Laparoscopic sleeve gastrectomy improves body composition and alleviates insulin resistance in obesity related acanthosis nigricans

Abstract

BackgroundAcanthosis nigricans (AN) has a close relationship with obesity. It is believed that obesity and AN have the common pathophysiological basis such as hyperinsulinism. This study is aimed to observe the effect of laparoscopic sleeve gastrectomy (LSG) on body composition and insulin resistance in Chinese obese patients with acanthosis nigricans.MethodsA total of 37 obese patients who underwent LSG in our hospital were selected for analysis. They were divided into simple obesity (OB n = 14) and obesity with acanthosis nigricans (AN n = 23) group respectively. Body composition was measured by dual-energy X-ray absorptiometry (DEXA). Anthropometric measurements and glucolipid metabolism before and 3 months post LSG were collected for analysis.ResultsPatients with AN got noticeable improvement in skin condition and their AN score was significantly decreased (3.52 ± 0.79 vs. 1.48 ± 0.73, P < 0.001).Alleviated insulin resistance and more trunk fat loss than limbs’ were observed in both groups (P value < 0.01). In AN group, preoperative android fat mass (FM) was positively correlated with fasting insulin and natural logarithm of HOMA-IR (LNIR) (r = 0.622, 0.608, respectively; all P < 0.01). Besides, changes in android FM and visceral adipose tissue (VAT) also showed significantly positive correlation with changes in LNIR (r = 0.588, r = 0.598, respectively; all P < 0.01).ConclusionsLSG had a positive impact on body composition and skin condition in Chinese obese patients with AN. Loss of android FM and VAT might result in the alleviation of insulin resistance in AN patients. Android fat distribution seems to be a potential indicator of postoperative metabolic benefits for obese patients with AN.

Changes in inflammatory markers correlated with increased testosterone after laparoscopic sleeve gastrectomy in obese Chinese men with acanthosis nigricans

“…Bariatric surgery is the most effective treatment option for severe obesity and its associated comorbidities . Zhang et al . also revealed significant improvement in skin condition and severity of AN after LSG.…”

“…Bariatric surgery is the most effective treatment option for severe obesity and its associated comorbidities. 13 Zhang et al 6 also revealed significant improvement in skin condition and severity of AN after LSG. Consistently, we observed substantial weight reduction and improvement in skin condition and severity of AN in obese Chinese men with AN.…”

“…To date, AN has been treated with various therapeutics with limited and unsatisfactory effect. Interestingly, laparoscopic sleeve gastrectomy (LSG) has led to significant improvement in its treatment . However, the efficacy of LSG on sex hormones and inflammatory status in obese men with AN is unexplored.…”

“…Interestingly, laparoscopic sleeve gastrectomy (LSG) has led to significant improvement in its treatment. 6 However, the efficacy of LSG on sex hormones and inflammatory status in obese men with AN is unexplored. We thus investigated the alterations of sex hormones and inflammatory markers before and 1 year after LSG after LSG and their correlations in obese Chinese males with AN.…”

The Obesity Epidemic and the Rise of Acanthosis Nigricans – A Case for Lifestyle Medicine

“…In this study, all 23 patients had noticeable improvement in AN at a 3-month follow up, likely due to improved insulin resistance and fat loss. 13 We present a case of a 33-year-old African American woman who presented with a chief complaint of dark discoloration on her face. Physical exam revealed dark brown symmetric velvety thin plaques on the bilateral cheeks consistent with AN.…”