{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T03:37:09Z","timestamp":1777952229295,"version":"3.51.4"},"reference-count":29,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T00:00:00Z","timestamp":1777852800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T00:00:00Z","timestamp":1777852800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J Dermatology"],"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n The role of androgens in female pattern hair loss (FPHL) is disputed as patients usually have normal androgen levels. 3\u03b1\u2010androstanediol glucuronide (3\u03b1\u2010diol G) is a marker of peripheral hyperandrogenism, but has not been assessed in FPHL. We aimed to evaluate ovarian, adrenal, and peripheral (3\u03b1\u2010diol G) androgens in Indian women with FPHL and correlate them with the clinical severity of FPHL.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A cross\u2010sectional observational study was conducted at a tertiary care hospital in India, involving 44 women with trichoscopically confirmed FPHL and 30 age\u2010matched healthy controls. Clinical severity was graded using the Ludwig and Sinclair scales. Serum total testosterone (tT), SHBG, free androgen index, AMH, DHEAS, LH, FSH, TSH, prolactin, and 3\u03b1\u2010diol G were measured.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n FPHL patients presented with Ludwig grade 1 (70%,\n n<\/jats:italic>\n \u2009=\u200931) and Ludwig grade 2 (29.5%,\n n<\/jats:italic>\n \u2009=\u200913). Serum 3\u03b1\u2010diol G levels were significantly higher in FPHL (mean: 8.43\u2009\u00b1\u20094.44\u2009nmol\/L, range: 3.2\u201320.74\u2009nmol\/L) compared to controls (mean: 4.23\u2009\u00b1\u20091.39\u2009nmol\/L, range: 1.81\u20137.29\u2009nmol\/L;\n p<\/jats:italic>\n \u2009<\u20090.001). Levels of other androgens and pre\u2010androgens were not significantly different between the groups. Abnormal tT levels (6.8%,\n n<\/jats:italic>\n \u2009=\u20093) and DHEAS (4.5%,\n n<\/jats:italic>\n \u2009=\u20092) were seen in a minority of cases. There was a positive correlation of 3\u03b1\u2010diol G with FPHL severity (Ludwig scale, Spearman's\n \u03c1<\/jats:italic>\n \u2009=\u20090.37,\n p<\/jats:italic>\n \u2009=\u20090.013), with receiver operating characteristics (ROC) analysis revealing a high diagnostic accuracy (AUROC 0.85; cut\u2010off \u2265\u20095.242\u2009nmol\/L; 82% sensitivity, 73% specificity) as compared to other hormonal parameters.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Serum 3\u03b1\u2010diol G is a promising biomarker of peripheral hyperandrogenism in FPHL and correlates with clinical severity and may help in monitoring antiandrogen therapy.<\/jats:p>\n \n \n \n image<\/jats:alt-text>\n <\/jats:graphic>\n <\/jats:boxed-text>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/ijd.70445","type":"journal-article","created":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T11:56:08Z","timestamp":1777895768000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Evidence of Increased 3\u2010Alpha\u2010Androstanediol Glucuronide in Female Pattern Alopecia: A Cross\u2010Sectional Observational Study Evaluating Ovarian, Adrenal, and Peripheral Androgens"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-2484-462X","authenticated-orcid":false,"given":"Arunesh Padmini","family":"Kathirvelu","sequence":"first","affiliation":[{"name":"Department of Dermatology, Venereology and Leprosy Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1757-3406","authenticated-orcid":false,"given":"Kabir","family":"Sardana","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Venereology and Leprosy Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lokesh Kumar","family":"Sharma","sequence":"additional","affiliation":[{"name":"Department of Biochemistry Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7020-7777","authenticated-orcid":false,"given":"Ananta","family":"Khurana","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Venereology and Leprosy Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Savitha","family":"Sharath","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Venereology and Leprosy Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,5,4]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1111\/j.1365-2133.1977.tb15179.x","article-title":"Classification of the Types of Androgenetic Alopecia (Common Baldness) Occurring in the Female Sex","volume":"97","author":"Ludwig E.","year":"1977","journal-title":"British Journal of Dermatology"},{"key":"e_1_2_11_3_1","doi-asserted-by":"crossref","first-page":"2875","DOI":"10.1210\/jc.2018-02548","article-title":"Female Pattern Hair Loss and Androgen Excess: A Report From the Multidisciplinary Androgen Excess and PCOS Committee","volume":"104","author":"Carmina E.","year":"2019","journal-title":"Journal of Clinical Endocrinology and Metabolism"},{"key":"e_1_2_11_4_1","doi-asserted-by":"crossref","first-page":"598","DOI":"10.1007\/s004030000184","article-title":"Role of Androgens in Female\u2010Pattern Androgenetic Alopecia, Either Alone or Associated With Other Symptoms of Hyperandrogenism","volume":"292","author":"Vexiau P.","year":"2000","journal-title":"Archives of Dermatological Research"},{"key":"e_1_2_11_5_1","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1097\/md.0b013e3181946a2c","article-title":"Androgen Dependence of Hirsutism, Acne, and Alopecia in Women: Retrospective Analysis of 228 Patients Investigated for Hyperandrogenism","volume":"88","author":"Karrer\u2010Voegeli S.","year":"2009","journal-title":"Medicine (Baltimore)"},{"key":"e_1_2_11_6_1","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1007\/s12016-025-09034-5","article-title":"Immune and Non\u2010Immune Interactions in the Pathogenesis of Androgenetic Alopecia","volume":"68","author":"Xiao Y.","year":"2025","journal-title":"Clinical Reviews in Allergy and Immunology"},{"key":"e_1_2_11_7_1","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1016\/S0015-0282(16)56810-1","article-title":"The Climacteric Ovary as a Functional Gonadotropin\u2010Driven Androgen\u2010Producing Gland","volume":"62","author":"Adashi E. Y.","year":"1994","journal-title":"Fertility and Sterility"},{"key":"e_1_2_11_8_1","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1080\/17446651.2023.2299400","article-title":"An Updated Clinico\u2010Investigative Approach to Diagnosis of Cutaneous Hyperandrogenism in Relation to Adult Female Acne, Female Pattern Alopecia & Hirsutism a Primer for Dermatologists","volume":"19","author":"Sardana K.","year":"2024","journal-title":"Expert Review of Endocrinology and Metabolism"},{"key":"e_1_2_11_9_1","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1016\/0738-081X(88)90066-1","article-title":"Markers of Peripheral Androgen Action In\u00a0Vivo and In\u00a0Vitro","volume":"6","author":"Horton R.","year":"1988","journal-title":"Clinics in Dermatology"},{"key":"e_1_2_11_10_1","doi-asserted-by":"crossref","first-page":"752","DOI":"10.1080\/09546634.2019.1708245","article-title":"A Prospective Study Examining Isolated Acne and Acne With Hyperandrogenic Signs in Adult Females","volume":"32","author":"Bansal P.","year":"2021","journal-title":"Journal of Dermatological Treatment"},{"key":"e_1_2_11_11_1","doi-asserted-by":"crossref","first-page":"872","DOI":"10.1016\/S0015-0282(16)54290-3","article-title":"Serum Androsterone Conjugates Differentiate Between Acne and Hirsutism in Hyperandrogenic Women","volume":"55","author":"Carmina E.","year":"1991","journal-title":"Fertility and Sterility"},{"key":"e_1_2_11_12_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1111\/j.1365-2265.1990.tb03744.x","article-title":"Plasma C19 Steroid Sulphate Levels and Indices of Androgen Bioavailability in Female Pattern Androgenic Alopecia","volume":"32","author":"Montalto J.","year":"1990","journal-title":"Clinical Endocrinology"},{"key":"e_1_2_11_13_1","doi-asserted-by":"crossref","first-page":"1011","DOI":"10.1001\/archderm.1986.01660210061019","article-title":"Female Androgenic Alopecia the 3 Alpha,17 Beta\u2010Androstanediol Glucuronide\/Sex Hormone Binding Globulin Ratio as a Possible Marker for Female Pattern Baldness","volume":"122","author":"De Villez R. L.","year":"1986","journal-title":"Archives of Dermatology"},{"key":"e_1_2_11_14_1","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1111\/j.1087-0024.2005.10102.x","article-title":"Prevalence of Male and Female Pattern Hair Loss in Maryborough","volume":"10","author":"Gan D. C.","year":"2005","journal-title":"Journal of Investigative Dermatology Symposium Proceedings"},{"key":"e_1_2_11_15_1","doi-asserted-by":"crossref","first-page":"123","DOI":"10.4103\/0974-7753.58555","article-title":"Dermoscopy in Female Androgenic Alopecia: Method Standardization and Diagnostic Criteria","volume":"1","author":"Rakowska A.","year":"2009","journal-title":"International Journal of Trichology"},{"key":"e_1_2_11_16_1","doi-asserted-by":"crossref","DOI":"10.1111\/dth.13974","article-title":"A Prospective Study of Anti\u2010Mullerian Hormone and Other Ovarian and Adrenal Hormones in Adult Female Acne","volume":"33","author":"Bansal P.","year":"2020","journal-title":"Dermatologic Therapy"},{"key":"e_1_2_11_17_1","volume-title":"Endotext","author":"McEwan I. J.","year":"2000"},{"key":"e_1_2_11_18_1","doi-asserted-by":"crossref","first-page":"1203","DOI":"10.1172\/JCI110558","article-title":"3 Alpha, 17 Beta\u2010Androstanediol Glucuronide in Plasma. A Marker of Androgen Action in Idiopathic Hirsutism","volume":"69","author":"Horton R.","year":"1982","journal-title":"Journal of Clinical Investigation"},{"key":"e_1_2_11_19_1","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1210\/jcem-57-2-393","article-title":"Evidence for the Importance of Peripheral Tissue Events in the Development of Hirsutism in Polycystic Ovary Syndrome","volume":"57","author":"Lobo R. 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M.","year":"1983","journal-title":"Cleveland Clinic Quarterly"},{"key":"e_1_2_11_25_1","first-page":"68","article-title":"Serum Levels of Testosterone and Dehydroepiandrosterone Sulfate in Females With Acne and\/or Female Pattern Hair Loss","volume":"3","author":"Venkatta R. B.","year":"2021","journal-title":"J Skin Sex Transm Dis"},{"key":"e_1_2_11_26_1","doi-asserted-by":"crossref","first-page":"744","DOI":"10.1016\/S0015-0282(16)56999-4","article-title":"Alterations in Androgen Conjugate Levels in Women and Men With Alopecia","volume":"62","author":"Legro R. S.","year":"1994","journal-title":"Fertility and Sterility"},{"key":"e_1_2_11_27_1","doi-asserted-by":"crossref","first-page":"421","DOI":"10.1530\/eje.0.1380421","article-title":"Serum Levels of 3alpha\u2010Androstanediol Glucuronide in Hirsute and Non Hirsute Women","volume":"138","author":"Falsetti L.","year":"1998","journal-title":"European Journal of Endocrinology"},{"key":"e_1_2_11_28_1","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1007\/s00403-017-1798-0","article-title":"5\u03b1\u2010Reductase Isozymes and Aromatase mRNA Levels in Plucked Hair From Young Women With Female Pattern Hair Loss","volume":"310","author":"S\u00e1nchez P.","year":"2018","journal-title":"Archives of Dermatological Research"},{"key":"e_1_2_11_29_1","doi-asserted-by":"crossref","first-page":"734","DOI":"10.1016\/S0015-0282(16)58627-0","article-title":"Outcome of Long\u2010Term Treatment With the 5 Alpha\u2010Reductase Inhibitor Finasteride in Idiopathic Hirsutism: Clinical and Hormonal Effects During a 1\u2010Year Course of Therapy and 1\u2010Year Follow\u2010Up","volume":"66","author":"Castello R.","year":"1996","journal-title":"Fertility and Sterility"},{"key":"e_1_2_11_30_1","first-page":"233","article-title":"A Prospective Randomized Trial Comparing Finasteride to Spironolactone in the Treatment of Hirsute Women","volume":"80","author":"Wong I. L.","year":"1995","journal-title":"Journal of Clinical Endocrinology and Metabolism"}],"container-title":["International Journal of Dermatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ijd.70445","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ijd.70445","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ijd.70445","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T11:56:11Z","timestamp":1777895771000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ijd.70445"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,4]]},"references-count":29,"alternative-id":["10.1111\/ijd.70445"],"URL":"https:\/\/doi.org\/10.1111\/ijd.70445","archive":["Portico"],"relation":{},"ISSN":["0011-9059","1365-4632"],"issn-type":[{"value":"0011-9059","type":"print"},{"value":"1365-4632","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,4]]},"assertion":[{"value":"2025-11-27","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-15","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-04","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"ijd.70445"}}