Alopecia androgenética associada à síndrome metabólica: revisão integrativa da literatura

Abstract

Androgenetic alopecia (AGA) is the most common form of non-scarring alopecia and is characterized by progressive follicular miniaturization mainly mediated by dihydrotestosterone (DHT) activity in genetically predisposed individuals. Although traditionally considered an aesthetic dermatological condition, recent evidence has demonstrated a significant association between AGA and metabolic syndrome (MetS), a cluster of metabolic abnormalities characterized by abdominal obesity, insulin resistance, dyslipidemia, and arterial hypertension. This study aimed to analyze the relationship between androgenetic alopecia and metabolic syndrome, emphasizing the shared pathophysiological mechanisms, hormonal and metabolic biomarkers involved, as well as the diagnostic and therapeutic implications of this association. This is an integrative literature review conducted using PubMed, SciELO, and Virtual Health Library (BVS) databases, including studies published between 2015 and 2025. The findings demonstrated that individuals with AGA present a higher prevalence of cardiometabolic alterations, especially insulin resistance, central obesity, dyslipidemia, and hypertension. In addition, mechanisms such as hyperandrogenism, chronic low-grade inflammation, oxidative stress, and endothelial dysfunction appear to simultaneously participate in the pathophysiology of both AGA and metabolic syndrome. It was also observed that the severity of alopecia may be associated with increased cardiovascular risk. It is concluded that androgenetic alopecia should not be regarded solely as a localized aesthetic disorder, but also as a potential early clinical marker of cardiometabolic risk, reinforcing the importance of a multidisciplinary approach integrating metabolic investigation with especialized healthcare professional.