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Free Androgen Index (FAI): Marker of Premature Androgenetic Alopecia in Men
Sarita Sanke, Ram Chander, Taru Garg and Anju Jain
Introduction: Premature androgenetic alopecia (AGA) in men is alopecia occurring before the age of 30 years. We conducted this study to evaluate various androgenic hormones in men with premature androgenetic alopecia and to assess if free androgen index (FAI) can be used as a marker of hyperandrogenism in these men.
Materials and methods: 57 men with premature AGA (defined as grade 3 or more on Hamilton-Norwood scale) were taken as subjects. The serum concentrations of Testosterone, DHEAS, and SHBG were measured and Free androgen index (FAI) was calculated and compared with age and sex-matched controls.
Results: There were significant differences in the mean values of all the three indicators for androgen status (FAI, DHEAS and testosterone) in cases as compared to the controls. The statistical significance was higher for FAI and DHEAS than that for testosterone. FAI appeared to be a better predictor of hyperandrogenism than DHEAS and testosterone.
Conclusion: FAI is the best marker of a person’s androgen status and can be considered as the marker of premature AGA. Taking into consideration the technical limitations of the currently available methods for measuring free testosterone, and the diagnostic importance of using FAI as an indicator of androgen status, it is recommended to implement these parameters in the routine investigation and assessment of men with AGA.