Document Detail


High risk for hyperlipidemia and the metabolic syndrome after an episode of hypertriglyceridemia during 13-cis retinoic acid therapy for acne: a pharmacogenetic study.
MedLine Citation:
PMID:  11955026     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Administration of 13-cis retinoic acid (isotretinoin) for acne is occasionally accompanied by hyperlipidemia. It is not known why some persons develop this side effect. OBJECTIVE: To determine whether isotretinoin triggers a familial susceptibility to hyperlipidemia and the metabolic syndrome. DESIGN: Cross-sectional comparison. SETTING: University hospital in Lausanne, Switzerland. PARTICIPANTS: 102 persons in whom triglyceride levels increased at least 1.0 mmol/L (> or =89 mg/dL) (hyperresponders) and 100 persons in whom triglyceride levels changed 0.1 mmol/L (< or =9 mg/dL) or less (nonresponders) during isotretinoin therapy for acne. Parents of 71 hyperresponders and 60 nonresponders were also evaluated. MEASUREMENTS: Waist-to-hip ratio; fasting glucose, insulin, and lipid levels; and apoE genotype. RESULTS: Hyperresponders and nonresponders had similar pretreatment body weight and plasma lipid levels. When reevaluated approximately 4 years after completion of isotretinoin therapy, hyperresponders were more likely to have hypertriglyceridemia (triglyceride level > 2.0 mmol/L [>177 mg/dL]; odds ratio [OR], 4.8 [95% CI, 1.6 to 13.8]), hypercholesterolemia (cholesterol level > 6.5 mmol/L [>252 mg/dL]; OR, 9.1 [CI, 1.9 to 43]), truncal obesity (waist-to-hip ratio > 0.90 [OR, 11.0 (CI, 2.0 to 59]), and hyperinsulinemia (insulin-glucose ratio > 7.2; OR, 3.0 [CI, 1.6 to 5.7]). In addition, more hyperresponders had at least one parent with hypertriglyceridemia (OR, 2.6 [CI, 1.2 to 5.7]) or a ratio of total to high-density lipoprotein cholesterol that exceeded 4.0 (OR, 3.5 [CI, 1.5 to 8.0]). Lipid response to isotretinoin was closely associated with the apoE gene. CONCLUSION: Persons who develop hypertriglyceridemia during isotretinoin therapy for acne, as well as their parents, are at increased risk for future hyperlipidemia and the metabolic syndrome.
Authors:
Nicolas Rodondi; Roger Darioli; Albert-Adrien Ramelet; Daniel Hohl; Vincent Lenain; Jean Perdrix; Vincent Wietlisbach; Walter F Riesen; Thomas Walther; Laurent Medinger; Pascal Nicod; Béatrice Desvergne; Vincent Mooser
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Annals of internal medicine     Volume:  136     ISSN:  1539-3704     ISO Abbreviation:  Ann. Intern. Med.     Publication Date:  2002 Apr 
Date Detail:
Created Date:  2002-04-16     Completed Date:  2002-05-06     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0372351     Medline TA:  Ann Intern Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  582-9     Citation Subset:  AIM; IM    
Affiliation:
Department of Internal Medicine, CHUV University Hospital, University Medical Policlinic, CH-1011 Lausanne, Switzerland.
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MeSH Terms
Descriptor/Qualifier:
Acne Vulgaris / blood,  drug therapy
Adolescent
Adult
Apolipoproteins E / genetics
Body Weight
Cross-Sectional Studies
Dermatologic Agents / adverse effects*
Female
Genetic Predisposition to Disease*
Genotype
Glucose Tolerance Test
Humans
Hyperlipidemias / chemically induced*,  genetics*
Insulin / blood
Isotretinoin / adverse effects*
Lipids / blood
Male
Metabolic Syndrome X / genetics*
Middle Aged
Pharmacogenetics
Retrospective Studies
Risk Factors
Chemical
Reg. No./Substance:
0/Apolipoproteins E; 0/Dermatologic Agents; 0/Lipids; 11061-68-0/Insulin; 4759-48-2/Isotretinoin
Comments/Corrections
Comment In:
Arch Dermatol. 2003 Mar;139(3):376-7   [PMID:  12622636 ]
Summary for patients in:
Ann Intern Med. 2002 Apr 16;136(8):I38   [PMID:  11955046 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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