The association of metabolic syndrome and insulin resistance in early-onset androgenetic alopecia in males: a case-control study

• Author Details:   
• M. Ranga Swaroop
• Manohara BK
• BD Sathyanarayana
• Yogesh D
• Raghavendra JC

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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 out-patient 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.

Keywords: Early-onset androgenetic alopecia, Insulin resistance, Metabolic syndrome