The high homeostatic model assessment of insulin resistance as risk factor for acne vulgaris

G. A. Praharsini, A. A. Wiraguna, Stefani Nurhadi
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Abstract

Background: Acne vulgaris (AV) is a common chronic skin disease involving blockage and or inflammation of pilosebaceous glands which usually affects teenagers and young adults. Elevated sebaceous gland secretion, Propionibacterium acne colonization and inflammation, high androgen effects, and follicular hyperproliferation are the main pathogenic factors of AV. IGF-1 and insulin were studied to stimulate sebaceous lipogenesis. In the skin, besides inducing lipid production in human sebocytes IGF-1 also induces keratinocyte proliferation in vitro and in vivo. HOMA-IR is an examination to determine insulin activity in the basal state.Objective: To prove that high HOMA-IR value is a risk factor for the occurrence of acne vulgaris.Methods: This study is a case control analytic study by comparing HOMA-IR in subjects with AV (case group) and non AV (control group). AV is diagnosed based on clinical predilection. Insulin testing was carried out by the immulite 2000 device through the immunochemiluminescent method.Results: Mean HOMA-IR of case group is 2.63 ± 0.29 meanwhile in the control group was 1.71 ± 0.26 (p <0.001). Subjects with high HOMA-IR had 4.8 times higher risk to experience AV compared to patients with normal HOMA-IR values (p <0.001; 95% IK 2,765-8,332). Conclusion: HOMA-IR values in acne patients were higher than controls. A high HOMA-IR value is an AV risk factor.
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胰岛素抵抗作为寻常痤疮危险因素的高稳态模型评估
背景:寻常痤疮(AV)是一种常见的慢性皮肤病,涉及毛囊皮脂腺阻塞和/或炎症,通常影响青少年和年轻人。皮脂腺分泌升高、痤疮丙酸杆菌定植和炎症、高雄激素效应和卵泡增生是AV的主要致病因素。研究了IGF-1和胰岛素对皮脂腺脂肪生成的刺激作用。在皮肤中,除了诱导人皮脂细胞的脂质生成外,IGF-1还在体外和体内诱导角质细胞增殖。HOMA-IR是一种测定基础状态下胰岛素活性的检查。目的:证明高HOMA-IR值是寻常性痤疮发生的危险因素。方法:本研究为病例对照分析研究,通过比较AV(病例组)和非AV(对照组)受试者的HOMA-IR。AV的诊断是基于临床倾向。胰岛素检测采用免疫化学发光法,用immulite 2000装置进行。结果:病例组平均HOMA-IR为2.63±0.29,对照组平均HOMA-IR为1.71±0.26 (p <0.001)。HOMA-IR值高的受试者发生AV的风险是HOMA-IR值正常患者的4.8倍(p <0.001;95%(2765 - 8332)。结论:痤疮患者HOMA-IR值高于对照组。高HOMA-IR值是AV的危险因素。
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