Zitat von paba
Hier noch ein wissenschaftlicher Artikel zum Thema Akne und Insulin, den ich mir vor kurzem bestellt habe. Er ist zwar schon über 20 Jahre alt, aber nichtsdestotrotz sehr interessant. Was ich besonders faszinierend fand, ist die Beobachtung, dass die Injektion von Insulin die Akne nicht verschlechtert, sondern im Gegenteil, sogar verbessert. Das Problem sind anscheinend nicht die hohen Insulinspiegel an sich, sondern die Insulinresistenz in der Haut, weshalb Akne auch schon als Haut-Diabetes bezeichnet wurde.
Medical Hypotheses 14: 307-310, 1984
HIGH-CHROMIUM YEAST FOR ACNE?
Mark McCarty, Nutrition 21, 11095 Torreyana Road, Suite 105, San Diego,
Many dermatologists have reported that insulin and tolbutamide are therapeutically effective in acne. This rationalizes a recent observation that high-chromium yeast appears to have value as an acne treatment.
INSULIN AND ACNE
Rubin (1) has recently reported rapid improvement of acne in a child treated with high-chromium yeast (Chromax, 100 ppm chromium). Comparable improvement was noted in 9 further patients treated with this regimen. Each patient received two teaspoons of yeast daily providing 400 mcg chromium.
Uncontrolled clinical observations in acne therapy are usually greeted
with justified scepticism. However, my subsequent review of the literature reveals that therapeutic response to chromium can in fact be predicted on the basis of past findings.
Recent studies indicate that high-chromium yeast as well as chromium salts act to improve glucose tolerance and enhance the insulin sensitivity of tissues (2-5). The exceptional value of high-chromium yeast in this regard has been attributed to its high content of "glucose tolerance factor" (GTF), an as yet poorly-characterized organic chromium complex postulated to mediate the actions of chromium in vivo (6). Chromium appears to play an essential physiological role in maintaining tissue sensitivity to insulin (7)
A number of publications dating back to the 1930s indicate that measures which enhance insulin activity have value in the treatment of acne. The first such observation was made by Wortis (8 ), who noted rapid improvement of acne in 6 non-diabetic psychotic patients subjected to continuing courses of insulin shock therapy. This finding subsequently was confirmed by other authors (9). Semon and Herrmann (10) went so far as to treat acne with insulin injections in non-diabetics. Courses providing 5 - 10 units per injection, 2 to 3 times weekly, were claimed to confer marked benefit in 13 treated patients. Intralesional insulin injections have also been noted to reduce the elevation and depth of acne lesions (9).
The introduction of tolbutamide as an anti-diabetic agent was followed by a number of reports claiming it to be effective in treating acne, in doses (.5 - 1 gram daily) which did not precipitate reactive hypoglycemia (11-13). In one of these studies (12), tolbutamide was proved superior
to placebo in a double-blind cross-over trial. A plant-derived "glucokinin" claimed to be effective in diabetes treatment, was also noted to have value in the therapy of acne (14).
Abdel Kader et al (15) administered glucose tolerance tests to 14 male acne patients and 15 normal controls. While systemic glucose tolerance did not differ in the acne patients as compared to controls, skin glucose tolerance (as assessed by repetitive punch biopsies) was found to be significantly impaired in the acne patients. This finding hearkens back to an earlier claim that acne patients have "skin diabetes" (11).
There is considerable evidence that pharmacological measures which enhance the action of insulin are of therapeutic value in acne. It can therefore be predicted that high-chromium yeast will have comparable value in this regard. Controlled trials should be initiated to verify this prediction, and to quantify the extent and duration of response.
The mechanism behind insulin's beneficial action in acne remains obscure, but a role in essential fatty acid metabolism can be postulated. Insulin induces the synthesis of delta-6-desaturase, the enzyme which is rate-limiting for the conversion of linoleic acid to more proximal prostaglandin precursors (16). High-dose zinc has demonstrated therapeutic efficacy in some but not all controlled trials in acne (17); Huang et al (18 ) have presented evidence that dermatological and various other effects of zinc deficiency in rats are mediated by an impairment in essential fatty acid metabolism and that zinc may be a cofactor for the delta-6-desaturase. Vitamin B6, which also plays a necessary but poorly-defined role in essential fatty acid metabolism (19), has been found to be effective in preventing premenstrual acne flare (20). Finally, Hubler observed that corn oil supplementation appeared to improve the clinical course in acne patients on low-fat diets (21). Taken as a group, these observations suggest that measures which aid the conversion of linoleic acid to more proximal prostaglandin precursors - probably including dietary chromium - may have therapeutic value in acne. If the postulated efficacy of chromium in acne is mediated by an effect on delta-6-desaturase, it can be predicted that gammalinolenic acid will have comparable therapeutic value in acne.
In passing, it is interesting to note the claim by Singh et al (13) that tolbutamide therapy was clinically beneficial in hyperhidrosis. Rapid remission of severe hyperhidrosis of many years duration has been reported in a subject receiving high-chromium yeast (22).
1. Rubin D, personal communication.
2. Freiberg JM, Schneider JR, Streeten DHP, Schneider AJ, Effects of brewer's yeast on glucose tolerance. Diabetes 24; 433, 1975.
3. Offenbacher EG, Pi-Sunyer FX. Improvement of glucose tolerance and blood lipids in elderly subjects given chromium-rich yeast. Am J Clin Nutr 33: 916, 1980.
4. Check WA. And if you add chromium, that's even better. J Am Med Assoc 247: 3046, 1982.
5. Elias AN, Grossman MK, Valenta Li. Use of the artificial beta cell (ABC) in the assessment of peripheral insulin sensitivity: effect of chromium supplementation in diabetes. Clin Res 28: 391A, 1980.
6. Mertz W. Effects and metabolism of glucose tolerance factor. Nutr Rev 33: 129, 1975.
7. Schwarz K, Mertz W. Chromium (III) and the glucose tolerance factor. Arch Biochem Biophys 85: 292, 1959.
8. Wortis J. Common acne and insulin hypoglycemia. J Am Med Assoc 108: 971, 1937.
9. Grover RW, Arikian N. The effect of intralesional insulin and glucagon in acne vulgaris. J Invest Derm 40: 259, 1963.
10. Semon HC, Herrmann F. Some observations on the sugar metabolism in acne vulgaris, and its treatment by insulin. Brit J Derm 52: 123, 1940.
11. Cohen JL, Cohen AD. Pustular acne, staphyloderma and its treatment with tolbutamide. Can Med Assoc J 80: 629, 1959.
12. Bettley FR. The treatment of acne vulgaris with tolbutamide. Brit J Derm 73: 149, 1961.
13. Singh I, Gaind ML, Jayram D. Tolbutamide in the treatment of skin diseases. Brit J Derm 73: 362, 1961.
14. Aichinger F. Beeinflussung des Kohlenhydratstoffwechsels durch Glukokinine, dargestellt an der Akne-Therapie. Landartzt 43: 928, 1967.
15. Abdel Kader MM, El-Mofty AM, Ismail AA, Bassili F. Glucose tolerance in blood and skin of patients with acne vulgaris. Indian J Derm 22: 139, 1977
16. Brenner RR. The oxidative desaturation of unsaturated fatty acids in animals. Molec Cell Biochem 3: 41, 1974.
17. Michaelsson G. Oral zinc in acne. Acta Dermatovener Suppl 89: 87, 1980.
18. Huang YS, Cunnane SC, Horrobin DF, Davignon J. Most biological effects of zinc deficiency corrected by alpha-linolenic acid (18:3w6) but not by linoleic acid (18:2w6). Athrosclerosis 41: 193, 1982.
19. Witten PW, Holman RT. Polyethenoid fatty acid metabolism. VI. Effect of pyridoxine on essential fatty acid conversions. Arch Biochem Biophys 41: 266, 1952.
20. Snider BL, Dieteman DF. Pyridoxine therapy for premenstrual acne flare. Arch Derm 110: 130, 1974.
21. Hubler WR. Unsaturated fatty acids in acne. Arch Derm 79: 644, 1959.
22. Neuharth P, personal communication.