Assessment of lipid profile and its association with acne vulgaris severity in adolescents and young adults: A cross-sectional study in Kurdistan Region, Iraq.

Background: The relationship between acne vulgaris and lipid profiles has been the subject of limited research across diverse populations, yielding conflicting results. The aim of this study was to determine whether there are any significant differences in lipid profile and selected apolipoproteins between two groups: adolescents and young adults with acne vulgaris and an age- and sex-matched control group. Additionally, the study aimed to identify indicators associated with severe acne vulgaris.

Methods: The cross-sectional study involved 100 adolescent and young adult patients (50 adolescents aged 11-18 years and 50 young adults aged 19-26 years) who were visitors to the Dermatology Unit of Azadi Teaching Hospital in Duhok City, Kurdistan Region of Iraq, diagnosed with acne vulgaris. These patients were compared with a control group of 90 healthy individuals who were matched for age, sex, and BMI (body mass index). Measurements included lipid profile, apolipoprotein A (Apo A), apolipoprotein B, and lipase. The Ethics Committee of the Directorate of Health of Duhok City Governate approved the study (reference number: 15092021-9-3). Data were statistically analyzed using SPSS software (version 26.0 for Windows), and the p value ≤ 0.05 was considered statistically significant.

Results: The results showed an increase in total cholesterol, triglycerides, HDL-C (high-density lipoprotein cholesterol), non-HDL-C, and Apo A in the acne vulgaris group compared with the control group (157.5 ± 36, 125.4 ± 50.5, 40.9 ± 10.9, 114.6 ± 41, and 189.5 ± 26 versus 129 ± 22.5, 98.1 ± 49.9, 33.4 ± 8.1, 95.6 ± 32.1 and 179.6 ± 22.4, respectively), all with p values of ≤ 0.05. The regression model showed that an increase in one unit of cholesterol resulted in a 4% increase in the odds of acne vulgaris (p < 0.001). The severity of acne vulgaris was associated with age (mild (17.9 ± 2.7), moderate (18.09 ± 2.8), severe (20 ± 2.7), p < 0.05) and with a decrease in Apo A levels compared with the mild group (179.2 ± 25.5 and 200 ± 25.9, respectively, p < 0.05). There was a significant increase in non-HDL-C levels in young adult patients compared with adolescent patients (125.8 ± 40.3 versus 103.5 ± 39.9, p = 0.01).

Conclusions: High cholesterol is a feature of adolescent and young adult patients with acne vulgaris. Older patients tend to have more severe forms of acne, which are significantly associated with elevated non-HDL-C levels. Decreased Apo A levels have also been identified as an additional indicator of severe cases of acne vulgaris.