Association of HOMA-IR and Fai with acne vulgaris in Iraqi women

Background: Acne vulgaris is a chronic inflammatory skin disorder that disproportionately affects women due to hormonal and metabolic influences. This case-control study investigates the association between insulin resistance (IR) metabolic syndrome (MetS) and acne severity among Iraqi women focusing on the impact of these metabolic disruptions on disease progression Methods: The study included 100 Iraqi women aged (20-40) years 50 with clinically diagnosed acne vulgaris and 50 healthy controls from June 2023 to June 2024. Metabolic markers such as fasting blood glucose insulin levels lipid profiles glycated hemoglobin (HbA1c) C-reactive protein (CRP) and Free Androgen Index (FAI) were analyzed Insulin resistance was assessed using the Homeostasis Model Assessment (HOMA-IR). Multiple regression analysis and ROC curves were used to assess the independent contribution of metabolic factors to acne severity and diagnostic accuracy. Results: Women with acne showed significantly higher rates of IR (65%) and MetS (58%) compared to controls. There was a strong correlation between acne severity and elevated HOMA-IR scores fasting glucose insulin levels CRP and FAI. Regression analysis confirmed that HOMA-IR independently predicted acne severity (p<0.01). ROC curve analysis demonstrated that a HOMA-IR value >3.0 had 85% sensitivity and 78% specificity in predicting moderate-to-severe acne. Conclusion: This study underscores a significant link between metabolic dysfunction and acne severity in Iraqi women. Integrating metabolic screening into dermatological practice may improve acne management and prevent long-term complications associated with IR and MetS.