Acanthosis nigricans em mulheres obesas de uma população miscigenada: um marcador de distúrbios metabólicos

Abstract

Acanthosis nigricans em mulheres obesas de uma população miscigenada: um marcador de distúrbios metabólicos * Acanthosis nigricans in obese women in a mixed-race population: a marker of metabolic disturbances * Resumo: FUNDAMENTOS -Acanthosis nigricans (AN) tem sido associada a diversos distúrbios metabólicos e endócrinos. OBJETIVO: O objetivo deste estudo é avaliar a freqüência das co-morbidades da síndrome metabólica em mulheres obesas de uma população miscigenada com AN, comparada a um grupo sem AN. CASUÍSTICA E MÉTODOS -Foram estudadas 481 mulheres, consecutivamente admitidas em um ambulatório de obesidade (388 com AN e 93 sem AN) e submetidas ao teste de tolerância à glicose oral, excetuando-se 20, que já se sabiam diabéticas. RESULTADOS -A distribuição segundo a raça indicou 34,5% de brancas, 38,9% de pardas e 26,6% de negras. A freqüência global de AN foi de 80,7%, sendo fortemente maior nas negras versus brancas (90,6 % e 66,9%, p=0,000000) e negras versus pardas (86% e 90,6%, p= 0,000006). Foi também maior nas pardas versus brancas (86% e 66,9%, p<0,02). As pacientes com AN eram mais jovens (35 ± 10 versus 38 ± 10 anos, p < 0,01), mais obesas (41 ± 6 versus 39 ± 6 kg/m 2 , p<0.01), tinham maior circunferência de cintura, maior freqüência de obesidade andróide, de diabetes tipo 2 (11,1% versus 4,3%, p=0,05), maiores níveis de insulina de jejum e de resistência insulina (Homa IR) do que aquelas sem AN. As freqüências de hipertensão diastólica e alterações do colesterol total e frações e de triglicérides entre os grupos foram similares. CONCLUSÃO -Em mulheres obesas de uma população miscigenada, AN foi mais freqüente nas de raça negra e parda e foi observada maior freqüência de co-morbidades da síndrome metabólica em comparação à população sem AN. As mulheres obesas com AN devem ser investigadas para distúrbios metabólicos, mesmo sendo jovens. Palavras-chaves: Acantose nigricans; diabetes mellitus não insulino-dependente; metabolismo; obesidade; raças; resistência à insulina. Summary: BACKGROUND -Acanthosis nigricans (AN) has been associated with various metabolic and endocrine disturbances.OBJECTIVE: The objective of this study is to evaluate the frequency of metabolic syndrome clusters in a group of obese mixed-race women with AN as compared to a group without AN. SUBJECTS AND METHODS -481 women consecutively admitted to an outpatient obesity clinic were studied: 388 with AN, and 93 without AN. Except for 20 diabetic patients, all patients were submitted to an oral glucose tolerance test (75 g). RESULTS: The skin color distribution was 34.5% white, 38.9% mulatto and 26.6% black. The global frequency of AN was 80.7%. AN frequency was significantly higher in black versus white and black versus mulatto (90.6 % and 66.9%, p = 0.000006). It was also higher in mulatto versus white (86% and 66.9%, p<0,02). The AN group was younger (35 ± 10 years versus 38 ± 10 years, p < 0,01) and heavier (41 ± 6 kg/m 2 versus 39 ± 6 kg/m 2 , p<0.01). It consisted of larger waist circumference and higher frequency android obes...

Skin manifestations of obesity: a comparative study

“…Our results demonstrate a clear correlation between obesity and acrochordons, even when adjusted for diabetes, dyslipidemia and metabolic syndrome. Another disease associated with hyperinsulinemia and endocrinopathies is pseudoacanthosis nigricans 14–16 . This sample showed obesity to be an independent factor for pseudoacanthosis nigricans, besides that the correlation between this dermatosis and the increase in the BMI should also be taken into consideration.…”

“…Another disease associated with hyperinsulinemia and endocrinopathies is pseudoacanthosis nigricans. [14][15][16] This sample showed obesity to be an independent factor for pseudoacanthosis nigricans, besides that the correlation between this dermatosis and the increase in the BMI should also be taken into consideration.…”

As principais alterações dermatológicas em pacientes obesos

“…It is a dermatological condition characterized by thickening, hyperpigmentation and accentuation of skin lines, creating a rough and velvety appearance at the affected site 2 .…”

Dermatological aspects influencing the practice of physical activities by obese individuals

“…Skin lesions generate significant costs to all involved and influence patient's quality of life, as well as their social, recreational and work relationships (7,18) Dermatoses may serve as metabolic markers of obesity and insulin resistance (19)(20)(21)(22)(23)(24). Depending on their appearance, location and circumstances, they can cause embarrassment and hinder or prevent the practice of physical and sporting activities (3,4,(25)(26)(27)(28).…”