Insulin resistance and acne: a new risk factor for men?


The purpose of this study is to investigate the relationship between acne and insulin resistance as well as other metabolic impairment in young males. Acne is a skin disease that can be influenced by endocrine abnormalities. In females, it is associated with polycystic ovary syndrome, with peripheral insulin resistance and hyperinsulinemia, whereas few data are available in males. For investigating this, 22 young males with acne have been compared to 22 controls of comparable age and gender. Acne was scored using the global acne grading system score. Clinical as well as biochemical parameters of glucose and lipid metabolism, circulating levels of androgens, and IGF-1 were evaluated. Oral glucose tolerance test was performed and homeostasis model assessment of insulin resistance was calculated. The results thus obtained are as follows, patients had higher BMI (p = 0.003), WC (p = 0.002), WHR (p = 0.02), SBP (p = 0.0001), DBP (p = 0.001), basal (p = 0.01) and 120 min. oGTT serum insulin concentrations (p = 0.002), basal glucose concentrations (p = 0.03), HOMA-IR (p = 0.016), and lower HDL-cholesterol than controls (p = 0.001). Among the subgroup of subjects with BMI <24.9, HDL-cholesterol (p = 0.05) and 120 min. oGTT serum insulin concentrations (p = 0.009) resulted to be independent predictors of acne at multivariate analysis. In conclusion, these findings highlight a metabolic imbalance in young males affected with acne. Insulin resistance seems to play the main role for the development of acne in these subjects. Insulin resistance could represent an effective target for therapy in male acne.

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  1. 1.

    V. Bataille, H. Snieder, A.J. MacGregor, P. Sasieni, T.D. Spector, The influence of genetics and environmental factors in the pathogenesis of acne: a twin study of acne in women. J. Invest. Dermatol. 119(6), 1317–1322 (2002)

    PubMed  Article  CAS  Google Scholar 

  2. 2.

    L. Cordain, S. Lindeberg, M. Hurtado, K. Hill, B. Eaton, B. Brand-Miller, Acne vulgaris-a disease of western civilization. Arch. Dermatol. 138, 1584–1590 (2002)

    PubMed  Article  Google Scholar 

  3. 3.

    G. Plewig, A.M. Kligman, Acne and Rosacea, 3rd edn. (Springer, Berlin, 2000)

    Book  Google Scholar 

  4. 4.

    W. Chen, D. Thiboutot, C.C. Zouboulis, Cutaneous androgen metabolism: basic research and clinical perspectives. J. Invest. Dermatol. 119(5), 992–1007 (2002)

    PubMed  Article  CAS  Google Scholar 

  5. 5.

    R.L. Rosenfield, D. Deplewski, Role of androgens in the developmental biology of the pilosebaceous unit. Am. J. Med. 98, 80S–88S (1995)

    PubMed  Article  CAS  Google Scholar 

  6. 6.

    J.F. Cara, R. Rosenfield, R. Furlanetto, A longitudinal study of the relationship of plasma somatomedin-C concentration to the pubertal growth spurt. Am. J. Dis. Child. 141, 562–564 (1987)

    PubMed  CAS  Google Scholar 

  7. 7.

    M. Cappel, D. Mauger, D. Thiboutot, Correlation between serum levels of insulin-like growth factor 1, dehydroepiandrosterone sulfate, and dihydrotestosterone and acne lesion counts in adult women. Arch. Dermatol. 141(3), 333–338 (2005)

    PubMed  Article  CAS  Google Scholar 

  8. 8.

    D. Deplewski, R. Rosenfield, Growth hormone and insulin-like growth factors have different effects on sebaceous cell growth and differentiation. Endocrinology 140, 4089–4094 (1999)

    PubMed  Article  CAS  Google Scholar 

  9. 9.

    H. Aizawa, M. Niimura, Elevated serum insulin-like growth factor-I (IGF-1) levels in women with postadolescent acne. J. Dermatol. 22, 249–252 (1995)

    PubMed  CAS  Google Scholar 

  10. 10.

    L. Speroff, M.A. Fritz, Anovulation and the polycystic ovary, in Clinical Gynecologic Endocrinology and Infertility, 7th edn., ed. by L. Speroff, M.A. Fritz (Lippincott Williams & Wilkins, Philadelphia, 2005), pp. 470–483

    Google Scholar 

  11. 11.

    R. Azziz, Diagnostic criteria for polycystic ovary syndrome: a reappraisal. Fertil. Steril. 83(5), 1343–1346 (2005)

    PubMed  Article  Google Scholar 

  12. 12.

    Rotterdam ESHRE/ASRM-Sponsored PCOS consensus workshop group, Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS). Hum. Reprod. 19(1), 41–47 (2004)

    Article  Google Scholar 

  13. 13.

    R.N. Smith, N.J. Mann, A. Braue, H. Makelainen, G.A. Varigos, A low-glycemic-load diet improves symptoms in acne vulgaris patients: a randomized controlled trial. Am. J. Clin. Nutr. 86, 107–115 (2007)

    PubMed  CAS  Google Scholar 

  14. 14.

    A. Nast, B. Dréno, V. Bettoli et al. Guidelines on the treatment of acne. European evidence based. European Dermatology Forum 2011

  15. 15.

    A. Doshi, A. Zaheer, M.J. Stiller, A comparison of current acne grading systems and proposal of a novel system. Int. J. Dermatol. 36(6), 416–418 (1997)

    PubMed  Article  CAS  Google Scholar 

  16. 16.

    World Health Organization. Obesity: Preventing and Managing the Global Epidemic. Report of a WHO Consultation, Geneva, 2000

  17. 17.

    World Health Organization. Waist Circumference and Waist–Hip Ratio. Report of a WHO Expert Consultation, Geneva, 8–11 Dec 2008

  18. 18.

    G. Mansia, G. De Backer, A. Dominiczak, R. Cifkova, R. Fagard, G. Germano, G. Grassi, A.M. Heagerty, S.E. Kjeldsen, S. Laurent, K. Narkiewicz, L. Ruilope, A. Rynkiewicz, R.E. Schmieder, H.A. Struijker Boudier, A. Zanchetti, European Society of Hypertension; European Society of Cardiology. 2007 ESH-ESC Guidelines for the management of arterial hypertension: the task force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Blood Press. 16(3), 135–232 (2007)

    PubMed  Article  Google Scholar 

  19. 19.

    D. Macut, D. Vojnović Milutinović, I. Božić, G. Matić, J. Brkljačić, D. Panidis, M. Petakov, N. Spanos, J. Bjekić, O. Stanojlović, A. Petrović Milinković, Z. Radojičić, S. Damjanović, Age, body mass index, and serum level of DHEA-S can predict glucocorticoid receptor function in women with polycystic ovary syndrome. Endocrine 37(1), 129–134 (2010)

    PubMed  Article  CAS  Google Scholar 

  20. 20.

    B. Dilbaz, E. Ozkaya, M. Cinar, E. Cakir, S. Dilbaz, Cardiovascular disease risk characteristics of the main polycystic ovary syndrome phenotypes. Endocrine 39(3), 272–277 (2011)

    PubMed  Article  CAS  Google Scholar 

  21. 21.

    Bahíllo-Curieses, M.P., Hermoso-López, F., Martínez-Sopena, M.J., Cobreros-García, P., García-Saseta, P., Tríguez-García, M., Marugán-Miguelsanz, J.M. Prevalence of insulin resistance and impaired glucose tolerance in a sample of obese spanish children and adolescents. Endocrine 41(2), 289–295 (2012)

    Google Scholar 

  22. 22.

    C.H. Tsai, T.C. Li, C.C. Lin, H.S. Tsay, Factor analysis of modifiable cardiovascular risk factors and prevalence of metabolic syndrome in adult Taiwanese. Endocrine 40(2), 256–264 (2011)

    PubMed  Article  CAS  Google Scholar 

  23. 23.

    D. Matthews, J. Hosker, A. Rudenski, B. Naylor, D. Treacher, R. Turner, Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologica 28, 412–419 (1985)

    Article  CAS  Google Scholar 

  24. 24.

    R.N. Smith, N.J. Mann, A. Braue, H. Mäkeläinen, G.A. Varigos, The effect of a high-protein, low glycemic-load diet versus a conventional, high glycemic-load diet on biochemical parameters associated with acne vulgaris: a randomized, investigator-masked, controlled trial. J. Am. Acad. Dermatol. 57(2), 247–256 (2007)

    PubMed  Article  Google Scholar 

  25. 25.

    R.N. Smith, N. Mann, H. Mäkeläinen, J. Roper, A. Braue, G. Varigos, A pilot study to determine the short-term effects of a low glycemic load diet on hormonal markers of acne: a nonrandomized, parallel, controlled feeding trial. Mol. Nutr. Food Res. 52(6), 718–726 (2008)

    PubMed  Article  CAS  Google Scholar 

  26. 26.

    K.N. Whitaker, Polycystic ovary syndrome: an overview. J. Pharm. Pract. 24(1), 94–101 (2011)

    PubMed  Article  Google Scholar 

  27. 27.

    L.G. Nardo, S. Patchava, I. Laing, Polycystic ovary syndrome: pathophysiology, molecular aspects and clinical implications. Panminerva. Med. 50(4), 267–278 (2008)

    PubMed  CAS  Google Scholar 

  28. 28.

    M.L. Fernandez, J.J. Jones, D. Ackerman, J. Barona, M. Calle, M.V. Comperatore, J.E. Kim, C. Andersen, J.O. Leite, J.S. Volek, M. McIntosh, C. Kalynych, W. Najm, R.H. Lerman, Low HDL cholesterol is associated with increased atherogenic lipoproteins and insulin resistance in women classified with metabolic syndrome. Nutr. Res. Pract. 4(6), 492–498 (2010)

    PubMed  Article  CAS  Google Scholar 

  29. 29.

    M.K. Arora, S. Seth, S. Dayal, The relationship of lipid profile and menstrual cycle with acne vulgaris. Clin. Biochem. 43(18), 1415–1420 (2010)

    PubMed  Article  Google Scholar 

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We are extremely grateful to all volunteers who took part in these studies and the research teams who collected the data.

Conflict of interest

The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research reported.

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Correspondence to Antongiulio Faggiano.

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Del Prete, M., Mauriello, M.C., Faggiano, A. et al. Insulin resistance and acne: a new risk factor for men?. Endocrine 42, 555–560 (2012).

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  • Acne
  • Male acne
  • Insulin
  • Insulin resistance
  • HDL-cholesterol