Early onset androgenic alopecia: not a cosmetic problem but a sign of life time risk factors. Male phenotypic equivalent of polycystic ovarian syndrome: Is There a Male Phenotype of PCOS

Main Article Content

Didem Dereli Akdeniz
Candeğer Yılmaz

Abstract

Objective: Polycystic ovarian syndrome (PCOS) was thought to be a gynecologic disorder and then accepted as a general endocrine and metabolic syndrome. The genetic component of PCOS seems to be very important in its etiology. Because of this reason there should be a male PCOS equivalent. Early androgenetic alopecia (EAGA) is a specific pattern of hair loss and it should start before age 30 years and it is claimed to be a male equivalent of PCOS in women.


Materials and Methods: In this study we aimed to investigate the hormonal and metabolic parameters of men with EAGA and compare them with healthy age-matched controls. Thirty men with EAGA and 30 controls were screened for free testosterone, DHEAS, gonadotropins, 17OH progesterone, ACTH, fasting glucose, fasting insulin, homocysteine and metabolic profile. Homeostasis model assessment (HOMA) results were used for the marker of insulin sensitivity. Alopecia classification was made by using the scale of Hamilton with Norwood modification.


Results: Patients with EAGA had higher free testosterone (25,12±3,05 vs 21,3±1,77), DHEAS (634,90±27,09 vs 578±17,82), LH (9,16±0,28 vs 5,13±0,40). The EAGA group had insulin resistance but the control group did not (HOMA results were 3,34±0,47 vs 1,43±0,3). The homocysteine levels of EAGA group were higher than controls (12,37±1,31 vs 9,33±2,12) which is another cardiovascular risk factor. The correlations that we found in our study among HOMA, serum androgen levels, homocysteine and alopecia scores were positive in EAGA patients. We didn’t find any correlations among those parameters in control group. Because of these findings men with EAGA can be considered as male synonym to PCOS syndrome. These young men should be followed for the same long time risk profile like PCOS women. Insulin resistance and its results like metabolic syndrome, diabetes and cardiovascular diseases are real risks but there may be even a risk for infertility.


Conclusion: We aimed to investigate whether EAGA can be accepted as the male phenotype of PCOS and if they have elevated risk factors for chronic complications than their age and sex matched controls.

Downloads

Download data is not yet available.

Article Details

How to Cite
Akdeniz, D. D., & Yılmaz, C. (2021). Early onset androgenic alopecia: not a cosmetic problem but a sign of life time risk factors. Male phenotypic equivalent of polycystic ovarian syndrome: Is There a Male Phenotype of PCOS. Medical Science and Discovery, 8(4), 231-236. https://doi.org/10.36472/msd.v8i4.522
Section
Research Article

References

1. Ndefo UA, Eaton A, Green MR. Polycystic ovary syndrome: a review of treatment options with a focus on pharmacological approaches. P T: 2013 Jun;38(6):336-55 p.

2. Delcour C, Robin G, Young J, Dewailly D. PCOS and Hyperprolactinemia: what do we know in 2019? Clin Med Insights Reprod Health: 2019 Sep 9;13 p DOI: 10.1177/1179558119871921

3. Di Guardo F, Ciotta L, Monteleone M, Palumbo M. Male equivalent polycystic ovarian syndrome: hormonal, metabolic and clinical aspects. Int J Fertil Steril: 2020; 14(2): 79-83 p. DOI: 10.22074/ijfs.2020.6092

4. Guardoa F, Ceranab MC, D'ursoa G et al Male PCOS equivalent and nutritional restriction: Are we stepping forward? Med Hypothese: 2019 May;126:1-3 p. DOI: 10.1016/j.mehy.2019.03.003

5. Cannarella R, Condorelli RA, Mongioì LM, La Vignera S, Calogero AE. Does a male polycystic ovarian syndrome equivalent exist? J Endocrinol Invest: 2018 Jan; 41(1):49-57 p. DOI: 10.1007/s40618-017-0728-5

6. Sanke S, Chander R, Jain A, Garg T, Yadav P. A. A Comparison of the Hormonal Profile of Early Androgenetic Alopecia in Men with the Phenotypic Equivalent of Polycystic Ovarian Syndrome in Women. MA Dermatol : 2016 Sep 1;152(9):986-91 p. DOI: 10.1001/jamadermatol.2016.1776

7. Narad S, Pande S, Gupta M, Chari S. Hormonal profile in Indian men with premature androgenetic alopecia. Int J Trichology: 2013;5(2):69-72 p. DOI: 10.4103/0974-7753.122961

8. Schmidt JB. Hormonal basis of male and female androgenic alopecia: clinical relevance. Skin Pharmacol.: 1994;7(1-2):61-66 p. DOI: 10.1159/000211275

9. Yildiz BO, Yarali H, Oguz H, Bayraktar M. Glucose intolerance, insulin resistance, and hyperandrogenemia in first degree relatives of women with polycystic ovary syndrome. J Clin Endocrinol Metab: 2003;88(5):2031-2036 p. DOI: 10.1210/jc.2002-021499























10. Dusková M, Cermáková I, Hill M, Vanková M, Sámalíková P, Stárka L. What may be the markers of the male equivalent of polycystic ovary syndrome? Physiol Re: 2004;53(3):287-294. PMID: 15209536

11. Stárka L, Cermáková I, Dusková M, Hill M, Dolezal M, Polácek V. Hormonal profile of men with premature balding. Exp Clin Endocrinol Diabetes: 2004;112(1):24-28 p. DOI: 10.1055/s-2004-815723

12. Legro RS, Kunselman AR, Demers L, Wang SC, Bentley-Lewis R, Dunaif A. Elevated dehydroepiandrosterone sulfate levels as the reproductive phenotype in the brothers of women with polycystic ovary syndrome. J Clin Endocrinol Metab: 2002;87(5):2134-2138 p. DOI: 10.1210/jcem.87.5.8387

13. Goodarzi MO., Carmina E., Azziz R. DHEA, DHEAS and PCOS. J Steroid Biochem Mol Biol: 2015 Jan;145:213-25 p. DOI: 10.1016/j.jsbmb.2014.06.003

14. Cinar N, Cetinozman F, Aksoy DY, Elcin G, Yildiz BO. Comparison of adrenocortical steroidogenesis in women with post-adolescent severe acne and polycystic ovary syndrome. J Eur Acad Dermatol Venereol: 2015 May;29(5):875-80 p. DOI: 10.1111/jdv.12696

15. Cohen PN, Givens JR, Wiser WL, Wilroy RS, Summitt RL, Coleman SA, et al. Polycystic ovarian disease, maturation arrest of spermiogenesis, and Klinefelter’s syndrome in siblings of a family with familial hirsutism. Fertil Steril: 1975;26(12):1228-1238 p. PMID: 803038

16. Arias-Santiago S, Gutiérrez-Salmerón MT, Buendía-Eisman A, Girón-Prieto MS, Naranjo-Sintes R. Sex hormone binding globulin and risk of hyperglycemia in patients with androgenetic alopecia. J Am Acad Dermatol: 2011 Jul;65(1):48-53 p. DOI: 10.1016/j.jaad.2010.05.002

17. Kaushal R, Parchure N, Bano G, Kaski JC, Nussey SS. Insulin resistance and endothelial dysfunction in the brothers of Indian subcontinent Asian women with polycystic ovaries. Clin Endocrinol (Oxf): 2004; 60(3): 322-328. DOI: 10.1111/j.1365-2265.2004.01981.x

18. Norman RJ, Masters S, Hague W. Hyperinsulinemia is common in family members of women with polycystic ovary syndrome. Fertil Steril: 1996; 66(6): 942-947 p. DOI: 10.1016/s0015-0282(16)58687-7

19. Tüttelmann F, Laan M, Grigorova M, Punab M, Sõber S, Gromoll J. Combined effects of in correlation analysis the variants FSHB-211G>T and FSHR 2039A>G on male reproductive parameters. J Clin Endocrinol Metab: 97(10):3639–3647 p. DOI: 10.1210/jc.2012-1761

20. Framingham Offspring Study. Fasting plasma homocysteine levels in the insulin resistance syndrome: the Framingham offspring study. Diabetes Care: 2001; 24(8):1403–10 p. DOI: 10.2337/diacare.24.8.1403

21. Sharma L., Dubey A., Gupta P. R., Agrawal A. Androgenetic alopecia and risk of coronary artery disease. Indian Dermatol Online J: 2013 Oct-Dec; 4(4): 283–287 p. DOI: 10.4103/2229-5178.120638