METABOLIC AND HORMONAL ALTERATIONS ASSOCIATED WITH EARLY-ONSET ANDROGENETIC ALOPECIA IN YOUNG MEN: CASE–CONTROL STUDY

Abstract

Background: There is growing recognition that early-onset androgenetic alopecia (AGA) may be a clinical indicator of systemic metabolic disorders. Its relationship to hormonal and metabolic biomarkers is still unclear, though. Objective: To compare metabolic and androgenic hormonal profiles between young men with early-onset AGA and healthy controls and to evaluate their relationships with disease severity. Methods: This case–control study included 160 participants (80 patients with early-onset AGA and 80 age-matched healthy controls) recruited in Kirkuk, Iraq. Body mass index (BMI), fasting glucose, fasting insulin, HOMA-IR, lipid profile, and total testosterone were assessed. Disease severity was graded using the Hamilton–Norwood classification. Correlation analysis, multivariable logistic regression, and receiver operating characteristic (ROC) curve analysis were performed. Results: Patients with AGA exhibited significantly higher BMI, fasting glucose, fasting insulin, HOMA-IR, total cholesterol, triglycerides, and LDL-C, whereas HDL-C and total testosterone were significantly lower than those of controls (all P < 0.001). Disease severity was positively correlated with metabolic abnormalities and inversely correlated with total testosterone. Family history, HOMA-IR, LDL-C, and total testosterone were identified as independent predictors of AGA. HOMA-IR showed the highest diagnostic performance (AUC = 0.871), with 83.8% sensitivity and 80.0% specificity. Conclusion: Early-onset AGA is associated with significant metabolic and hormonal alterations, particularly insulin resistance and dyslipidemia. HOMA-IR may represent a useful metabolic marker for identifying young men at increased cardiometabolic risk.