مقالات پذیرفته شده در هفتمین کنگره بین المللی زیست پزشکی
The Association Between Dietary Inflammatory Index and Androgenic Alopecia in Fasa Adult Cohort Study: A cross-Sectional Study
The Association Between Dietary Inflammatory Index and Androgenic Alopecia in Fasa Adult Cohort Study: A cross-Sectional Study
Matin Sepehrinia,1Hossein Pourmontaseri,2azizallah dehghan,3reza homayounfar,4hadi bazyar,5negin shakouri,6,*
1. Student Research Committee, Fasa University of Medical Sciences, Fasa, Iran. 2. Student Research Committee, Fasa University of Medical Sciences, Fasa, Iran. 4. National Nutrition and Food Technology Research Institute (WHO Collaborating Center), Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 5. Department of Public Health, Sirjan School of Medical Sciences, Sirjan, Iran 6. Non-Communicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran.
Introduction: Androgenic alopecia (AGA) is the most common type of alopecia in both genders, affecting 80% of men and 40% of women till the age of 70 years. Increasing dihydrotestosterone (DHT), genetics, and unhealthy lifestyle. Inflammation plays a role in AGA pathogenesis. Bacterial colonization in the infundibulum may trigger inflammation by producing toxins and antigens. Also, keratinocytes may produce Interleukin-1a (IL-1a), reactive oxygen species (ROS), and nitric oxide in response to chemical stress from irritants, pollutants, and ultraviolet irradiation. IL-1a per se inhibits the hair growth cycle. Besides, this cytokine increases the inflammatory status in adjacent keratinocytes and makes them release other pro-inflammatory cytokines such as IL-1β and tumor necrosis factor α (TNFα). Finally, this low-grade chronic inflammation leads to perifollicular fibrosis.
Previous studies showed that zinc, iron, and selenium are associated with AGA. Also, diets with low cholesterol and glycemic index have beneficial effects on AGA. Additionally, diet affects systemic inflammation. The dietary inflammatory index (DII) was developed to assess the inflammatory potential of diet. Higher scores of the DII indicate a pro-inflammatory diet and vice versa. Therefore, the present study aimed to investigate the association between DII and AGA.
Methods: This Cross-sectional study involved 10,318 from the Fasa Adult Cohort Study (FACS). After excluding the individuals with missing data or pregnancy, the remaining participants were divided into two groups based on having androgenic alopecia (AGA), confirmed by an expert clinician. The DII was calculated based on the food frequency questionnaire with the global standard model developed by Shivappa et al. Then, the participants were divided into quartiles based on their DII scores. Age, gender, body mass index, smoking, opium, alcohol, educational status, occupational status, physical activity, marital status, and underlying diseases were considered as potential covariates. The potential covariates that had considerable differences (p-value < 0.2) between the two studied groups of AGA and non-AGA were included in the Wald Logistic Regression (WLR). Then, the covariates that were achieved as the most important covariates were adjusted in the final models. The crude and adjusted association of the DII Quartile with AGA were investigated using the Enter model of Logistic Regression. The significant level was considered as a P value < 0.05.
Results: The mean age of the final studied population (n=10,030) was 48.6 ± 9.6 years, including 4,523 men (45.1%). The mean DII was -0.27 ± 2.07, ranging from -6.50 to 5.66. Interestingly, 7,629 of the studied population (76.1%) had AGA. Also, 19.2% and 20.9% of the studied population was smoker and opium users. Participants in the 4th Quartile of the DII (pro-inflammatory diet) had a higher chance of having AGA (Odds Ratio: 1.294, 95% confidence interval: [1.13, 1.48], P value: <0.001) compared with 1st Quartile of the DII (anti-inflammatory diet). Among male participants, the adjusted model for age, education, smoking, opium consumption, socioeconomic status, and metabolic syndrome showed that the association of DII with AGA got stronger (Odds Ratio: 1.41, 95% Confidence Interval: [1.14, 1.75], P value: 0.002). However, in the case of women, adjusting for the same covariates made the association of DII with AGA insignificant (Odds Ratio: 0.95; 95% Confidence interval: [0.78, 1.16]; P value: 0.615).
Conclusion: A pro-inflammatory diet is associated with a higher risk of AGA in men, but not women. Therefore, an anti-inflammatory diet is beneficial for AGA prevention in men. Further studies are recommended to assess the association between the pro-inflammatory diet and AGA in women. Also, our findings added to the previous evidence about the influence of inflammation on the AGA.