Abstract
Background and Objectives: Alopecia areata (AA) is an autoimmune disorder characterized by non-scarring hair loss and has been associated with systemic immune-inflammatory activity and potential cardiometabolic risk. This study aimed to evaluate cardiovascular risk markers-including ECG parameters, arterial stiffness indices, anthropometric measurements, and body composition-in patients with AA according to disease severity and duration, and to compare these findings with healthy controls. Materials and Methods: This case-control study included 50 AA patients (32 men, 18 women; mean age: 28.98 ± 9.81 years) and 50 healthy controls (30 men, 20 women; mean age: 28.00 ± 7.86 years). All participants underwent anthropometric and electrocardiographic evaluations. Body composition was assessed, and arterial stiffness was measured. Subgroup analyses were performed according to SALT score (mild vs. moderate-to-severe) and disease duration (≥10 years vs. <10 years). Results: Heart rate was lower in AA patients compared with controls (mean difference -5.14 bpm; 95% CI -10.267 to -0.013). No significant differences were found between the groups regarding anthropometric variables, body composition, or arterial stiffness indices. Among AA patients, those with moderate-to-severe disease had significantly lower body fat mass (mean difference 4.95 kg; 95% CI 0.26 to 9.644) and lower visceral fat rating (mean difference 2.428 units; 95% CI 0.800 to 4.056) compared with mild AA. Conclusions: AA patients demonstrated lower heart rate and disease-severity-related alterations in body composition, although the clinical significance of these findings remains uncertain. Larger longitudinal studies are needed to clarify whether these subclinical differences translate into meaningful cardiovascular risk over time.