The Effect of Isotretinoin on Retinol-Binding Protein 4, Leptin, Adiponectin and Insulin Resistance in Acne Vulgaris Patients

Abstract

Background: The effect of isotretinoin (ISO) on adipokines and insulin resistance has been investigated in a few studies, and the results are conflicting. Objective: The aim of this study was to investigate the effect of ISO treatment on insulin resistance and adipokines. Methods: Thirty-three patients with acne vulgaris and a control group of 30 healthy volunteers were included in our study. Screening for the biochemical parameters was performed just before the initiation and after 3 months of ISO treatment. Results: In the acne group, basal leptin levels were significantly lower (p = 0.003) and basal adiponectin levels significantly higher (p = 0.008) compared with the control group. After ISO treatment, leptin levels (p = 0.0005) decreased and adiponectin levels (p = 0.003) increased significantly. However, measurements of fasting blood glucose, insulin, C peptide, retinol-binding protein 4 (RBP4), homeostasis model assessment insulin resistance and BMI did not differ after ISO treatment. Conclusion: ISO may affect leptin and adiponectin levels. It does not, however, affect insulin resistance and RBP4 levels.

Effects of isotretinoin on body mass index, serum adiponectin, leptin, and ghrelin levels in acne vulgaris patients

“…Additionally, adiponectin and leptin serum levels were significant increased with isotretinoin treatment. Prior to the current study, serum leptin and adiponectin levels in acne patients were investigated in only one study, which reported that leptin levels decreased, while adiponectin levels increased with isotretinoin treatment [13]. In our current study, adiponectin levels were similarly increased after isotretinoin treatment.…”

“…In animal studies, retinoic acid induced decreases in body weight and fat loss despite unchanged or increased energy intake [27]. In contrast, clinical studies reported that BMI was unchanged [13] or increased [15] following retinoic acid. In the current study, we found no significant difference in pre- and posttreatment BMI values, which is comparable with the results of previous clinical studies.…”

“…Adiponectin can also suppress the production of interferon-γ [31], while pro-inflammatory mediators, such as TNF-α and IL-6, inhibit adiponectin gene expression [30, 32]. To our knowledge, there are only 3 published studies relating isotretinoin treatment and adiponectin blood level [11–13]. All of these reports indicate that isotretinoin treatment leads to elevated levels of adiponectin.…”

“…They reported that local leptin increases dendritic cells and Th1 cells in vivo , but inhibits Th17 cells and Tregs cells [40]. To our knowledge, there is only one published study investigating the effect of isotretinoin treatment on insulin resistance and adipokines in patients with acne vulgaris [13]. Karadag et al .…”

“…To our knowledge, few studies have focused on changes in body mass index (BMI) in humans treated with isotretinoin [11–15], and only one reported associations between adipocytokines and isotretinoin treatment [13]. In addition, investigation of correlations between global acne grading system (GAGS) and adipocytokines, and pre-post treatment levels of adipocytokines has not been evaluated previously.…”