Premature androgenic alopecia and insulin resistance. Male equivalent of polycystic ovary syndrome?
BACKGROUND
Polycystic ovary syndrome (PCOS), the most frequent endocrinopathy in women with estimated prevalence of 5-10 %, is characterised by a hormonal and metabolic imbalance of polygene autosomal trait. The complexity of symptoms and genetic base started up the hypothesis on the existence of male equivalent of PCOS. Precocious loss of hair before 30 years of age was suggested as one of the male symptoms of this syndrome.


OBJECTIVE
The aim was to confirm the association of lower levels of follicle stimulating hormone (FSH) and sexual hormone binding globulin (SHBG) or higher free androgen index (FAI) in premature balding men with a reduced insulin sensitivity.


METHODS
The study included 30 men with premature hair loss (defined as grade 3 vertex or more on the alopecia classification scale by Hamilton with Norwood modification) starting before 30 years of age. The hormonal values of the investigated group were compared with those regarded as normal reference values obtained in a group of 256 males in the age of 20-40 years during the Czech population study of iodine deficiency. In all men with premature baldness besides hormonal level determinations insulin tolerance test was carried out.


RESULTS
The observed group was divided into two subgroups. The first one showed similar hormonal changes as women with PCOS, namely subnormal SHBG, FSH or increased FAI. The other had either no anomalies in steroid spectrum or only lower SHBG. The groups did not differ either in BMI or in age. The group with hormonal profile resembling that of women with PCOS, showed significantly higher insulin resistance than the group without these changes.


CONCLUSIONS
The findings are consistent with the hypothesis that at least a part of the men with premature androgenic alopecia could be considered as a male equivalent of the polycystic ovary syndrome of the women. These premature balding men represent a risk group for the development of impaired glucose tolerance or diabetes mellitus type 2.
Starka
L
L
Institute of Endocrinology, Narodni 8, CZ 116 94 Prague 1, Czech Republic. lstarka@endo.cz
Duskova
M
M
Cermakova
I
I
Vrbiková
J
J
Hill
M
M
D000328:Adult; D000505:Alopecia / Q000209:etiology*; D000728:Androgens / Q000097:blood; D018153:Czech Republic; D003924:Diabetes Mellitus, Type 2; D005260:Female; D005640:Follicle Stimulating Hormone / Q000172:deficiency; D018149:Glucose Intolerance; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology*; D008297:Male; D011085:Polycystic Ovary Syndrome; D012307:Risk Factors; D012738:Sex Hormone-Binding Globulin / Q000172:deficiency
D000728:Androgens; D012738:Sex Hormone-Binding Globulin; D005640:Follicle Stimulating Hormone