Psychological stress impact neurotrophic factor levels in patients with androgenetic alopecia and correlated with disease progression

Table 1 Baseline demographic characteristics of two groups, n (%)/mean ± SD

Parameter	Non-stress group (n = 30)	Stress group (n = 90)	t/χ²	P value
Age (years)	29.03 ± 2.39	29.79 ± 4.81	1.131	0.261
Gender			0.048	0.827
Male	18 (60.00)	58 (64.44)
Female	12 (40.00)	32 (35.56)
BMI (kg/m2)	25.36 ± 2.12	25.82 ± 1.92	1.051	0.299
Smoking history (pack-years)	0.78 ± 1.66	0.89 ± 2.03	0.254	0.800
Alcohol intake (g/week)	20.18 ± 4.56	18.96 ± 3.81	1.319	0.194
Comorbidities
Hypertension	2 (6.67)	5 (5.56)	0	1
Diabetes	2 (6.67)	7 (7.78)	0	1
Family history of alopecia	17 (56.67)	48 (53.33)	0.011	0.916
Educational status			0	1
Junior high and below	4 (13.33)	13 (14.44)	0	1
Above junior high school	26 (86.67)	77 (85.56)
Marital status
Unmarried	10 (33.33)	35 (38.8)
Married	14 (46.67)	41 (45.56)
Divorced	5 (16.67)	12 (13.33)
Widowed	1 (3.33)	2 (2.22)	0.924	0.863
Duration of AGA			4.538	0.209
< 1 year	9	21
1–5 years	15	32
5–10 years	4	28
> 10 years	2	9

BMI: Body mass index; AGA: Androgenetic alopecia.

Table 2 Baseline hair growth parameters in non-stress and stress groups, mean ± SD

Hair growth parameters	Non-stress group (n = 30)	Stress group (n = 90)	t-value	P value
Mean hair diameter (μm)	59.81 ± 6.40	50.047 ± 7.36	6.492	0.000
Hair density (hairs/cm²)	105.24 ± 21.38	93.11 ± 28.69	2.124	0.036
Hair follicle count (per 1 cm²)	60.14 ± 10.89	56.47 ± 15.83	1.416	0.161
Terminal/vellus hair ratio	7.16 ± 0.61	7.25 ± 0.72	0.649	0.519

Table 3 Comparison of neurotrophic factors between non-stress and stress groups, mean ± SD

Neurotrophic factor	Non-stress group (n = 30)	Stress group (n = 90)	t-value	P value
NGF (pg/mL)	24.65 ± 5.32	22.18 ± 4.76	2.264	0.028
BDNF (ng/mL)	9.61 ± 2.14	8.46 ± 1.85	2.637	0.011
NT-3 (pg/mL)	15.89 ± 3.76	17.48 ± 3.21	2.077	0.044
NT-4 (ng/mL)	7.73 ± 1.64	8.89 ± 1.47	3.44	0.001
GDNF (pg/mL)	12.45 ± 2.78	11.18 ± 2.35	2.244	0.030

NGF: Nerve growth factor; BDNF: Brain-derived neurotrophic factor; GDNF: Glial cell-derived neurotrophic factor; NT: Neurotrophin.

Table 4 Androgenetic alopecia progression scores in non-stress and stress groups, n (%)

Subgroup	Non-stress group (n = 30)	Stress group (n = 90)	χ2	P value
Before treatment			12.801	0.002
< 3/I	18 (60)	22 (24.44)
3–5/II	8 (26.67)	45 (50)
6 or 7/III	4 (13.33)	23 (25.56)
After 12 months of treatment			5.106	0.078
< 3/I	23 (76.67)	48 (53.33)
3–5/II	4 (13.33)	22 (24.44)
6 or 7/III	3 (10)	20 (22.22)

Table 5 Androgenetic alopecia progression in non-stress and stress groups, n (%)

Progress	Non-stress group (n = 30)	Stress group (n = 90)	χ2	P value
Progress ≥ 1 class	2 (6.67)	13 (14.44)	7.589	0.022
Ineffective	5 (16.67)	34 (37.78)
Improved	23 (76.67)	43 (47.78)

Table 6 Correlation analysis of stress and neurotrophic factors

Parameter	r	P value
NGF (pg/mL)	−0.215	0.018
BDNF (ng/mL)	−0.252	0.005
NT-3 (pg/mL)	0.237	0.009
NT-4 (ng/mL)	0.236	0.01
GDNF (pg/mL)	−0.219	0.016

NGF: Nerve growth factor; BDNF: Brain-derived neurotrophic factor; GDNF: Glial cell-derived neurotrophic factor; NT: Neurotrophin.

Table 7 Correlation analysis of hair loss progression and neurotrophic factors

Parameter	r	P value
NGF (pg/mL)	−0.121	0.189
BDNF (ng/mL)	−0.118	0.198
NT-3 (pg/mL)	−0.114	0.214
NT-4 (ng/mL)	0.341	< 0.001
GDNF (pg/mL)	−0.12	0.193

NGF: Nerve growth factor; BDNF: Brain-derived neurotrophic factor; GDNF: Glial cell-derived neurotrophic factor; NT: Neurotrophin.