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Página de Inicio arrow Artículos Científicos arrow Acanthosis Nigricans Identifies Youth at High Risk for Metabolic Abnormalities
Acanthosis Nigricans Identifies Youth at High Risk for Metabolic Abnormalities Imprimir E-Mail
Wendy J. Brickman, MD, Jie Huang, ScD, Bernard L. Silverman, MD, Boyd
E. Metzger, MD
Received 1 November 2008; received in revised form 11 June 2009;
accepted 2 July 2009. published online 05 October 2009.
Corrected Proof

Objective

To determine the prevalence of abnormal glucose homeostasis and
cardiovascular risk factors in youth with acanthosis nigricans (AN).

Study design

Youth (8-14 years) were recruited from community pediatric offices.
Each subject underwent a questionnaire, a targeted physical
examination, and an oral glucose tolerance test.

Results

Subjects (n = 236) with AN of the neck (AN+) (60% Hispanic, 30%
African American, 54% female, body mass index [BMI] z-score 2.3 kg/m2)
and 51 youth without AN (65% Hispanic, 22% African American, 37%
female, BMI z-score 2.1 kg/m2) completed the study. Twenty-nine
percent of the AN+ group had abnormal glucose homeostasis, 27% had
systolic blood pressure > 95th percentile, and 50% had high-density
lipoprotein–cholesterol ≤5th percentile. Once corrected for sex,
puberty, maternal education, and BMI z-score, AN remained
significantly associated with insulin resistance and abnormal glucose
homeostasis. For youth in the AN+ group, homeostasis model assessment
of insulin resistance, female sex, and positive glutamic acid
decarboxylase antibodies remained significantly and independently
associated with impaired glucose tolerance.

Conclusions

Youth in the AN+ group had severe insulin resistance, and more than 1
in 4 already had abnormal glucose homeostasis. AN identified a
high-risk population, for whom appropriate interventions have the
potential to attenuate or even prevent the development of diabetes and
further metabolic abnormalities.
 
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