Vitamin D deficiency in non-scarring and scarring alopecias: a systematic review and meta-analysis.
Tanat Yongpisarn,
Kasama Tejapira,
Kunlawat Thadanipon,
Poonkiat Suchonwanit
Systematic Review
Frontiers in nutrition
2024
4 件の引用
PubMed
DOI
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Study Design
- 研究タイプ
- Meta-analysis
- 介入
- Vitamin D deficiency in non-scarring and scarring alopecias: a systematic review and meta-analysis. None
- 比較対照
- Placebo
- 効果の方向
- Negative
- バイアスリスク
- Moderate
Abstract
BACKGROUND: Numerous studies have linked vitamin D deficiency (VDD) to the pathogenesis of various alopecia disorders. OBJECTIVE: This study aimed to investigate whether patients with alopecia are more likely to have VDD or lower vitamin D levels than controls, and the prevalence of VDD among patients with certain alopecia disorders. METHODS: Electronic searches were conducted using PubMed, Embase, Scopus, and Cochrane Library databases from the dates of their inception until September 2024. Studies that reported data allowing for the calculation of odds ratios, mean differences, or correlation coefficients related to vitamin D levels and alopecia were included, while studies without a confirmed diagnosis of alopecia or those involving patients taking vitamin D supplements were excluded. RESULTS: It was found that 51.94% of patients with alopecia areata (AA), 50.38% of patients with female pattern hair loss (FPHL), 47.38% of patients with male androgenic alopecia (MAGA), 53.51% of patients with telogen effluvium (TE), and 38.85% of patients with primary scarring alopecia had VDD. Compared to controls, AA patients had a pooled odds ratio (OR) of VDD of 2.84 (95% confidence interval: 1.89-4.26, I2 = 84.29%, p < 0.01) and a pooled unstandardized mean difference (UMD) of vitamin D levels of -8.20 (-10.28 - -6.12, I2 = 74.25%, p < 0.01) ng/mL. For FPHL patients, a pooled OR of VDD of 5.24 (1.50-18.33, I2 = 81.65%, p < 0.01) and a pooled UMD of vitamin D levels of -15.67 (-24.55 - -6.79, I2 = 91.60%, p < 0.01) ng/mL were found. However, for MAGA, a pooled VDD OR of 4.42 (0.53-36.61, I2 = 88.40%, p < 0.01), and a pooled UMD of vitamin D levels of -2.19 ng/mL (-4.07 - -0.31 ng/mL, I2 = 7.64%, p = 0.37) were found. For TE patients, pooled UMD of vitamin D levels of -5.71 (-10.10 - -1.32) ng/mL were found. CONCLUSION: People with alopecia frequently have VDD; however, only in patients with AA or FPHL was the association of VDD and decreased vitamin D levels statistically significant compared to control. The findings indicate screening for vitamin D could benefit patients with AA or FPHL, potentially addressing vitamin D deficiency. Further study on vitamin D supplementation as a treatment for alopecia is recommended.
Full Text
Figures
Figure 1
PRISMA flow diagram for the systematic review and meta-analysis investigating vitamin D deficiency in patients with non-scarring and scarring alopecias.
flowchart
Figure 2
Forest plot comparing serum vitamin D levels between alopecia patients and healthy controls, indicating that vitamin D deficiency is significantly associated with various alopecia subtypes.
forest_plot
Figure 3
Subgroup meta-analysis of vitamin D levels stratified by alopecia type, such as alopecia areata, androgenetic alopecia, or telogen effluvium.
forest_plot
Figure 4
Forest plot or pooled analysis of vitamin D deficiency prevalence in scarring versus non-scarring alopecia populations.
forest_plot
Figure 5
Sensitivity analysis evaluating the stability of meta-analytic findings on vitamin D and alopecia after sequential study exclusion.
forest_plot
Figure 6
Funnel plot assessing publication bias in the meta-analysis of vitamin D deficiency and alopecia disorders.
chartTables
Table 1
| Author, year | Country | Study design | Group (case/control) | Mean age (SD) | Female (%) | Severity of alopecia |
|---|---|---|---|---|---|---|
| Hasanbeyzade and Tunca (2024) ( | Turkey | Case–control | Patients with AA (41) | 26.80 (7.00) | 6 (14.60) | AT 10 (24.4%), AU 9 (22.0%), patchy AA 11 (26.8%), diffuse AA 11 (26.8%) |
| Age- and sex-matched healthy controls (41) | 26.90 (6.90) | 5 (12.20) | – | |||
| AbdElneam et al. (2024) ( | Saudi Arabia | Case–control | Patients with AA (82) | 25 (3.90) | 40 (48.80) | Localized patchy 38 (46.4%), Multiple patchy 31 (37.8%), Ophiasis 13 (15.8%) |
| Age-matched healthy controls (81) | 23.8 (2.80) | 45 (55.60) | – | |||
| Saleem et al. (2023) ( | Pakistan | Case–control | Patients with AA (45) | 22.94 (7.92) | 18 (40) | SALT class; S1 = 7 (15.6%), S2 = 10 (22.2%), S3 = 18 (40%), S4 = 3 (6.7%), S5 = 7 (15.6%), mean SALT score 56.3%§ |
| Age- and sex-matched healthy controls (45) | 23.84 (8.46) | 18 (40) | – | |||
| Hamidpour et al. (2023) ( | Iran | Descriptive | Patients with AA (402) | 27.20 (13.40) | 192 (47.80) | Median SALT score 68 (IQR 40–100) |
| Gupta et al. (2023) ( | India | Case–control | Patients with AA (25) | 27.64 (9.83) | 8 (32) | SALT class; S1 = 20 (80%), S2 = 2 (8%), S3-5 = 3 (12%) |
| Age- and sex-matched healthy controls (25) | 28.56 (7.95) | 8 (32) | – | |||
| Fahim et al. (2023) ( | Pakistan | Descriptive | Patients with AA (100) | 30.50 (8.40) | 58 (58) | Mean SALT score 20.7 ± 5.4 |
| Alsenaid et al. (2023) ( | Saudi Arabia | Case–control | Patients with AA (59) | 27.10 (9.10) | 6 (10.20) | Moderate 6 (10.2%), severe 9 (15.3%) |
| Age-matched healthy controls (60) | 27.4 (10.30) | 9 (15) | – | |||
| Das (2022) ( | India | Case–control | Patients with AA (50) | 25.07 (7.40) | 18 (36) | SALT class; S1 = 35 (70%), S2 = 10 (20%), S3 = 5 (10%), mean SALT score 22.3%§ |
| Age- and sex-matched healthy controls (50) | 24.48 (6.30) | 20 (40) | – | |||
| deQueiroz et al. (2022) ( | Brazil | Case–control | Patients with AA (7) | 44.2 (14.90) | 7 (100) | NR |
| Unmatched controls with other skin conditions (33) | 38.8 (16.00) | 37 (100) | – | |||
| Gao et al. (2022) ( | China | Case–control | Patients with AA (672) | 31.28 (14.42) | 276 (41.08) | NR |
| Age- and sex-matched healthy controls (580) | 30.89 (13.00) | 238 (41.03) | – | |||
| Goksin (2022) ( | Turkey | Descriptive | Patients with AA (218) | 27.8 (12.30) | 84 (38.5) | AU 7 (3.2%), AT 1 (0.5%) |
| Lim et al. (2022) ( | USA | Descriptive | Patients with pediatric AA (96) | 9 (4.40) | 61 (64) | NR |
| Oner and Akdeniz (2022) ( | Turkey | Descriptive | Patients with AA (99) | 26.1 (12.3) | 25 (25.3) | NR |
| Tran et al. (2022) ( | USA | Case–control* | Patients with AA (417) | 45.70 (NR) | 561 (61.60) | NR |
| Age-, sex-, and race-matched patients (3127) | 49.40 | 3,685 (74.50) | – | |||
| Abedini et al. (2021) ( | Iran | Case–control | Patients with AA (50) | 32.48 (12.61) | 23 (46) | Ophiasis 6 (12%), AT 9 (18%), AU 18 (36%) |
| Age, sex, and BMI-matched healthy controls (50) | 32.26 (12.32) | 23 (46) | – | |||
| Alamoudi et al. (2021) ( | Saudi Arabia | Descriptive | Patients with AA (177) | 28.37 (12.68) | 92 (52) | AU 16 (9%), AT 23 (7%) |
| Conic et al. (2021) ( | USA | Descriptive | Patients with AA (77) | 37.2‡ (NR) | 54 (70.10) | NR |
| Lizarondo et al. (2021) ( | Philippines | Case–control | Patients with AA (29) | 31.48 (10.82) | 19 (65.5) | SALT class; S1 = 20 (68.97%), S2 = 5 (17.24%), S3 = 2 (6.90%), S4 = 2 (6.90%), mean SALT score 25.24%§ |
| Age-, sex-, and sun exposure per day-matched healthy controls (29) | 31.86 (10.51) | 19 (65.5) | – | |||
| Conic et al. (2020) ( | USA | Case–control* | Patients with pediatric AA (3510) | NR | 1940 (55.3) | NR |
| Unmatched pediatric controls without AA (8310710) | NR | 4,018,940 (48.4) | – | |||
| Zhao et al. (2020) ( | China | Case–control | Patients with AA (443) | 41.26 (14.10) | 279 (62.98) | NR |
| Age-, sex-, and season-matched healthy controls (2070) | 41.76 (11.25) | 1,006 (48.60) | – | |||
| Conic et al. (2019) ( | USA | Descriptive | Patients with AA (18) | 71.83 (6.34) | 15 (83.3) | NR |
| El-Ghareeb (2019) ( | Egypt | Case–control | Patients with AA (20) | NR | NR | NR |
| Age-matched healthy controls (20) | NR | NR | – | |||
| Marahatta et al. (2019) ( | Nepal | Case–control | Patients with AA (30) | 28.37 (10.07) | 14 (48.3) | SALT score = 3.56 ± 3.50% |
| Age- and sex-matched healthy controls (30) | 30.50 (9.03) | 15 (51.7) | – | |||
| Namdar and Arikan (2019) ( | Turkey | Case–control | Patients with AA (60) | 31.4 (10.03) | 30 (50) | SALT class; S1 = 43 (71.7%), S2 = 17 (28.3%), mean SALT score 19.44%§ |
| Unmatched controls without chronic or dermatological diseases (61) | 36.61 (10.08) | 27 (44.3) | – | |||
| Rehman et al. (2019) ( | India | Case–control | Patients with AA (135) | 26 (12.89) | 44 (32.59) | SALT class; S1 = 52 (38.52%), S2 = 35 (25.93%), S3 = 17 (12.59%), S4 = 11 (8.15%), S5 = 7 (5.19%), mean SALT score 38.09%§ |
| Age- and sex-matched healthy controls (135) | 26 (13.20) | 44 (32.59) | – | |||
| Siddappa et al. (2019) – adult AA ( | India | Case–control | Patients with AA (100) | 24.52 (10.06) | 28 (28) | SALT class; S1 = 75 (99%), S3 = 1 (1%), mean SALT score 13.14%§ |
| Age- and sex-matched healthy controls (100) | 28.96 (11.49) | 42 (42) | – | |||
| Siddappa et al. (2019) – pediatric AA ( | India | Case–control | Patients with pediatric AA (30) | 11.13 (4.17) | 12 (40) | NR |
| Age- and sex-matched healthy controls (30) | 11.46 (4.41) | 12 (40) | – | |||
| Daroach et al. (2018) ( | India | Case–control | Patients with AA (30) | 28.97 (9.96) | 19 (63.33) | SALT class; S1-2 = 24 (80%), S3-4 = 3 (10%), S5 = 3 (10%), SALT score = 35.8 ± 27.5% |
| Age- and sex-matched healthy controls (30) | 31.17 (9.43) | 14 (46.67) | – | |||
| Gade et al. (2018) ( | India | Case–control | Patients with AA (45) | 32.73 (10.43) | 31 (68.89) | Median SALT score (%) 4.23 (3.12–6.33) |
| Age- and sex-matched healthy controls (45) | 33.98 (8.48) | 31 (68.89) | – | |||
| Karaguzel et al. (2018) ( | Turkey | Case–control | Patients with pediatric AA (30) | 10.5 (2.9) | 20 (66) | NR |
| Age- and sex-matched healthy pediatric control (30) | 10.5 (2.8) | 20 (66) | – | |||
| Saniee et al. (2018) ( | Iran | Case–control | Patients with AA (77) | 27.38 (11.94) | 37 (48.1) | Mean involved area = 43.51 ± 20.25 |
| Age- and sex-matched normal controls who visited dermatology clinics (112) | 29.54 (13.65) | 54 (48.2) | – | |||
| Unal and Gonulalan (2018) ( | Turkey | Case–control | Patients with pediatric AA (20) | 12.67 (4.16) | 6 (30) | SALT class; S1 = 6 (30%), S2 = 9 (45%), S3 = 5 (25%), S4 = 0, S5 = 0, mean SALT score 35.78%§ |
| Unmatched healthy controls (34) | 16.54 (0.91) | 19 (55.88) | – | |||
| Bhat et al. (2017) ( | India | Case–control | Patients with AA (50) | 22.4 (8.6) | NR | SALT class; S1 = 38 (76%), S2 = 12 (24%), mean SALT score 18.38%§ |
| Age- and sex-matched healthy controls randomly recruited from clinic with no history of AA (35) | 29.2 (7.6) | NR | – | |||
| Conic et al. (2017) ( | USA | Case–control* | Patients with AA (584) | 35.54 (19.28) | 400 (68.50) | AT 12 (2.05%), AU 19 (3.25%) |
| Age-matched controls with seborrheic dermatitis without hair loss (172) | 35.80 (15.56) | 126 (73.25) | – | |||
| Erpolat et al. (2017) ( | Turkey | Case–control | Patients with AA (41) | 32.8 (7.5) | 15 (36.59) | NR |
| Unmatched healthy controls (32) | 32.7 (7.5) | 14 (43.75) | – | |||
| Ghafoor and Anwar (2017) ( | Pakistan | Case–control | Patients with AA (30) | 23.77 (8.86) | 18 (60) | SALT class; S1 = 4 (13.33%), S2 = 7 (23.33%), S3 = 12 (40%), S4 = 1 (3.33%), S5 = 6 (20%), mean SALT score 57.8%§ |
| Age- and sex-matched healthy volunteers and patients coming to dermatology department for other disorders (30) | 24.03 (8.62) | 18 (60) | – | |||
| Narang et al. (2017) ( | India | Descriptive | Patients with AA (22) | 30.4 (10.8) | 10 (45.5) | SALT score ranged 8.4–40 |
| Attawa et al. (2016) ( | Egypt | Case–control | Patients with AA (23) | 26.44 (10.87) | 8 (34.8) | SALT class; S1 = 14 (61%), S2 = 3 (13%), S3 + S4 + S5 = 6 (26%), mean SALT score 34.04%§ |
| Unmatched healthy controls (23) | 29.39 (8.10) | 9 (39.1) | – | |||
| Bakry et al. (2016) ( | Egypt | Case–control | Patients with AA (60) | 20.7 (10.85) | 24 (40) | Ophiasis 12 (20%), AT/AU 16 (26.7%) |
| Age-, sex-, FST-, and BMI-matched healthy controls (60) | 23.71 (7.45) | 32 (53.3) | – | |||
| Darwish et al. (2016) ( | Egypt | Case–control | Patients with AA (30) | 28.67 (10) | 17 (56.7) | SALT score: S1 = 10 (33.3%), S2 = 7 (23.3%), S3 = 4 (13.3%), S4 = 3 (10%), S5 = 1 (3.3%), S4 B = 3 (10%), S5 B = 2 (6.7%), mean SALT score 39.64%§ |
| Age- and sex-matched healthy controls (20) | 24.8 (6) | 10 (50) | – | |||
| Fattah and Darwish (2015) ( | Egypt | Case–control | Patients with AA (30) | 26.8 (6.9) | 12 (40) | SALT class; S3 = 15 (50%), S4 = 3 (10%), S5 = 12 (40%), B0 = 27 (90%), B2 = 3 (10%), mean SALT score 79.45%§ |
| Age-, sex-, FST-, approximate daily amount of vitamin D intake-, occupation (indoor or outdoor)-, and time of blood sampling- matched healthy controls (30) | 25.1 (6.9) | 12 (40) | – | |||
| Ogrum et al. (2015) ( | Turkey | Case–control | Patients with AA (40) | 31.23 (7.34) | 21 (52.5) | SALT class; S1 = 35 (87.5%), S2 = 3 (7.5%), S3 = 2 (5%), mean SALT score 16.79%§ |
| Age-, sex-, and FST-matched healthy controls (40) | 30.58 (7.19) | 21 (52.5) | – | |||
| Cerman et al. (2014) ( | Turkey | Case–control | Patients with AA (86) | 32.21 (9.60) | 30 (42) | SALT class; S1 = 41 (83%), S2 = 15 (17%), SALT 14.41 ± 9.92% |
| Age- and sex-matched healthy controls (58) | 32.55 (9.78) | 24 (41.38) | – | |||
| Mahamid et al. (2014) ( | Israel | Case–control | Patients with AA (23) | 24.2 (12.3) | 9 (39.13) | Extensive 5 (21.74%) |
| Age- and sex-matched controls without AA (20) | 27 (11.26) | 7 (35) | – | |||
| D’Ovidio et al. (2013) ( | Italy | Case–control | Patients with AA (70) | 27.79 (9.12) | 33 (47.1) | Ophiasis 69 (44%), AT/AU 38 (24.5%) |
| Unmatched healthy controls (70) | 30.49 (11.06) | 26 (37.1) | – | |||
| El-Mongy et al. (2013) ( | Egypt | Case–control | Patients with AA (156) | 37.8 (NR) | 111 (71.15) | SALT class; S1 = 30 (42.9%), S2 = 12 (17.1%), S3 + S4 + S5 = 28 (40.0%), mean SALT score 44.83%§ |
| Unmatched healthy controls (148) | 34.5 (NR) | 130 (87.84) | – | |||
| Nassiri et al. (2013) ( | Iran | Case–control | Patients with AA (28) | 27.75 (7.97) | 9 (32.14) | SALT (%); 0–24 = 6 (21.4%), 25–49 = 4 (14.3%), 50–74 = 1 (3.6%), and 100 = 17 (60.7%), mean SALT score 70.79%§ |
| Unmatched healthy controls (44) | 33.16 (12.52) | 28 (63.63) | – | |||
| Yilmaz et al. (2012) ( | Turkey | Case–control | Patients with AA (42) | 31.1 (8.2) | 28 (66.67) | SALT class; S1 = 30 (71.43%), S2 = 6 (14.29%), S3 = 3 (7.14%), S4 = 2 (4.76%), S5 = 1 (2.38%), mean SALT score 25.13%§ |
| Unmatched healthy controls (42) | 29.3 (7.4) | 29 (69.05) | – |
Table 4
| Author, year | Country | Study design | Group (case/control) | Mean age (SD) | Female (%) | Severity of alopecia |
|---|---|---|---|---|---|---|
| Leung et al. (2023) ( | USA | Case–control | Patients with CCCA (53) | 51.3 (9.60) | 53 (100) | NR |
| Age- and sex-matched healthy controls (212) | 50.3 (9.50) | 212 (100) | – | |||
| Gharaei Nejad et al. (2023) ( | Iran | Descriptive | Patients with LPP (60) | 43.60 (10.17) | 44 (73.3) | NR |
| Arasu et al. (2022) ( | Australia | Descriptive | Patients with FFA (100) | 63 (NR) | 100 (100) | NR |
| Collins et al. (2022) ( | USA | Descriptive | Patients with CCCA (27) | NR | NR | NR |
| Conic et al. (2021) ( | USA | Descriptive | Patients with LPP (58) | 56.6‡ (NR) | 55 (94.8) | NR |
| Patients with CCCA (29) | 55.2‡ (NR) | 29 (100) | NR | |||
| Conic et al. (2019) ( | USA | Descriptive | Patients with LPP (37) | 69.24 (3.11) | 37 (100) | NR |
| Patients with FFA (7) | 68.86 (3.24) | 7 (100) | NR | |||
| Patients with CCCA (4) | 67.25 (1.26) | 4 (100) | NR | |||
| Brankov et al. (2018) ( | USA | Case–control | Patients with LPP (334) | 54.77 (12.83) | 311 (93.1) | NR |
| Age- and race-matched controls with seborrheic dermatitis without hair loss (78) | 52.19 (15.37) | 62 (79.5) | – |
Table 2
| Author, year | Country | Study design | Group (case/control) | Mean age (SD) | Female (%) | Severity of alopecia |
|---|---|---|---|---|---|---|
| Wang et al. (2024) ( | China | Case–control | Patients with MAGA (40) | 27.3 (5.30) | 0 | NR |
| Age- and gender-matched healthy controls (45) | 28.3 (4.20) | 0 | – | |||
| Losoya-Jaquez et al. (2024) ( | Mexico | Descriptive | Patients with pediatric AGA (13†) | 16.08 (1.30) | 42 (21) | NR |
| Wu et al. (2023) ( | China | Case–control | Patients with MAGA (80) | 36.28 (10.49) | 0 | Mild 36 (45%), moderate alopecia 37 (46.3%), severe alopecia 7 (0.09%) |
| Age-, gender- and BMI-matched healthy controls (60) | 36.28 (10.98) | 0 | – | |||
| Vandana et al. (2023) ( | India | Descriptive | Patients with FPHL (24) | 28.9 (NR) | 24 (100) | NR |
| Okhovat et al. (2023) ( | USA | Descriptive | Patients with FPHL (54†) | 50.04 (16.40) | 54 (100) | NR |
| Hailat et al. (2023) ( | Pakistan | Case–control | Patients with FPHL (72) | 28.6 (2.40) | 72 (100) | NR |
| Sex-matched healthy controls (72) | NR | 72 (100) | – | |||
| Arasu et al. (2022) ( | Australia | Descriptive | Patients with FPHL (100) | 51 (NR) | 100 (100) | NR |
| deQueiroz et al. (2022) ( | Brazil | Case–control | Patients with FPHL (37) | 54.8 (15.00) | 37 (100) | NR |
| Unmatched controls with other skin conditions (33) | 38.8 (16.00) | 37 (100) | – | |||
| Krysiak et al. (2022) ( | Poland | Case–control | Patients with MAGA (72) | 37 (6.00) | 0 | NR |
| Age-, blood pressure-, BMI-, insulin sensitivity-, and plasma lipids-matched controls without hair loss (75) | 38 (6.00) | 0 | – | |||
| Oner and Akdeniz (2022) ( | Turkey | Descriptive | Patients with AGA (101) | 25.6 (7.3) | 25 (24.8) | NR |
| Tran et al. (2022) ( | USA | Case–control* | Patients with AGA (404) | NR | NR | NR |
| Age-, sex-, and race-matched patients (3127) | 49.40 | 3,685 (74.50) | – | |||
| Conic et al. (2021) ( | USA | Descriptive | Patients with AGA (73) | 53.2‡ (NR) | 65 (89) | NR |
| Danane et al. (2021) ( | India | Descriptive | Patients with MAGA (50) | 24 (NR) | 0 | NR |
| El-Tahlawy et al. (2021) ( | Egypt | Case–control | Patients with MAGA (30) | NR | 0 | NR |
| Age- and sex-matched healthy controls (30) | NR | 0 | – | |||
| Jasim et al. (2021) ( | Iraq | Case–control | Patients with FPHL (50) | NR | 50 (100) | NR |
| Unmatched healthy controls (50) | NR | 50 (100) | – | |||
| Kerkemeyer et al. (2021) ( | Australia | Descriptive | Patients with MAGA (31†) | 28.7 (NR) | 0 | Sinclair grade; 2.0 = 15 (17.6%), 2.5 = 6 (7.1%), 3.0 = 40 (47.6%), 3.5 = 0 (0.0%), 4.0 = 18 (21.4%), 4.5 = 2 (2.4%), and 5.0 = 3 (3.6%) |
| Sanke et al. (2020) ( | India | Case–control | Patients with MAGA (50) | 21.17 (3.66) | 0 | Hamilton-Norwood grade; III = 14 (25%), IV = 19 (33%), V = 20 (35%), and grade VI = 4 (7%) |
| Age-, sex-, socioeconomic status, and outdoor exposure-matched healthy controls who attended dermatology department (50) | NR | 0 | – | |||
| Zhao et al. (2020) ( | China | Case–control | Patients with FPHL (657) | 32.59 (10.51) | 657 (100) | NR |
| Patients with MAGA (777) | 29.89 (7.02) | 0 | NR | |||
| Age-, sex-, and season-matched healthy controls (2070) | 41.76 (11.25) | 1,006 (48.60) | – | |||
| Conic et al. (2019) ( | USA | Descriptive | Patients with FPHL (27) | 70.26 (4.99) | 27 (100) | NR |
| Kondrakhina et al. (2019) ( | Russia | Case–control | Patients with MAGA (50) | 26.2 (5.3) | 0 | NR |
| Age- and origin-matched healthy controls (25) | NR | NR | – | |||
| Sarac and Koca (2018) ( | Turkey | Case–control | Patients with AGA (58) | 30.3 (8.8) | 28 (48.28) | NR |
| Unmatched healthy controls (58) | 28.5 (10.1) | 47 (81.03) | – | |||
| Banihashemi et al. (2016) ( | Iran | Case–control | Patients with FPHL (45) | 29.11 (7.31) | 45 (100) | NR |
| Age-, sex-, hours spent under sunlight per day-, and BMI-matched healthy controls (45) | 28.82 (7.11) | 45 (100) | – | |||
| Moneib et al. (2014) ( | Egypt | Case–control | Patients with FPHL (60) | 28.67 (10) | 60 (100) | NR |
| Age-, sex-, FPT-, socioeconomic status-, outdoor exposure- matched heatlhy controls (60) | 24.8 (6) | 60 (100) | – | |||
| Rasheed et al. (2013) ( | Egypt | Case–control | Patients with FPHL (38) | NR | 38 (100) | |
| Age-, sex-, and FST- matched healthy female controls (40) | 30.8 (8.56) | 40 (100) | – |
Table 3
| Author, year | Country | Study design | Group (case/control) | Mean age (SD) | Female (%) |
|---|---|---|---|---|---|
| Vandana et al. (2023) ( | India | Descriptive | Patients with TE (76) | 24.40 (NR) | 76 (100) |
| Arslan et al. (2023) ( | Turkey | Descriptive | Patients with TE (58†) | 27.54 (9.42) | 840 (86.3) |
| Chen et al. (2022) ( | USA | Descriptive | Patients with pediatric TE (68†) | 12.3 (NR) | 67 (88) |
| deQueiroz et al. (2022) ( | Brazil | Case–control | Patients with TE (17) | 42.8 (14.55) | 17 (100) |
| Unmatched controls with other skin conditions (33) | 38.8 (16.00) | 37 (100) | |||
| Oner and Akdeniz (2022) ( | Turkey | Descriptive | Patients with TE (160) | 27.7 (8.8) | 156 (97.5) |
| Yorulmaz et al. (2022) ( | Turkey | Descriptive | Patients with TE (1688†) | 26‡ (NR) | 2,794 (92.30) |
| Alizadeh et al. (2021) ( | Iran | Case–control | Patients with TE (83) | 35‡ (NR) | 83 (100) |
| Age- and sex-matched healthy controls (83) | 35‡ (NR) | 83 (100) | |||
| Conic et al. (2021) ( | USA | Descriptive | Patients with TE (121) | 46.9‡ (NR) | 120 (99.2) |
| Naser et al. (2021) ( | Baghdad | Case–control | Patients with TE (60) | 32.6 (6.47) | 60 (100) |
| Age- and sex-matched healthy controls (60) | 41.3 (4.59) | 60 (100) | |||
| Mohammad et al. (2020) ( | Iran | Case–control | Patients with TE (50) | NR | 50 (100) |
| Age- and sex-matched healthy controls who referred to dermatology clinic for cosmetic procedures other than hair loss (50) | NR | 50 (100) | |||
| Sokmen (2020) ( | Turkey | Descriptive | Patients with TE (151) | 29‡ (NR) | 151 (100) |
| Conic et al. (2019) ( | USA | Descriptive | Patients with TE (70) | 71.07 (5.35) | 68 (97.1) |
| Cifcia (2018) ( | Turkey | Case–control | Patients with TE (155) | 30.7 (9.80) | 149 (96.13) |
| Age- and sex-matched healthy controls who visited other clinics for health checkup (168) | 30.76 (8.80) | 155 (92.26) | |||
| Sarac and Koca (2018) ( | Turkey | Case–control | Patients with TE (71) | 26.6 (8.4) | 65 (91.55) |
| Unmatched healthy controls (58) | 28.5 (10.1) | 47 (81.03) | |||
| Gurel et al. (2017) ( | Turkey | Case–control | Patients with TE (80) | 26.41 (6.93) | 80 (100) |
| Age- and sex-matched controls without hair loss (80) | 25.79 (7.41) | 80 (100) | |||
| Cheung et al. (2016) ( | USA | Descriptive | Patients with TE (115†) | NR | 110 (26.63) |
| Rasheed et al. (2013) ( | Egypt | Case–control | Patients with TE (42) | NR | 42 (100) |
| Age-, sex-, and FST- matched healthy female controls (40) | 30.8 (8.56) | 40 (100) | |||
| Karadag et al. (2011) ( | Turkey | Case–control | Patients with TE (63) | 29.1 (11.9) | 63 (100) |
| Sex-matched controls without AA (50) | 28.4 (9.4) | 50 (100) |
Table 5
| Alopecia areata | Androgenetic alopecia | Telogen effluvium | |||||||
|---|---|---|---|---|---|---|---|---|---|
| Subgroup | No. of studies | Prevalence | I2 (%)/ | No. of studies | Prevalence | I2 (%)/ | No. of studies | Prevalence | I2 (%)/ |
| Overall | 34 | 51.94% (41.54–62.25%) | 97.48/<0.01 | 16 | 47.27% (32.49–62.29%) | 96.06/<0.01 | 13 | 53.51% (37.33–69.33%) | 97.99/<0.01 |
| Country | |||||||||
| Eastern | 28 | 56.70% (43.04–69.87%) | 97.88/<0.01 | 9 | 64.31% (48.41–78.81%) | 92.10/<0.01 | 9 | 64.42% (49.17–78.33%) | 97.10/<0.01 |
| Western | 6 | 31.36% (23.51–39.74%) | 82.73/<0.01 | 7 | 25.54% (16.80–35.34%) | 82.88/<0.01 | 4 | 27.56% (13.59–44.07%) | 88.11/<0.01 |
| Age | |||||||||
| Mean age 18–25 years | 3 | 47.01% (1.32–96.78%) | – | 3 | 70.69% (51.32–86.96%) | – | 0 | – | – |
| Mean age 25–60 years | 29 | 54.67% (44.56–64.60%) | 96.79/<0.01 | 11 | 42.07% (25.49–59.60%) | 96.42/<0.01 | 9 | 56.00% (38.63–72.67%) | 97.70/<0.01 |
| Mean age > 60 years | 1 | 5.56% (0.99–25.76%) | – | 1 | 14.81% (5.92–32.48%) | – | 1 | 28.57% (19.32–40.05%) | – |
| Unspecified | 1 | 35.00% (18.12–56.71%) | – | 1 | 68.00% (54.19–79.24%) | – | 1 | 10.43% (6.07–17.36%) | – |
| Severity | |||||||||
| Severe cohorts | 9 | 44.36% (19.70–70.54%) | 98.01/<0.01 | – | – | – | – | – | – |
| Non-severe cohorts | 13 | 63.71% (47.43–78.58%) | 95.25/<0.01 | ||||||
| Unspecified | 12 | 44.64% (31.88–57.75%) | 96.90/<0.01 | ||||||
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