BMJ：严重秃顶男心脏病风险高48%

日前，一项最新研究表明，秃顶男比不秃顶的男子面临更大的心脏病风险。脱发年龄越年轻，问题越大。

研究者发现，患有严重脱发的男性比不秃顶的男性患有冠状动脉疾病的机率高三成三。但是这个发现仅适用于那些头顶上脱发的人。发际线在太阳穴附近渐渐上移的人并无风险。

研究还发现，年轻时就开始脱发的男性风险更大。他们脱发越多，患有心脏病的可能性越大。尽管何种因素引起了秃顶和心脏病之间的关联尚不明朗，但研究者们说秃顶可能是某种潜在症状的表现，最终引发心脏病，比如胰岛素抗药性、慢性炎症或对睾丸激素的敏感度增加。

该研究发表于《英国医学期刊》网络公开版上。它综合分析了六项寻找秃顶和心脏病之间可能联系的既有研究，样本包括37,000名男性。其中三篇文章追踪了一组男性至少11年。结果发现那些脱发殆尽的男性罹患心脏病的可能性增加三成二；而那些在60岁之前秃顶的人，罹患心脏病的可能性增加四成四。

另外三项研究比较了秃顶和正在变得秃顶的男性和不秃顶男性的健康。它们显示脱发男性罹患心脏病的机率高出七成；对于年轻脱发者，这一机率增至八成四。

综合所有证据，研究者们发现头顶大量脱发的人患心脏病的风险增加四成八，中等脱发三成六，少量脱发一成八。研究者们表示，其结果显示也许应当鼓励秃顶男性增进其心血管疾病风险指标，特别是那些年轻时就脱发的人。

但是英国心脏基金会高级心血管疾病护士麦道克（Doireann Maddock）说：“尽管这些发现很有趣，秃顶男性大可不必因为这个分析而忧心忡忡。需要更多的研究方能证实男性秃顶和冠状动脉疾病风险增加有关联。因此，关注你的腰围比你的发际线更重要。”

Male pattern baldness and its association with coronary heart disease: a meta-analysis
Objective
To confirm the association between male pattern baldness and coronary heart disease (CHD).
Design
Meta-analysis of observational studies.
Data sources
Medline and the Cochrane Library were searched for articles published up to November 2012 using keywords that included both ‘baldness’ and ‘coronary heart disease’ and the reference lists of those studies identified were also searched.
Study selection
Observational studies were identified that reported risk estimates for CHD related to baldness. Two observers independently assessed eligibility, extracted data and assessed the possibility of bias.
Data synthesis
The adjusted relative risk (RR) and 95% CI were estimated using the DerSimonian-Laird random-effect model.
Results
850 possible studies, 3 cohort studies and 3 case–control studies were selected (36 990 participants). In the cohort studies, the adjusted RR of men with severe baldness for CHD was 1.32 (95% CI 1.08 to 1.63, p=0.008, I2=25%) compared to those without baldness. Analysis of younger men (<55 or ≤60 years) showed a similar association of CHD with severe baldness (RR 1.44, 95% CI 1.11 to 1.86, p=0.006, I2=0%). In three studies employing the modified Hamilton scale, vertex baldness was associated with CHD and the relation depended on the severity of baldness (severe vertex: RR 1.48 (1.04 to 2.11, p=0.03); moderate vertex: RR 1.36 (1.16 to 1.58, p<0.001); mild vertex: RR 1.18 (1.04 to 1.35, p<0.001)). However, frontal baldness was not associated with CHD (RR 1.11 (0.92 to 1.32, p=0.28)).
Conclusions
Vertex baldness, but not frontal baldness, is associated with an increased risk of CHD. The association with CHD depends on the severity of vertex baldness and also exists among younger men. Thus, vertex baldness might be more closely related to atherosclerosis than frontal baldness, but the association between male pattern baldness and CHD deserves further investigation.