Associação Entre Acantose Nigricans E Outros Fatores De Risco Cardiometabólico Em Crianças E Adolescentes Com Sobrepeso E Obesidade

Abstract

Objective: To evaluate the presence or absence of acanthosis nigricans and its association with metabolic alterations in a group of obese and overweight children and adolescents.Methods: A cross sectional study of 161 overweight children and adolescents, who were divided into two groups, according to presence or absence of acanthosis nigricans. Anthropometric measurements (body mass index, skinfolds, abdominal circumference), blood pressure, laboratory tests (fasting glycemia, insulin, lipid profile, triglycerides, uric acid, transaminases) and homeostasis model assessment index.Results: The acanthosis nigricans group represented 51.5% of the sample. The mean age was similar between groups. The group with acanthosis nigricans presented higher body mass index, Z score of body mass index, body fat percentage, abdominal circumference (p<0.0001), systolic (p=0.006) and diastolic blood pressure (p=0.002). There was no significant difference in the analysis of lipid profile, except for the high-density cholesterol, which was lower (p=0.003) in the group with acanthosis. On the other hand, uric acid (p<0.0001), fasting glycemia (p=0.006), insulin (p<0.0001), glutamic oxalacetic transaminase (p<0.0001), and homeostasis model assessment index (p<0.0001) were significantly higher in the group with acanthosis nigricans.Conclusions: Acanthosis nigricans in overweight and obese children and adolescents is associated with elevation of body fat, blood pressure, insulin and homeostasis model assessment index, indicating that it is a clinical marker associated with the metabolic syndrome.

Acanthosis Nigricans in Children and Adolescents with Type 1 Diabetes or Obesity: The Potential Interplay Role between Insulin Resistance and Excess Weight

“…The role of metabolic derangement is described [14][15][16][17][31][32][33]. In our study, the presence of AN in subjects with obesity was associated with IR, while AN seemed to be related more with excess weight than IR in the T1D group.…”

“…AN prevalence varies among different age groups and ethnicities, reaching 25% in the general population and ranges from 49.2% to 58.2% in children or adolescents with obesity [29,30]. AN has been previously described in children with obesity [31][32][33] and less frequently in pediatric patients with T1D [14][15][16]. In our pediatric population, we described an overall AN prevalence of 15.75%, with a higher prevalence in patients with T1D (5%) and obesity (34.57%) compared with controls.…”

“…Although the exact pathogenic mechanisms of AN are not fully understood, these data support an interplay between impaired insulin signaling and increased insulin resistance, as well as adipose tissue (AT) dysfunction. Moreover, other components of MS [14][15][16][17][31][32][33] and an elevated chronic inflammation status should be also considered [30].…”

Metabolic Syndrome and Skin Diseases

“…A case-control study, which included 100 children who were overweight or obese, showed that 73% of them had a diagnosis of MetS with a strong association to AN (OR 1,872 [95% CI: 112.9–31,028]) (32). Another cross-sectional study also found that AH in overweight and obese children might be a clinical indicator of MetS, with the elevation of body fat, blood pressure, insulin, and homeostasis model assessment index (33). Furthermore, a 2-year multicenter case-control study including 123 patients at the age of 38.83 ± 8.62 years in India, found that facial AN was strongly related to impaired glucose tolerance, increased waist–hip ratio (WHR), and increased BMI.…”

“…The prevalence of AN varies among different ages and ethnicities, reaching 25% in the general population and even over 60% in overweight and obese children (30). There is solid evidence for the existence of a link between AN and MetS (31–33). For overweight and obese women, the incidence of MetS is significantly higher in AN patients (60%) than controls (37.6%) ( p = 0.0001)(31).…”