title: Sex hormone-binding globulin and risk of hyperglycemia in patients with androgenetic alopecia.
abstract: BACKGROUND
  Low circulating levels of sex hormone-binding globulin (SHBG) are a strong predictor of the risk of type 2 diabetes. Androgenetic alopecia (AGA) has been related to an increase in cardiovascular risk, but the mechanism of this association has not been elucidated. AGA can be associated with low levels of SHBG and insulin resistance, which could be related to hyperglycemia and type 2 diabetes.
  
  
  OBJECTIVE
  The objective of this study was to evaluate SHBG and blood glucose levels in men and women with early-onset AGA and control subjects to determine whether low levels of SHBG are associated with hyperglycemia.
  
  
  METHODS
  This case-control study included 240 patients consecutively admitted to the outpatient clinic (Dermatology Department of San Cecilio University Hospital, Granada, Spain), 120 with early-onset AGA (60 men and 60 women) and 120 control subjects (60 men and 60 women) with skin diseases other than alopecia.
  
  
  RESULTS
  Of patients with AGA, 39.1% presented with hyperglycemia (>110 mg/dL) versus 12.5% of controls (P < 0.0001). AGA patients with hyperglycemia or diabetes presented lower significant levels of SHBG than alopecic patients without hyperglycemia or type 2 diabetes, respectively. Patients with AGA and hyperglycemia presented significantly lower levels of SHBG than controls with hyperglycemia (22.3 vs 39.4 nmol/L for AGA patients and controls, respectively, P = .004). No significant differences in SHBG levels were noticed between patients and controls without hyperglycemia. Binary logistic regression showed a strong association between lower SHBG levels and glucose levels greater than 110 mg/dL in patients with AGA even after additional adjustment for sex, abdominal obesity, and free testosterone (odds ratio = 3.35; 95% confidence interval = 1.9-5.7; P < .001).
  
  
  CONCLUSIONS
  The study of a wider sample of AGA patients would confirm these findings and would permit analysis of the pathogenic mechanisms underlying the increase in cardiovascular risk in patients with AGA.
  
  
  CONCLUSIONS
  An association between early-onset AGA, hyperglycemia/diabetes, and low levels of SHBG was observed in the current study. Low levels of SHBG could be a marker of insulin resistance and hyperglycemia/diabetes in patients with AGA.
authors.affiliation: Dermatology Unit, San Cecilio University Hospital, Granada, Spain. salvadorarias@hotmail.es
authors.forename: Salvador
authors.initials: S
authors.lastname: Arias-Santiago
authors.forename: María Teresa
authors.initials: MT
authors.lastname: Gutiérrez-Salmerón
authors.forename: Agustín
authors.initials: A
authors.lastname: Buendía-Eisman
authors.forename: María Sierra
authors.initials: MS
authors.lastname: Girón-Prieto
authors.forename: Ramón
authors.initials: R
authors.lastname: Naranjo-Sintes
mesh_terms: D000328:Adult; D017677:Age Distribution; D000505:Alopecia / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology*; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D016001:Confidence Intervals; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology*; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011237:Predictive Value of Tests; D018570:Risk Assessment; D017678:Sex Distribution; D012738:Sex Hormone-Binding Globulin / Q000032:analysis*
chemical_list: D015415:Biomarkers; D012738:Sex Hormone-Binding Globulin