Paradoxical rise in serum adiponectin concentration in the face of acid-induced insulin resistance 13-cis-retinoic

Aims/hypothesis: We previously reported that treatment of acne with 13-cis-retinoic acid causes insulin resistance and disturbances in lipid metabolism resembling those of the insulin-resistance syndrome. It is not known whether this is associated with alterations in the concentrations of serum adiponectin, an insulin-sensitising hormone secreted by adipocytes. Materials and methods: Eleven men ( age 24 +/- 2 years, BMI 22.1 +/- 0.9 kg/m(2)) received 13-cis- retinoic acid (Roaccutan) treatment for acne for an average of 5 months. The insulin sensitivity of the subjects and concentrations of serum adiponectin were measured before, during and 1 month after the treatment by a euglycaemic-hyperinsulinaemic clamp and ELISA, respectively. Results: There was a reversible reduction in whole-body insulin sensitivity during therapy with 13-cis-retinoic acid. This was associated with a transient 34% increase in serum adiponectin concentration ( from 5.3 +/- 0.9 to 7.1 +/- 1.2 mu g/ml, p< 0.05), with a return to pretreatment levels by 1 month after the end of therapy. In the pretreatment study, as well as in the study performed 1 month after the end of therapy, there was a small yet significant decrease in serum adiponectin concentration during a 4-h euglycaemic hyperinsulinaemic clamp. This decrease was not observed in the clamp performed during treatment with 13-cisretinoic acid. Conclusions/interpretation: There is a paradoxical increase in fasting serum adiponectin concentration during the 13-cis-retinoic acid-induced reduction in insulin sensitivity.