Kızılyel Okan, Metin Mahmut S, Elmas Ömer F, Çayır Yasemin, Aktaş Akın
Department of Dermatology, Faculty of Medicine, Atatürk University, 25000 Erzurum, Turkey.
Cutis. 2014 Nov;94(5):234-8.
Isotretinoin has been used to treat severe inflammatory acne that is resistant to antibiotics or topical agents; however, it also may cause alterations in lipids and liver enzymes. In this retrospective study, we evaluated changes in lipids and liver enzymes in 322 acne patients who had been treated with oral isotretinoin at our institution over a 3-year period. Each patient's medical records were evaluated to determine baseline triglyceride (TG), low-density lipoprotein (LDL), high-density lipoprotein (HDL), aspartate aminotransferase (AST), and alanine aminotransferase (ALT) levels compared to levels recorded at 3 and 6 months following initiation of treatment with oral isotretinoin. Overall, statistically significant increases in TG and LDL levels were noted following treatment with isotretinoin (P<.001, respectively), while HDL levels were shown to decrease (P=.016). Although ALT levels also increased, the changes were not statistically significant increases in AST levels also were noted (P=.72). In our study, isotretinoin appeared to have a greater effect on lipids than liver enzymes. Dermatologists should not avoid isotretinoin use for appropriate indications, but close follow-up is important.
异维A酸已被用于治疗对抗生素或外用药物耐药的重度炎性痤疮；然而，它也可能导致血脂和肝酶的改变。在这项回顾性研究中，我们评估了我院322例在3年期间接受口服异维A酸治疗的痤疮患者的血脂和肝酶变化。评估每位患者的病历，以确定口服异维A酸治疗开始时的基线甘油三酯（TG）、低密度脂蛋白（LDL）、高密度脂蛋白（HDL）、天冬氨酸转氨酶（AST）和丙氨酸转氨酶（ALT）水平，并与治疗3个月和6个月时记录的水平进行比较。总体而言，异维A酸治疗后TG和LDL水平有统计学意义的显著升高（P值分别<.001），而HDL水平则降低（P = 0.016）。虽然ALT水平也升高，但变化无统计学意义；AST水平也有升高（P = 0.72）。在我们的研究中，异维A酸对血脂的影响似乎大于对肝酶的影响。皮肤科医生不应因适当的适应症而避免使用异维A酸，但密切随访很重要。
