Background: AGA is a common hair disease with genetic predisposition and is characterized by non-scarring progressive miniaturization of the hair follicle. IR is a state in which a given concentration of insulin produces a less‐than‐expected biological effect. Obesity is the most common cause. Insulin was suggested to play a role in the regulation of cutaneous androgen metabolism and hair‐growth cycle, which are relevant to AGA. The newly regulatory role of PGRN on energy homeostasis and chronic inflammation raised the possibility that PGRN may contribute to the progression of IR and metabolic dysfunction. The aim of this study was to evaluate serum PGRN, FBG and fasting insulin levels in patients with AGA, assessment of its clinical significance and its relation to IR and MetS. Methods: This study included 60 AGA male patients. In addition to 20 healthy individuals of matched age and sex served as controls. All participants were recruited from outpatient clinic of Dermatology, Venereology and Andrology department of Benha University Hospitals. Results: There was a non-significant difference between patients and control groups regarding weight, height and BMI. AGA patients showed significantly higher fasting insulin level and HOMA-IR, as compared to the control group. Serum PGRN was higher significantly in AGA group as compared to control group. Conclusion: Serum PGRN level and HOMA-IR were significantly higher in AGA patients when compared to control group. PGRN has a critical role which contributes to IR and MetS. AGA patients should be closely followed-up in the long term. Early detection of IR and MetS might help in good management of AGA patients.