Acanthosis Nigricans: relation to risk of Type 2 diabetes and cardiovascular diseases among Jamaican adolescents

Abstract

adulthood [8,14]. Obesity has been cited as "a risk factor for CVD, ventricular dysfunction, congestive heart failure, stroke, and cardiac arrhythmias" [15]. According to Calderon et al. [16] "Persons with body mass index (BMI) >35 kg/m 2 are 2-3 times more likely than lean persons with lower BMI (18.5-24.9 kg/m 2 ) to die from CVD". Therefore, detection of the early signs of T2D and CVD is needed to help in the prevention of these and other related medical conditions. Similar to higher BMI, abdominal fat or central adiposity is closely associated with hyperinsulinemia and IR [17]. According to Ramachandran (2004) AbstractThe objectives of the study were to determine if Jamaican adolescents were at risk for type 2 diabetes (T2D) and cardiovascular diseases (CVD), and examine the relationship between the presence of Acanthosis Nigricans (AN) and the risk of developing T2D and CVD among Jamaican adolescents.A descriptive epidemiological cross-sectional study of 276 Jamaican adolescents ages 14-19 years (15.6 ± 1.2) participated. Subjects were selected from grades 9-12 from ten high schools on the island and included males (112) and females (164). Fasting blood glucose (FBG), total cholesterol (TC), glycated hemoglobin (A1c), blood pressure (BP), body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), and presence of Acanthosis Nigricans were examined. Of the eight risk factors for T2D and CVD examined, the presence of AN classified more subjects at risk than all the other risk factors. Spearman correlations of AN with the other seven risk factors were highly significant for six of these other risk factors (P<0.05). High A1c was the only risk factor which did not correlate with the presence of AN (P=0.085). Females had significantly higher WC (P<0.041), and presence of AN (P<0.013), whereas, males had significantly higher FBG (P<0.039). Urban subjects had significantly higher BMI (P<0.018) and WC (P<0.021) than rural subjects. High total cholesterol was significant for subjects with lower income (P<0.039). The presence of AN classified more subjects at risk than did the other seven risk factors. Examining students for the presence of AN can be economically and easily performed within the schools. A1c classified more subjects at risk for T2D and CVD than FBG and TC, however, there was no correlation between high A1c and the presence of AN. Over one third of the study subjects reported three or more risk factors for T2D and CVD which indicates early intervention measures are needed for this population.

Clinical Characterization of Data-Driven Diabetes Clusters of Pediatric Type 2 Diabetes

“…The prevalence of AN was lowest among individuals with lower BMI and higher A1c (Cluster 4), suggesting that AN is closely associated with obesity as a manifestation of cutaneous insulin resistance [ 37 – 39 ], while it may also develop prior to the onset of obesity [ 40 ]. The higher levels of A1c in this subgroup brings up the hypothesis that AN might not be directly associated with A1c [ 41 ] and BMI might be a more important factor in developing this complication.…”