Insulin Resistance in Patients with Acne Vulgaris

Abstract

Acne vulgaris presents multifactorial pathogenesis, which may include insulin resistance. To investigate whether insulin resistance is a causative factor in acne vulgaris development, this cohort study and a systematic review were conducted. A cohort of 41 acne vulgaris patients and 47 healthy BMI-matched controls were recruited. Glucose and insulin fasting serum levels were obtained and the HOMA-IR was calculated; insulin resistance was diagnosed in cases with a HOMA-IR value over 2.1. The mean ± SD values for glucose fasting serum level were as follows: 94.88 ± 7.731 (mg/dL) in the study group and 79.51 ± 7.175 (mg/dL) in the controls (p < 0.001). The mean ± SD insulin fasting serum levels were 14.47 ± 6.394 (µIU/mL) and 11.83 ± 4.309 (µIU/mL) (p = 0.059), respectively. The HOMA-IR mean ± SD value calculated for the study group was 3.4 ± 1.49 and, in the control group, it was 2.34 ± 0.909 (p < 0.001). Out of 41 patients, 32 were diagnosed with insulin resistance (78%), and 26 of the 47 controls were diagnosed with IR (55%) (p = 0.026). An insulin resistance diagnosis was statistically more common among the acne patients, compared to the controls. In the articles reviewed in this paper, insulin resistance was found to be more frequent in acne vulgaris patients. Both our study and the papers analyzed in the review indicate that insulin resistance might be an independent factor in acne vulgaris development and should be considered when diagnosing and treating acne.

Metformin Therapy for Acne Vulgaris: A Meta-Analysis

“…PCOS is associated with plenty of hormonal disorders, including IR [13][14][15][16]. It was also meaningful to indicate the relationship between IR as the only presented hormonal disorder and acne [17,18,35]. Due to the availability of many studies on the use of metformin in patients with PCOS, we decided to consider its The results of our meta-analysis proved a statistically significant (p = 0.00000008) improvement in GAGS after metformin treatment in patients with acne vulgaris.…”

“…Symptomatic therapies turned out to be insufficient and there was a need to find and treat the causes of acne. Possible connections between acne and other diseases or abnormalities such as IR, PCOS, hyperandrogenism, and other hormonal disorders were studied [ 13 , 17 , 32 , 33 , 34 ].…”

“…PCOS is associated with plenty of hormonal disorders, including IR [ 13 , 14 , 15 , 16 ]. It was also meaningful to indicate the relationship between IR as the only presented hormonal disorder and acne [ 17 , 18 , 35 ]. Due to the availability of many studies on the use of metformin in patients with PCOS, we decided to consider its usefulness in patients without this endocrinopathy.…”

“…The global score is the result of the summation of individual scores. Depending on the obtained result, the GAGS defines acne as mild (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18), moderate (19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30), severe (31)(32)(33)(34)(35)(36)(37)(38), and very severe (>39) [67].…”

“…The latest outcomes prove the correlation between Insulin Resistance (IR) and acne vulgaris not only in female patients with PCOS but also in men and patients without a PCOS diagnosis [ 17 ]. Acne and IR seem to have similar underlying pathomechanisms.…”