Androgenetic alopecia in men aged 40-69 years: prevalence and risk factors

Severi G, Sinclair R, Hopper JL, English DR, McCredie MR, Boyle P, Giles GG (2003) Androgenetic alopecia in men aged 40-69 years: prevalence and risk factors. Br J Dermatol 149:1207-1213

BACKGROUND: The epidemiology of androgenetic alopecia (AGA) is not fully understood. Although a strong genetic basis has long been identified, little is known of its non-genetic causes. OBJECTIVES: To estimate the prevalence of and to determine risk factors for AGA in men aged 40-69 years in Australia. METHODS: Men (n = 1390) were recruited at random from the electoral rolls to serve as controls in a population-based case-control study of prostate cancer. All were interviewed in person and direct observations of AGA were made. Men were grouped into the following categories; no AGA, frontal AGA, vertex AGA and full AGA (frontal and vertex AGA). Epidemiological data collected from these men were used for an analysis of risk factors for each AGA category using unconditional logistic regression with AGA category as the response variable adjusting for age, education and country of birth. RESULTS: The prevalence of vertex and full AGA increased with age from 31% (age 40-55 years) to 53% (age 65-69 years). Conversely, the proportion of men with only frontal AGA was very similar across all age groups (31-33%). No associations were found between pubertal growth spurt or acne, reports of adult body size at time of interview, urinary symptom score, marital status, or current smoking status or duration of smoking and the risk of any form of AGA. The consumption of alcohol was associated with a significant increase in risk of frontal and vertex AGA but not full AGA. Men with vertex AGA had fewer female sexual partners but average ejaculatory frequency did not differ between men in different AGA categories. Reported weight and lean body mass at reaching maturity at about 21 years of age were negatively associated with vertex balding (P for trend < 0.05)="" but="" not="" with="" frontal="" aga="" or="" full="" aga.="" conclusions:="" evidence="" for="" environmental="" influences="" on="" aga="" remains="" very="" slight.="" our="" study="" failed="" to="" confirm="" previously="" reported="" or="" hypothesized="" associations="" with="" smoking="" and="" benign="" prostatic="" hypertrophy.="" the="" associations="" that="" we="" found="" with="" alcohol="" consumption="" and="" with="" lean="" body="" mass="" at="" age="" 21="" years="" would="" be="" worthy="" of="" further="" research="" if="" they="" were="" able="" to="" be="" replicated="" in="" other="">