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

摘要

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, 17α-hydroxyprogesterone (17αOH-P), testicular volume (TV), fat mass percentage, and sperm conventional parameters. Among men with AGA, we identified Group 1 (n?=?21), as those with at least one of the following parameters: body mass index (BMI) 25?kg/m2, 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/m2; P0.05) and 17αOH-progesterone (2.1?±?0.9 vs. 1.5?±?0.6?ng/ml; P0.05) compared to controls. Group 1 had higher BMI (27.9?±?3.8 vs. 23.7?±?3.8?ml; P0.05), fat-mass percentage (17.5?±?4.1 vs. 13.2?±?5.3; P0.05), HOMA index (2.5?±?1.8 vs. 1.5?±?0.7; P0.05), DHEAS (323.3?±?112.6 vs. 257.8?±?107.1?μg/dl; P0.05), seminal fluid volume (4.2?±?2.8 vs. 2.8?±?1.3?ml; P0.05), lower TT (5.16?±?1.70 vs. 6.47?±?4.30?ng/ml; P=0.016), and left TV (12.3?±?2.8 vs. 15.0?±?4.3?ml; P0.05) compared to controls. Conclusion. Men with early-onset AGA and at least one among BMI 25?kg/m2, 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.