Pathophysiological association in acne vulgaris and metabolic syndrome: The role of biogenic amines and glutathione peroxidase
Dr. Pawan Kumar
MBBS, MD, (AIIMS Delhi), DNB, FRGUHS
Dermaqure Skin & Cosmetology Clinic
Karnataka
The rising prevalence of metabolic syndrome (MetS) has emerged as a significant global public health concern. A cluster of risk factors, including insulin resistance, abdominal obesity, dyslipidemia, and hypertension characterizes this complex condition. In recent years, researchers have begun to explore the intriguing connection between MetS and various skin conditions. Studies have identified a link between metabolic dysfunctions and skin disorders, such as acne vulgaris. Evidence suggests that individuals with MetS exhibit lower levels of antioxidant enzymes in their plasma and higher levels of oxidative stress markers, particularly lipid peroxidation, compared to healthy individuals. These findings indicate that MetS may contribute to the development of oxidative stress. A cross-sectional analysis was performed to investigate the function of glutathione peroxidase (GTPx) and biogenic amines as a potential novel pathophysiological link between MetS and acne vulgaris.
The patients were distributed into two groups: metabolic precondition (MPG, n=78) and control (CG, n=81). To determine the extent of acne and metabolic preconditioning, patients were subjected to extensive clinical/paraclinical investigations. Additionally, catecholamine levels in urine and GTPx levels in blood were measured.
Mild acne was more common in the CG (32.1% vs. 6.4%; p<0.001), and severe acne was more common in the MPG (61.54% vs. 25.9%; p<0.001), with the average age being substantially higher in the MPG (23.81 vs. 21.05; p=0.002). Significant variations were observed in catecholamine levels (p<0.05). In the MPG, most severe acne patients were overweight (52.1%), insulin-resistant (48.8%), or obese (47.9%). Moderate acne was most often linked to obesity (56%), overweight (44%), and insulin resistance (20%). Patients with severe acne (48.83%) had a higher incidence of insulin resistance syndrome (p=0.039) compared to those with moderate or mild acne (20%). The presence of two or three metabolic disorders considerably raised the risk of severe acne. Significant differences between groups were observed only in the subgroup of patients with severe acne, with lower GTPx values in the MPG (p=0.015). Significant differences in catecholamine values were seen between groups (p<0.05), independent of acne severity, except for adrenaline in mild acne patients (p=0.059).
The complex connection between GTPx and catecholamines in MetS suggests a significant role of these factors in the pathogenesis of acne associated with this condition.
Reference: Bungau AF, Tit DM, Stoicescu M, et al. Exploring a new pathophysiological association in acne vulgaris and metabolic syndrome: The role of biogenic amines and glutathione peroxidase. Medicina (Kaunas). 2024;60(3):513.
