Features of neurohormonal regulation of digestive organs in patients with acne vulgaris in metabolically associated fatty liver disease

Acne vulgaris (AV) is a chronic inflammatory disease of the pilosebaceous unit. The pathogenesis of acne is complex and multifactorial, as there are many pathophysiological processes involved: increased sebum production, hyperkeratinization of the pilosebaceous duct, colonization by Propionibacterium acnes, and inflammation. The aim of the study: to evaluate the effect of complex treatment on the dynamics of neuropsychometric disorders depending on changes in the level of free fatty acids (FFA) in sebum and IGF-1 in blood serum in patients with AV and metabolically associated fatty liver disease (MAFLD). Materials and methods. 59 patients with AV and MAFLD were examined. Patients were divided into 3 groups: 1st group of examined (n=20) underwent topical therapy with adapalene gel with benzoyl peroxide; 2nd group included 19 patients who were prescribed an oral symbiotic containing Lactobacillus rhamnosus GG AF ATCC 53103, D-chiro inositol, inulin; 3rd group patients (n=20) received a combination of topical gel application and symbiotic administration. Patients were measured for free fatty acids (FFA) in sebum, insulin-like growth factor-1 (IGF-1) in serum, and their psychoemotional state was assessed using testing. Results. Due to the treatment of acne, an improvement in quality of life (decrease in patient assessment scores on the DLQI scale) was observed in all groups. Analysis of differences between groups confirmed better final results in 3rd group (LR=21.3; p=0.00009). Comparison of dynamics taking into account the initial DLQI level of each patient preserved a statistically significant advantage of this group with a likelihood ratio when comparing logistic regression models with a cumulative relationship LR=13.7 (p=0.0034). Patients with AV and MAFLD revealed high levels of depression on the BDI scale, as well as pronounced signs of aggressiveness and hostility according to the BDHI test. The vast majority of patients with AV and MAFLD, according to the TAS test, revealed disorders in the expression of their own experiences (alexithymia). Patients with acne are introverts, with pronounced manifestations of neuroticism, they have a reduced sense of benevolence, reduced conscientiousness and openness to experience. Conclusion. Patients with AV and MAFLD revealed disorders of psychoemotional status, which directly depends on the severity and severity of acne. Improvement of the spectrum of fatty acids and IGF-1 levels in serum against the background of complex combined treatment has a positive effect on the psycho-emotional status in these patients.