Adiponectin
Six 8,20,27,28,30,31 studies assessed adiponectin levels in serum before and after treatment with systemic isotretinoin. Our meta-analysis showed that adiponectin increases significantly after treatment [pooled SMD: 0.86, 95% CI (0.48 – 1.25), p-value <0.0001; I2: 58%] (Figure 2). We conducted a sensitivity analysis excluding one study30that was assessed as having serious risk of bias, with similar results [pooled SMD: 0.90, 95% CI (0.40 – 1.39), p-value: 0.0004; I2: 67%] (Figure 3), but in our subgroup analysis the meta-analyzed cohort studies revealed a higher and more statistically significant increase of adiponectin levels after treatment [pooled SMD: 1.21, 95% CI (0.81 – 1.61), p-value <0.00001; I2: 8%] (Figure 4). Two of the meta-analyzed studies 27,28 measured the levels of adiponectin 1-3 months after treatment, and showed that even though isotretinoin increases adiponectin levels, this increase is transient.