Association of acanthosis nigricans with race and metabolic disturbances in obese women

Abstract

Acanthosis nigricans (AN) has been recognized as a marker of insulin resistance and diabetes mellitus. We have compared frequency of race and metabolic disturbances in obese women with several degrees of AN (AN group, N = 190) to a group without AN (non-AN group, N = 61) from a mixed racial population. The groups were similar regarding age and body mass index. All patients (except the diabetic patients) underwent an oral glucose tolerance test (75 g). The racial distribution of this population was 35.1% white, 37.8% mulatto and 27.1% black and the frequency of AN was 62.5, 82.1 and 83.8%, respectively, higher in black versus white (P = 0.003) and mulatto versus white (P = 0.002) women. The frequencies of diabetes mellitus and impaired glucose tolerance were 5.8 and 12.6% in the AN group and 1.6 and 8.2% in the non-AN group, respectively (P>0.05). Fasting glucose, ß cell function determined by the homeostasis model of assessment (HOMA), fasting insulin and insulin area under the curve were similar for the AN and non-AN groups. A higher HOMA insulin resistance was observed in the AN group compared to the non-AN group (P = 0.02) and in the subgroup of highest degree of AN compared to those with other degrees. The mean lipid levels and the frequency of dyslipidemia were similar for the two groups. AN was strongly associated with the black or mulatto rather than the white race, even after taking into account the effect of age, body mass index and HOMA insulin resistance.

Associated Cutaneous Diseases in Obese Adult Patients: A Prospective Study from a Skin Referral Care Center

“…Development of plantar hyperkeratosis may be regarded as a physiologic response to mechanical trauma, as obese patients have increased forefoot width and higher plantar pressures during walking and standing [13] . Acanthosis nigricans is a consistently reported finding in studies of obese persons [6,14] and it is the most common dermatological condition associated with obesity reported in the literature. However, the prevalence of acanthosis nigricans in this study is lower than the 74% [6] and 76% [14] reported for the USA and Brazil, respectively, but higher than the 0.6% [15] for Egypt.…”

A Study on Correlation Between Acanthosis Nigricans And Polycystic Ovarian Syndrome (PCOS) in Indian Adult Women Population

“…The clinical importance of AN has been claimed to be due to its association with various metabolic and hormonal abnormalities such as obesity, diabetes, PCOS, dyslipidaemia, Cushing's syndrome, thyroid dysfunction etc 10,11,12 . The actual prevalence of AN in the population has not been assessed widely in India.…”

Acanthosis Nigricans dan Hubungannya dengan Resistensi Insulin pada Anak dan Remaja

“…3 Prevalensi AN bervariasi dari 7% pada populasi umum sampai dengan 74% pada orang dewasa dengan obesitas. 7 Penelitian terakhir memperlihatkan bahwa derajat beratnya AN berhubungan dengan konsentrasi insulin plasma puasa dan indeks masa tubuh (IMT). Acanthosis nigricans lebih sering dijumpai pada orang berkulit gelap dengan prevalensi pada kulit putih <1%, sedangkan pada kulit hitam 13,3%.…”

“…Kondisi metabolik lain yang berhubungan dengan AN antara lain obesitas, diabetes mellitus, toleransi glukosa terganggu, dislipidemia, ovarium polikistik, hipertensi, hiperprolaktinemia, hipertiroid, hipotiroid, dan penyakit Addison. [1][2][3][4][5][6][7][8] Insidens diabetes mellitus tipe 2 terus meningkat sehingga dibutuhkan intervensi lebih dini berupa pencegahan. Didapatkan bahwa intervensi berupa perubahan gaya hidup dapat mencegah atau memperlambat timbulnya diabetes mellitus tipe 2 sebanyak 58%.…”

“…Manifestasi klinis AN maligna sulit dibedakan dengan AN benigna, akan tetapi AN maligna biasanya timbul pada pasien tengah baya, tidak gemuk dan lesinya timbul secara mendadak. 3,7 Burke dkk 10 membuat skala kuantitatif untuk menyatakan derajat AN. Skala ini dibuat berdasarkan derajat beratnya penyakit berdasarkan lokasi AN yaitu pada daerah aksila, leher, siku, lutut, dan ruas sendisendi jari (Tabel 2).…”