Predictors of severity of acne vulgaris in young adolescent girls: Results of a five-year longitudinal study
Predictors of severity of acne vulgaris in young adolescent girls: Results of a five-year longitudinal study
复制标题
DOI：
10.1016/s0022-3476(97)70307-x
复制
发表时间：
1997-01-01
影响因子：
5.1
通讯作者：
Sorg, NW
中科院分区：
文献类型：
--
作者：
Lucky, AW;Biro, FM;Sorg, NW
目的：这项研究的目的是确定青春期早期女孩的哪些因素可能预示着后来的严重面部痤疮。研究设计：这项研究是一项为期5年的纵向队列研究，从1987年到1991年每年访问一次，志愿者样本包括439名黑人和432名白人四、五年级女孩，并征得其法定监护人的同意。受试者是从俄亥俄州辛辛那提的公立和教区学校招募的。面部粉刺的程度每年被归类为轻度、中度或重度。在研究的第一年、第三年和第五年采集血样。以研究第5年期间的痤疮状况为结果变量，我们测定了既往痤疮状况和血清硫酸脱氢表雄酮(DHEAS)、睾酮、游离睾酮(FT)、雌二醇(E(2))、孕酮和睾酮-雌激素结合球蛋白(TEBG)水平的影响，并比较了不同年龄和月经前后的结果。痤疮皮损的数量随着年龄和成熟度的增加而逐渐增加。这些女孩表现出比炎症性粉刺皮损更多的粉刺，无论年龄，在研究的第五年发展成严重粉刺的女孩比轻度或中度粉刺的女孩有更多的粉刺和炎性皮损，早在10岁，大约在月经初潮前两年半，当她们的粉刺程度轻微的时候，轻度粉刺粉刺的女孩比严重粉刺粉刺的女孩更晚来月经(12.5比12.2岁)。与轻度或中度粉刺的女孩相比，发生严重粉刺的女孩的血清DHEAS水平显著更高，在纵向分析中，睾酮和FT的水平略高。血清E(2)、睾酮/E(2)、孕酮和TEBG值在重度和轻中度痤疮女孩组中无差异。结论：痤疮的早期发展可能是预测病情较晚、病情较重的最佳指标之一。肾上腺激素DHEAS似乎在痤疮的发生中起着重要作用。脱氢表雄酮、睾酮和FT与严重粉刺痤疮的持续存在有关。及早认识到年轻女孩有患严重粉刺的风险，可能使临床医生能够进行干预，从而防止不必要的后遗症。
Objectives: The objectives of this study were to determine which factors in early pubertal girls might be predictive of later, severe facial acne.Study design: The study was a 5-year longitudinal cohort study, with yearly visits from 1987 through 1991, in a volunteer sample of 439 black and 432 white fourth- and fifth-grade girls with consent from their legal guardians. The subjects were recruited from public and parochial schools in Cincinnati, Ohio. The degree of facial acne was classified annually as mild, moderate, or severe. Blood samples were obtained at the first, third, and fifth years of the study. Using the acne status during the fifth year of the study as the outcome variable, we determined the contributions from the prior acne status and the serum levels of dehydroepiandrosterone sulfate (DHEAS), testosterone, free testosterone (FT), estradiol (E(2)), progesterone, and testosterone-estrogen binding globulin (TEBG) and compared the results at various ages and at times before and after menarche.Results: No racial differences in acne or hormone levels were found. There was a progressive increase in the number of acne lesions with age and maturation. The girls exhibited many more comedonal than inflammatory acne lesions, regardless of age, The girls in whom severe acne developed by the fifth year of the study had significantly more comedones and inflammatory lesions than girls with mild or moderate acne, as early as age 10 years, approximately 2 1/2 years before menarche, a time when their degree of acne was mild, Girls with mild comedonal acne had significantly later onset of menarche (12.5 compared with 12.2 years) than girls with severe comedonal acne. Girls in whom severe comedonal acne developed had significantly higher levels of serum DHEAS and, in a longitudinal analysis, somewhat higher levels of testosterone and FT in comparison with girls who had mild or moderate comedonal acne. Serum E(2), testosterone/E(2), progesterone, and TEBG values were no different in girls with severe compared with mild or moderate comedonal acne.Conclusions: The early development of comedonal acne may be one of the best predictors of later, more severe disease. The adrenal hormone DHEAS appears to play an important role in the initiation of acne. DHEAS, testosterone, and FT are associated with the perpetuation of severe comedonal acne. Early recognition of young girls at risk of having severe comedonal acne may enable the clinician to intervene and thus prevent unwanted sequelae.