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Role of insulin, insulin-like growth factor-1, hyperglycaemic food and milk consumption in the pathogenesis of acne vulgaris.

Abstract

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 5alpha-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.

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  • Authors+Show Affiliations

    ,

    Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Osnabrück, Germany. melnik@t-online.de

    Source

    Experimental dermatology 18:10 2009 Oct pg 833-41

    MeSH

    Acne Vulgaris
    Animals
    Glycemic Index
    Humans
    Insulin
    Insulin-Like Growth Factor I
    Milk

    Pub Type(s)

    Journal Article
    Review

    Language

    eng

    PubMed ID

    19709092

    Citation

    Melnik, Bodo C., and Gerd Schmitz. "Role of Insulin, Insulin-like Growth Factor-1, Hyperglycaemic Food and Milk Consumption in the Pathogenesis of Acne Vulgaris." Experimental Dermatology, vol. 18, no. 10, 2009, pp. 833-41.
    Melnik BC, Schmitz G. Role of insulin, insulin-like growth factor-1, hyperglycaemic food and milk consumption in the pathogenesis of acne vulgaris. Exp Dermatol. 2009;18(10):833-41.
    Melnik, B. C., & Schmitz, G. (2009). Role of insulin, insulin-like growth factor-1, hyperglycaemic food and milk consumption in the pathogenesis of acne vulgaris. Experimental Dermatology, 18(10), pp. 833-41. doi:10.1111/j.1600-0625.2009.00924.x.
    Melnik BC, Schmitz G. Role of Insulin, Insulin-like Growth Factor-1, Hyperglycaemic Food and Milk Consumption in the Pathogenesis of Acne Vulgaris. Exp Dermatol. 2009;18(10):833-41. PubMed PMID: 19709092.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Role of insulin, insulin-like growth factor-1, hyperglycaemic food and milk consumption in the pathogenesis of acne vulgaris. AU - Melnik,Bodo C, AU - Schmitz,Gerd, Y1 - 2009/08/25/ PY - 2009/8/28/entrez PY - 2009/8/28/pubmed PY - 2009/12/22/medline SP - 833 EP - 41 JF - Experimental dermatology JO - Exp. Dermatol. VL - 18 IS - 10 N2 - 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 5alpha-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. SN - 1600-0625 UR - https://www.unboundmedicine.com/medline/citation/19709092/Role_of_insulin_insulin_like_growth_factor_1_hyperglycaemic_food_and_milk_consumption_in_the_pathogenesis_of_acne_vulgaris_ L2 - https://doi.org/10.1111/j.1600-0625.2009.00924.x DB - PRIME DP - Unbound Medicine ER -