<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2795-5001</journal-id>
<journal-title><![CDATA[Portuguese Journal of Dermatology and Venereology]]></journal-title>
<abbrev-journal-title><![CDATA[Port J Dermatol Venereol.]]></abbrev-journal-title>
<issn>2795-5001</issn>
<publisher>
<publisher-name><![CDATA[Permanyer Publications]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2795-50012025000300176</article-id>
<article-id pub-id-type="doi">10.24875/pjdv.25000034</article-id>
<title-group>
<article-title xml:lang="en"><![CDATA[Exploring the association between acne and metabolic syndrome in patients from North-Eastern India: a cross-sectional study in a tertiary care setting]]></article-title>
<article-title xml:lang="pt"><![CDATA[Explorando a associação entre acne e síndrome metabólica em doentes do nordeste da Índia: um estudo transversal num ambiente de cuidados terciários]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Verma]]></surname>
<given-names><![CDATA[Shikha]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Goswami]]></surname>
<given-names><![CDATA[Aniket]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Thakur]]></surname>
<given-names><![CDATA[Binod K.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Bora]]></surname>
<given-names><![CDATA[Kaustubh]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ruram]]></surname>
<given-names><![CDATA[Alice A.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,NEIGRIHMS Department of Dermatology ]]></institution>
<addr-line><![CDATA[Shillong Meghalaya]]></addr-line>
<country>India</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Nazareth Hospital Department of Dermatology and STD ]]></institution>
<addr-line><![CDATA[Shillong Meghalaya]]></addr-line>
<country>India</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,ICMR-RMRCNE Division of Biochemistry and Molecular Genetics ]]></institution>
<addr-line><![CDATA[Dibrugarh Assam]]></addr-line>
<country>India</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,NEIGRIHMS Department of Biochemistry ]]></institution>
<addr-line><![CDATA[Shillong Meghalaya]]></addr-line>
<country>India</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>09</month>
<year>2025</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>09</month>
<year>2025</year>
</pub-date>
<volume>83</volume>
<numero>3</numero>
<fpage>176</fpage>
<lpage>184</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_arttext&amp;pid=S2795-50012025000300176&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_abstract&amp;pid=S2795-50012025000300176&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_pdf&amp;pid=S2795-50012025000300176&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Objectives: Acne vulgaris is increasingly considered not just as a dermatological condition, but as a manifestation of broader systemic disturbances, including metabolic imbalance and hormonal dysregulation, with emerging evidence linking it to insulin resistance and metabolic syndrome. This study aimed to evaluate the prevalence of metabolic syndrome and insulin resistance among patients with acne vulgaris in a tertiary care setting in North-Eastern India, and to explore their relation with acne severity, body mass index (BMI), and selected biochemical parameters.  Methods: A cross-sectional study was conducted in acne patients attending the outpatient department of dermatology at a tertiary care center in North-Eastern India. Clinical grading of acne severity was performed, along with anthropometric assessments and biochemical evaluation, which included serum insulin, fasting glucose, thyroid function, sex hormones, and vitamin D levels. Metabolic syndrome was diagnosed based on standard clinical criteria, and insulin resistance was calculated using the homeostasis model assessment. Associations were analyzed using non-parametric statistical tests, with a significance threshold of p &lt; 0.01.  Results: Among the 73 participants, mean age 22.2 ± 3.85 years, the majority (35.6%, n = 26) with a severe acne, 31.5% (n = 23) were overweight or obese, but only 5.47% (n = 4) met the diagnostic criteria for metabolic syndrome and 6.85% (n = 5) for insulin resistance. Despite the elevated BMI in a subset, no statistically significant association was observed between acne severity and either metabolic syndrome or insulin resistance.  Conclusion: In this studied population, no significant association was found between acne severity and metabolic syndrome or insulin resistance, and these findings highlight acne&#8217;s complex and context-dependent pathophysiology. Given the study&#8217;s limitations (cross-sectional design and lack of matched controls), results should be interpreted within the region&#8217;s unique clinical and nutritional landscape. Further research is needed in diverse populations, particularly in under-represented regions.]]></p></abstract>
<abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo  Objectivos: A acne vulgar é cada vez mais considerada não só uma condição dermatológica, mas também uma manifestação de distúrbios sistémicos mais amplos, incluindo o desequilíbrio metabólico e a desregulação hormonal, com evidências emergentes que a associam à resistência à insulina e à síndrome metabólica. Este estudo teve como objetivo avaliar a prevalência da síndrome metabólica e da resistência à insulina entre os doentes com acne vulgar num ambiente de cuidados terciários no nordeste da Índia e explorar a sua relação com a gravidade da acne, o índice de massa corporal e parâmetros bioquímicos selecionados.  Métodos: Foi realizado um estudo transversal em doentes com acne atendidos no ambulatório de Dermatologia de um centro de cuidados terciários no nordeste da Índia. Foi realizada a classificação clínica da gravidade da acne, juntamente com avaliações antropométricas e bioquímicas, que incluíram a insulina sérica, a glicemia em jejum, a função tiroideia, as hormonas sexuais e os níveis de vitamina D. A síndrome metabólica foi diagnosticada com base em critérios clínicos padrão e a resistência à insulina foi calculada através do modelo de avaliação da homeostasia. As associações foram analisadas através de testes estatísticos não paramétricos, com um limiar de significância de p &lt; 0.01.  Resultados: Entre os 73 participantes, com uma média de idades de 22.2 ± 3.85 anos, a maioria (35.6%, n = 26) apresentava acne grave, 31.5% (n = 23) tinham excesso de peso ou obesidade, mas apenas 5.47% (n = 4) preenchiam os critérios de diagnóstico de síndrome metabólica e 6.85% (n = 5) de resistência à insulina. Apesar do índice de massa corporal elevado num subconjunto, não foi observada uma associação estatisticamente significativa entre a gravidade da acne e a síndrome metabólica ou a resistência à insulina.  Conclusão: Nesta população estudada, não foi encontrada uma associação significativa entre a gravidade da acne e a síndrome metabólica ou a resistência à insulina, e estes achados realçam a fisiopatologia complexa e dependente do contexto da acne. Dadas as limitações do estudo (desenho transversal e ausência de controlos emparelhados), os resultados devem ser interpretados dentro do cenário clínico e nutricional único da região. São necessárias mais pesquisas em populações diversas, particularmente em regiões sub-representadas.]]></p></abstract>
<kwd-group>
<kwd lng="en"><![CDATA[Acne vulgaris]]></kwd>
<kwd lng="en"><![CDATA[Metabolic syndrome]]></kwd>
<kwd lng="en"><![CDATA[Insulin resistance]]></kwd>
<kwd lng="en"><![CDATA[Body mass index]]></kwd>
<kwd lng="en"><![CDATA[Mechanistic target of rapamycin complex 1]]></kwd>
<kwd lng="pt"><![CDATA[Acne vulgar]]></kwd>
<kwd lng="pt"><![CDATA[Síndrome metabólico]]></kwd>
<kwd lng="pt"><![CDATA[Resistência à insulina]]></kwd>
<kwd lng="pt"><![CDATA[IMC (índice de massa corporal)]]></kwd>
<kwd lng="pt"><![CDATA[Alvo mecanístico do complexo 1 da rapamicina]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Sutaria]]></surname>
<given-names><![CDATA[AH]]></given-names>
</name>
<name>
<surname><![CDATA[Masood]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Saleh]]></surname>
<given-names><![CDATA[HM]]></given-names>
</name>
<name>
<surname><![CDATA[Schlessinger]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Acne vulgaris]]></article-title>
<source><![CDATA[In:StatPearls]]></source>
<year>2025</year>
<publisher-loc><![CDATA[Treasure Island, FL ]]></publisher-loc>
<publisher-name><![CDATA[StatPearls Publishing]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Bungau]]></surname>
<given-names><![CDATA[AF]]></given-names>
</name>
<name>
<surname><![CDATA[Radu]]></surname>
<given-names><![CDATA[AF]]></given-names>
</name>
<name>
<surname><![CDATA[Bungau]]></surname>
<given-names><![CDATA[SG]]></given-names>
</name>
<name>
<surname><![CDATA[Vesa]]></surname>
<given-names><![CDATA[CM]]></given-names>
</name>
<name>
<surname><![CDATA[Tit]]></surname>
<given-names><![CDATA[DM]]></given-names>
</name>
<name>
<surname><![CDATA[Endres]]></surname>
<given-names><![CDATA[LM]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Oxidative stress and metabolic syndrome in acne vulgaris:pathogenetic connections and potential role of dietary supplements and phytochemicals]]></article-title>
<source><![CDATA[Biomed Pharmacother]]></source>
<year>2023</year>
<volume>164</volume>
<page-range>115003</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Adibi]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Robati]]></surname>
<given-names><![CDATA[RM]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Skin and metabolic syndrome:a review of the possible associations]]></article-title>
<source><![CDATA[J Res Med Sci]]></source>
<year>2021</year>
<volume>26</volume>
<page-range>16</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Hu]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
<name>
<surname><![CDATA[Zhu]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
<name>
<surname><![CDATA[Lian]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Chen]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Bartke]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Yuan]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Metabolic syndrome and skin diseases]]></article-title>
<source><![CDATA[Front Endocrinol (Lausanne)]]></source>
<year>2019</year>
<volume>10</volume>
<page-range>788</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Bae]]></surname>
<given-names><![CDATA[IH]]></given-names>
</name>
<name>
<surname><![CDATA[Kwak]]></surname>
<given-names><![CDATA[JH]]></given-names>
</name>
<name>
<surname><![CDATA[Na]]></surname>
<given-names><![CDATA[CH]]></given-names>
</name>
<name>
<surname><![CDATA[Kim]]></surname>
<given-names><![CDATA[MS]]></given-names>
</name>
<name>
<surname><![CDATA[Shin]]></surname>
<given-names><![CDATA[BS]]></given-names>
</name>
<name>
<surname><![CDATA[Choi]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[A comprehensive review of the acne grading scale in 2023]]></article-title>
<source><![CDATA[Ann Dermatol]]></source>
<year>2024</year>
<volume>36</volume>
<page-range>65-73</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Matthews]]></surname>
<given-names><![CDATA[DR]]></given-names>
</name>
<name>
<surname><![CDATA[Hosker]]></surname>
<given-names><![CDATA[JP]]></given-names>
</name>
<name>
<surname><![CDATA[Rudenski]]></surname>
<given-names><![CDATA[AS]]></given-names>
</name>
<name>
<surname><![CDATA[Naylor]]></surname>
<given-names><![CDATA[BA]]></given-names>
</name>
<name>
<surname><![CDATA[Treacher]]></surname>
<given-names><![CDATA[DF]]></given-names>
</name>
<name>
<surname><![CDATA[Turner]]></surname>
<given-names><![CDATA[RC]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Homeostasis model assessment:insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man]]></article-title>
<source><![CDATA[Diabetologia]]></source>
<year>1985</year>
<volume>28</volume>
<page-range>412-9</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Huang]]></surname>
<given-names><![CDATA[PL]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[A comprehensive definition for metabolic syndrome]]></article-title>
<source><![CDATA[Dis Model Mech]]></source>
<year>2009</year>
<volume>2</volume>
<page-range>231-7</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="">
<collab>The Jamovi Project</collab>
<source><![CDATA[Jamovi (Version 2.6) [Computer Software]]]></source>
<year>2025</year>
</nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ross]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Neeland]]></surname>
<given-names><![CDATA[IJ]]></given-names>
</name>
<name>
<surname><![CDATA[Yamashita]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Shai]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
<name>
<surname><![CDATA[Seidell]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Magni]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Waist circumference as a vital sign in clinical practice:a consensus statement from the IAS and ICCR working group on visceral obesity]]></article-title>
<source><![CDATA[Nat Rev Endocrinol]]></source>
<year>2020</year>
<volume>16</volume>
<page-range>177-89</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Fatima]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Das]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Kumar]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Datta]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Skin and metabolic syndrome:an evidence based comprehensive review]]></article-title>
<source><![CDATA[Indian J Dermatol]]></source>
<year>2021</year>
<volume>66</volume>
<page-range>302-7</page-range></nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Hasrat]]></surname>
<given-names><![CDATA[NH]]></given-names>
</name>
<name>
<surname><![CDATA[Al-Yassen]]></surname>
<given-names><![CDATA[AQ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The relationship between acne vulgaris and insulin resistance]]></article-title>
<source><![CDATA[Cureus]]></source>
<year>2023</year>
<volume>15</volume>
</nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Chandak]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Singh]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Madke]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Jawade]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Khandelwal]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Acne vulgaris and metabolic syndrome:a possible association]]></article-title>
<source><![CDATA[Cureus]]></source>
<year>2022</year>
<volume>14</volume>
</nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Bansal]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Sardana]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Vats]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Sharma]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Garga]]></surname>
<given-names><![CDATA[UC]]></given-names>
</name>
<name>
<surname><![CDATA[Khurana]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[A prospective study examining trigger factors and hormonal abnormalities in adult female acne]]></article-title>
<source><![CDATA[Indian Dermatol Online J]]></source>
<year>2020</year>
<volume>4</volume>
<page-range>544-50</page-range></nlm-citation>
</ref>
<ref id="B14">
<label>14</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Roma&#324;ska-Gocka]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Wo&#378;niak]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Kaczmarek-Skamira]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Zegarska]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The possible role of diet in the pathogenesis of adult female acne]]></article-title>
<source><![CDATA[Postepy Dermatol Alergol]]></source>
<year>2016</year>
<volume>33</volume>
<page-range>416-20</page-range></nlm-citation>
</ref>
<ref id="B15">
<label>15</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Kaya]]></surname>
<given-names><![CDATA[&#304;F]]></given-names>
</name>
<name>
<surname><![CDATA[Ery&#305;lmaz]]></surname>
<given-names><![CDATA[MA]]></given-names>
</name>
<name>
<surname><![CDATA[Pekgör]]></surname>
<given-names><![CDATA[O]]></given-names>
</name>
<name>
<surname><![CDATA[Külahç&#305;]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Evaluation of the relationship between insulin resistance and visceral adiposity index in patients with acne vulgaris]]></article-title>
<source><![CDATA[Turk J Med Sci]]></source>
<year>2022</year>
<volume>52</volume>
<page-range>477-83</page-range></nlm-citation>
</ref>
<ref id="B16">
<label>16</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Melnik]]></surname>
<given-names><![CDATA[BC]]></given-names>
</name>
<name>
<surname><![CDATA[John]]></surname>
<given-names><![CDATA[SM]]></given-names>
</name>
<name>
<surname><![CDATA[Plewig]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Acne:risk indicator for increased body mass index and insulin resistance]]></article-title>
<source><![CDATA[Acta Derm Venereol]]></source>
<year>2013</year>
<volume>93</volume>
<page-range>644-9</page-range></nlm-citation>
</ref>
<ref id="B17">
<label>17</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Melnik]]></surname>
<given-names><![CDATA[BC]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Linking diet to acne metabolomics, inflammation, and comedogenesis:an update]]></article-title>
<source><![CDATA[Clin Cosmet Investig Dermatol]]></source>
<year>2015</year>
<volume>8</volume>
<page-range>371-88</page-range></nlm-citation>
</ref>
<ref id="B18">
<label>18</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Bull]]></surname>
<given-names><![CDATA[FC]]></given-names>
</name>
<name>
<surname><![CDATA[Al-Ansari]]></surname>
<given-names><![CDATA[SS]]></given-names>
</name>
<name>
<surname><![CDATA[Biddle]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Borodulin]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Buman]]></surname>
<given-names><![CDATA[MP]]></given-names>
</name>
<name>
<surname><![CDATA[Cardon]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[World health organization 2020 guidelines on physical activity and sedentary behaviour]]></article-title>
<source><![CDATA[Br J Sports Med]]></source>
<year>2020</year>
<volume>54</volume>
<page-range>1451-62</page-range></nlm-citation>
</ref>
<ref id="B19">
<label>19</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Bungau]]></surname>
<given-names><![CDATA[AF]]></given-names>
</name>
<name>
<surname><![CDATA[Tit]]></surname>
<given-names><![CDATA[DM]]></given-names>
</name>
<name>
<surname><![CDATA[Bungau]]></surname>
<given-names><![CDATA[SG]]></given-names>
</name>
<name>
<surname><![CDATA[Vesa]]></surname>
<given-names><![CDATA[CM]]></given-names>
</name>
<name>
<surname><![CDATA[Radu]]></surname>
<given-names><![CDATA[AF]]></given-names>
</name>
<name>
<surname><![CDATA[Marin]]></surname>
<given-names><![CDATA[RC]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Exploring the metabolic and endocrine preconditioning associated with thyroid disorders:risk assessment and association with acne severity]]></article-title>
<source><![CDATA[Int J Mol Sci]]></source>
<year>2024</year>
<volume>25</volume>
<page-range>721</page-range></nlm-citation>
</ref>
<ref id="B20">
<label>20</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Hasamoh]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
<name>
<surname><![CDATA[Thadanipon]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Juntongjin]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Association between vitamin D level and acne, and correlation with disease severity:a meta-analysis]]></article-title>
<source><![CDATA[Dermatology]]></source>
<year>2022</year>
<volume>238</volume>
<page-range>404-11</page-range></nlm-citation>
</ref>
<ref id="B21">
<label>21</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Nagpal]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[De]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Handa]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Pal]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Sachdeva]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Insulin resistance and metabolic syndrome in young men with acne]]></article-title>
<source><![CDATA[JAMA Dermatol]]></source>
<year>2016</year>
<volume>152</volume>
<page-range>399-404</page-range></nlm-citation>
</ref>
<ref id="B22">
<label>22</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Gruszczy&#324;ska]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Sadowska-Przytocka]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Szybiak]]></surname>
<given-names><![CDATA[W]]></given-names>
</name>
<name>
<surname><![CDATA[Wi&#281;ckowska]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Lacka]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Insulin resistance in patients with acne vulgaris]]></article-title>
<source><![CDATA[Biomedicines]]></source>
<year>2023</year>
<volume>11</volume>
<page-range>2294</page-range></nlm-citation>
</ref>
<ref id="B23">
<label>23</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Andreadi]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Muscoli]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Tajmir]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Meloni]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Minasi]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Muscoli]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Insulin resistance and acne:the role of metformin as alternative therapy in men]]></article-title>
<source><![CDATA[Pharmaceuticals (Basel)]]></source>
<year>2022</year>
<volume>16</volume>
<page-range>27</page-range></nlm-citation>
</ref>
<ref id="B24">
<label>24</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Solanki]]></surname>
<given-names><![CDATA[AD]]></given-names>
</name>
<name>
<surname><![CDATA[Solanki]]></surname>
<given-names><![CDATA[DK]]></given-names>
</name>
<name>
<surname><![CDATA[Banker]]></surname>
<given-names><![CDATA[KK]]></given-names>
</name>
<name>
<surname><![CDATA[Rangnani]]></surname>
<given-names><![CDATA[TC]]></given-names>
</name>
<name>
<surname><![CDATA[Patel]]></surname>
<given-names><![CDATA[NM]]></given-names>
</name>
<name>
<surname><![CDATA[Modi]]></surname>
<given-names><![CDATA[KR]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Role of insulin resistance in patients of acne vulgaris and hirsutism in the western part of India- a cross-sectional study]]></article-title>
<source><![CDATA[Indian Dermatol Online J]]></source>
<year>2023</year>
<volume>14</volume>
<page-range>38-43</page-range></nlm-citation>
</ref>
<ref id="B25">
<label>25</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Meher]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Sahoo]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The epidemiological profile of metabolic syndrome in Indian population:a comparative study between men and women]]></article-title>
<source><![CDATA[Clin Epidemiol Glob Health]]></source>
<year>2020</year>
<volume>8</volume>
<page-range>1047-52</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
