Short-term isotretinoin treatment decreases insulin-like growth factor-1 and insulin-like growth factor binding protein-3 levels: does isotretinoin affect growth hormone physiology?

Br J Dermatol. 2010 Apr;162(4):798-802. doi: 10.1111/j.1365-2133.2009.09618.x. Epub 2010 Feb 1.

Abstract

Background: Isotretinoin is an effective treatment for acne vulgaris. However, it has numerous side-effects. It was previously reported that serum growth hormone (GH) levels decreased with isotretinoin treatment.

Objectives: To analyse whether isotretinoin has any effects on insulin-like growth factor-1 (IGF-1), insulin-like growth factor binding protein-3 (IGFBP3) and GH levels.

Methods: Forty-seven patients aged 21.5 +/- 5.1 years (mean +/- SD) with acne vulgaris were included in this study. Isotretinoin therapy was initiated at a dose of 0.5-0.75 mg kg(-1) daily and then adjusted to 0.88 mg kg(-1) daily as maintenance dosage after 1 month. Screening for biochemical and hormonal parameters was performed just before initiation and after 3 months of isotretinoin treatment.

Results: IGF-1 and IGFBP3 levels decreased significantly after treatment (P < 0.01), while GH levels did not change. Post-treatment, significant increases were seen in aspartate aminotransferase, total cholesterol, low-density lipoprotein cholesterol, triglycerides and low-density lipoprotein cholesterol/high-density lipoprotein cholesterol ratio (P < 0.0001) while high-density lipoprotein cholesterol levels were significantly decreased (P < 0.0001).

Conclusions: Isotretinoin therapy may have an effect on GH physiology, and further studies are needed to understand this association.

MeSH terms

  • Acne Vulgaris / blood
  • Acne Vulgaris / drug therapy*
  • Adolescent
  • Dermatologic Agents / therapeutic use*
  • Female
  • Human Growth Hormone / blood*
  • Human Growth Hormone / drug effects
  • Human Growth Hormone / physiology
  • Humans
  • Insulin-Like Growth Factor Binding Protein 3 / blood*
  • Insulin-Like Growth Factor I / metabolism*
  • Isotretinoin / therapeutic use*
  • Male
  • Reference Values
  • Young Adult

Substances

  • Dermatologic Agents
  • Insulin-Like Growth Factor Binding Protein 3
  • Human Growth Hormone
  • Insulin-Like Growth Factor I
  • Isotretinoin