Significance of insulin and insulin-like growth factor-1 in the pathogenesis of acne

Abstract

Background. The potential involvement of insulin and insulin-like growth factor-1 in the pathogenesis of acne may be due to direct stimulation of sebaceous gland cells, an increase in androgen synthesis in the endocrine glands, activation of 5-reductase, and an increase in the sensitivity of androgen receptors in tissues.
 Aim. To study the level of insulin and insulin-like growth factor-1 in women of fertile age suffering from acne; to identify the dependence of these indicators on the clinical and anamnestic features of the disease and the nature of the nutrition of patients.
 Material and methods. 60 patients suffering from acne (mean age 23.90.92 years) were examined. Clinical indices, reflecting the severity of the skin process and quality of life, were calculated, hormonal status indicators (insulin, insulin-like growth factor-1, total testosterone, estradiol, progesterone) and blood plasma glucose levels were studied. The blood of 30 healthy women (mean age 25.91.04 years) was examined as a control. Groups were compared using Student's t-test and odds ratio calculation, correlation analysis was performed using Spearman's rank correlation coefficient.
 Results. Patients with acne showed a significant increase in the level of insulin-like growth factor-1 (p=0.0002) and total testosterone (p=0.005). The correlation of the insulin-like factor content with the indices that determine the severity of the skin process and the quality of life of patients was closer than that of the total testosterone. A lower concentration of insulin-like growth factor-1 was noted in the blood of acne patients who followed a diet with restriction of milk and dairy products, foods rich in easily digestible carbohydrates and saturated fats. The level of insulin in patients with acne did not differ from that in the control group.
 Conclusion. In women suffering from acne, an increase in the content of insulin-like growth factor-1 in the blood plasma was revealed; at the same time, its level has a closer relationship with the severity of the course of dermatosis and the quality of life of patients in comparison with the indicator of total testosterone.