Vol. 6, Issue 1, Part A (2024)

Background: Acne vulgaris is a chronic inflammatory disease of the pilosebaceous unit that usually affects adolescents. The aetiology and severity of acne may be influenced by hyperinsulinemia and insulin resistance.

Aim: The present study was aimed at determining the association between insulin resistance and the development of acne vulgaris.

Patients and Methods: This case-control study conducted at Salah Aldin General Hospital from September 1, 2023, to the end of March 2024 included 80 patients diagnosed with acne vulgaris (45 males and 35 females) and 80 healthy controls (45 males and 35 females), aged between 10 to 19 years. Informed consent was obtained from all participants. The inclusion criteria comprised individuals with acne vulgaris aged 10 to 19 years, including both males and females. Exclusion criteria involved hormonal disorders, hormonal treatment, chronic diseases, and high consumption of specific food items. Acne severity was classified based on the American Academy of Dermatology Acne Consensus. Data collection involved questionnaires, physical examinations, and laboratory assessments. Laboratory assessments included the collection of venous blood samples from patients and controls after an overnight fast. Serum insulin and C-peptide levels were determined using ELISA, while blood sugar levels were assessed through biochemical colorimetric methods. Homeostasis model assessment of insulin resistance (HOMA-IR) was calculated using a specific formula.

Results: The study compared various metabolic parameters between acne patients and a control group, revealing significant differences. Acne patients exhibited higher mean levels of RBS (6.16±0.89 mmol/L) and C-Peptide (3.98±0.17 ng/mL) compared to the control group (RBS: 5.43±0.98 mmol/L; C-Peptide: 0.92±0.11 ng/mL), with corresponding p-values of 0.032 and 0.001 respectively. Conversely, acne patients showed lower insulin levels and higher HOMA-IR values compared to the control group. The study found a significant association between acne and insulin resistance, with 31.25% of acne patients testing positive for insulin resistance compared to none in the control group. Additionally, the severity of acne, as classified by the Voulgaris classification, showed that 21.25% had mild acne, 45.00% had moderate acne, and 33.75% had severe acne. The predominant site of acne lesions was the face (76.25%), with combinations across multiple areas observed. Age and sex were found to be associated with acne severity, with older age groups and males showing a higher prevalence of severe acne. Furthermore, a significant relationship was observed between insulin resistance and age among acne patients, with higher HOMA-IR levels associated with older age groups. Sex-based differences were also noted, with males exhibiting lower mean HOMA-IR levels compared to females. These findings highlight the intricate interplay between metabolic factors, acne severity, age, and sex in individuals with acne, underscoring the importance of considering these factors in acne management and treatment strategies.