Variations in lipid and lipoprotein levels during isotretinoin treatment for acne vulgaris with special emphasis on HDL-cholesterol

Background: Many studies have demonstrated an increase in total cholesterol and triglycerides on oral isotretinoin therapy. This has led several investigators to comment on the possibility of increased risk for cardiovascular disease. Yet, the status of high density lipoprotein (HDL) in patients on isotretinoin therapy has not been studied extensively. Patients and methods: We studied 104 United Arab Emirates (UAE) nationals (78 women, 26 men) who underwent isotratinoin therapy for ache at doses ranging from 0.2 to 1.6 mg/kg, and determined the lipid and lipoprotein levels before and after an 8-week period of treatment. The risk for cardiovascular disease was evaluated as the ratio of cholesterol/HDL-cholesterol. Results: Mean cholesterol, triglycerides, and low density lipoprotein-cholesterol (LDL- cholesterol) levels rose significantly after treatment (p=0.01) whereas HDL- cholesterol values decreased significantly (p=0.01). In the entire subject population, the overall risk for cardiovascular disease rose from 3.45 to 3.67, indicating that these subjects remained in the category considered to have 'half-average' to 'average' risk of cardiovascular disease. Conclusions: In young and healthy individuals, significant variations in lipid and lipoprotein levels, resulting from isotretinoin treatment for ache, do not influence the overall risk for cardiovascular disease. Isotretinoin is thus a safe and efficient drug for the treatment of acne in these subjects.