Exploring the association between acne and metabolic syndrome in patients from North-Eastern India: a cross-sectional study in a tertiary care setting

Shikha Verma, Department of Dermatology, NEIGRIHMS, Shillong, Meghalaya, India Aniket Goswami, Department of Dermatology, NEIGRIHMS, Shillong, Meghalaya, India Binod K. Thakur, Department of Dermatology and STD, Nazareth Hospital, Shillong, Meghalaya, India Kaustubh Bora, Division of Biochemistry and Molecular Genetics, ICMR-RMRCNE, Dibrugarh, Assam, India Alice A. Ruram, Department of Biochemistry, NEIGRIHMS, Shillong, Meghalaya, India

Objectives: Acne vulgaris is increasingly considered not just as a dermatological condition, but as a manifestation of broader systemic disturbances, including metabolic imbalance and hormonal dysregulation, with emerging evidence linking it to insulin resistance and metabolic syndrome. This study aimed to evaluate the prevalence of metabolic syndrome and insulin resistance among patients with acne vulgaris in a tertiary care setting in North-Eastern India, and to explore their relation with acne severity, body mass index (BMI), and selected biochemical parameters. Methods: A cross-sectional study was conducted in acne patients attending the outpatient department of dermatology at a tertiary care center in North-Eastern India. Clinical grading of acne severity was performed, along with anthropometric assessments and biochemical evaluation, which included serum insulin, fasting glucose, thyroid function, sex hormones, and vitamin D levels. Metabolic syndrome was diagnosed based on standard clinical criteria, and insulin resistance was calculated using the homeostasis model assessment. Associations were analyzed using non-parametric statistical tests, with a significance threshold of p < 0.01. Results: Among the 73 participants, mean age 22.2 ± 3.85 years, the majority (35.6%, n = 26) with a severe acne, 31.5% (n = 23) were overweight or obese, but only 5.47% (n = 4) met the diagnostic criteria for metabolic syndrome and 6.85% (n = 5) for insulin resistance. Despite the elevated BMI in a subset, no statistically significant association was observed between acne severity and either metabolic syndrome or insulin resistance. Conclusion: In this studied population, no significant association was found between acne severity and metabolic syndrome or insulin resistance, and these findings highlight acne’s complex and context-dependent pathophysiology. Given the study’s limitations (cross-sectional design and lack of matched controls), results should be interpreted within the region’s unique clinical and nutritional landscape. Further research is needed in diverse populations, particularly in under-represented regions.

Keywords: Acne vulgaris. Metabolic syndrome. Insulin resistance. Body mass index. Mechanistic target of rapamycin complex 1.