Androgenetic alopecia and insulin resistance: are they truly associated?

BACKGROUND: Controversies exist regarding the association of androgenetic alopecia (AGA) with insulin resistance. Are they truly associated, or is insulin resistance just related to aging, obesity, or to the presence of metabolic syndrome? OBJECTIVE: To assess insulin resistance in young nonobese patients with AGA with and without metabolic syndrome. METHODS: The study included four equally distributed groups of age-, sex-, and body mass index-matched young, nonobese subjects: 30 patients with AGA and metabolic syndrome (group 1); 30 patients with AGA and no metabolic syndrome (group 2); 30 patients with metabolic syndrome and no AGA (group 3); and 30 healthy controls (group 4). Insulin resistance based on fasting insulin levels and homeostasis model assessment of insulin resistance (HOMA-IR) was assessed in all groups. RESULTS: Twenty-three patients in group 1, four patients in group 2, 25 patients in group 3, and three healthy controls had insulin resistance with statistically significant differences in fasting insulin and HOMA-IR levels between all groups, between groups 1 and 2, groups 1 and 4, groups 2 and 3, and groups 3 and 4. No significant differences existed between groups 2 and 4 or groups 1 and 3. Correlations between insulin resistance parameters, age of patients, disease duration, and stages of AGA in males and females revealed nonsignificant differences. CONCLUSIONS: Patients with metabolic syndrome, with or without AGA, were significantly more insulin resistant compared with patients with AGA with no metabolic syndrome and with healthy subjects and, therefore, no true association exists between AGA and insulin resistance.