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

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 A1c (HbA1c), and HOMA-IR.

Material and methods
Eighty one patients with acne vulgaris were divided into two groups: the first group was treated with isotretinoin 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 HbA1c serum levels were assessed in two groups.

Results
IGFBP-3 levels were significantly increased in patients receiving 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.