Changes in plasma cholesterol and triglyceride levels after treatment with oral isotretinoin. A prospective study

Zech, L. A.

doi:10.1001/archderm.119.12.987

Cited by 35 publications

(20 citation statements)

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“…Retinoid therapy is known to be associated with hypertriglyceridemia and often with low HDL-cholesterol (13,14). Significant alterations in serum triglycerides levels were not detected in this series, likely due to the low doses of acitretin used.…”

Section: Discussionmentioning

confidence: 99%

Effects of retinoid therapy on insulin sensitivity, lipid profile and circulating adipocytokines

et al. 2006

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Objective: In vitro and in vivo models indicate that all-trans retinoic acids influence glucose and lipid metabolism. We aimed to evaluate the effects of chronic treatment with acitretin, an all-trans retinoic acid, on glucose metabolism, lipid profile and adiponectin and resistin levels. Design: Ten normoglycemic, normolipemic patients affected with psoriasis vulgaris were studied before and after 1 and 3 months of oral treatment with 35 mg of acitretin. Methods: Glucose metabolism, lipid profile, and adiponectin and resistin levels were evaluated in basal conditions and after acitretin treatment. Ten healthy subjects matched for age, body mass index (BMI) and insulin sensitivity were studied as controls. Results: One-month acitretin treatment reduced psoriasis activity, insulin sensitivity, evaluated as QUICKI values (0.364^0.034 versus 0.329^0.051; P , 0.05) and HOMA-IR index (1.53^0.73 versus 2.59^1.41; P , 0.05), and high-density lipoprotein (HDL)-cholesterol levels (45.2^11.7 versus 39.4^10.4 mg/dl; P ¼ 0.01). The impairment in glucose and lipid homeostasis was transient and not associated to BMI variations. Adiponectin levels did not change during the treatment, while resistin levels, which were higher in untreated patients than in controls (9.4^4.4 versus 6.2^2.1 ng/ml; P ¼ 0.05), fell within the normal range after 1 and 3 months of therapy. The normalization of resistin levels occurred without significant changes in circulating tumor necrosis factor a (TNFa) levels, which persisted elevated throughout the treatment. Conclusions: Treatment with a low dose of acitretin induced a mild, transient reduction of insulin sensitivity and HDL-cholesterol levels that was not related to modifications of adiponectin, resistin and TNFa levels. Although the role of resistin in humans remains elusive, the levels of this adipocytokine seem to be affected, at least in part, by retinoids. European Journal of Endocrinology 154 83-86

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Section: Discussionmentioning

confidence: 99%

Effects of retinoid therapy on insulin sensitivity, lipid profile and circulating adipocytokines

et al. 2006

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“…One of these side effects is increased cholesterol levels (Lyons et al, 1982;Zech et al, 1983;Marsden et al, 1984;Bershad et al, 1985;Michaelsson et al, 1986;Barth et al, 1993;Fex et al, 1996;Ostlere et al, 1996;Lestringant et al, 1997). Here, the effects of 13-cis-RA on serum chemistry were studied after oral treatment with doses that mimic plasma levels achieved by humans taking the recommended doses.…”

Section: Discussionmentioning

confidence: 99%

“…Here, neither 13-cis-RA nor alltrans-RA altered overall levels of cholesterol, a fineding similar to that reported by Gerber and Erdman (1980) after 7 days of dietary exposure to 315 µg RA g −1 diet of 13-cis-RA or all-trans-RA. Longer durations of exposure may be necessary for cholesterol elevations (Lyons et al, 1982;Zech et al, 1983;Bershad et al, 1985;Michaelsson et al, 1986;Barth et al, 1993;Ostlere et al, 1996;Lestringant et al, 1997).…”

Section: Discussionmentioning

confidence: 99%

Serum levels of albumin, triglycerides, total protein and glucose in rats are altered after oral treatment with low doses of 13-cis-retinoic acid or all-trans-retinoic acid

Cisneros¹,

Gough²,

Patton³

et al. 2005

J. Appl. Toxicol.

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Currently used to treat severe acne, 13-cis-retinoic acid (13-cis-RA) is under investigation for its anticancer effects as is the isomer, all-trans-retinoic acid (all-trans-RA). Here, the effects of oral 13-cis-RA or all-trans-RA treatment on serum chemistry, leptin and adiponectin levels were evaluated. Adult Sprague-Dawley rats were gavaged once daily for 7 consecutive days with 13-cis-RA (7.5 or 15 mg kg(-1)), all-trans-RA (10 or 15 mg kg(-1)) (n=24/sex/dose), or soy oil (n=16/sex) and blood was sampled 30-480 min after the last gavage. The body weight was unaffected; however, the liver/body weight ratios were increased by both doses of all-trans-RA. Sex differences were noted for levels of cholesterol, creatine, triglycerides, albumin, alanine aminotransferase and total protein. Both doses of all-trans-RA reduced albumin levels to approximately 90% of the control and total protein levels to approximately 93% of the control while substantially elevating triglyceride levels to approximately 66%-99% above the control. Additionally, triglyceride levels of the 15 mg kg(-1) 13-cis RA group were approximately 62% higher than the controls and total protein levels were approximately 5% less. Glucose levels were affected by sex and RA treatment in that males treated with 15 mg kg(-1) of 13-cis-RA or 10 mg kg(-1) all-trans-RA had lower (13%-19%) levels than the same-sex controls; however, females were not similarly affected. Neither 13-cis-RA nor all-trans-RA treatment had significant effects on the levels of blood urea nitrogen, aspartate amino transferase, leptin or adiponectin. On a mg kg(-1) basis, all-trans-RA was more potent than 13-cis-RA. These results replicate previous findings of RA-induced increased triglyceride levels. Additionally, several new findings indicate there may be sex-specific effects of RA treatment. Finally, neither treatment appeared to alter the typical diurnal cycles of these endpoints.

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“…Synthetic retinoids have been well documented to affect the lipid profile, causing elevations in both triglycerides and cholesterol (Zech et al, 1983;Bershad et al, 1985;Vahlquist et al, 1985;Marsden, 1986;Tangrea et al, 1993). Data for high dose vitamin A (300 000 IU per day) show a similar effect on both triglycerides and cholesterol (Murray et al, 1983;Infante et al, 1991;Pastorino et al, 1991).…”

Section: Introductionmentioning

confidence: 99%

Changes in cholesterol and triglyceride concentrations in the Vanguard population of the Carotene and Retinol Efficacy Trial (CARET)

et al. 2005

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Background: The Beta-Carotene and Retinol Efficacy Trial (CARET) was terminated 21 months ahead of schedule due to an excess of lung cancers. Deaths from cardiovascular disease also increased (relative risk ¼ 1.26 (95% confidence interval (CI) 0.99-1.61)) in the group assigned to a combination of 30 mg beta-carotene and 25 000 IU retinyl palmitate (vitamin A) daily. The basis for increased cardiovascular mortality is unexplained. Design: We analyzed data on serum lipids, available for 1474 CARET Vanguard participants who were enrolled in the two CARET pilot studies and transitioned to the Vanguard study. Total cholesterol and triglycerides were measured 2 months prior to, 4 and 12 months following randomization, and annually thereafter for up to 7 y. Intervention: In the asbestos-exposed pilot (N ¼ 816), participants were assigned to beta-carotene and retinol or to placebo; in the smokers pilot (N ¼ 1029), participants were assigned to beta-carotene, retinol, a combination, or placebo. Results: Serum cholesterol showed a decline over time in both arms; serum triglycerides had a continuous decline over time in the placebo arm, but an initial increase that persisted in the active arm. Both serum cholesterol concentrations (Po0.0003) and serum triglycerides (Po0.0001) were significantly higher in the participants receiving vitamin A and/or a combination of vitamin A and beta-carotene (n ¼ 863) as compared to the placebo group (n ¼ 611). Those in this active intervention group had an average cholesterol concentration 5.3 mg/dl (0.137 mmol/l) higher than those in the placebo arm. Conclusion: The differences in cholesterol and triglyceride concentrations between the groups following randomization may account in part for the unexpected excess in cardiovascular deaths seen in the active intervention arm of CARET.

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Changes in plasma cholesterol and triglyceride levels after treatment with oral isotretinoin. A prospective study

Cited by 35 publications

References 1 publication

Effects of retinoid therapy on insulin sensitivity, lipid profile and circulating adipocytokines

Effects of retinoid therapy on insulin sensitivity, lipid profile and circulating adipocytokines

Serum levels of albumin, triglycerides, total protein and glucose in rats are altered after oral treatment with low doses of 13-cis-retinoic acid or all-trans-retinoic acid

Changes in cholesterol and triglyceride concentrations in the Vanguard population of the Carotene and Retinol Efficacy Trial (CARET)

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