Female pattern hair loss: the relation to metabolic syndrome in premenopausal women

Background Androgenetic alopecia and its female counterpart, female pattern hair loss (FPHL), are commonly associated with underlying clinical and metabolic abnormalities. Although there are several studies addressing the association of androgenetic alopecia with individual components of the metabolic syndrome (MS) (abdominal obesity, dyslipidemia, hypertension, and hyperglycemia), there are little data available regarding the association between FPHL and the MS as a whole. Objective To examine the association of FPHL with MS, diagnosed according to the Adult Treatment Panel-III criteria in premenopausal women, aiming at early identification and management of their modifiable cardiovascular risk factors. Participants and methods Thirty-three premenopausal women with Ludwig’s stage II and III FPHL and 33 healthy controls were included. For each participant, fasting insulin, fasting blood glucose, homeostasis model assessment of insulin resistance index, lipid profile, waist circumference, and blood pressure were evaluated. Results The patients were found to have a significantly higher prevalence of MS compared with the controls (39.4 vs. 9.1%; Po0.01), with an odds ratio of 5.95 (95% confidence interval 0.58–61.2). The most common feature in the patients was an increased waist circumference, which occurred at a significantly higher frequency compared with the controls (75.8 vs. 30.3%; Po0.01). Patients had a significantly higher waist circumference (Po0.01), fasting insulin, fasting blood glucose, homeostasis model assessment of insulin resistance, and lower HDL cholesterol (Po0.05) compared with controls. Conclusion Women with FPHL have an increased prevalence of the MS, and should be screened and treated for the underlying clinical and metabolic abnormalities.