The Association of Acne Severity with Inflammatory and Metabolic Markers: A Prospective Cross-sectional Study

Abstract

Objective: This study aimed to investigate the relationships between acne severity with inflammatory and metabolic markers, and their interplay. Additionally, the study sought to explore the overall activity of these markers within different inflammatory and metabolic pathways in the mechanism of acne. Material and Methods: Our study was conducted as a prospective cross-sectional study with 203 patients diagnosed with acne. Acne severity was categorized into three classes: mild, moderate, and severe, according to the "International Consensus Conference on Acne Classification System". We evaluated inflammatory and metabolic markers, including fibrinogen/albumin ratio (FAR), D-dimer/albumin ratio (DAR), uric acid/HDL ratio (UHR), CRP levels, sedimentation rate (ESH), leukocyte count (WBC), vitamin D, triglyceride (TG) and HOMA-IR values in the patients. The relationships between these markers and acne severity, as well as their interrelationships, were examined. Mann-Whitney U test, Kruskal-Wallis H test, and Spearman's correlation analysis were employed for statistical analysis. Results: It was observed that CRP (p=0.008), WBC (p=0.006) and the novel inflammatory marker UHR (p<0.001) were significantly associated with acne severity. Additionally, it is worth noting the notable impact of vitamin D deficiency on exacerbating acne severity (p=0.074). In the relationships between the markers we defined; there were significant positive correlations between ESH-CRP, ESH-FAO, ESH-HOMAIR, ESH-DAO, CRP-WBC, CRP-FAO, CRP-UHO, CRP-TG, WBC-UHO, WBC-TG, FAO-HOMAIR, FAO-DAO, HOMAIR-UHO, HOMAIR-DAO, HOMAIR-TG, UHO-TG and vitamin D-TG. Conclusion: Due to the multifactorial and complex nature of acne pathogenesis, the combined use of multiple metabolic and inflammatory markers would be more beneficial in determining severity and prognosis. Comprehensive studies are needed to develop potential new treatment methods that can target different inflammatory and metabolic pathways.

Keywords

• Acne
• acne severity
• inflammation
• laboratory markers

AKNE ŞİDDETİNİN İNFLAMATUAR VE METABOLİK BELİRTEÇLER İLE İLİŞKİSİ: PROSPEKTİF KESİTSEL BİR ÇALIŞMA

Abstract

Amaç: Bu çalışmada inflamatuar ve metabolik belirteçlerin akne şiddeti ve birbirleri ile olan ilişkilerini incelemek, bu belirteçlerin akne mekanizmasındaki farklı inflamatuar ve metabolik yollardaki etkinliklerini bir bütün olarak araştırmak amaçlanmıştır. Gereç ve Yöntemler: Çalışmamız akne tanısı almış 203 hasta ile prospektif kesitsel bir çalışma olarak yürütüldü. Akne şiddeti “International Consensus Conference on Acne Classification System” ’e göre hafif, orta ve ağır olarak üç sınıfa ayrıldı. Hastaların inflamatuar ve metabolik belirteçlerinden fibrinojen/albümin oranı (FAO), D-dimer/albümin oranı (DAO), ürik asit/HDL oranı (UHO), CRP, sedimantasyon (ESH), lökosit sayısı (WBC), D-vitamini, trigliserid (TG) ve HOMA-IR değerlerine bakıldı. Elde edilen değerlerin akne şiddeti ve birbirleri ile ilişkileri incelendi. İstatiksel test olarak Mann- Whitney U testi, Kruskal-Wallis H testi ve Spearmans korelasyon analizinden faydalanıldı. Bulgular: Çalışmamızda CRP (p=0.008), WBC (p=0.006) ve yeni inflamatuar belirteçlerden UHO’nun (p<0.001) akne şiddeti ile anlamlı derecede ilişkili olduğu gözlenmiştir. Ayrıca D vitamini eksikliğinin akne şiddetini arttırıcı etkisi (p=0.074) dikkat çekmiştir. Tanımladığımız belirteçlerin birbirleriyle ilişkileri incelendiğinde; ESH-CRP, ESH-FAO, ESH-HOMAIR, ESH-DAO, CRP-WBC, CRP-FAO, CRP-UHO, CRP-TG, WBC-UHO, WBC-TG, FAO-HOMAIR, FAO-DAO, HOMAIR-UHO, HOMAIR-DAO, HOMAIR-TG, UHO-TG, D vitamini-TG aralarında anlamlı pozitif korelasyonlar saptanmıştır. Sonuç: Akne oluşum mekanizmasının multifaktöriyel ve karmaşık yapısı nedeniyle metabolik ve inflamatuar birçok belirtecin şiddet ve prognoz tayininde kombine olarak kullanılması daha faydalı olacaktır. Bununla birlikte farklı inflamatuar ve metabolik yolları hedefleyebilecek potansiyel yeni tedavi yöntemlerinin de geliştirilmesi açısından kapsamlı çalışmaların artması gerekmektedir.

Keywords

• Akne
• akne şiddeti
• inflamasyon
• laboratuvar belirteçleri

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