#38 | GMJ Podcast | Acne and Metabolic Dysfunction — Insulin Resistance, IGF-1, and Clinical Implications

In this episode of the ⁠GMJ Podcast — the official podcast of the Georgian Medical Journal⁠ — we present an evidence-based analysis examining the relationship between acne and metabolic dysfunction, with a focus on insulin resistance, IGF-1 signaling, and their clinical implications.Acne vulgaris is one of the most common dermatological conditions worldwide, traditionally explained by androgen activity, follicular hyperkeratinization, sebaceous gland dysfunction, microbial imbalance, and inflammation. However, growing evidence indicates that systemic metabolic disturbances — particularly insulin resistance and related endocrine pathways — may play a significant role in disease severity and persistence.This episode explores how metabolic mechanisms influence dermatological outcomes, highlighting the role of insulin signaling, insulin-like growth factor-1 (IGF-1), and mTORC1 pathways in promoting sebaceous gland activity, inflammation, and increased androgen bioavailability.The episode examines key clinical and public health considerations, including:• The role of insulin resistance and glucose metabolism in acne severity• IGF-1 and mTORC1 signaling as central biological drivers• The influence of obesity, adipokines, and chronic low-grade inflammation• Dyslipidemia and its heterogeneous association with acne• Links between acne and endocrine disorders such as polycystic ovary syndrome• The distinction between metabolic syndrome and its individual componentsThe findings suggest that while acne should not be classified as a metabolic disease, its severity may be influenced by systemic metabolic and hormonal processes. The strongest evidence supports a role for insulin resistance and IGF-1–mediated pathways, while associations with metabolic syndrome as a unified condition remain inconsistent.From a clinical perspective, this episode supports a more integrated, patient-centered dermatological approach, particularly in cases of severe, persistent, treatment-resistant, or hormonally driven acne.This episode highlights the importance of interdisciplinary care, early identification of metabolic risk factors, and the need for further research to clarify causality and guide targeted interventions.https://doi.org/10.5281/zenodo.19135373Citation:Inaishvili, M., & Glonti, S. (2026). Metabolic Dysfunction and Acne Severity: Mechanisms and Clinical Implications. The Georgian Medical Journal.https://doi.org/10.5281/zenodo.19135373