Acanthosis Nigricans: High Prevalence and Association with Diabetes in a Practice-based Research Network Consortium--A PRImary care Multi-Ethnic Network (PRIME Net) Study

Abstract

Background: Previous work has established a surprisingly high prevalence of acanthosis nigricans (AN) and its association with increased risk of type 2 diabetes in a Southwestern practice-based research network (PBRN). Our objective was to establish whether this high prevalence of AN would be present in other areas.Methods: We examined the prevalence of type 2 diabetes and its risk factors and the prevalence of AN among patients aged 7 to 65 years who had been seen by one of 86 participating clinicians in a national PBRN consortium during a 1-week data collection period. In a subsample of nondiabetic matched pairs who had or did not have AN, we compared fasting glucose, insulin, and lipid levels.Results: AN was present in 19.4% of 1730 patients from among all age ranges studied. AN was most prevalent among persons with more risk factors for diabetes. Patients with AN were twice as likely as those without AN to have type 2 diabetes (35.4% vs 17.6%; P < .001). In multivariable analysis, the prevalence ratio for diabetes was 2.1 (95% CI, 1.3-3.5) among non-Hispanic whites with AN and 1.4 (95% CI, 1.1-1.7) among minority patients with AN. In a subsample of 11 matched pairs, those with AN had higher levels of insulin and insulin resistance.

Nursing care in childcare services: Acantose nigricans as a marker for metabolic risk

“…at greater cardio-metabolic risk must be identified, so that they may be referred to the appropriate service as early as possible (3) . Studies suggest that the presence of AN is a risk indicator for IR, type 2 diabetes and MS, principally when associated with obesity (6)(7)(8) .…”

“…However, its inclusion could help in the classification of risk among overweight adolescents, as AN is an easily-identifiable clinical characteristic, with no financial onus for the investigating body, and is applicable in primary healthcare (8) . It also stands out that for the primary prevention of nutritional problems, one needs methods which nurses and healthcare professionals can use easily (11) .…”

“…One can, however, adopt as another indicator Acantose nigricans (AN), which is characterized by dark-brown velvety papilomatous dermatitis, with hyperkeratotic plaques in regions such as the neck (93-99%) and the axilla areas (73%), followed, with a lower frequency, by the fingers and toes (6)(7)(8) . Although AN is more commonly associated with obesity and insulin resistance (IR), studies have suggested that its presence may also indicate type 2 diabetes, metabolic syndrome (MS), and polycystic ovary syndrome (9) .…”

Acantose nigricante: inter-relações metabólicas inerentes à síndrome dos ovários policísticos

“…Foram definidos os grupamentos ponderais de acordo com o IMC: normal (18,(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)9), sobrepeso (25-30) e obesidade (>30). A pressão arterial (mmHg) foi mensurada no braço direito, com a paciente sentada, após cerca de dez minutos em repouso.…”

“…Ainda que vinculada à obesidade e ao diabetes tipo 2, a prevalência da AN observa certa disparidade, conforme diferentes resultados recentes. Entre todas as dermatopatias relacionadas à SOP, a prevalência da AN ocupa posição ínfima (5,2%) 18 , ao contrário de estudos com porcentagens maiores, a exemplo de 64,6% 19 , particularmente focalizados nas relações com o diabetes tipo 2 20 . A discrepância envolve fatores étnicos, geográficos e, notadamente, a coexistência de múltiplas condições de risco para o diabetes.…”