女性型脱发患者激素测试值得吗?

PubMed ID
发表日期 2020年Oct月

原始出处 波尔斯基·梅尔库里乌斯·列卡斯基:波尔斯基管风琴
Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego
作者 Kozicka  Karolina  Łukasik  Adriana  Pastuszczak  Maciej  Jaworek  Andrzej  Spałkowska  Magdalena  Kłosowicz  Agata  Dyduch  Grzegorz  Wojas-Pelc  Anna 

文献标题 女性型脱发患者激素测试值得吗?
Is hormone testing worthwhile in patients with female pattern hair loss?

文献摘要

雄激素性脱发(AGA)是男性和女性患者最常见的脱发类型。至于其病因,它是假定毛囊生长敏感的人谁是遗传易感雄激素。在疾病的病理机制中,毛囊发生了小型化。

AIM

本研究的目的是评估选定的激素水平(性激素、肾上腺和甲状腺激素)以及在一组女性AGA患者中进行的实验室检查(铁代谢)的结果,以明确在此类患者的诊断过程中应进行哪些检查。

MATERIALS AND METHODS

对106例不同年龄、不同病程的女性型脱发患者的测试结果和治疗方法进行了分析。对选定的激素参数以及铁代谢、BMI(体重指数)和患者病史中的雄激素化迹象(月经紊乱、多毛症和痤疮)进行了分析。此外,还测定了他们的胰岛素水平。

RESULTS

研究人群中最常见的激素紊乱包括性激素结合球蛋白(SHBG)浓度升高38.8%,总睾酮浓度降低25.4%,抗甲状腺过氧化物酶(ATPO)抗体滴度升高17.3%,二氢表雄酮(DHEAS)浓度降低15.6%,胰岛素浓度增加12.6%。只有6.8%的受试者体内游离睾酮浓度升高,6.7%的受试者体内皮质醇浓度升高。40%的患者抱怨与月经失调、多毛和痤疮有关的症状。性激素浓度与所报告的症状无关,该亚组的检测结果与未报告高雄激素血症症状的其他患者没有显著差异。

CONCLUSIONS

尽管事实上,近一半的患者报告的症状可能暗示激素紊乱,但在激素测试中没有发现明显异常。


Androgenetic alopecia (AGA) is the most common type of hair loss both in male and female patients. As regards its etiopathology, it is postulated that hair follicles grow sensitive to androgens in persons who are genetically predisposed to it. In the pathomechanism of the disease, hair follicles undergo miniaturization.

AIM

The aim of the study was to evaluate the levels of selected hormones (sex hormones, adrenal and thyroid hormones), and the results of laboratory tests (iron metabolism) performed in a group of female patients with AGA in order to specify which of those tests should be taken during the diagnostic process in such patients.

MATERIALS AND METHODS

Test results and types of therapies have been analyzed for a group of 106 adult female patients (of different age) with female pattern hair loss (FPHL) of different duration. Selected hormone parameters have been analyzed as well as iron metabolism, BMI ( body mass index), and signs of androgenization in the patients' histories (presence of menstrual disorders, hirsutism and acne). Additionally, their insulin levels were measured.

RESULTS

The most common hormonal disorders in the study population involved increased concentrations of sex hormone binding globulin (SHBG) in 38.8%, decreased concentration of total testosterone in 25.4%, increased antibody titers against thyroid peroxidase (ATPO) in 17.3%, decreased concentrations of dihydroepiandrostendione (DHEAS) in 15.6%, and increased concentrations of insulin in 12.6%. Increased concentrations of free testosterone were only observed in 6.8 % of the study participants, and increased concentrations of cortisol were revealed in 6.7% of them. 40% of the patients complained about symptoms related to menstrual disorders, hirsutism and acne. Sex hormone concentrations did not correlate with the reported symptoms, and test results in that sub-group were not found to significantly differ from the rest of the patients who did not report signs of hyperandrogenism.

CONCLUSIONS

In spite of the fact that nearly half of the patients reported symptoms which may be suggestive of hormonal disorders, no significant abnormalities were revealed in hormone tests.