Obese/overweight and the risk of acne vulgaris in Chinese adolescents and young adults

Background: An association between obese/overweight and acne vulgaris has long been postulated, but with controversial results. Aim: This study was designed to investigate the relationship between acne vulgaris, body mass index (BMI), and family history of related metabolic disorders in Chinese. Methods: We conducted a case-control study of risk factors for acne in a Chinese Han population aged 10 to 25 years attending outpatient departments in PR China. A total of consecutive 364 patients with acne were recruited, while 295 non-acne patients or healthy subjects served as controls. Results: The mean BMI was higher in moderate to severe acne patients (Pillsbury grading scale, grades 3 and 4) (21.86 +/- 2.83 kg/m(2)) than controls (20.22 +/- 2.43 kg/m(2)) (P<0.001). Moderate to severe acne was positively associated with overweight and obesity in people aged 18-25 years, with a more pronounced effect in women [Odds ratio (OR) 14.526, 95% confidence interval (Cl) 2.961-71.272, P<0.001] than in men (OR 3.528, 95% Cl 1.553-8.014, P=0.002). Body mass index in patients with thorax-back lesions were higher (22.30 +/- 2.57 kg/m(2)) than patients without thorax-back lesions (20.68 +/- 2.23 kg/m(2)) (P<0.001) and the relationship between thorax-back acne and overweight was observed (OR 4.480, 95% Cl 2.182-9.196, P<0.001). Presence of family history of metabolic disorders such as hypertension (OR 3.511, 95% Cl 1.977-6.233, P<0.001), diabetes (OR 2.697, 95% Cl 1.565-4.647, P<0.001), overweight and obesity (OR1.844, 95% Cl 1.242-4.407, P=0.032) were also found to be associated with increased acne severity. Conclusions: Obese/overweight in women aged 18-25 years with severe acne and family history of metabolic disorders could be risk factors of acne in Chinese acne patients.