Insulin Resistance and Metabolic Syndrome in Young Men With Acne

JAMA Dermatol. 2016 Apr;152(4):399-404. doi: 10.1001/jamadermatol.2015.4499.


Introduction: Robust evidence of the association of insulin resistance and metabolic syndrome with acne in male patients is lacking.

Objective: To assess the prevalence of metabolic syndrome and insulin resistance in male patients 20 years or older with acne.

Design, setting, and participants: We performed a cross-sectional study in 100 male patients with acne and 100 age-matched male controls without acne from a dermatology outpatient department of a tertiary care institute. Postadolescent patients were recruited only to negate the effects of physiologic insulin resistance that are seen at the time of puberty and adolescence. Twenty-five patients were included in each of the 4 individual severity groups according to the Global Acne Grading System and were age matched to 100 male controls without acne.

Exposures: Clinical examination, Global Acne Rating System, National Cholesterol Education Programme Adult Treatment Panel III (NCEP-ATP III), and Homeostasis Model Assessment-Insulin Resistance (HOMA-IR).

Main outcomes and measures: Metabolic syndrome was diagnosed as per the criteria of the modified NCEP-ATP III. Insulin resistance was assessed by the HOMA-IR. A HOMA-IR value greater than 2.5 was arbitrarily considered as insulin resistance.

Results: Prevalence of insulin resistance was significantly higher in cases (22%) compared with controls (11%) (P = .03). The prevalence of metabolic syndrome was comparable between cases (17%) and controls (9%) (P = .09). Prevalence of insulin resistance and metabolic syndrome did not differ significantly among the acne severity groups.

Conclusions and relevance: Postadolescent male patients with acne more commonly have insulin resistance. This resistance may be a stage of prediabetes, and the patients may develop hyperinsulinemia or type 2 diabetes in the future. These patients should be followed up for a prolonged time to determine whether they develop conditions associated with insulin resistance.

MeSH terms

  • Acne Vulgaris / epidemiology*
  • Acne Vulgaris / pathology
  • Adult
  • Case-Control Studies
  • Cross-Sectional Studies
  • Humans
  • Insulin Resistance / physiology*
  • Male
  • Metabolic Syndrome / epidemiology*
  • Prevalence
  • Severity of Illness Index
  • Young Adult