffuse hair loss affecting the entire scalp for which no obvious cause can be found. It usually affects women of 30 to 60 years of age who generally have a full head of hair prior to the onset of shedding. The onset is usually abrupt, with or without a recognizable initiating factor. The degree of shedding is usually severe in the early stages and the hair may come out in handfuls. Chronic telogen effluvium has distinctive clinical and histologic features that are usually diagnostic. Chronic telogen effluvium contrasts with classic acute telogen effluvium by its persistence and its tendency to fluctuate for a period of years. Patients are particularly troubled by the continuing hair loss and fear total baldness. Repeated reassurance that the condition represents shedding rather than actual hair loss and does not cause complete baldness is necessary. Chronic telogen effluvium does appear to be self-limiting in the long run.

Online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9238330&dopt=Abstract baldness, alopecia, hair loss



baldness
Patterns of coverage. Uniform versus graded density.

Knudsen R.

The goal of hair restoration surgery is undetectability. Anything that is unnatural or draws attention to itself is to be avoided. In extensive baldness (Norwood V1-V11) various patterns of coverage with grafting can be constructed. Principally they fall into either the graded or uniform density approaches. If the goal is to provide coverage of the entire area of extensive baldness, the uniform density approach offers the less noticeable result because it draws no attention to any particular part of the balding scalp. If the goal is to provide only frontal forelock reconstruction, both approaches are advocated. In less than ideal grooming situations such as in the wind, exercise, or swimming however, the uniform density approach appears to offer a less noticeable result.

Online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9311371&dopt=Abstract baldness, alopecia, hair loss