Age-Related Macular Degeneration in Patients with Androgenetic Alopecia: Could the Monocyte/HDL Ratio Be the Link?
Keywords:
Androgenetic alopecia, age-related macular degeneration, Monocyte/HDL ratio, pattern hair lossAbstract
Introduction: Both Androgenetic alopecia (AGA) and age-related macular degeneration (AMD) shared the microinflammatory milieu and increased oxidative stress as important criteria in pathogenesis.
Objectives: To assess the monocyte/High density lipoprotein (HDL) ratio (MHR) in patients with AGA and its correlation to AMD in these patients, if any.
Methods: 40 patients with AGA aged 40 years or more of both sexes and 40 control subjects participated in this case-control study. General, dermatological, and ophthalmologic examination, MHR evaluation and optical coherence tomography (OCT) were performed.
Results: The mean MHR was significantly higher in AGA patients (6.98 ± 2.21) than controls (3.82 ± 0.68) (p<0.001). AMD was significantly higher in patients than control (p <0.001). 80% of patients were diagnosed with AMD vs 20% of control subjects. Presence of AMD in AGA was significantly related to the degree of severity of AGA in male patients (P= 0.02). MHR was significantly higher in AGA patients found to have AMD (9.37 ± 1.1 and 7.01 ± 1.42 in wet and dry type respectively) than those without AMD (P<0.001). The best cutoff value of MHR in prediction of wet type among patients of AGA is ≥8.2337 with overall accuracy 80%. While the best cutoff value of MHR in prediction of dry type among AGA patients is ≥4.1408 to <8.2337 with overall accuracy 86.7%.
Conclusion: AMD may develop more frequently in those with AGA, and this may correspond with the disease's severity. MHR seems to be a missing link between both conditions.
References
Dhurat RS, Daruwalla SB. Androgenetic alopecia: Update on etiology. Dermatol Revi.2021;2:115–21.
Ho CH, Sood T, Zito PM. Androgenetic Alopecia. [Updated 2021 Nov 15]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan. Available from: https://www.ncbi.nlm.nih.gov/books/NBK430924/ accessed on 15 April 2023.
Chan L, Cook DK. Female pattern hair loss. Aust J Gen Pract. 2018;47(7):459-464. DOI: 10.31128/AJGP-02-18-4498. PMID: 30114864.
Mahé YF, Michelet JF, Billoni N, et al. Androgenetic alopecia and microinflammation. Int J Dermatol. 2000;39(8):576-584. DOI: 10.1046/j.1365-4362.2000.00612.x. PMID: 10971723.
Kim MW, Shin IS, Yoon HS, Cho S, Park HS. Lipid profile in patients with androgenetic alopecia: a meta-analysis. J Eur Acad Dermatol Venereol. 2017;31(6):942-951. DOI: 10.1111/jdv.14000. PMID: 27717019.
Ancuta P, Wang J, Gabuzda D. CD16+ monocytes produce IL-6, CCL2, and matrix metalloproteinase-9 upon interaction with CX3CL1-expressing endothelial cells. J Leukoc Biol. 2006;80(5):1156-1164. DOI: 10.1189/jlb.0206125. PMID: 17056766.
Canpolat U, Çetin EH, Cetin S, et al. Association of Monocyte-to-HDL Cholesterol Ratio with Slow Coronary Flow is Linked to Systemic Inflammation. Clin Appl Thromb Hemost. 2016;22(5):476-482. DOI: 10.1177/1076029615594002. PMID: 26139836.
Ban N, Lee TJ, Sene A, et al. Impaired monocyte cholesterol clearance initiates age-related retinal degeneration and vision loss. JCI Insight. 2018;3(17):e120824. DOI: 10.1172/jci.insight.120824. PMID: 30185655. PMCID: PMC6171801.
Gu BJ, Huang X, Avula PK, et al. Deficits in Monocyte Function in Age Related Macular Degeneration: A Novel Systemic Change Associated With the Disease. Front Med (Lausanne). 2021;8:634177. DOI: 10.3389/fmed.2021.634177. PMID: 33816525. PMCID: PMC8010137.
Deng Y, Qiao L, Du M, et al. Age-related macular degeneration: Epidemiology, genetics, pathophysiology, diagnosis, and targeted therapy. Genes Dis. 2021;9(1):62-79. DOI: 10.1016/j.gendis.2021.02.009. PMID: 35005108. PMCID: PMC8720701.
Usta A, Avci E, Bulbul CB, Kadi H, Adali E. The monocyte counts to HDL cholesterol ratio in obese and lean patients with polycystic ovary syndrome. Reprod Biol Endocrinol. 2018;16(1):34. DOI: 10.1186/s12958-018-0351-0. PMID: 29631598. PMCID: PMC5891948.
Murphy AJ, Chin-Dusting JP, Sviridov D, Woollard KJ. The anti inflammatory effects of high density lipoproteins. Curr Med Chem. 2009;16(6):667-675. DOI: 10.2174/092986709787458425. PMID: 19199930.
Vora RV, Kota RKSK, Singhal RR, Anjaneyan G. Clinical Profile of Androgenic Alopecia and Its Association with Cardiovascular Risk Factors. Indian J Dermatol. 2019;64(1):19-22. DOI: 10.4103/ijd.IJD_526_16. PMID: 30745630. PMCID: PMC6340244.
Bolayir A, Gokce SF, Cigdem B, et al. Monocyte/high-density lipoprotein ratio predicts the mortality in ischemic stroke patients. Neurol Neurochir Pol. 2018;52(2):150-155. DOI: 10.1016/j.pjnns.2017.08.011. PMID: 28864326.
Karatas A, Turkmen E, Erdem E, Dugeroglu H, Kaya Y. Monocyte to high-density lipoprotein cholesterol ratio in patients with diabetes mellitus and diabetic nephropathy. Biomark Med. 2018;12(9):953-959. DOI: 10.2217/bmm-2018-0048. PMID: 30043636.
Demirbaş A, Elmas ÖF, Atasoy M, Türsen Ü, Lotti T. Can monocyte to HDL cholesterol ratio and monocyte to lymphocyte ratio be markers for inflammation and oxidative stress in patients with vitiligo? A preliminary study. Arch Dermatol Res. 2021;313(6):491-498. DOI: 10.1007/s00403-020-02129-3. PMID: 32816078.
Acikgoz N, Kurtoğlu E, Yagmur J, Kapicioglu Y, Cansel M, Ermis N. Elevated Monocyte to High-Density Lipoprotein Cholesterol Ratio and Endothelial Dysfunction in Behçet Disease. Angiology. 2018;69(1):65-70. DOI: 10.1177/0003319717704748. PMID: 28421814.
Aktaş Karabay E, Demir D, Aksu Çerman A. Evaluation of monocyte to high-density lipoprotein ratio, lymphocytes, monocytes, and platelets in psoriasis. An Bras Dermatol. 2020;95(1):40-45. DOI: 10.1016/j.abd.2019.05.002. PMID: 31889591. PMCID: PMC7058861.
Gregor MF, Hotamisligil GS. Inflammatory mechanisms in obesity. Annu Rev Immunol. 2011;29:415-445. DOI: 10.1146/annurev-immunol-031210-101322. PMID: 21219177.
Kucuk B, Sirakaya E, Duru Z, Duru N. Monocyte / high-density lipoprotein ratio and neutrophil-to-lymphocyte ratio in age-related macular degeneration. Annals medres [Internet]. 2021 May 25 [cited 2023 Mar. 27];26(9):1880-1884. Available from: https://annalsmedres.org/index.php/aomr/article/view/1752 Accessed on 15 April 2023.
Rodrigues EB. Inflammation in dry age-related macular degeneration. Ophthalmologica. 2007;221(3):143-152. DOI: 10.1159/000099293. PMID: 17440275.
Dursun A, Ozturk S, Yucel H, et al. Association of neutrophil/lymphocyte ratio and retinal vein occlusion. Eur J Ophthalmol. 2015;25(4):343-346. DOI: 10.5301/ejo.5000570. PMID: 25633622.
Grossniklaus HE, Ling JX, Wallace TM, et al. Macrophage and retinal pigment epithelium expression of angiogenic cytokines in choroidal neovascularization. Mol Vis. 2002;8:119-126. PMID: 11979237.
Sene A, Apte RS. Eyeballing cholesterol efflux and macrophage function in disease pathogenesis. Trends Endocrinol Metab. 2014;25(3):107-114. DOI: 10.1016/j.tem.2013.10.007. PMID: 24252662. PMCID: PMC3943676.
Kwon HJ, Lee SM, Pak KY, Park SW, Lee JE, Byon IS. Gender Differences in the Relationship between Sex Hormone Deficiency and Soft Drusen. Curr Eye Res. 2017;42(11):1527-1536. DOI: 10.1080/02713683.2017.1337155. PMID: 28910205.
Shin YK, Lee GW, Kang SW, Kim SJ, Kim AY. Macular Abnormalities Associated With 5α-Reductase Inhibitor. JAMA Ophthalmol. 2020;138(7):732-739. DOI: 10.1001/jamaophthalmol.2020.1279. PMID: 32379286. PMCID: PMC7206535.
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