Division of Endocrinology and Metabolism, Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey.
Dermatology. 2017;233(4):314-319. doi: 10.1159/000484168. Epub 2017 Dec 1.
BACKGROUND/AIM: Isotretinoin, the drug of choice for severe acne, might be associated with a decrease in insulin sensitivity. Adiponectin is an adipose tissue-derived protein that increases insulin sensitivity. In this study, we aimed to investigate adiponectin levels in postadolescent severe acne and the effect of isotretinoin on adiponectin levels.
Participants included 18 female patients with severe acne and 18 healthy women matched for age and body mass index (BMI). Acne patients completed a 6-month isotretinoin treatment. Anthropometric measurements, serum adiponectin, lipids, fasting glucose, fasting insulin, and homeostatic model assessment for insulin resistance (HOMA-IR) were determined, and a standard 2-h oral glucose tolerance test (OGTT) was performed in healthy women once and in patients with acne before and after treatment.
At baseline, patients with acne had significantly lower serum adiponectin levels than controls. Isotretinoin treatment resulted in a significant increase in weight, BMI, and triglyceride and adiponectin levels. Glucose metabolism markers in patients with acne and controls were similar at baseline and did not change after treatment. Baseline OGTT in acne patients revealed an increased adiponectin response at 2 h, which was not present in healthy controls. Remarkably, this OGTT-induced adiponectin increment in acne patients was diminished after isotretinoin treatment.
Adiponectin levels are differently regulated in women with severe acne and healthy controls in that circulating basal levels in patients are suppressed and show an increase in response to oral glucose load. Suppression of baseline adiponectin ameliorates after 6 months of isotretinoin treatment, reaching levels similar to those of healthy controls.
背景/目的：异维 A 酸是治疗重度痤疮的首选药物，可能与胰岛素敏感性降低有关。脂联素是一种来源于脂肪组织的蛋白质，可增加胰岛素敏感性。本研究旨在探讨青春期后重度痤疮患者脂联素水平及异维 A 酸对脂联素水平的影响。
参与者包括 18 例女性重度痤疮患者和 18 例年龄和体重指数（BMI）相匹配的健康女性。痤疮患者完成 6 个月的异维 A 酸治疗。测定人体测量学指标、血清脂联素、血脂、空腹血糖、空腹胰岛素和稳态模型评估的胰岛素抵抗指数（HOMA-IR），并对健康女性进行一次标准的 2 小时口服葡萄糖耐量试验（OGTT），对痤疮患者在治疗前和治疗后各进行一次。
基线时，痤疮患者的血清脂联素水平明显低于对照组。异维 A 酸治疗导致体重、BMI、甘油三酯和脂联素水平显著增加。痤疮患者和对照组的葡萄糖代谢标志物在基线时相似，治疗后没有变化。痤疮患者的基线 OGTT 显示 2 小时时脂联素反应增加，而健康对照组则没有。值得注意的是，痤疮患者的这种 OGTT 诱导的脂联素增加在异维 A 酸治疗后减少。
重度痤疮女性和健康对照组的脂联素水平调节不同，患者的基础循环水平受到抑制，并对口服葡萄糖负荷呈增加反应。异维 A 酸治疗 6 个月后，基础脂联素抑制得到改善，达到与健康对照组相似的水平。
