Increases in uric acid and monocyte‐high‐density lipoprotein ratio as possible atherosclerotic indicators in acne patients using isotretinoin

Abstract

Purpose We aimed to reveal the relationship of serum uric acid (SUA) with monocyte‐high‐density lipoprotein ratio (MHR) and other inflammatory markers in acne patients before and after isotretinoin treatment. In this way, we can try to shed light on the relationship between isotretinoin treatment and atherosclerosis. Methods Two hundred twenty‐four acne patients who administered isotretinoin (0.5‐1 mg/kg/day) were enrolled in the study. In the pretreatment phase and 3 months after treatment, MHR, SUA, mean platelet volume, neutrophil‐lymphocyte ratio (NLR), platelet‐lymphocyte ratio, monocyte‐lymphocyte ratio, serum triglyceride, total cholesterol, high‐density lipoprotein (HDL), and low‐density lipoprotein (LDL) levels of the patients were analyzed. Results Compared to the pretreatment phase, three months after treatment, there was a statistically decrease in neutrophil count and an increase in lymphocyte count (p: 0.002, p: 0.011, respectively). Accordingly, there was a statistically significant decrease in NLR (p: 0.001). It was noteworthy that MHR and SUA levels increased significantly (p: 0.042, p: 0.010, respectively) and there was a positive correlation between SUA level and MHR (r: 0.212, p: 0.012). Serum total cholesterol, LDL, and triglyceride levels increased and HDL levels decreased significantly after treatment (p: 0.001). Conclusion This study contributes to the comprehension of the relationship between isotretinoin treatment and atherosclerosis, which has been frequently reported in the literature. It was thought that the isotretinoin‐induced SUA increase might be related to dyslipidemia. Isotretinoin may initiate the atherosclerotic process in vascular endothelial and smooth muscles, with SUA increase and HDL decrease. An increase in MHR is also an inflammatory marker indicating this process.

Akne Vulgaris Hastalarında Tedavinin Hematolojik Parametreler Üzerine Etkisi

“…Systemic inflammation triggers lymphopenia, causing an increase in NLR levels (19). In the current study, decreased NLR levels response to the treatment were in line with previous studies (15,16,20). Previous studies have demonstrated different results on platelet values (21,22).…”

The SII reflects inflammation in acne vulgaris, but fails to determine categorical severity

“…Studies in recent years have generally focused on the effects of isotretinoin on inflammatory markers such as NLR and monocyte/high-density lipoprotein ratio in patients with moderate to severe acne. 13,23 Acne severity is categorized as mild, moderate, or severe according to the extent and types of lesions, and often the clinician's experience. In this study, we used CASS and PASS, which were determined according to the physician's opinion and the patient's self-perception, respectively, as well as GAGS for objective evaluation.…”

“…SII has never been investigated before in acne, where we draw attention to the importance of the inflammatory response in its pathogenesis. Studies in recent years have generally focused on the effects of isotretinoin on inflammatory markers such as NLR and monocyte/high‐density lipoprotein ratio in patients with moderate to severe acne 13,23 . Acne severity is categorized as mild, moderate, or severe according to the extent and types of lesions, and often the clinician's experience.…”

Could uric acid to high-density lipoprotein cholesterol ratio be used to predict late-stage saphenous vein graft disease after coronary artery bypass graft surgery?

“…It has been shown that there is a relationship between coronary artery plaque load and HDL-C [6]. Various studies conducted on this topic have found a relationship between uric acid to HDL-C (UHR) and metabolic syndrome and atherosclerotic diseases [7,8].…”