Does isotretinoin have an effect on glucose metabolism, insulin growth factor-1 and insulin-like growth factor-3 binding protein?

Abstract

Introduction: Isotretinoin is the only effective agent at all stages of acne vulgaris, but its effects on certain systems remain unkown.

Objective: To evaluate the effects of isotretinoin and other acne treatments on insulin growth factor-1 (IGF-1), insulin-like growth factor-3 binding protein (IGFBP-3), insulin, C-peptide, glucose and glycated hemoglobin A(1c) (HbA(1c)), and HOMA-IR.

Material and methods: Eighty one patients with acne vulgaris were divided into two groups: the first group was treated with isotretino- in and the second group treated with systemic minocycline and topical benzoyl peroxide (in combined treatment). IGF-1, IGFBP3, insulin, HOMA-IR, C-peptide, glucose and HbA(1c) serum levels were assessed in two groups.

Results: IGFBP-3 levels were significantly increased in patients rece- iving isotretinoin treatment for 3 months. When isotretinoin and combined treatment groups were compared, a significant rise in the IGF-1 level was found in the combined treatment group. Unlike the literature, our results showed that the commonly used acne treatments did not change the serum levels of IGF-1, insulin, C-peptide, glucose and HbA1c significantly.

Conclusions: Consequently, we showed that isotretinoin did not impair glucose metabolism in patients who were previously not obese or insulin resistant. Since IGF-1, IGFBP-3 parameters have effects on cell growth and proliferation, we suggest that they play an effective role in acne pathogenesis and treatment mechanism.