Tang Lin, Yu Bei, Liao Yongmei, Long Siqi, Yan Haoxiang, He Qingqing, Li Changqiang
Department of Dermatology, Affiliated Hospital of Southwest Medical University, Luzhou, China.
Department of Dermatology, Sixth People's Hospital, Deyang, Sichuan, China.
Indian J Dermatol. 2022 Jul-Aug;67(4):477. doi: 10.4103/ijd.ijd_251_22.
Acne vulgaris (AV) is a chronic inflammatory disease of the pilosebaceous unit. Many factors are involved in the occurrence of acne. It has been confirmed that some adipokines play an important role in the development of AV. Irisin is a novel adipokine, which is highly expressed in skeletal muscle, liver, and fat. It improves insulin resistance (IR) by inducing the browning of white adipose tissue, increasing heat production and energy expenditure.
The purpose of this study was to investigate the role of serum irisin as an adipokine to explore its function in the pathogenesis of AV and its correlation with IR, and whether it can be used as a potential biomarker of insulin sensitivity. Although the hyperinsulinemic-euglycemic clamp remains the gold standard for accurate determination of IR, it cannot be performed routinely. Various alternative simpler measures have been used, the most common being homeostasis model assessment. However, these metrics are limited by their accuracy, cost, and blood collection requirements.[1] Therefore, an effective and feasible serum biomarker is an attractive and relatively straightforward method, which may provide clinicians with a more accurate and simple method for the prediction and diagnosis of IR. IR can often be detected before other symptoms appear, so establishing an early diagnosis method will allow for the appropriate treatment of patients before the disease develops.
The study included 171 subjects; 115 patients with newly diagnosed AV and 56 apparently healthy subjects. The contents of irisin and interleukin-1 alpha in serum were determined by enzyme-linked immunosorbent assay. The IR index was calculated by the homeostasis model.
Serum irisin levels in AV patients and control group were (24.0 ± 11.3) and (104.3 ± 27.0) ng/dl, respectively, which were significantly lower than those in control group ( < 0.001). Serum irisin was negatively correlated with IR ( = -0.711, 0.001). The sensitivity of irisin was 100.0%, the specificity was 92.8%, and the cutoff point was 53.32. The decrease of serum irisin level could predict the patients with IR in acne.
Serum irisin levels in AV patients were significantly decreased. Serum irisin showed acceptable performance criteria in the diagnosis of AV with IR. Serum irisin seems to be a good diagnostic and prognostic marker for IR. Further multi-center studies are needed to confirm this link, which could pave the way for new treatment options.
寻常痤疮（AV）是一种毛囊皮脂腺单位的慢性炎症性疾病。痤疮的发生涉及多种因素。已证实一些脂肪因子在寻常痤疮的发展中起重要作用。鸢尾素是一种新型脂肪因子，在骨骼肌、肝脏和脂肪中高表达。它通过诱导白色脂肪组织褐变、增加产热和能量消耗来改善胰岛素抵抗（IR）。
本研究旨在探讨血清鸢尾素作为一种脂肪因子在寻常痤疮发病机制中的作用，探索其与胰岛素抵抗的关系，以及它是否可作为胰岛素敏感性的潜在生物标志物。尽管高胰岛素-正常血糖钳夹技术仍然是准确测定胰岛素抵抗的金标准，但它不能常规进行。已经使用了各种替代的更简单的测量方法，最常见的是稳态模型评估。然而，这些指标受到其准确性、成本和采血要求的限制。[1]因此，一种有效且可行的血清生物标志物是一种有吸引力且相对直接的方法，它可能为临床医生提供一种更准确、简单的胰岛素抵抗预测和诊断方法。胰岛素抵抗通常在其他症状出现之前就能被检测到，因此建立早期诊断方法将使患者在疾病发展之前得到适当的治疗。
本研究纳入171名受试者；115例新诊断的寻常痤疮患者和56名明显健康的受试者。采用酶联免疫吸附测定法测定血清中鸢尾素和白细胞介素-1α的含量。通过稳态模型计算胰岛素抵抗指数。
寻常痤疮患者和对照组血清鸢尾素水平分别为（24.0±11.3）和（104.3±27.0）ng/dl，明显低于对照组（<0.001）。血清鸢尾素与胰岛素抵抗呈负相关（r=-0.711，P<0.001）。鸢尾素的敏感性为100.0%，特异性为92.8%，截断点为53.32。血清鸢尾素水平降低可预测痤疮患者的胰岛素抵抗。
寻常痤疮患者血清鸢尾素水平显著降低。血清鸢尾素在诊断伴有胰岛素抵抗寻常痤疮时表现出可接受的性能标准。血清鸢尾素似乎是胰岛素抵抗的良好诊断和预后标志物。需要进一步的多中心研究来证实这种联系，这可能为新的治疗选择铺平道路。
