Department of Dermatology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
Division of Endocrine and Metabolism, Wan Fang hospital, Taipei Medical University, Taipei, Taiwan.
J Dtsch Dermatol Ges. 2020 Jun;18(6):539-545. doi: 10.1111/ddg.14108. Epub 2020 May 11.
Previous studies reporting the influence of isotretinoin treatment on glucose metabolism have produced conflicting results. We therefore aimed to examine the effects of isotretinoin treatment on changes in insulin resistance and serum levels of adiponectin in patients with acne. A systematic review and meta-analysis of the literature published from the inception of isotretinoin to March 31, 2019 were conducted. In the absence of controlled trials, open-label studies on acne patients receiving isotretinoin treatment were included. Twelve studies met the inclusion criteria. The outcomes included changes in the homeostasis model assessment for insulin resistance (HOMA-IR) values and serum levels of adiponectin after isotretinoin treatment. Pooled analysis showed that HOMA-IR values did not change significantly after isotretinoin treatment (standardized mean difference [SMD] = 0.183; 95 % confidence interval [CI] = -0.004-0.371; I = 38.3), whereas the level of adiponectin significantly increased (SMD = 0.512; 95 % CI = 0.327-0.698; I = 10.7). Our study concluded that isotretinoin treatment for patients with acne resulted in an increased serum level of adiponectin but did not have a substantial impact on the status of insulin resistance.
先前关于异维 A 酸治疗对葡萄糖代谢影响的研究结果相互矛盾。因此，我们旨在研究异维 A 酸治疗对痤疮患者胰岛素抵抗和血清脂联素水平变化的影响。对从异维 A 酸问世到 2019 年 3 月 31 日发表的文献进行了系统评价和荟萃分析。由于缺乏对照试验，我们纳入了接受异维 A 酸治疗的痤疮患者的开放性研究。符合纳入标准的有 12 项研究。结果包括异维 A 酸治疗后稳态模型评估的胰岛素抵抗（HOMA-IR）值和血清脂联素水平的变化。汇总分析显示，异维 A 酸治疗后 HOMA-IR 值无显著变化（标准化均数差 [SMD] = 0.183；95%置信区间 [CI] = -0.004-0.371；I = 38.3），而脂联素水平显著升高（SMD = 0.512；95%CI = 0.327-0.698；I = 10.7）。我们的研究得出结论，异维 A 酸治疗痤疮患者可导致血清脂联素水平升高，但对胰岛素抵抗状况没有实质性影响。
