Acanthosis nigricans and insulin resistance in overweight children and adolescents

Kluczynik, Caroline Evelin Nascimento; Mariz, Larissa Soares; Souza, Larissa Camila Ferreira; Solano, Gabriela; Albuquerque, Fernanda Cruz de Lira; Medeiros, Carla Campos Muniz

doi:10.1590/s0365-05962012000400002

Cited by 39 publications

(48 citation statements)

References 16 publications

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“…19 Presence of AN can also be used as a grounds to initiate and reinforce discussions about lifestyle modification. 5,19,20 An observed AN frequency of 54% in our subjects was consistent with data reported in the Abbreviations: BMI = body mass index; HOMA-IR = homeostasis model of assessment-insulin resistance; SD = standard deviation * Acanthosis nigricans status was unavailable in 11 (2%) patients † HOMA-IR information was absent in 46 (8%) patients 21,22 Our adolescents were more likely to have AN than younger children, in line with hyperinsulinaemia being more severe among older individuals. 22 In our study, development of AN showed no gender preference, as in a study of 1412 unselected children by Stuart et al 23 In our cohort and that in Nsiah-Kumi et al's study, 13 obese children were more likely to have AN than overweight ones.…”

Section: Discussionsupporting

confidence: 87%

Acanthosis nigricans in obese Chinese children

Young

Huen

et al. 2014

Hong Kong Med J

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Objectives: To investigate the demographic characteristics and insulin resistance in local overweight/obese Chinese children with and without acanthosis nigricans, and the associations of acanthosis nigricans with insulin resistance and other cardiometabolic co-morbidities.Design: Case series with cross-sectional analyses.Setting: A regional hospital in Hong Kong.Patients: Chinese children assessed between January 2006 and December 2010 at Tseung Kwan O Hospital for being overweight or obese. Main outcome measures:The demographics, anthropometric data, acanthosis nigricans status, and biochemical results were analysed.Results: A total of 543 overweight/obese children were studied with 64% being boys and 29% had insulin resistance. Adolescents aged 12 to 18 years, compared with children aged 5 to 11 years, were more likely to have acanthosis nigricans (63% vs 47%; P<0.001) and insulin resistance (37% vs 25%; P=0.005). Compared with overweight children, those who were obese were more likely to have the two conditions: acanthosis nigricans (59% vs 44%; P=0.005) and insulin resistance (35% vs 19%; P=0.001). Compared with those without acanthosis nigricans, those with the condition had significantly higher mean values for systolic blood pressures Acanthosis nigricans in obese Chinese children IntroductionObesity was formally recognised as a global epidemic by the World Health Organization (WHO) in 1997. 1During the past decades, the prevalence of being overweight and obese has increased substantially. In Hong Kong, 17% of children were overweight/obese in 2005/6, which was a 5% increase since 1993, based on International Obesity Task Force cut-offs. 2Overweight/obese children and adolescents are more likely to have hyperinsulinaemia, hypertension, and dyslipidaemia. 3 The clustering of cardiometabolic risk factors in these patients tends to track into adult life.3 However, the Diabetes New knowledge added by this study • Hong Kong Chinese children with acanthosis nigricans were more likely to have insulin resistance, hypertension, fatty livers, and abnormal glucose homeostasis. Implications for clinical practice or policy • In children, acanthosis nigricans is an important clinical sign warranting early attention and evaluation.

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Section: Discussionsupporting

confidence: 87%

Acanthosis nigricans in obese Chinese children

Young

Huen

et al. 2014

Hong Kong Med J

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“…IR is also more severe in older children 20,22. This can be explained by the longer duration of being obese and having IR with puberty.…”

Section: Current Knowledge On Anmentioning

confidence: 99%

“…The latest recommendation of the American Diabetes Association endorsed the use of AN as one of the risk factors for testing asymptomatic overweight children 119. The presence of AN is a strong visual cue that may aid early detection of underlying cardiometabolic disease 20,117…”

Section: The Impact Of An On Obese Adolescentsmentioning

confidence: 99%

Acanthosis nigricans in obese adolescents: prevalence, impact, and management challenges

Ng¹

2016

AHMT

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Obesity in adolescence is a public health priority because it usually tracks into adulthood, resulting in enormous medical and social costs. This underscores the importance of early identification and intervention. Acanthosis nigricans (AN) was once considered a rare paraneoplastic dermatosis, but is now frequently observed in obese adolescents. Current understanding suggests that it is associated with insulin resistance and has a unique role in secondary prevention. The purpose of this narrative review is to provide a comprehensive overview of AN in obese adolescents, covering its history, current knowledge on the condition, its clinical significance, management challenges, and the direction of future research.

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“…Clinically AN is characterized by symmetrical, velvety, light brown to black thickened plaques with accentuation of skin marks, typically located in intertriginous areas [5, 9, 26, 33, 36]. The classic topography includes the neck, axillae, and elbows (see Figs.…”

Section: Introductionmentioning

confidence: 99%

Skin Manifestations of Insulin Resistance: From a Biochemical Stance to a Clinical Diagnosis and Management

González-Saldivar

Rodríguez-Gutiérrez

Ocampo‐Candiani

et al. 2016

Dermatol Ther (Heidelb)

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Worldwide, more than 1.9 billion adults are overweight, and around 600 million people suffer from obesity. Similarly, ~382 million individuals live with diabetes, and 40–50% of the global population is labeled at “high risk” (i.e., prediabetes). The impact of these two chronic conditions relies not only on the burden of illnesses per se (i.e., associated increased morbidity and mortality), but also on their increased cost, burden of treatment, and decreased health-related quality of life. For this review a comprehensive search in several databases including PubMed (MEDLINE), Ovid EMBASE, Web of Science, and Scopus was conducted. In both diabetes and obesity, genetic, epigenetic, and environmental factors overlap and are inclusive rather than exclusive. De facto, 70–80% of the patients with obesity and virtually every patient with type 2 diabetes have insulin resistance. Insulin resistance is a well-known pathophysiologic factor in the development of type 2 diabetes, characteristically appearing years before its diagnosis. The gold standard for insulin resistance diagnosis (the euglycemic insulin clamp) is a complex, invasive, costly, and hence unfeasible test to implement in clinical practice. Likewise, laboratory measures and derived indexes [e.g., homeostasis model assessment of insulin resistance (HOMA-IR-)] are indirect, imprecise, and not highly accurate and reproducible tests. However, skin manifestations of insulin resistance (e.g., acrochordons, acanthosis nigricans, androgenetic alopecia, acne, hirsutism) offer a reliable, straightforward, and real-time way to detect insulin resistance. The objective of this review is to aid clinicians in recognizing skin manifestations of insulin resistance. Diagnosing these skin manifestations accurately may cascade positively in the patient’s health by triggering an adequate metabolic evaluation, a timely treatment or referral with the ultimate objective of decreasing diabetes and obesity burden, and improving the health and the quality of care for these patients.

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Acanthosis nigricans and insulin resistance in overweight children and adolescents

Cited by 39 publications

References 16 publications

Acanthosis nigricans in obese Chinese children

Acanthosis nigricans in obese Chinese children

Acanthosis nigricans in obese adolescents: prevalence, impact, and management challenges

Skin Manifestations of Insulin Resistance: From a Biochemical Stance to a Clinical Diagnosis and Management

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