Role of insulin, insulin-like growth factor-1, hyperglycaemic food and milk consumption in the pathogenesis of acne vulgaris
Autor(en): | Melnik, Bodo C. Schmitz, Gerd |
Stichwörter: | 13-CIS-RETINOIC ACID; acne; Dermatology; GLYCEMIC-LOAD DIET; hyperglycaemic food; IGF-1; IGF-BINDING PROTEIN-3; insulin; metformin; METFORMIN TREATMENT; milk; POLYCYSTIC-OVARY-SYNDROME; PRECOCIOUS PUBARCHE; RAT LEYDIG-CELLS; RETINOIC ACID; SERUM-INSULIN; smoking; TRANSCRIPTIONAL REGULATION | Erscheinungsdatum: | 2009 | Herausgeber: | WILEY | Enthalten in: | EXPERIMENTAL DERMATOLOGY | Band: | 18 | Ausgabe: | 10 | Startseite: | 833 | Seitenende: | 841 | Zusammenfassung: | It is the purpose of this viewpoint article to delineate the regulatory network of growth hormone (GH), insulin, and insulin-like growth factor-1 (IGF-1) signalling during puberty, associated hormonal changes in adrenal and gonadal androgen metabolism, and the impact of dietary factors and smoking involved in the pathogenesis of acne. The key regulator IGF-1 rises during puberty by the action of increased GH secretion and correlates well with the clinical course of acne. In acne patients, associations between serum levels of IGF-1, dehydroepiandrosterone sulphate, dihydrotestosterone, acne lesion counts and facial sebum secretion rate have been reported. IGF-1 stimulates 5 alpha-reductase, adrenal and gonadal androgen synthesis, androgen receptor signal transduction, sebocyte proliferation and lipogenesis. Milk consumption results in a significant increase in insulin and IGF-1 serum levels comparable with high glycaemic food. Insulin induces hepatic IGF-1 secretion, and both hormones amplify the stimulatory effect of GH on sebocytes and augment mitogenic downstream signalling pathways of insulin receptors, IGF-1 receptor and fibroblast growth factor receptor-2b. Acne is proposed to be an IGF-1-mediated disease, modified by diets and smoking increasing insulin/IGF1-signalling. Metformin treatment, and diets low in milk protein content and glycaemic index reduce increased IGF-1 signalling. Persistent acne in adulthood with high IGF-1 levels may be considered as an indicator for increased risk of cancer, which may require appropriate dietary intervention as well as treatment with insulin-sensitizing agents. |
ISSN: | 09066705 | DOI: | 10.1111/j.1600-0625.2009.00924.x |
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geprüft am 07.06.2024