Gynecologic and Andrologic Dermatology and the Metabolic Syndrome

September 2017 in “ Clinics in Dermatology ”

María Magdalena Roth, Nicholas Leader, George Kroumpouzos

Studysummary This study highlights that lower testosterone in men and higher testosterone in women are linked to increased risks of metabolic syndrome and type 2 diabetes, with associated skin diseases indicating potential cardiovascular complications.

Our plain-language summary. Not medical advice or a treatment recommendation. Consult a qualified healthcare professional before changing treatment. Full disclaimer

The document from 2018 examines the link between sex hormones, metabolic syndrome (MetS), and related skin conditions, emphasizing the role of insulin resistance (IR) as a common factor. It points out that lower testosterone levels in men and higher levels in women are associated with increased risks of MetS and type 2 diabetes mellitus (T2DM), and that lower sex hormone-binding globulin (SHBG) levels are a risk factor for both sexes. Skin conditions like polycystic ovary syndrome (PCOS), acanthosis nigricans, acne vulgaris, and pattern alopecia are connected to IR, which can lead to metabolic and cardiovascular complications. The document suggests monitoring patients with these conditions for complications and intervening early to prevent T2DM and reduce cardiovascular risks. It also reviews the effects of exogenous sex hormones, such as estrogen replacement therapy and oral contraceptives, on MetS, and notes the higher prevalence of glucose intolerance and T2DM in non-obese PCOS patients compared to the general population. Additionally, it mentions that androgenetic alopecia (AGA) in men and female pattern alopecia (FPA) in women are linked to MetS, with early-onset AGA increasing the risk of MetS by 2.3 times. The conclusion stresses the importance of recognizing and managing skin diseases associated with IR and MetS to prevent T2DM and reduce cardiovascular disease risk. The document references a meta-analysis and several comparative studies but does not provide specific participant numbers.

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28 citations , January 2017 in “Indian Dermatology Online Journal”

In this study, skin manifestations such as hirsutism and acne were prevalent among women with PCOS, highlighting their importance in diagnosis and symptomatology.

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47 citations , June 2016 in “JAMA Dermatology”

This study suggests men with early androgenetic alopecia might have hormonal profiles similar to women with polycystic ovarian syndrome, potentially indicating risk for related health complications.

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21 citations , April 2016 in “International Journal of Dermatology”

This study found a significant association between female pattern hair loss and metabolic syndrome in Egyptian women, with waist circumference and hypertension particularly linked to the severity of hair loss.

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53 citations , December 2015 in “JAMA Dermatology”

This study found that hirsutism and acanthosis nigricans are the most reliable skin markers for diagnosing polycystic ovary syndrome in women and suggest a need for further evaluation of possible metabolic issues.

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13 citations , November 2015 in “Blood Pressure”

This study found that early-onset androgenetic alopecia, especially with a vertex pattern, may be an independent risk factor for cardiovascular disease and metabolic syndrome in men.

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42 citations , July 2015 in “Journal of The American Academy of Dermatology”

This review discusses diagnostic and treatment considerations for women with cutaneous hyperandrogenism, noting therapeutic options are more effective for hirsutism and acne than for androgenetic alopecia, but reports no new clinical results.

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13 citations , June 2015 in “International Journal of Dermatology”

In this study, non-obese females with early-onset androgenetic alopecia showed higher total cholesterol, LDL cholesterol, triglycerides, and atherogenic index, and lower HDL cholesterol compared to controls, suggesting an association with adverse cardiovascular risk factors.

research Is There Really a Relationship Between Androgenetic Alopecia and Metabolic Syndrome?

15 citations , January 2015 in “Dermatology Research and Practice”

This study found no significant association between androgenetic alopecia and metabolic syndrome, though systolic blood pressure was higher in the alopecia group compared to controls.

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24 citations , January 2015 in “International Journal of Trichology”

This research observed that among young men with androgenic alopecia, there was a significant association with metabolic syndrome compared to healthy controls, suggesting AGA as a potential early marker for metabolic risk.

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31 citations , November 2014 in “Journal of Endocrinological Investigation”

This article reviews androgen excess and cardiometabolic risks in women, highlighting increased cardiovascular disease risk in those with polycystic ovary syndrome, but reports no new clinical results.

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This review discusses diagnostic criteria for polycystic ovary syndrome and highlights the challenges and risks of misdiagnosing women with other hyperandrogenism causes; it reports no clinical results.

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50 citations , January 2013 in “Indian Journal of Dermatology”

This review highlights the increasing association of metabolic syndrome with various dermatological conditions and suggests a link through chronic inflammation, oxidative stress, and endocrine abnormalities, yet reports no new findings.

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44 citations , May 2012 in “Endocrinology”

This review discusses the etiology of polycystic ovary syndrome, emphasizing the role of genetic and environmental factors, and reports no new experimental findings.

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37 citations , April 2012 in “British Journal of Dermatology”

This study found that among middle-aged Korean women, those with metabolic syndrome had a higher risk of androgenetic alopecia, while no significant association was observed in men.

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4 citations , January 2012 in “Journal of the Egyptian Women's Dermatologic Society (Print)”

This study found that premenopausal women with female pattern hair loss had a higher prevalence of metabolic syndrome compared to healthy controls.

research Sex Hormone–Binding Globulin and Risk of Hyperglycemia in Patients With Androgenetic Alopecia

36 citations , April 2011 in “Journal of The American Academy of Dermatology”

People with hair loss have higher risk of high blood sugar and diabetes, and lower levels of a specific hormone.

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35 citations , March 2011 in “International Journal of Dermatology”

This study concluded that patients with metabolic syndrome, regardless of androgenetic alopecia presence, were more insulin resistant than those with only androgenetic alopecia or healthy controls, indicating no true association between alopecia and insulin resistance.

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26 citations , February 2011 in “Anais Brasileiros De Dermatologia”

This review discusses the pathophysiology, diagnosis, and treatment of polycystic ovary syndrome, emphasizing the critical importance of early diagnosis and treatment to prevent metabolic complications and improve quality of life.

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110 citations , July 2010 in “Journal of The American Academy of Dermatology”

Hair loss linked to higher heart disease risk in both men and women.

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40 citations , May 2010 in “American Journal of Clinical Dermatology”

This study reports that four Indian patients with acne keloidalis nuchae also exhibited acanthosis nigricans, suggesting a potential link to metabolic syndrome, though further research is needed to confirm this association.

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research Specific Dermatologic Features of Polycystic Ovary Syndrome and Its Association with Biochemical Markers of Metabolic Syndrome and Hyperandrogenism

67 citations , February 2010 in “Acta Obstetricia et Gynecologica Scandinavica”

In this study, hirsutism in women with PCOS was strongly associated with hyperandrogenism and metabolic abnormalities, while acne and androgenic alopecia were not effective markers for hyperandrogenism.

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37 citations , January 2010 in “Acta dermato-venereologica”

This study found that both men and women with androgenic alopecia had significantly higher triglycerides, total cholesterol, and LDL-C and lower HDL-C levels than controls, suggesting increased dyslipidemia prevalence.

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45 citations , November 2009 in “British Journal of Dermatology”

This study found that women with early-onset androgenetic alopecia had higher aldosterone levels and blood pressure, suggesting a possible link to the increased prevalence of hypertension in this group.

research Androgenic Alopecia and Insulin Resistance: Are They Really Related?

28 citations , March 2009 in “Clinical and Experimental Dermatology”

This article discusses the potential relationship between androgenic alopecia and insulin resistance but presents no new clinical findings, calling for further research on the topic.

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1540 citations , October 2008 in “Fertility and Sterility”

This review discusses the definition of polycystic ovary syndrome proposed by the AE-PCOS Society Task Force, emphasizing hyperandrogenism, ovarian dysfunction, and excluding related disorders, while noting potential variations needing more research.

A Prospective Study of the Prevalence of Nonclassical Congenital Adrenal Hyperplasia Among Women Presenting with Hyperandrogenic Symptoms and Signs

research A Prospective Study of the Prevalence of Nonclassical Congenital Adrenal Hyperplasia Among Women Presenting with Hyperandrogenic Symptoms and Signs

150 citations , November 2007 in “The Journal of Clinical Endocrinology and Metabolism”

This study determined that nonclassical congenital adrenal hyperplasia has a 2.2% prevalence among hyperandrogenic women in Spain, with basal serum 17-hydroxyprogesterone showing excellent diagnostic performance.

research Dermatologic Manifestations of Polycystic Ovary Syndrome

76 citations , January 2007 in “American Journal of Clinical Dermatology”

This review discusses the dermatologic features of PCOS as potential early indicators of the syndrome and notes that treatment of these conditions may enhance quality of life and psychological well-being, but it reports no new clinical results.

research Relative Prevalence of Different Androgen Excess Disorders in 950 Women Referred Because of Clinical Hyperandrogenism

352 citations , January 2006 in “The Journal of Clinical Endocrinology and Metabolism”

This study reported that classic anovulatory PCOS was the most common androgen excess disorder, followed by mild ovulatory PCOS and idiopathic hyperandrogenism, among patients evaluated for clinical hyperandrogenism.

Health-Related Quality of Life and Physical Well-Being Among a 63-Year-Old Cohort of Women With Androgenetic Alopecia: A Finnish Population-Based Study

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24 citations , August 2005 in “Health and Quality of Life Outcomes”

This study observed that women aged 63 with androgenetic alopecia had higher insulin resistance and more role limitations due to physical health compared to those with normal hair.

research The Metabolic Syndrome in Children and Adolescents

19 citations , January 2005 in “Paediatrics and Child Health”

This review discusses the features and diagnosis of metabolic syndrome in obese children and reports no new findings, highlighting the need for a uniform pediatric definition and early intervention.

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37 citations , January 2005 in “Dermatology Online Journal”

In this study, researchers observed a significant association between female androgenetic alopecia and coronary artery disease in women under 55, supporting a link similar to that seen in men.

research Androgen Excess in Women: Experience with Over 1000 Consecutive Patients

947 citations , February 2004 in “The Journal of Clinical Endocrinology and Metabolism”

In this study, polycystic ovary syndrome was the most prevalent cause of androgen excess, and suppressive hormonal therapy improved hirsutism, menstrual dysfunction, and acne in most patients, though side effects were common.

research Hair Loss, Insulin Resistance, and Heredity in Middle-Aged Women: A Population-Based Study

49 citations , June 2003 in “European journal of cardiovascular prevention & rehabilitation”

In this study, female androgenic alopecia (grade II or III on Ludwig's scale) was found to be common among Finnish women aged 63, and several markers of insulin resistance, along with paternal history of alopecia, were associated with an increased risk.

research Early Androgenetic Alopecia as a Marker of Insulin Resistance

115 citations , September 2000 in “The Lancet”

Early hair loss may indicate risk of insulin resistance.