Increased DHEAS and Decreased Total Testosterone Serum Levels in a Subset of Men with Early-Onset Androgenetic Alopecia: Does a Male PCOS-Equivalent Exist?

Background: Increased dehydroepiandrosterone sulfate (DHEAS) levels have been reported in men with early-onset (<35 years) androgenetic alopecia (AGA). It has been suggested that a male polycystic ovarian syndrome- (PCOS-) equivalent, defined as an endocrine syndrome with a metabolic background and a PCOS-like hormonal pattern, predisposing to type II diabetes mellitus (DM II), cardiovascular and prostate diseases later in life, may occur in at least a part of these men. The gonadal function, including sperm parameters and total testosterone (TT) levels, has been investigated in a low number of these men.
Objective: The aim of the study was to assess gonadal and adrenal function in a subset of men with early-onset AGA and controls.
Methods: 43 men with early-onset AGA and 36 controls were screened for DHEAS, TT, glycaemia, insulin, gonadotropins, 17 α -hydroxyprogesterone (17 α -hydroxyprogesterone (17 n  = 21), as those with at least one of the following parameters: body mass index (BMI) >25 kg/m ² , insulin resistance (IR), and/or SHBG <25 nmol/l.
Results: Patients with early-onset AGA had higher mean (±SD) BMI (25.5 ± 3.8 vs. 23.7 ± 3.0 kg/m ² ; P < 0.05) and 17 α -hydroxyprogesterone (17 P < 0.05) and 17 P < 0.05) and 17 P < 0.05) and 17 P < 0.05) and 17 μ g/dl; P < 0.05) and 17 P < 0.05) and 17 P < 0.05) and 17 P < 0.05) and 17.
Conclusion: Men with early-onset AGA and at least one among BMI >25 kg/m ² , IR, and SHBG <25 nmol/l have increased DHEAS levels and a worse gonadal steroidogenesis. They might have a greater risk to develop gonadal dysfunction later in life. These criteria may be used to define male PCOS-equivalent.
Competing Interests: The authors declare no conflicts of interest.
(Copyright © 2020 Rossella Cannarella et al.)