Aizawa H, Niimura M
Department of Dermatology, Jikei University School of Medicine, Tokyo, Japan.
J Dermatol. 1996 Aug;23(8):526-9. doi: 10.1111/j.1346-8138.1996.tb02645.x.
The purpose of this study was to evaluate serum levels of basal insulin and glucose-stimulated insulin, and to evaluate their correlations with androgen levels in women with acne. Serum levels of total testosterone (T), free testosterone (FT), dihydrotestosterone (DHT), dehydroepiandrosterone sulfate (DHEA-S), sex hormone binding globulin (SHBG), insulin-like growth factor-1 (IFG-1), and immunoreactive insulin (IRI) were measured and compared in thirty women with moderate or severe acne and thirteen healthy controls. Serum FT, DHT and DHEA-S levels in the acne group were significantly higher than those in the control group. In the acne group, there were no significant correlations between insulin or IGF-1 levels and T, FT, DHT and SHBG, despite the positive correlation between insulin and IGF-1. In order to determine the effects of insulin secretion as a dynamic response to an oral glucose tolerance test (OGTT) on serum androgen levels in acne patients, we examined the responses of serum insulin and androgen levels to a 75 g, 2 hour OGTT in the acne group and in the control group. Basal insulin levels were not significantly higher than those in the control group, but the summed insulin levels during the OGTT in the acne group were significantly higher than those in the control group. Serum T and FT levels in the acne group decreased during the OGTT, but these changes were not so significant when compared to normal controls. In conclusion, we tried to demonstrate mild insulin resistance during the OGTT in acne patients. However, postmeal transient hyperinsulinemia does not seem to play an important role in determining hyperandrogenemia in acne patients.
本研究的目的是评估寻常痤疮女性的基础胰岛素和葡萄糖刺激胰岛素的血清水平，并评估它们与雄激素水平的相关性。对30名中度或重度痤疮女性和13名健康对照者的血清总睾酮（T）、游离睾酮（FT）、二氢睾酮（DHT）、硫酸脱氢表雄酮（DHEA-S）、性激素结合球蛋白（SHBG）、胰岛素样生长因子-1（IFG-1）和免疫反应性胰岛素（IRI）水平进行了测量和比较。痤疮组的血清FT、DHT和DHEA-S水平显著高于对照组。在痤疮组中，尽管胰岛素与IGF-1呈正相关，但胰岛素或IGF-1水平与T、FT、DHT和SHBG之间无显著相关性。为了确定口服葡萄糖耐量试验（OGTT）时胰岛素分泌作为动态反应对痤疮患者血清雄激素水平的影响，我们检测了痤疮组和对照组对75g、2小时OGTT的血清胰岛素和雄激素水平反应。痤疮组的基础胰岛素水平并不显著高于对照组，但痤疮组OGTT期间的胰岛素总量显著高于对照组。痤疮组OGTT期间血清T和FT水平下降，但与正常对照组相比，这些变化并不显著。总之，我们试图证明痤疮患者在OGTT期间存在轻度胰岛素抵抗情况。然而，餐后短暂高胰岛素血症似乎在痤疮患者高雄激素血症的发生中并不起重要作用。
