Early androgenetic alopecia as a possible indicator of diabetes mellitus and its link to cardiovascular risks: A cross-sectional study.

He, Jiayu; He, Min; Zhang, Dehua; Ning, Ning; Chen, Lin; He, Shiyu; Ling, Yunxia; Zheng, Jinfen et al. · J Am Acad Dermatol · 2026

cross_sectional · Level IV

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Abstract

Previous studies have reported inconsistent associations between androgenetic alopecia (AGA) and diabetes mellitus (DM). To assess AGA prevalence in Southern China and explore its link to cardiovascular risks. A population-based cross-sectional study in Shenzhen was conducted. AGA was diagnosed by dermatologists. Logistic regression analyzed associations among AGA and obesity, DM, hypertension, dyslipidemia, and cerebrovascular diseases. Out of 11,968 participants, the AGA prevalence was 18.94%, higher in males (32.42%) than females (7.12%). AGA patients exhibited high rates of obesity, abdominal obesity, dyslipidemia, DM, and hypertension (All P < .05). Stratified analyses revealed a significantly higher DM prevalence in AGA patients aged 18∼49 years, but not in patients aged over 50 years. A significant negative age-DM interaction on AGA was observed (P<sub>interact</sub><.001). After rigorous adjustment, multivariable analyses in adults <45 years showed that AGA was associated with DM (OR = 1.66, 95% CI: 1.21∼2.27, P = .002), impaired fasting glucose (OR = 1.45, 95% CI: 1.11∼1.89, P = .006), fasting glucose ≥7.0 mmol/L (OR = 1.86, 95% CI: 1.27∼2.74, P = .002), and glycosylated hemoglobin, type A1C (HbA1c) ≥6.5% (OR = 1.65, 95% CI: 1.16∼2.34, P = .006). No associations were found in adults over 45 years. Cross-sectional design precludes causal inference. Early-onset AGA may indicate DM risk in young and middle-aged adults, highlighting the need for early identification aimed at preventive strategies.