Akne vulgarisin etyopatogenezinde insülin direnci ve endokrin hormon parametrelerin değerlendirilmesi, oral isotretinoin tedavisi sonrası insülin direnci ve hormonal parametrelerde değişiklik olup olmadığının incelenmesi

SÜLEYMAN EMRE KOÇYİĞİT

Akne vulgarisin etyopatogenezinde insülin direnci ve endokrin hormon parametrelerin değerlendirilmesi, oral isotretinoin tedavisi sonrası insülin direnci ve hormonal parametrelerde değişiklik olup olmadığının incelenmesi

Thesis Type: Expertise In Medicine

Institution Of The Thesis: Ankara University, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, Turkey

Approval Date: 2015

Thesis Language: Turkish

Student: SÜLEYMAN EMRE KOÇYİĞİT

Supervisor: MUSTAFA ŞAHİN

Open Archive Collection: AVESIS Open Access Collection

Abstract:

Introduction: Acne vulgaris is a chronic inflammatory disease of the pilosebaceous unit, Apart from adolescence,it can be seen on postadolescence period. Several studies show that adrenal and pituitary hormones have an important role in the pathogenesis. The studies which show the isotretinoin treatment takes effect on hormones are phenomenal in the literature. The aim of our study is to identify hormonal alteration in etiopathogenesis of acne vulgaris and to observe whether there is an alteration with insulin resistance and hormones with a systematic treatment. Patients and methods: 30 patients with acne vulgaris applied to the department of endocrinology and metabolic diseases and the department of dermatology in Ankara University Faculty of medicine between February 2015 and June 2015 were enrolled into the study. The patient group was composed of women diagnosed acne vulgaris clinically and practised the isotretinoin treatment.As for that, 30 healthy volunteer individuals who had similar sociodemographic characteristics to the patient group were participated in control group. Patient and control groups were compared to each other in terms of demographic, basal insulin resistance and endocrine hormones. Insulin resistance and endocrine hormonal parameters were evaluated on the third month of isotretinoin treatment. Results: In our study, Age, menarche age, waist circumference and body mass ındex were similar between patient and control groups. Modified Ferriman-Gallwey score has >8 was %30 of patient group and %10 of control group, but there was no istatistically difference between groups. (p=0,053) There was no difference in homeostatic model assessment of insulin resistance (HOMA-IR) values between groups. Values of ALT,AST,LDL,TSH, free T4, ACTH, cortisol, prolactin, progesterone,17-OH progestrone, total testosterone was seen increased on patient group compared to control group.(p<0,05) In our study, basal IGF-1 was associated with DHEAS and total testosterone. When basal values with values of third month after isotretinoin treatment were compared, values of DHEAS, free T4, ALT, AST, LDL, triglyceride showed increase while values of HOMA-IR did not change.(p<0,05) It is idendified that rate of change in the triglyceride was correlated with IGF-1, DHEAS, total testosterone, progesterone, LDL, estradiol. (p<0,05) Coclusion: In etiopatogenesis, both interaction with hormones and their interactions play important roles. İsotretinoin, is used in acne vulgaris, don't affect significantly pituitary, adrenal hormones and insulin resistance. Hypertriglyceridemia is an important adverse effect in patient used isotretinoin. Particularly, triglyceride increase should be expected to patient whom hormone levels are high. Further studies are necessary to evaluate both Key words: Acne vulgaris, isotretinoin, insulin resistance, endocrine hormones