Both males aged 40–91  and younger male patients of early onset AGA (before the age of 35), had a higher likelihood of metabolic syndrome (MetS)  and insulin resistance. With younger males, studies found metabolic syndrome to be at approximately a 4x increased frequency which is clinically deemed as significant. Abdominal obesity, hypertension and lowered high density lipoprotein were also significantly higher for younger groups. Signs and symptoms
Pattern hair loss is classified as a form of non-scarring hair loss. Male-pattern hair loss begins above the temples and at the vertex (calvaria) of the scalp. As it progresses, a rim of hair at the sides and rear of the head remains. This has been referred to as a Hippocratic wreath, and rarely progresses to complete baldness.Female-pattern hair loss more often causes diffuse thinning without hairline recession; similar to its male counterpart, female androgenic alopecia rarely leads to total hair loss. The Ludwig scale grades severity of female-pattern hair loss. These include Grades 1, 2, 3 of balding in women based on their scalp showing in the front due to thinning of hair.In most cases, receding hairline is the first starting point; the hairline starts moving backwards from the front of the head and the sides. Causes
Hormones and genes
KRT37 is the only keratin that is regulated by androgens. This sensitivity to androgens was acquired by Homo sapiens and is not shared with their great ape cousins. Although Winter et al.
IGF also circulates in the blood bound to a large protein whose production is also dependent on GH. GH release is dependent on normal thyroid hormone. During the sixth decade of life, GH decreases in production. Because growth hormone is pulsatile and peaks during sleep, serum IGF is used as an index of overall growth hormone secretion. The surge of androgens at puberty drives an accompanying surge in growth hormone. Age
A number of hormonal changes occur with aging:

Decrease in testosterone
Decrease in serum DHT and 5-alpha reductase
Decrease 3AAG, a peripheral marker of DHT metabolism
Increase in SHBG
Decrease in androgen receptors, 5-alpha reductase type I and II activity, and aromatase in the scalpThis decrease in androgens and androgen receptors, and the increase in SHBG are opposite the increase in androgenic alopecia with aging. This is not intuitive, as testosterone and its peripheral metabolite, DHT, accelerate hair loss, and SHBG is thought to be protective. The ratio of T/SHBG, DHT/SHBG decreases by as much as 80% by age 80, in numeric parallel to hair loss, and approximates the pharmacology of antiandrogens such as finasteride.Free testosterone decreases in men by age 80 to levels double that of a woman at age 20. About 30% of normal male testosterone level, the approximate level in females, is not enough to induce alopecia; 60%, closer to the amount found in elderly men, is sufficient. The testicular secretion of testosterone perhaps "sets the stage" for androgenic alopecia as a multifactorial diathesis stress model, related to hormonal predisposition, environment, and age.