#39 | 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 exploring the relationship between metabolic dysfunction and acne severity, with important implications for clinical practice and public health.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 suggests that systemic metabolic disturbances — including insulin resistance, IGF-1 signaling, obesity, dyslipidemia, and endocrine dysregulation — may significantly influence disease severity and persistence.This episode explores how metabolic pathways interact with dermatological mechanisms, highlighting the role of insulin signaling, IGF-1 activation, and mTORC1 pathways in promoting sebaceous activity, inflammation, and 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 impact of obesity, adipokines, and chronic low-grade inflammation• Dyslipidemia and its heterogeneous association with acne• The link between acne and endocrine disorders such as polycystic ovary syndrome• The distinction between metabolic syndrome and its individual componentsThe findings indicate 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 insulin resistance and IGF-1–mediated pathways, while associations with metabolic syndrome 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://gmj.ge/index.php/pub/article/view/36https://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