Association Between Altered Gut Microbiota and Acne Vulgaris: A Comparative Study of Trimethylamine N-Oxide Levels in Patients and Healthy Controls.

INTRODUCTION: Microbiota refers to the microorganisms inhabiting specific environments, while the microbiome encompasses these organisms, their metabolites, and environmental factors. Variations in microbiota composition across body regions influence physiological processes, including metabolism, immunity, and skin health. Trimethylamine N-oxide (TMAO), a metabolite linked to gut dysbiosis, inflammation, and systemic diseases, has not been previously investigated in acne patients. OBJECTIVE: We aimed to investigate the potential relationship between gut dysbiosis and acne vulgaris by assessing serum TMAO levels in acne patients compared to healthy controls. METHODS: This case-control, cross-sectional study involved 70 acne patients and 70 age- and sex-matched healthy controls. Serum TMAO levels were measured, and acne severity was graded using the Global Acne Grading System (GAGS). Statistical analysis was performed using SPSS 20.0, with p-values <0.05 considered significant. RESULTS: Acne patients exhibited significantly higher serum TMAO levels (16.74 ± 10.10 ng/ml) compared to controls (13.11 ± 4.28 ng/ml, P=0.007). While no significant correlation was found between TMAO levels and acne severity, a weak negative trend was observed (P=0.062). Similarly, TMAO levels showed no significant correlation with body mass index (BMI) (P=0.933). CONCLUSION: This study identified elevated serum TMAO levels in acne vulgaris patients, suggesting a potential link between gut dysbiosis, diet, and acne pathogenesis. While these findings emphasize the role of systemic inflammation and microbiota, further research is necessary to establish causal relationships and to evaluate the impact of dietary and microbial interventions in acne management.