Iftikhar Usma, Choudhry Nakhshab
Dr. Usma Iftikhar, FCPS. Department of Dermatology, Mayo Hospital, King Edward Medical University, Lahore, Pakistan.
Dr. Nakhshab Choudhry, PhD. Professor & Chairman, Department of Biochemistry, King Edward Medical University, Lahore, Pakistan.
Pak J Med Sci. 2019 Jan-Feb;35(1):146-150. doi: 10.12669/pjms.35.1.131.
To correlate acne severity with elevated androgen levels and to compare androgen levels between cases and controls.
This case-control study was carried out in the Department of Dermatology, Mayo Hospital, Lahore from March 2016 - March 2017. Two hundred and seventy patients and eighty age and gender-matched controls were recruited after ethical approval and informed consent and categorized into mild, moderate and severe acne. Severity was correlated with serum Testosterone, Dihydrotestoststerone and Dihydroepiandrosterone Sulphate levels. Quantitative variables were expressed as median and percentiles, comparisons done by Mann-Whitney and correlations by Spearman correlation. P value of < 0.05 was considered statistically significant.
There were 142 (41%) males and 208 (59%) females. Ninety-Seven patients had mild, 108 moderate and 65 had severe disease. Median hormonal levels were 3.5ng/ml, 184pg/ml and 0.82ug/dl for Testosterone, Dihydrotestosterone and Dihydroepiandrosterone Sulphate respectively which differed significantly between cases and controls. There was no correlation with severity but the levels differed significantly between the different grades in case of Testosterone and DHEAS.
Androgens are not directly correlated with acne severity, but affect acne severity as seen in difference between their levels in different grades of acne. Anti-androgens may be initiated early in acne resistant to conventional therapy.
将痤疮严重程度与雄激素水平升高相关联,并比较病例组和对照组的雄激素水平。
本病例对照研究于2016年3月至2017年3月在拉合尔梅奥医院皮肤科进行。在获得伦理批准并取得知情同意后,招募了270例患者和80例年龄及性别匹配的对照,将其分为轻度、中度和重度痤疮。将严重程度与血清睾酮、双氢睾酮和硫酸脱氢表雄酮水平相关联。定量变量以中位数和百分位数表示,采用曼-惠特尼检验进行比较,采用斯皮尔曼相关性分析进行相关性分析。P值<0.05被认为具有统计学意义。
有142例(41%)男性和208例(59%)女性。97例患者为轻度痤疮,108例为中度痤疮,65例为重度痤疮。睾酮、双氢睾酮和硫酸脱氢表雄酮的激素水平中位数分别为3.5ng/ml、184pg/ml和0.82μg/dl,病例组和对照组之间存在显著差异。与严重程度无相关性,但睾酮和硫酸脱氢表雄酮在不同等级之间的水平存在显著差异。
雄激素与痤疮严重程度无直接相关性,但如不同等级痤疮中其水平的差异所示,雄激素会影响痤疮严重程度。对于对传统治疗耐药的痤疮,可早期启用抗雄激素治疗。