Introduction

Insulin resistance is a physiological state where the body's cells have a reduced response to the action of insulin. This metabolic disorder is often associated with the development of conditions such as type 2 diabetes, obesity, metabolic syndrome and cardiovascular disease [1, 2].

Insulin resistance significantly affects the skin, compromising both its health and appearance. This condition can increase the chronic inflammatory state [3]. Furthermore, insulin resistance impairs the production of collagen, essential for the integrity and elasticity of the skin, resulting in more fragile skin with less elasticity, which contributes to premature aging and the formation of wrinkles [4].

As Insulin resistance, glycation have significant impacts on skin health, directly affecting collagen production and accelerating skin aging [4, 5]. In insulin resistance, the body does not efficiently utilize insulin, leading to high blood glucose levels which, in turn, reduce collagen synthesis and increase its breakdown. The glycation process occurs when glucose increase and reacts with proteins such as collagen, forming advanced glycation end products (AGEs) that make collagen fibers rigid and less elastic. This contributes to wrinkles, tightness and loss of elasticity, as well as promoting oxidative stress and inflammatory processes that accelerate skin aging [5, 6].

Some nutritional strategies can be used to minimize the effect of insulin resistence and glycation on the body and skin. It is already known that carcinine improves the biochemical parameters associated with AGEs. Therefore, it is believed that carcinine supplementation can improve the damage associated with insulin resistance and glycation on the skin [7-9].

Case Report

In this case report, six menopausal women, with insulin resistance, aged between 44 and 59 years (±50.2 years) took 300 mg of carcinine orally and underwent two radiofrequency sessions with an interval of 15 days. To assess dermal density, all women underwent facial ultrasound, in which the chin and malar region were measured (Figure 1). The density value was measured by the average density of the regions compared at the beginning (T0) and end of treatment (T1). The study lasted 30 days. After 30 days of intervention, he recommended an increase in dermal density in all women.

Figure 1: Facial ultrasound in which the chin and malar region were measured.

The results of the present study are expressed in table 1. Thus, in the malar region there was a 10% increase in dermal density. In the mental region there was an increase of 7.1%. The overall increase in dermal density, that is, the average of all measurements was 8.6%.

Table 1: Result of the intervention after 30 days.

Discussion

Insulin resistance, identified as an impaired biological response to insulin stimulation in target tissues. The metabolic consequences of insulin resistance can result in hyperglycemia, hypertension, dyslipidemia, hyperuricemia, elevated inflammatory markers, and endothelial dysfunction [10]. During menopause, according to some studies, the decline in estrogen increases the chances of developing insulin resistance and its associated diseases [11] The skin is one of the tissues damaged by insulin resistance and type II diabetes. With an increase in blood glucose, skin structures, such as collagen and elastin, tend to suffer from the gligation process, oxidative stress and inflammation. Studies show that, with changes in glucose metabolism, there is an increase in the activity of matrix metalloproteinases, enzymes that degrade skin collagen, as well as a reduction in the rate of collagen synthesis in the tissue. Thus, insulin resistance is one of the factors associated with atrophy and the skin aging process [12].

Nutrition is understood as a determining factor in the treatment of insulin resistance. Dietary glycemic control reduces blood glucose and insulin levels in plasma [13]. Nutraceutical supplementation, in turn, helps in the nutritional treatment of insulin resistance [7, 8]. The use of carcinine has been widely studied as a resource that helps with glycemic and insulinemic control in individuals with insulin resistance and type II diabetes [8]. Another important aspect associated with carcinine is its potential antioxidant and anti-glycating effects [13]. It is already known that glycation interferes with the structure of the skin, mainly altering the function of collagen in the tissue [14]. In the present study we were able to observe that carcinine supplementation (300mg) was able to improve tissue density parameters. The result of the present study is believed to be associated with the anti-glycating role of carcinin in the skin. Studies using carnosine, an analogue of carcinine, show that its supplementation is capable of improving hydration parameters, as well as reducing skin roughness [15, 16]. Through ultrasound analysis, an increase in dermal density was observed in menopausal women and those with insulin resistance, showing that carcinane is an excellent strategy for reducing the effects of glucotoxicity on the skin.

Conclusion

In the present study, it was demonstrated that carcinine supplementation in menopausal women with insulin resistance was able to increase dermal density.

References

1. Chopra AK (2022) Metabolic Syndrome or Insulin Resistance: Evolution, Controversies and Association With Cardiovascular Disease Risk. Indian Journal of Clinical Cardiology 1(2):77-85.
2. Hauner, H (2002) Insulin resistance and the metabolic syndrome—a challenge of the new millennium. Eur J Clin Nutr 56 (Suppl 1): S25–S29.
3. Napolitano M, Megna M, Monfrecola G (2015) Insulin resistance and skin diseases. Scientific World Journal 2015:479354.
4. Chen CY, Jia-Qi Z, Li L, Miao-Miao G, Yi-Fan H, et al (2022). Advanced Glycation End Products in the Skin: Molecular Mechanisms, Methods of Measurement, and Inhibitory Pathways. Front Med (Lausanne) 11:837222.
5. Portero-Otin M, Pia de la Maza M, Uribarri J (2023) Dietary Advanced Glycation End Products: Their Role in the Insulin Resistance of Aging. Cells 12: 1684.
6. Prasad C, Davis KE, Imrhan V, Juma S, Vijayagopal P (2017) Advanced Glycation End Products and Risks for Chronic Diseases: Intervening Through Lifestyle Modification. Am J Lifestyle Med 13(4):384-404.
7. Sadowska-Bartosz I, Bartosz G (2015). Prevention of Protein Glycation by Natural Compounds. Molecules 20: 3309-3334.
8. Wolpe L, Granzoti R (2020) Carcinine supplementation and its implication in fasting glycemia, glycated hemoglobin, insulin, frutosamine and lipid profile in overweight and obese women: a placebo-controlled double-blind randomized clinical trial. Braz. J. of Develop 6(10): 78877-78889.
9. Palmieri B, Vadala M (2023) The role of Carcinine treatment on glico-lipidic imbalance of patients with altered blood glucose pattern. Clin Ter. 174 (2):195-202.
10. Freeman AM (2024). Insulin Resistance. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing.
11. Sathya BCV, Balaji S, Seethalakshmi A (2012) Analysis of the degree of insulin resistance in post menopausal women by using skin temperature measurements and fasting insulin and fasting glucose levels: a case control study. J Clin Diagn Res 6(10):1644-7.
12. Gonza´lez-Saldivar G et al (2017). Skin Manifestations of Insulin Resistance: From a Biochemical Stance to a Clinical Diagnosis and Management. Dermatol Ther (Heidelb) 7:37–51.
13. Gołąbek KD, Regulska-Ilow B (2019) Dietary support in insulin resistance: An overview of current scientific reports. Adv Clin Exp Med 28(11):1577-1585.
14. Zheng W, Li H, Go Y, Chan XHF, Huang Q, et al (2022) Research Advances on the Damage Mechanism of Skin Glycation and Related Inhibitors. Nutrients 14(21):4588.
15. Sureshkumar K, Durairaj M, Srinivasan K, Wen Goh K, Undela K, et al (2023). Effect of L-Carnosine in Patients with Age-Related Diseases: A Systematic Review and Meta-Analysis. Front. Biosci. (Landmark Ed) 28(1): 18.
16. Wang L, Jiang Y, Zhao C (2024) The effects of advanced glycation end-products on skin and potential anti-glycation strategies. Experimental Dermatology 33: e15065.