The association between dyslipidemia and androgenic alopecia: A cross-sectional study from the PERSIAN Guilan cohort study

Background Androgenetic alopecia (AGA) is the most common type of hair loss worldwide and may be linked to systemic metabolic abnormalities such as dyslipidemia. This study evaluated the associations between androgenic alopecia and dyslipidemia among the Prospective Epidemiological Research Studies of the Iranian Adults (PERSIAN) Guilan Cohort Study (PGCS) population. Methods This cross-sectional study included 10,520 adults aged 30–70 years. Demographic, lifestyle, and clinical data were collected. Lipid profiles, including triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL), and low-density lipoprotein cholesterol (LDL), were measured. AGA was diagnosed and classified by dermatologists using the Norwood–Hamilton scale in men and the Sinclair Scale in women. Data was analyzed using SPSS software version 16, and GraphPad Prism software version 8.0.1. A significant level was set at 0.05. Results Dyslipidemia prevalence was 75.8%, higher in females than in males ( P < 0.001). AGA was observed in 52.7% of participants, more common in males than in females (65.8% vs. 41.2%, P < 0.001). Overall, AGA showed no significant association with dyslipidemia ( P = 0.230). However, in females, dyslipidemia was associated with higher odds of AGA (aOR = 1.16; 95% CI: 1.01–1.34; P = 0.040). A dose-response trend was observed as the number of dyslipidemia components increased ( P = 0.007). Low HDL was the strongest predictor in women (aOR = 1.24; 95% CI: 1.11–1.39; P < 0.001). In contrast, no significant associations were detected in males, while paradoxical inverse relationships were noted for hypercholesterolemia and elevated LDL. Conclusion This study revealed a sex-specific association between dyslipidemia and AGA, with low HDL and multiple lipid abnormalities increasing risk in females but not in males, underscoring the need to consider gender differences in clinical evaluation and management.