Impaired metabolic effects of metformin in men with early-onset androgenic alopecia

Abstract

Background Early-onset androgenic alopecia is considered the phenotypic equivalent of polycystic ovary syndrome in men. The purpose of the current study was to investigate whether the presence of early-onset male-pattern baldness modulates metabolic effects of metformin. Methods This prospective case–control study included 2 groups of men at high risk for type 2 diabetes: 72 individuals with androgenic alopecia (group A) and 75 subjects with normal hair growth (group B). Both groups were matched for age, blood pressure, body mass index, insulin sensitivity and plasma lipids. Glycated hemoglobin, glucose, plasma lipids, indices of insulin sensitivity/resistance, sex hormones, high-sensitivity C-reactive protein (hsCRP) and 25-hydroxyvitamin D were determined before and after metformin treatment (1.7 g daily). Results Twelve-month metformin treatment reduced fat content, waist circumference, glycated hemoglobin, glucose and triglycerides, as well as improved insulin sensitivity. Although observed in both study populations, these effects were more pronounced in group B. Moreover, metformin decreased hsCRP and bioavailable testosterone levels in group B, as well as reduced 25-hydroxyvitamin D concentration in group A. Treatment-induced changes in glucose homeostasis markers correlated with the impact of metformin on hsCRP and 25-hydroxyvitamin D levels. Conclusions Metabolic effects of metformin in males are attenuated if they have coexisting early-onset androgenic alopecia. This finding may be partially explained by differences in severity of low-grade systemic inflammation and vitamin D status. The obtained results, requiring confirmation in large prospective studies, suggest that men with early-onset male-pattern baldness benefit to a lesser degree from metformin treatment than other men at high risk for type 2 diabetes.

Pituitary Effects of Metformin in Men With Early‐Onset Androgenic Alopecia

“…As in previous reports, 6,7 males with early-onset androgenic alopecia were characterized by hormonal changes similar to those observed in women with polycystic ovary syndrome: elevated values of total and bioavailable testosterone, DHEA-S, LH, and the LH/FSH ratio. Interestingly, the degree of insulin sensitivity positively correlated with testosterone levels.…”

“…To the best of our knowledge, only 1 previous study has investigated hormonal effects of metformin in men with early‐onset male‐pattern hair loss. In the study by Krysiak et al, 7 metformin administered to this group of patients had no effect on total and bioavailable testosterone and DHEA‐S. However, the authors did not assess levels of gonadotropins.…”

“…The presence of early‐onset androgenic alopecia is associated with an increased risk of obesity, overweight, insulin resistance, dyslipidemia, hypertension, metabolic syndrome, and atherosclerosis 3–5 . Compared with healthy controls, men with early‐onset male‐pattern hair loss are also characterized by increased concentrations of testosterone, dehydroepiandrosterone sulfate (DHEA‐S), and prolactin and by increased values of the free androgen index and the luteinizing hormone (LH)/follicle‐stimulating hormone (FSH) ratio 6,7 . This condition is often observed in fathers and brothers of women with polycystic ovary syndrome, 2,8 and metabolic and hormonal abnormalities in early‐onset androgenic alopecia resemble those observed in polycystic ovary syndrome 8,9 …”

“…[3][4][5] Compared with healthy controls, men with earlyonset male-pattern hair loss are also characterized by increased concentrations of testosterone, dehydroepiandrosterone sulfate (DHEA-S), and prolactin and by increased values of the free androgen index and the luteinizing hormone (LH)/follicle-stimulating hormone (FSH) ratio. 6,7 This condition is often observed in fathers and brothers of women with polycystic ovary syndrome, 2,8 and metabolic and hormonal abnormalities in early-onset androgenic alopecia resemble those observed in polycystic ovary syndrome. 8,9 Metformin, the drug of choice for treatment of type 2 diabetes, prevents or delays the onset of this disorder and improves metabolic and hormonal profiles in women with polycystic ovary syndrome.…”

Cardiometabolic profile of young women with hypoprolactinemia

“…The body mass index and the fat-free mass index were calculated, while the waist circumference and blood pressure were measured as previously described [ 13 ]. The measurement of carotid intima-media thickness (CIMT) was performed on the common carotid arteries approximately 1.5 cm proximal to the flow divider using high resolution ultrasonography (Toshiba Aplio-500).…”