Impact of insulin resistance in acne vulgaris

Summary: Abstract Body: Background: Acne vulgaris is a chronic inflammatory skin disease with multifactorial pathogenesis affecting the pilosebaceous units. The development of acne lesions is strongly associated with metabolic and hormonal disorders. Insulin is a hormone-like myokine with anti-inflammatory, antioxidant, and anti-diabetic effects. It may have a role in the pathogenesis of acne vulgaris and the associated insulin resistance. Aims: We aimed to evaluate serum insulin levels in patients with acne vulgaris to assess its correlation with disease pathogenesis. Method: A cross-sectional observational study was conducted in the dermatology department. Patient’s detailed clinical history and necessary parameters like height, weight, body mass index (BMI), etc were recorded in predefined proforma, noting signs and symptoms of underlying IR, along with acne severity calculated by global acne grading system (GAGS) and then analysing using Pearson’s correlation test to establish correlation between IR and acne vulgaris. Serum insulin level was measured by an ELISA technique in 86 acne vulgaris patients and 86 healthy controls. Insulin resistance was calculated using the Homeostasis Model Assessment of Insulin Resistance index. A level of 2.5 of HOMA-IR is considered as insulin resistance. Result: Serum insulin level was significantly higher in acne vulgaris patients than in the control group (P < 0.001). It showed a significant correlation with insulin resistance among patients (P 0.000). Moreover, it increased significantly with the increase in disease severity (P 0.000). In acne, raised BMI and severity of acne (GAGs) were positively associated with IR. Conclusions: IR has emerged as an important contributory, if not causative, event in the pathogenesis of severe, resistant acne. These conditions have a great deal of impact on the psychological health of those affected, necessitating different approaches to managing such cases. Our results revealed that serum insulin is not only a biomarker of disease pathogenesis but also a potential prognostic predictor of severity in acne vulgaris. Sharmin Jahan¹ 1. Dermatology, Dhaka Medical College and Hospital, Dhaka, Bangladesh, Bangladesh. Clinical Research: Epidemiology and Observational Research