Early Androgenetic Alopecia and Insulin Resistance-A case control study (original) (raw)
Related papers
Clinical Endocrinology, 2009
Background Epidemiological studies have associated androgenetic alopecia (AGA) with severe young-age coronary artery disease and hypertension, and linked it to insulin resistance. We carried out a case–control study in age- and weight-matched young males to study the link between AGA and insulin resistance using the homeostasis model assessment of insulin resistance (HOMA-IR) index or metabolic syndrome clinical manifestations.Methods Eighty young males, 18–35 years old, with AGA ≥ stage III in the Hamilton–Norwood classification, and 80 weight- and age-matched controls were included. Alopecia, glucose, serum insulin, HOMA-IR index, lipid profile and androgen levels, as well as metabolic syndrome criteria, were evaluated.Results The HOMA-IR index was significantly higher in cases than controls. Nonobese cases had a higher mean diastolic blood pressure and a more frequent family history of AGA than nonobese controls. A borderline difference in the HOMA-IR index was found in obese AGA cases vs. obese controls [P = 0·055, 95% confidence interval (CI) 2·36–4·20 vs. 1·75–2·73]. Free testosterone values were significantly higher in controls than cases, regardless of body mass index (BMI). A statistically significant additive effect for obesity plus alopecia was found, with significant trends for insulin, the HOMA-IR index, lipids and free testosterone when BMI and alopecia status were used to classify the participants.Conclusions Our results support the recommendation for assessing insulin resistance and cardiovascular-related features and disorders in all young males with stage III or higher AGA, according to the Hamilton–Norwood classification.
Androgenetic alopecia and insulin resistance in young men
Clinical Endocrinology, 2009
Background Epidemiological studies have associated androgenetic alopecia (AGA) with severe young-age coronary artery disease and hypertension, and linked it to insulin resistance. We carried out a case-control study in age-and weight-matched young males to study the link between AGA and insulin resistance using the homeostasis model assessment of insulin resistance (HOMA-IR) index or metabolic syndrome clinical manifestations. Methods Eighty young males, 18-35 years old, with AGA ‡ stage III in the Hamilton-Norwood classification, and 80 weight-and agematched controls were included. Alopecia, glucose, serum insulin, HOMA-IR index, lipid profile and androgen levels, as well as metabolic syndrome criteria, were evaluated. Results The HOMA-IR index was significantly higher in cases than controls. Nonobese cases had a higher mean diastolic blood pressure and a more frequent family history of AGA than nonobese controls. A borderline difference in the HOMA-IR index was found in obese AGA cases vs. obese controls [P ¼ 0AE055, 95% confidence interval (CI) 2AE36-4AE20 vs. 1AE75-2AE73]. Free testosterone values were significantly higher in controls than cases, regardless of body mass index (BMI). A statistically significant additive effect for obesity plus alopecia was found, with significant trends for insulin, the HOMA-IR index, lipids and free testosterone when BMI and alopecia status were used to classify the participants. Conclusions Our results support the recommendation for assessing insulin resistance and cardiovascular-related features and disorders in all young males with stage III or higher AGA, according to the Hamilton-Norwood classification.
Innovative Publication, 2016
Introduction: Men with premature androgenetic alopecia (AGA) are found to be susceptible to cardiovascular diseases, metabolic syndrome, diabetes mellitus and hypertension and also premature baldness can have a definite negative impact on self-image and self-esteem in these patients. Insulin resistance (IR), metabolic syndrome (MS) are known to be independent risk factors for coronary heart disease (CHD). The aim of this study was to assess the strength of association between MS and/or insulin resistance in males with early-onset Androgenetic alopecia (AGA). Methods: A total of 50 male patients with premature AGA attending the dermatology outpatient department and satisfying the inclusion and exclusion criteria were recruited in the study. Equal number of normal age and gender matched patients attending the dermatology OPD were taken as control group. A detailed history of the patients as per the prepared questionnaire was taken. Elaborate general, physical and systemic examination were carried out and recorded in standard proforma. Complete examination of scalp was done with emphasis on pattern and severity of hair loss. Hair loss was graded according to Hamilton-Norwood scale. Anthropometric and blood pressure measurement was done according to structured proforma. Fasting blood samples were collected and fasting insulin level, fasting blood sugar levels, high density lipoproteins, triglycerides were determined. Results: In this study, majority of patients with early onset AGA were in the age group of 22-24 years. Most common grade of hair loss was grade III a (32%) of Hamilton-Norwood scale of hair loss. 5 out of 50 cases (10%) and 2 out of 50 controls (4%) had shown association with insulin resistance and the difference between the groups was statistically insignificant (p= 0.23). 15 out of 50 cases (30%) and 4 out of 50 controls had shown association with metabolic syndrome and the difference between the group was statistically significant (p= 0.005). Conclusion: In our study, majority of patients with early onset AGA were in age group 22-24 years. 31% of cases had family history of AGA. Majority of the patients had stage III of Hamilton-Norwood scale of hair loss. Male patients with early onset AGA were not associated with IR. Metabolic syndrome was associated with male patients with early onset AGA.
JAMA Dermatology, 2016
IMPORTANCE Early androgenetic alopecia (AGA) is patterned hair loss occurring before age 30 years. Early AGA in men is frequently reported as the phenotypic equivalent of polycystic ovarian syndrome (PCOS) in women, which carries the risk of developing obesity, metabolic syndrome, and cardiovascular diseases. Very few studies have been conducted to evaluate this. OBJECTIVE To study the hormonal profile of men with early AGA and to evaluate if early AGA in men can be considered as the phenotypic equivalent of PCOS, the associated risks of which are well known. DESIGN, SETTING, AND PARTICIPANTS This case-control study was conducted from January 1, 2014, to March 31, 2015, in a tertiary care government hospital. Fifty-seven men aged 19 to 30 years presenting with patterned hair loss were recruited as study participants. Thirty-two age-matched men with no evidence of hair loss were recruited as controls. Men who had any established endocrine disorder, diabetes mellitus, or cardiovascular disease and those who took any oral medication or hormonal treatment for hair loss were excluded from the study. The serum concentrations of total testosterone, sex hormone-binding globulin (SHBG), dehydroepiandrosterone sulfate (DHEAS), luteinizing hormone (LH), follicle-stimulating hormone (FSH), prolactin, fasting plasma glucose, and insulin levels were measured. Insulin resistance (IR) and free androgen index (FAI) were calculated and compared with age-and sex-matched controls. MAIN OUTCOMES AND MEASURES The primary outcome was to measure the clinico-endocrinological profiles (LH, FSH, SHBG, DHEAS, and testosterone levels) of men with early AGA and to compare it with the PCOS profile; the secondary outcome was to establish a relationship between this endocrinological profile and IR. RESULTS Compared with the 32 controls, the 57 participants with AGA showed significantly increased mean (SD) levels of testosterone (24.61 [7.97] vs 20.57 [4.9] nmol/L; P = .04), DHEAS (3.63 [2.19] vs 2.64 [1.49] μg/mL; P = .02), LH (7.78 [3.19] vs 4.56 [2.01] mIU/mL; P < .001), and prolactin (14.14 [9.48] vs 9.97 [3.12] ng/mL; P = .01) and decreased mean levels of FSH (4.02 [2.69] vs 5.66 [1.93] mIU/mL; P < .001) and SHBG (35.07 [11.11] vs 46.41 [14.03] nmol/L; P < .001). The mean FAI and LH/FSH ratio were was also increased in the AGA group. These hormonal parameters resemble the well-known profile of women with PCOS. The mean (SD) insulin levels did not show any significant difference between the cases and controls (6.34 [3.92] vs 5.09 [3.38] μIU/mL; P = .07). There was no statistically significant association between hormone levels and AGA or IR grade severity. CONCLUSIONS AND RELEVANCE Men with early AGA could be considered as male phenotypic equivalents of women with PCOS. They can be at risk of developing the same complications associated with PCOS, including obesity, metabolic syndrome, IR, cardiovascular diseases, and infertility.
Androgenic alopecia and insulin resistance: are they really related?
Clinical and Experimental Dermatology, 2009
Androgenic alopecia is known to be androgen-dependent. Insulin is found in hair follicles and may play a role in the regulation of androgen metabolism and the hair-growth cycle. To compare the insulin resistance between people with androgenic alopecia and a control group. A case-control study was conducted with 97 cases in the patient and 87 in the control group. Serum fasting insulin level, fasting blood glucose, serum total cholesterol, triglyceride and high-density lipoprotein (HDL) were all measured in both groups. There was no difference in serum fasting insulin level, fasting blood glucose, serum total cholesterol, triglyceride, HDL and insulin resistance between the two groups (P > 0.05). Despite previous reports suggesting a link, our study found no significant relationship between insulin resistance and androgenic alopecia. Further studies are warranted.
Archives of Dermatological Research, 2000
The roles of androgen hypersecretion, in situ enzyme activity, and androgen receptors in androgenetic alopecia in women are still a matter of debate. We studied 187 women with alopecia, which we graded I, II, or III, according to Ludwig's classification, and 21 healthy control women. All participants were subjected to full basal and 1 h post-1-24 corticotropin stimulation endocrine profiles. Abnormal hormone profiles were observed in 67% of the patients with alopecia alone (group A, n = 110) and in 84% of the patients with alopecia plus other symptoms of hyperandrogenism including acne, hirsutism, and menstrual cycle disturbances (group B, n = 77). Mean serum 5α-androstane-3α,17-diol glucuronide (3α-AdiolG) levels in all three patient groups (6.50 ± 4.10, 8.90 ± 5.80, and 14.70 ± 8.90 nmol/l, respectively) correlated with the grade of alopecia (I-III) and were significantly higher than in the control group (4.80 ± 2.05 nmol/l, P < 0.005). Mean serum sex hormone-binding globulin (SHBG) levels were inversely correlated with the grade of alopecia (I-III) and were significantly lower in all three patient groups (50.55 ± 23.50, 40.00 ± 17.65, and 38.80 ± 14.10 nmol/l, respectively) than in the control group (61.15 ± 17.65 nmol/l, P < 0.05). Mean serum levels of ∆4-androstenedione, dehydroepiandrosterone, dehydroepiandrosterone sulfate, and 3α-AdiolG were higher in group B than in group A, and higher in group A than in the control group. The significant correlations found between adrenal secretion-either positive (with 3α-AdiolG levels and the body mass index) or negative (with SHBG levels)-might reflect the important contribution of secretory and metabolic components in the development of alopecia, the severity of which has been shown to be very closely related to observed levels of two of these parameters (3α-AdiolG and SHBG). Keywords Androgenetic alopecia • Androstanediol glucuronide • Adrenal • SHBG • Body mass index Abbreviations 3α-AdiolG 5α-androstane-3α,17β-diol glucuronide • AGA androgenetic alopecia • AH adrenal hyperandrogenism • BMI body mass index • DHEA dehydroepiandrosterone • DHEA-S dehydroepiandrosterone sulfate • DHT dihydrotestosterone • 11-DOF 11-desoxycortisol • 21-DOF 21-desoxycortisol • FSH follicle-stimulating hormone • FUF free urinary cortisol • He heterozygosity • Ho homozygosity • LH luteinizing hormone • PCOS polycystic ovary syndrome • HPRL hyperprolactinemia • MH mixed hyperandrogenism • NC21-OHase nonclassical 21-hydroxylase deficiency • 11β-OHA 11β-hydroxy-∆4-androstenedione • 17-OHP 17-hydroxyprogesterone • PRL prolactin • 5α-RAH 5α-reductase hyperactivity • RIA radioimmunoassay • SHBG sex hormone-binding globulin • U DHEA urinary DHEA
International Journal of Research in Medical Sciences, 2017
Background: Several previous studies have investigated the association between androgenetic alopecia (AGA) and metabolic syndrome (MS), with inconsistent results. Objectives of the study were to study the prevalence of metabolic syndrome in male patients of androgenetic alopecia and compare with control population and study the relationship of metabolic syndrome with different grades of AGA.Methods: This prospective hospital based case control study included 100 new clinically diagnosed males of androgenetic alopecia, and age and sex matched control group. Assessment for presence of various components of metabolic syndrome was done following a uniform protocol in cases and controls. AGA was classified as per Hamilton –Narwood classification, grade I to III was classified as mild –moderate and grade IV and higher as severe AGA.Results: Of the 100 male AGA patients (age range 21-50, mean 34.49), 36 had grade II AGA, 24 had grade III AGA, 20 had grade IV AGA, 15 had grade V AGA and 5 h...
Androgenetic Alopecia as a Marker of Metabolic Syndrome
Journal of Pharmaceutical Research, 2021
Background: Alopecia induced by androgens in genetically predisposed individuals is termed as Androgenetic alopecia (AGA). There is proof appearance the relationship between Androgenetic alopecia and metabolic condition. Objective: To determine frequency of metabolic syndrome in Androgenetic alopecia as a biomarker of disease in adult male patients. Materials and methods: It was a Cross Sectional Study conducted at the Department of Dermatology, Liaquat University of Medical and Health Sciences Hospital, Jamshoro/Hyderabad. Total 178 diagnosed male patients of Androgenetic alopecia were included. The grading of male Original Research Article Memon et al.; JPRI, 33(30A): 146-153, 2021; Article no.JPRI.69360 147 pattern Androgenetic alopecia was done according to modified Norwood-Hamilton classification. Norwood-Hamilton Stage I-III were regarded to be mild to moderate and Stage IV and higher were regarded as severe. Vein was engorged by a tourniquet applied above the cubital fossa. B...