Acanthosis Nigricans among Native Americans: an indicator of high diabetes risk.

Stuart, Charles Alexander; Smith, Michael J.; Gilkison, Charles R.; Shaheb, Sudah; Stahn, R M

doi:10.2105/ajph.84.11.1839

Cited by 87 publications

(106 citation statements)

References 29 publications

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“…The prevalence of AN in the present study was 41.7%, greater than that reported by Stoddart et al, who found 34.2% AN in a Cherokee Indian population (25). Meanwhile, Mukhtar et al documented an 18.9% prevalence of AN in obese adolescents in New Mexico (26), Nguyen et al reported 25% of AN in overweight Afro-American children (27), and Stuart et al found 38% of AN in Native Americans (28). On the other hand, Thivel D and Maisonneuve B have reported the prevalence of AN to be as high as 68 and 69.9%, respectively, in obese children (29,30).…”

Section: Discussioncontrasting

confidence: 66%

Acantosis nigricans is associated with risk factors related to cardiovascular disease in Mexican children with obesity

Martínez-Rojano

Pizano-Zárate²,

Sánchez-Jiménez³

et al. 2016

Nutr Hosp

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ResumenIntroducción: la mayor prevalencia de obesidad en la población infantil mexicana durante la última década incrementa el riesgo de presentar trastornos metabólicos y enfermedades cardiovasculares a edades cada vez más tempranas. Objetivo: determinar la asociación entre Acantosis nigricans (AN) con dislipidemia, hipertensión arterial, índice de masa corporal (IMC) y conductas alimentarias de riesgo en niños con sobrepeso y obesidad. Pacientes y métodos: estudio transversal analítico realizado en dos escuelas públicas de la zona metropolitana de la ciudad de México donde participaron 300 niños, de ambos sexos, obteniéndose información de los antecedentes heredofamiliares y perinatales. Con la exploración física se valoró la presencia o ausencia de AN y presión sanguínea. Se pesó y midió a los escolares, se calculó el IMC y se estimó su puntaje Z. Se cuantifi có la concentración sérica de glucosa, colesterol, triglicéridos y perfi l de lipoproteínas. Resultados: la prevalencia de AN fue 41,7%, al determinar la asociación entre la AN y los factores de riesgo cardiovascular, se identifi có una asociación con el IMC (rS 0.432; p < 0.0001), entre las cifras de presión arterial sistólica y diastólica por encima del percentil 90 (rS 0.231; p < 0.0001) y (rS 0.128; p = 0,026) respectivamente, la hipertrigliceridemia (rS 0.156; p = 0.007), las bajas concentraciones de colesterol de lipoproteínas de alta densidad (cHDL) (rS -0,160; p = 0,006), así como la existencia de los trastornos de la conducta alimenticia; haber realizado dietas p = 0.004, ha perdido el control de lo que come p = 0,023 y cuando el porcentaje de grasa corporal fue superior al percentil 90, χ 2 = 35.1; p = 0.0001, no se observó asociación con la concentración sérica de glucosa (rS -0.018; p = 0,759). En el análisis de regresión logística se observó que la presencia de AN mostró una asociación con las menores concentraciones de cHDL (RM: 1.726; p = 0,041) y con el porcentaje de grasa corporal (> 48%) (RM: 3.591; p = 0,001). Conclusión: se observó una alta prevalencia de AN en niños con sobrepeso u obesidad y su asociación con factores de riesgo cardiovascular: puntaje Z del IMC, dislipidemia y las cifras tensionales elevadas. AbstractIntroduction: The prevalence of obesity in Mexican children has increased during the last decade, as has the risk of early onset metabolic disorders and cardiovascular disease. Objective: To determine the association of Acantosis nigricans (AN) with dyslipidemia, high blood pressure, body mass index (BMI), and risk factors related to eating behavior in overweight and obese children. Patients and methods: This transverse analytical study, conducted in two Mexico City primary schools, included 300 boys and girls. Information was gathered on hereditary and perinatal background. A physical examination provided data on the presence/absence of AN, blood pressure, weight and height. The BMI and Z-score were calculated. The serum concentration of glucose, cholesterol and triglycerides was quantifi ed and the lipoprotein profi l...

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Section: Discussioncontrasting

confidence: 66%

Acantosis nigricans is associated with risk factors related to cardiovascular disease in Mexican children with obesity

Martínez-Rojano

Pizano-Zárate²,

Sánchez-Jiménez³

et al. 2016

Nutr Hosp

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“…The first large-scale study of AN in an American Indian population found AN in 38% of 260 members (10 -70 years of age) of the Alabama-Coushatta tribe in Texas and 1,141 children (3-19 years of age) of the Winnebago/Omaha tribe in Nebraska (16). In addition, they found a twofold higher fasting insulin concentration in subjects who exhibited AN than in weight-matched subjects who did not have the skin condition, concluding that AN was highly prevalent among American Indians and that its presence suggests insulin resistance and an increased risk for type 2 diabetes.…”

Section: Prevalence Of Hyperinsulinemiamentioning

confidence: 99%

“…AN is common among AfricanAmericans, Hispanics, and American Indians but rare among whites (7, 9 -11,15,17) and has been reported to be strongly influenced by genetic factors (19). Previously thought to be rare in children and adolescents (14), AN is now common in young people, especially in populations with high rates of adult diabetes (7,10,11,16,18).…”

mentioning

confidence: 99%

Association of Acanthosis Nigricans With Hyperinsulinemia Compared With Other Selected Risk Factors for Type 2 Diabetes in Cherokee Indians

et al. 2002

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OBJECTIVE -To report prevalence rates of acanthosis nigricans (AN) and hyperinsulinemia and the association of AN with hyperinsulinemia compared with other known or suspected risk factors for type 2 diabetes in young American Indians. RESEARCH DESIGN AND METHODS-A random sample of Cherokee Nation members aged 5-40 years was invited to participate in the Cherokee Diabetes Study, a cross-sectional study of type 2 diabetes and its risk factors in a young American Indian population. Data were collected by personal interview, medical history, physical examination (including anthropometric and blood pressure measurements and examination of the neck for AN), and laboratory analyses of blood specimens. Levels of insulin, lipids, and glucose were measured on fasting blood specimens. Diabetes status was determined according to the American Diabetes Association criteria.RESULTS -A total of 2,205 participants were examined. Overall prevalence rates for AN and hyperinsulinemia were 34.2 and 47.2%, respectively. In general, the rates for both increased with age and degree of Indian heritage and were higher in female subjects, overweight/obese individuals, those with type 2 diabetes, and those with a parental history of type 2 diabetes. In addition, both had significantly higher age-and sex-adjusted means for selected known or suspected risk factors for type 2 diabetes. AN remained significantly associated with hyperinsulinemia (P ϭ 0.0001) in multivariate analysis.CONCLUSIONS -AN is independently associated with hyperinsulinemia and therefore may be useful as an early indicator of high risk for diabetes.

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“…AN in any place in the body is taken as an overall diagnosis; unfortunately, many times the knuckles are overseen and obviated in physical examination. 13 , 16 , 18-22 In fact, without reliable evidence, some authors mention that AN does not exist unless the neck is involved. 16 , 23 They recommend just examining the neck when a clinician is looking for AN.…”

Section: Discussionmentioning

confidence: 99%

“…14 , 22 , 27-30 There is a paucity of evidence, however, on the clinical epidemiology of AN. For example, AN prevalence among different BMI or age ranges, different anatomical sites, subjects with 1 or 2 skin phototypes, varieties of clinical expression in these two phototypes, and as a diagnostic tool beyond the link to hyperinsulinemia in overweight or obese subjects.…”

Section: Discussionmentioning

confidence: 99%

Acanthosis nigricans in the knuckles: An early, accessible, straightforward, and sensitive clinical tool to predict insulin resistance

González-Saldivar

Rodríguez-Gutiérrez

Treviño-Alvarez

et al. 2018

Dermato-Endocrinology

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Any clinical/biochemical marker revealing obesity or diabetes before their appearance is valuable. Insulin resistance (IR) is present in both disorders many years before occurrence. Accordingly, we determined whether acanthosis nigricans (AN) in the knuckles is associated to higher insulin and homeostasis model assessment for estimated insulin resistance (HOMA-IR) index values, and assessed the influence of body-mass index (BMI) and the diagnostic performance of AN in the knuckles to detect IR. In this cross-sectional controlled study, we included men or women, 18 to 23 years old, with or without AN in the knuckles. In 149 cases with AN in the knuckles and 145 controls, fasting insulin was higher in cases (13.45 µU/mL ± 7.8 vs. 8.59 µU/mL ± 3.63, P < .001, respectively). Mean HOMA-IR index was also higher (2.86 ± 1.68 vs. 1.78 ± 0.77, P < .001). A significant increase in fasting insulin and HOMA-IR values between and within BMI groups from normal through obese category was identified in controls and cases. By multivariate regression analysis, cases with normal BMI were significantly associated to a HOMA-IR ≥2.5 (OR = 3.09, CI95% = 1.75–5.48, P = .001). A model of AN in the knuckles, normal BMI, and increased waist circumference allowed identifying 2 out of 3 cases with HOMA-IR index ≥2.5. AN in the knuckles could be addressed with two aims: as an easy, accessible, and costless diagnostic tool suggesting hyperinsulinemia secondary to IR, and, an early marker of IR even in the absence of overweight or obesity.

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Acanthosis Nigricans among Native Americans: an indicator of high diabetes risk.

Cited by 87 publications

References 29 publications

Acantosis nigricans is associated with risk factors related to cardiovascular disease in Mexican children with obesity

Acantosis nigricans is associated with risk factors related to cardiovascular disease in Mexican children with obesity

Association of Acanthosis Nigricans With Hyperinsulinemia Compared With Other Selected Risk Factors for Type 2 Diabetes in Cherokee Indians

Acanthosis nigricans in the knuckles: An early, accessible, straightforward, and sensitive clinical tool to predict insulin resistance

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