الفهرس 
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Abstract
Acne vulgaris is an extremely prevalent disorder that is frequently encountered in the practice of most medical disciplines, not only dermatologists. It is the most common dermatologic condition, affecting nearly 80% of people among the age group of 11 to 30 years.
IGF-1 plays a significant role in epidermal homeostasis and possesses a distinct effect on sebocytes growth and differentiation, along with insulin and GH. IGF-1 exerts its major effect on proliferation, while having an effect similar to insulin on differentiation. The strongest expression of IGF-1 protein in humans was found in maturing sebocytes and suprabasal cells of sebaceous glands.
The aim of the study was to assess the role of hyperglycemic diet, dairy products, glucose, insulin and IGF-1 in the development of acne. The study was conducted on 55 subjects; all were selected from the outpatient clinic of the Dermatology department of Alexandria Main University Hospital. The patients’ groups compressed of 40 patients with acne, while the controls’ group compressed of 15 age and sex matched subjects free of acne.
All subjects in the present study were subjected to detailed history taking with emphasis on age, sex, dietary habits, onset and duration of lesions. Clinical examination was conducted with stress on the location, number and type of acne lesions for the purpose of grading of the severity of the disease according to the Indian acne grading system. Blood samples were obtained from subjects for laboratory determination of fasting blood glucose and quantitative detection of fasting insulin and IGF-1 using ELISA technique.
The present study showed statistically significant higher levels of IGF-1 detected by ELISA, in acne patients than in control subjects. Additionally, results of blood samples obtained from participating candidates in the present study showed a significantly higher mean level of insulin in acne patients when compared to the control group. Moreover, significantly higher FBG levels were observed in acne patients than in controls. The present study also showed a higher mean IGF-1 levels and insulin levels in females than in males, although these differences were not statistically significant.
The present study showed a similar pattern of increment in IGF-1, insulin and FBG levels in that the mean levels proportionally increase with the higher grades of acne according to the SAG proposed in 2009 by Adityan, Kumary and Thappa that is based on the predominant lesion and the number of each. The highest mean IGF-1 levels were observed with grade 4 (the highest grade on the grading system), while these levels were lower with grades1 and 2. This relation showed a strong significance upon statistical evaluation.
Clinical markers of androgenicity were assessed in female patients with acne where 23.7% of patients had androgenic alopecia, while 25.5% complained of hirsutism. These clinical markers were statistically associated with the laboratory findings of acne patients, where higher mean levels of IGF-1, insulin and FBG were observed in these patients.
Finally, the present study showed a significant correlation between mean serum insulin and IGF-1 levels, in which the rise in insulin levels was directly proportion to the rise in IGF-1 levels and vice versa.
These findings go hand in hand with the knowledge that the interplay of these hormones and the cascade of events they initiate in acne and other conditions are interrelated and affect the incidence and severity of acne vulgaris.