Effects of isotretinoin on glucose metabolism in patients with acne: A systematic review and meta-analysis

Previous studies reporting the influence of isotretinoin treatment on glucose metabolism have produced conflicting results. We therefore aimed to examine the effects of isotretinoin treatment on changes in insulin resistance and serum levels of adiponectin in patients with acne. A systematic review and meta-analysis of the literature published from the inception of isotretinoin to March 31, 2019 were conducted. In the absence of controlled trials, open-label studies on acne patients receiving isotretinoin treatment were included. Twelve studies met the inclusion criteria. The outcomes included changes in the homeostasis model assessment for insulin resistance (HOMA-IR) values and serum levels of adiponectin after isotretinoin treatment. Pooled analysis showed that HOMA-IR values did not change significantly after isotretinoin treatment (standardized mean difference [SMD] = 0.183; 95 % confidence interval [CI] = -0.004-0.371; I-2 = 38.3), whereas the level of adiponectin significantly increased (SMD = 0.512; 95 % CI = 0.327-0.698; I-2 = 10.7). Our study concluded that isotretinoin treatment for patients with acne resulted in an increased serum level of adiponectin but did not have a substantial impact on the status of insulin resistance.