Increased Prevalence of Insulin Resistance and Metabolic Syndrome in Men With Early‐Onset Androgenetic Alopecia: A Case–Control Study

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Abstract
Aim: This study aimed to investigate the relationship between early‐onset androgenetic alopecia (AGA) and the prevalence of insulin resistance (IR) and metabolic syndrome (MetS) in young adult males. Methods: A total of 200 males aged 18 to 35 years were enrolled in this case–control study, including 100 patients with early‐onset AGA and 100 age‐ and body mass index‐matched controls. Clinical staging was performed using the Hamilton–Norwood classification, and all participants underwent standardized physical and biochemical evaluation. Results: The prevalence of insulin resistance (HOMA‐IR ≥ 2.7) was significantly higher in the AGA group compared to the control group (18% vs. 4%, p = 0.003). Similarly, MetS was more common among AGA patients (21% vs. 9%, p = 0.011). Fasting insulin levels, triglyceride concentrations, and HOMA‐IR scores were all significantly elevated in the AGA group, while HDL‐C levels were comparable between groups. Waist circumference was also significantly greater in the AGA group ( p = 0.026). When stratified by AGA severity, the frequency of IR progressively increased with increasing Hamilton–Norwood stages. No significant differences were observed in fasting glucose or blood pressure categories. Although individual MetS components were similar, cumulative clustering of risk factors appeared to be associated with a significantly higher MetS frequency among patients with AGA. Conclusion: Early‐onset AGA in men may serve as a visible clinical indicator of underlying metabolic disturbances, particularly IR. Routine metabolic screening may be advisable in young men presenting with advanced AGA stage.

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