Increases in uric acid and monocyte-high-density lipoprotein ratio as possible atherosclerotic indicators in acne patients using isotretinoin.

Purpose: We aimed to reveal the relationship of serum uric acid (SUA) with monocyte-high-density lipoprotein ratio (MHR) and other inflammatory markers in acne patients before and after isotretinoin treatment. In this way, we can try to shed light on the relationship between isotretinoin treatment and atherosclerosis.

Methods: Two hundred twenty-four acne patients who administered isotretinoin (0.5-1 mg/kg/day) were enrolled in the study. In the pretreatment phase and 3 months after treatment, MHR, SUA, mean platelet volume, neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio, monocyte-lymphocyte ratio, serum triglyceride, total cholesterol, high-density lipoprotein (HDL), and low-density lipoprotein (LDL) levels of the patients were analyzed.

Results: Compared to the pretreatment phase, three months after treatment, there was a statistically decrease in neutrophil count and an increase in lymphocyte count (p: 0.002, p: 0.011, respectively). Accordingly, there was a statistically significant decrease in NLR (p: 0.001). It was noteworthy that MHR and SUA levels increased significantly (p: 0.042, p: 0.010, respectively) and there was a positive correlation between SUA level and MHR (r: 0.212, p: 0.012). Serum total cholesterol, LDL, and triglyceride levels increased and HDL levels decreased significantly after treatment (p: 0.001).

Conclusion: This study contributes to the comprehension of the relationship between isotretinoin treatment and atherosclerosis, which has been frequently reported in the literature. It was thought that the isotretinoin-induced SUA increase might be related to dyslipidemia. Isotretinoin may initiate the atherosclerotic process in vascular endothelial and smooth muscles, with SUA increase and HDL decrease. An increase in MHR is also an inflammatory marker indicating this process.