邱顯清陳秀熙臺灣大學：蘇琳惠Su, Lin-HuiLin-HuiSu2007-11-282018-06-292007-11-282018-06-292005http://ntur.lib.ntu.edu.tw//handle/246246/59240前言： 在不同種族，雄性禿的盛行率及嚴重度不同。但是，目前台灣欠缺男性雄性禿盛行率的資料。此外，回顧文獻，抽煙和雄性禿之間的關係仍無定論。 目的： 為估計台灣男性雄性禿之盛行率，以及釐清抽煙和雄性禿之間之相關性。 方法： 以743位32至91歲之男性民眾自主參加台南縣社區整合型疾病篩檢、以及758位20至64歲之基隆市男性警察人員參加職業整合型疾病篩檢者為對象，進行橫斷面研究，以整合型疾病篩檢為平台，蒐集雄性禿、抽煙、家族史、疾病史、及其他流行病學資料。以此分析雄性禿之盛行率、並以邏輯式迴歸模式分析抽煙與雄性禿之間的相關性。 結果： 台灣男性雄性禿的盛行率隨著年齡增加而上升，此發現與文獻回顧相同，但是和白種人相比，盛行率較低。而台南縣社區研究中，在調整年齡及雄性禿家族史兩個變項之後，抽煙和雄性禿之間呈現統計上顯著意義的正相關。 結論： 這是第一個針對台灣男性雄性禿盛行率、以群體為基礎的橫斷面研究。而且，抽煙和雄性禿之間有顯著之正相關存在。Background: Prevalence and types of androgenetic alopecia (AGA) are fraught with great variation and the association between smoking and AGA remains controversial. Objective: To estimate the prevalence of AGA in Taiwanese men and to evaluate its association with smoking. Methods: Two data from Community-based sample of men (n=743) aged 32 to 91 years and from occupation-based sample of the policemen (n=758) aged 20 to 64 years were available for analysis. All were interviewed in person and direct observations of AGA were made by the trained staffs using standardized classification for AGA. The association between smoking and AGA was assessed by using unconditional logistic regression. Results: The prevalence of AGA in men in Taiwan increased with age, but was lower than that in Caucasians. After adjusting for age and family history of AGA, we found a significant positive association between smoking and AGA in the community-based program but not in occupation-based program. The relationships of family history of AGA or degrees of relationship to occurrence of AGA was demonstrated to be statistically significant. Conclusions: This is the first population-based cross-sectional survey for the prevalence of AGA in Taiwanese men. Smoking is found to be positively associated with moderate or severer AGA.I. INTRODUCTION ...……………………………………………..….1 1.1 Clinical presentation and classification ...………….………..2 1.2 Pathophysiology ...…………………………………….………3 1.3 Associations with other conditions…………..…….…………5 1.4 Association with smoking…………..……..………….………6 II. LITERATURE REVIEW ...……………………………….………8 2.1 Prevalence …………………………………………….……….8 2.2 The association of smoking with AGA ……………………..11 III. MATERIAL AND METHODS …………………………………13 3.1 Target population and study population …………………..13 3.1.1 Occupation-based Program …………………………….13 3.1.2 Community-based Program ……………………………13 3.2 Study design and data collection …………………………...14 3.2.1 Exposure measurement ………………………………...14 3.2.2 Outcome measurement ………………………………...15 3.2.3 Measurement of potential confounders ………………..16 Statistical Analysis ………………………………………….…...18 IV RESULTS ……………………………………………………..…..21 4.1 Descriptive Findings ……………………………………..….21 4.2 Prevalence …………………………………………………....21 4.2.1 Occupation-based program …………………………….21 4.2.2 Community-based program …………………………....22 4.3 Association between smoking and moderate or severer AGA (type IV or greater) ………………………….………...23 4.3.1 Occupation-based program ……………………………23 4.3.2 Community-based program ……………………………24 4.4 Early-onset AGA on AGA grades ………………………….25 4.5 Early-onset AGA and family history of AGA ……………..26 4.6 Family history of AGA by degrees of relationships ……….26 4.7 Family history of AGA by parental relationship ………….27 V DISCUSSION ……………………………………………………29 5.1 Prevalence ……………………………………………………29 5.2 Association between smoking and the risk of moderate or severer AGA (type IV or greater) ………………………….30 5.3 Association between other variables and the risk of moderate or severe AGA …………………….……………..32 5.4 Association between the age at onset and the severity of AGA ………………………………………………………....33 5.5 Association between the family history and the risk of moderate or severer AGA …………………...……………..34 REFERENCES ………………………………………………………37 TABLE LIST Table 2.1 Summary of studies for prevalence of androgenetic alopecia ……………………………………………………………39 Table 2.2 Summary of studies for the association of smoking with AGA ……………………………………………………………43 Table 4.1.1 Demographic characteristics of the policemen in the occupation-based program ………………………………46 Table 4.1.2 Demographic characteristics of the participants in the community-based program …………………...…………47 Table 4.2.1 Age-specific number and percentage of different AGA types in the occupation-based program ………………….48 Table 4.2.2 Age-specific number and percentage of Norwood types A variants in the occupation-based program …………...….49 Table 4.2.3 Age-specific number and percentage of ‘female pattern’ AGA types rated by Ludwig classification in the occupation-based program ……………………...……….50 Table 4.2.4 Age-specific number and percentage of different AGA types in the community-based program …………………51 Table 4.2.5 Age-specific number and percentage of Norwood types A variants in the community-based program ………………52 Table 4.2.6 Age-specific number and percentage of ‘female pattern’ AGA types rated by Ludwig classification in the community-based program ……………...………………53 Table 4.3.1 Univariate analysis in the occupation-based program ……54 Table 4.3.2 Multivariate analysis adjusted for age and family history in the occupation-based program ………………...………...56 Table 4.3.3 Univariate analysis in the community-based program …...58 Table 4.3.4 Multivariate analysis adjusted for age and family history in the community-based program ………………………….60 Table 4.3.5 Multivariate model for variables in the community-based Program …………………………………………………62 Table 4.4.1 Proportional odds model reveals positive association between early onset of AGA and grade of AGA after adjusting for age and family history in the occupation-based program ……………………...……….63 Table 4.4.2 Proportional odds model reveals positive association between early onset of AGA and grade of AGA after adjusting for age and family history in the community-based program ……………………..…….….64 Table 4.5.1 The association between early onset of AGA and family history of AGA by univariate logistic regression in the occupation-based program ………………………...….…65 Table 4.5.2 The association between early onset of AGA and family history of AGA by univariate logistic regression in the community-based program …………………...…………66 Table 4.6.1 The association between family history in different degrees of relatives and moderate or severer AGA after adjusting for age in the occupation-based program ………………..67 Table 4.6.2 The association between family history in different degrees of relatives and moderate or severer AGA after adjusting for age in the community-based program ……………….68 Table 4.7.1 The association between moderate or severer AGA and parental family history of AGA after adjusting for age in the occupation-based program ……………..……………69 Table 4.7.2 The association between moderate or severer AGA and parental family history of AGA after adjusting for age in the community-based program ………………….………70 Figure 1.1.1 Norwood classification of AGA ………………………...71 Figure 1.1.2 Ludwig classification of ‘female pattern’ AGA ………...73 Figure 1.2.1. Pathogenic mechanisms in AGA …………………….…74 Figure 2.1 Prevalence of Androgenetic Alopecia in Eight Studies ...…75 Figure 4.2.1 Age-specific prevalence of AGA in the occupation-based program …………………….……76 Figure 4.2.2 Prevalence of AGA in previous and our studies ………...77 Figure 4.2.3 Age-specific prevalence of AGA in the community-based program …………………………78 Figure 4.4.1 Cumulative logits model in the occupation-based program……………………………………………...79 Figure 4.4.2 Cumulative logits model in the community-based program ……………………………………………..80450551 bytesapplication/pdfen-US雄性禿抽煙盛行率androgenetic alopeciasmokingprevalencethesishttp://ntur.lib.ntu.edu.tw/bitstream/246246/59240/1/ntu-94-R92846009-1.pdf