Is There an Association Between 5α-Reductase Inhibitors and Metabolic Syndrome? A Narrative Review of the Literature

This narrative review explores the potential association between 5a Reductase Inhibitors (5a-RIs), specifically finasteride and dutasteride, and the development of metabolic syndrome. These inhibitors, used primarily for benign prostatic hyperplasia, are expressed in various tissues and can affect glucocorticoid levels and androgen regulation, potentially leading to adverse metabolic events such as liver disease, hyperglycemia, hyperlipidemia, and diabetes mellitus. Despite numerous studies on both humans and animal models, the exact mechanisms remain unclear. The review emphasizes the need for further well-designed clinical trials to better understand the role of 5a-RIs in metabolic syndrome progression.