Paradoxical rise in serum adiponectin concentration in the face of acid-induced insulin resistance 13-cis-retinoic.
OBJECTIVE
We previously reported that treatment of acne with 13-cis-retinoic acid causes insulin resistance and disturbances in lipid metabolism resembling those of the insulin-resistance syndrome. It is not known whether this is associated with alterations in the concentrations of serum adiponectin, an insulin-sensitising hormone secreted by adipocytes.


METHODS
Eleven men (age 24+/-2 years, BMI 22.1+/-0.9 kg/m(2)) received 13-cis-retinoic acid (Roaccutan) treatment for acne for an average of 5 months. The insulin sensitivity of the subjects and concentrations of serum adiponectin were measured before, during and 1 month after the treatment by a euglycaemic-hyperinsulinaemic clamp and ELISA, respectively.


RESULTS
There was a reversible reduction in whole-body insulin sensitivity during therapy with 13-cis-retinoic acid. This was associated with a transient 34% increase in serum adiponectin concentration (from 5.3+/-0.9 to 7.1+/-1.2 mug/ml, p<0.05), with a return to pretreatment levels by 1 month after the end of therapy. In the pretreatment study, as well as in the study performed 1 month after the end of therapy, there was a small yet significant decrease in serum adiponectin concentration during a 4-h euglycaemic-hyperinsulinaemic clamp. This decrease was not observed in the clamp performed during treatment with 13-cis-retinoic acid.


CONCLUSIONS
There is a paradoxical increase in fasting serum adiponectin concentration during the 13-cis-retinoic acid-induced reduction in insulin sensitivity.
Koistinen
H A
HA
Department of Medicine, Division of Cardiology and Biomedicum, Helsinki University Central Hospital, P.O. Box 700, 00029 HUS, Finland. heikki.koistinen@hus.fi
Remitz
A
A
Koivisto
V A
VA
Ebeling
P
P
D000152:Acne Vulgaris / Q000188:drug therapy / Q000503:physiopathology; D017667:Adipocytes / Q000378:metabolism; D052242:Adiponectin / Q000097:blood* / Q000502:physiology; D000328:Adult; D003627:Data Interpretation, Statistical; D004797:Enzyme-Linked Immunosorbent Assay; D005215:Fasting / Q000097:blood; D005947:Glucose / Q000378:metabolism; D015309:Glucose Clamp Technique; D006801:Humans; D007328:Insulin / Q000502:physiology*; D007333:Insulin Resistance; D015474:Isotretinoin / Q000009:adverse effects* / Q000627:therapeutic use; D008055:Lipids / Q000097:blood; D008297:Male; D013997:Time Factors
D052242:Adiponectin; D007328:Insulin; D008055:Lipids; D015474:Isotretinoin; D005947:Glucose