Acanthosis Nigricans and Diabetes Risk Factors: Prevalence in Young Persons Seen in Southwestern US Primary Care Practices

Kong, Alberta S.; Williams, Robert L.; Smith, Melissa A.; Sussman, Andrew L.; Skipper, Betty J.; Hsi, Andrew; Rhyne, Robert L.

doi:10.1370/afm.678

Cited by 80 publications

(113 citation statements)

References 23 publications

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“…Further, Katz and Feldman, [25] also reported that subjects with AN were also at risk for atherosclerotic cardiovascular diseases. Our findings on high BMI, risk for T2D and CVD and the presence of AN are supported by other studies [26][27][28]. Hirschler et al [26] found that the presence of AN is likely to correlate with BMI.…”

Section: Discussionsupporting

confidence: 91%

“…In general, the presence of AN is likely to correlate with BMI [26] and high BMI has been shown to be associated with risk for T2D and CVD in several studies [27,28]. Acanthosis Nigricans and the associated IR is common among obese minority adolescents such as Native Americans, African Americans and Hispanics [29], similar results are expected among Jamaican adolescents, many of whom are of African descent and who are already showing signs of being overweight.…”

Section: Introductionmentioning

confidence: 84%

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

Barrett¹,

Huffman²,

Johnson³

et al. 2016

Integr Food Nutr Metab

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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.

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 84%

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

Barrett¹,

Huffman²,

Johnson³

et al. 2016

Integr Food Nutr Metab

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show abstract

“…24,25 In a study involving 34 obese individuals of both sexes in a predominantly black population (59%), Hud et al reported prevalence of AN in 74% of the patients and demonstrated clear predominance of AN in dark-skinned and black women in relation to white women. 19 Stoddart et al (2002) and Kong et al (2007) recognized AN as an independent risk factor associated with hyperinsulinemia, with the development of DM. 26,27 Kong showed that children with a family history of type 2 diabetes presented AN more often and that acanthosis was more frequent in patients with hypertension and high BMI.…”

Section: Acanthosis Nigricansmentioning

confidence: 99%

Association of acanthosis nigricans and skin tags with insulin resistance

Barbato

Criado

Silva

et al. 2012

An. Bras. Dermatol.

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Abstract:Insulin resistance is a metabolic disorder in which target cells fail to respond to normal levels of circulating insulin. Insulin resistance has been associated with presence of acanthosis nigricans and acrochordons. It is known that early diagnosis and early initial treatment are of paramount importance to prevent a series of future complications. These dermatoses may represent an easily identifiable sign of insulin resistance and non-insulin-dependent diabetes. Keywords: Acanthosis nigricans; Diabetes mellitus, type 2; Insulin resistance; Metabolic syndrome X Resumo: A resistência insulínica é uma alteração metabólica caracterizada por falhas das células-alvo em responder aos níveis normais de insulina circulante. A resistência insulínica já foi relacionada à presença de acantose nigricante e de acrocórdons. Sabe-se que o diagnóstico e o início do tratamento precoce são de suma importância para prevenção de uma série de manifestações futuras. Estas dermatoses podem representar um sinal facilmente identificável para rastreamento de resistência à insulina e do diabetes mellitus não insulinodependente.

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“…13,14 The study protocol required data collection and AN diagnosis at the time of the patient encounter but included no patient intervention.…”

Section: Original Prevalence Studiesmentioning

confidence: 99%

“…In a study of the prevalence of Acanthosis Nigricans (AN, a skin condition often associated with hyperinsulinemia) and diabetes risk factors, several clinicians reported that making a diagnosis of AN resulted in changes in the dynamics of the encounter. 13 Reportedly, more time was spent on preventive counseling than would have been the case without diagnosing AN.…”

mentioning

confidence: 99%

Reports of Persistent Change in the Clinical Encounter Following Research Participation: A Report From the Primary Care Multiethnic Network (PRIME Net)

Rhyne¹,

Sussman²,

Fernald³

et al. 2011

The Journal of the American Board of Family Medicine

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Purpose: Following anecdotal reports of unexpected patient and/or clinician behavior change in the primary care encounter in a previous study, we conducted this study to learn more about the short-and long-term effects on clinician and/or patient behavior from participation in a practice-based research network (PBRN) study.Methods: Clinicians in two PBRN studies of Acanthosis nigricans were surveyed and interviewed 3 to 6 months following one study and surveyed 3 to 5 years following a second study. We gathered data on clinicians' reports of behavior change in the encounter, the persistence of those changes, and the likely causes of reported changes.Results: Eighty-six percent of clinicians in the short-term and 79% in the long-term samples reported more frequent diagnostic efforts, and 68% and 54%, respectively, reported more frequent preventive counseling after participation in the studies. Interview data suggested that several factors contributed to this reported behavior change: increased clinician knowledge, availability of a feasible tool to support counseling, change in patient receptivity/motivation, and creation of a new context for counseling. In the primary care setting, changing unhealthy behaviors in their patients is one of the most challenging tasks clinicians face. Theoretical models can guide approaches to inducing patient behavior change, 1-3 but studies have shown limited success in actually changing behavior. Somewhat ironically, efforts to change physician behavior have been similarly unproductive. A large scientific literature reports the limited and often short-term effects of various strategies to modify clinician be- Conclusions

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Acanthosis Nigricans and Diabetes Risk Factors: Prevalence in Young Persons Seen in Southwestern US Primary Care Practices

Cited by 80 publications

References 23 publications

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

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

Association of acanthosis nigricans and skin tags with insulin resistance

Reports of Persistent Change in the Clinical Encounter Following Research Participation: A Report From the Primary Care Multiethnic Network (PRIME Net)

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