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Original Investigation |

Insulin Resistance and Metabolic Syndrome in Young Men With Acne

Mohit Nagpal, MD1; Dipankar De, MD1; Sanjeev Handa, MD1; Arnab Pal, MD, PhD2; Naresh Sachdeva, PhD3
[+] Author Affiliations
1Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
2Department of Biochemistry, Postgraduate Institute of Medical Education and Research, Chandigarh, India
3Department of Endocrinology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
JAMA Dermatol. 2016;152(4):399-404. doi:10.1001/jamadermatol.2015.4499.
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Introduction  Robust evidence of the association of insulin resistance and metabolic syndrome with acne in male patients is lacking.

Objective  To assess the prevalence of metabolic syndrome and insulin resistance in male patients 20 years or older with acne.

Design, Setting, and Participants  We performed a cross-sectional study in 100 male patients with acne and 100 age-matched male controls without acne from a dermatology outpatient department of a tertiary care institute. Postadolescent patients were recruited only to negate the effects of physiologic insulin resistance that are seen at the time of puberty and adolescence. Twenty-five patients were included in each of the 4 individual severity groups according to the Global Acne Grading System and were age matched to 100 male controls without acne.

Exposures  Clinical examination, Global Acne Rating System, National Cholesterol Education Programme Adult Treatment Panel III (NCEP-ATP III), and Homeostasis Model Assessment–Insulin Resistance (HOMA-IR).

Main Outcomes and Measures  Metabolic syndrome was diagnosed as per the criteria of the modified NCEP-ATP III. Insulin resistance was assessed by the HOMA-IR. A HOMA-IR value greater than 2.5 was arbitrarily considered as insulin resistance.

Results  Prevalence of insulin resistance was significantly higher in cases (22%) compared with controls (11%) (P = .03). The prevalence of metabolic syndrome was comparable between cases (17%) and controls (9%) (P = .09). Prevalence of insulin resistance and metabolic syndrome did not differ significantly among the acne severity groups.

Conclusions and Relevance  Postadolescent male patients with acne more commonly have insulin resistance. This resistance may be a stage of prediabetes, and the patients may develop hyperinsulinemia or type 2 diabetes in the future. These patients should be followed up for a prolonged time to determine whether they develop conditions associated with insulin resistance.

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