Paradoxical rise in serum adiponectin concentration in the face of acid-induced insulin resistance 13-cis-retinoic

Diabetologia. 2006 Feb;49(2):383-6. doi: 10.1007/s00125-005-0089-z. Epub 2005 Dec 28.


Aims/hypothesis: We previously reported that treatment of acne with 13-cis-retinoic acid causes insulin resistance and disturbances in lipid metabolism resembling those of the insulin-resistance syndrome. It is not known whether this is associated with alterations in the concentrations of serum adiponectin, an insulin-sensitising hormone secreted by adipocytes.

Materials and methods: Eleven men (age 24+/-2 years, BMI 22.1+/-0.9 kg/m(2)) received 13-cis-retinoic acid (Roaccutan) treatment for acne for an average of 5 months. The insulin sensitivity of the subjects and concentrations of serum adiponectin were measured before, during and 1 month after the treatment by a euglycaemic-hyperinsulinaemic clamp and ELISA, respectively.

Results: There was a reversible reduction in whole-body insulin sensitivity during therapy with 13-cis-retinoic acid. This was associated with a transient 34% increase in serum adiponectin concentration (from 5.3+/-0.9 to 7.1+/-1.2 mug/ml, p<0.05), with a return to pretreatment levels by 1 month after the end of therapy. In the pretreatment study, as well as in the study performed 1 month after the end of therapy, there was a small yet significant decrease in serum adiponectin concentration during a 4-h euglycaemic-hyperinsulinaemic clamp. This decrease was not observed in the clamp performed during treatment with 13-cis-retinoic acid.

Conclusions/interpretation: There is a paradoxical increase in fasting serum adiponectin concentration during the 13-cis-retinoic acid-induced reduction in insulin sensitivity.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acne Vulgaris / drug therapy
  • Acne Vulgaris / physiopathology
  • Adipocytes / metabolism
  • Adiponectin / blood*
  • Adiponectin / physiology
  • Adult
  • Data Interpretation, Statistical
  • Enzyme-Linked Immunosorbent Assay
  • Fasting / blood
  • Glucose / metabolism
  • Glucose Clamp Technique
  • Humans
  • Insulin / physiology*
  • Insulin Resistance*
  • Isotretinoin / adverse effects*
  • Isotretinoin / therapeutic use
  • Lipids / blood
  • Male
  • Time Factors


  • Adiponectin
  • Insulin
  • Lipids
  • Isotretinoin
  • Glucose