Acanthosis nigricans predicts the clustering of metabolic syndrome components in Hispanic elementary school-aged children

Abstract

Background Acanthosis nigricans (AN) is a dermatologic condition associated with hyperinsulinemia, a marker of insulin resistance that is the principal abnormality in metabolic syndrome (MetS). We examined the association of AN with the clustering of MetS components. Methods A cross-sectional study was conducted in an urban school-based health center in New Mexico. Students without diabetes were evaluated for AN, a family history of type 2 diabetes, body mass index (BMI), and MetS components. The clustering of MetS components by BMI category and AN status was assessed by comparing the group means of summed average z-scores of fasting insulin, triglycerides, high-density lipoprotein- cholesterol, and systolic blood pressure among the students. A multivariate model with BMI category and AN status controlling for Tanner stage was performed to identify the variables associated with the clustering of MetS components. Results Complete data were available for 90 children (age, 9.7 ± 1.4 years; 94 % Hispanic; 60 % female). In multivariate modeling of MetS cluster z-score, significant differences were found between the students with BMI < 85th percentile [−0.27; 95 % confidence interval (95 % CI) = − 0.42 to − 0.11] and (a) the students with BMI 85th – 94.9th percentile with AN (0.74; 95 % CI = 0.17 – 1.31) and (b) the students with BMI ≥ 95th percentile with AN (0.86; 95 % CI = 0.54 – 1.18). No significant differences in the MetS cluster z-score were seen between the students with BMI < 85th percentile and those with BMI 85th – 94.9th percentile without AN (0.24; 95 % CI = − 0.33 to 0.81) or those with BMI ≥ 95th percentile without AN (0.31; 95 % CI = − 0.13 to 0.75). Conclusions Overweight/obese Hispanic elementary school-aged children with AN exhibit clustering of MetS components and could benefit from early intervention.

Arterial stiffening, insulin resistance and acanthosis nigricans in a community sample of adolescents with obesity

“…AN was common in our study population, with 63 % and 43% found to have AN and Severe AN respectively. There was a positive association between BMIz and presence of AN (with an increase of 1SD in BMI leading to a doubling in the risk of AN) consistent with other published studies of AN in adolescent groups (4)(5)(6). …”

“…Studies have identified AN in adolescence as a marker for type 2 Diabetes Mellitus (DM) (2,3) and insulin resistance (IR)(4-7) yet it is unclear whether AN in adolescent obesity is associated with increased cardiovascular risk separately to risk for diabetes. Whilst attempts to identify cardiovascular risk by presence of AN in adolescents have been made using adult-based components of the metabolic syndrome, (6) (7) evidence for associations between AN and contemporary arterial pathological processes, such as arterial stiffening, has not been investigated. Pulse Wave Velocity (PWV), is a non-invasive proxy for arterial stiffness, demonstrated to be a reliable predictor of future cardiovascular mortality and morbidity in adults, (8,9) and shown to correlate with degree of atheroma in adults.…”

Continuous cardiometabolic risk score definitions in early childhood: a scoping review

“…Additionally, articles where the score calculated was non‐continuous ( n = 8) and articles where the score was measured at adolescence or adulthood ( n = 58) were excluded. A total of 91 articles met the review criteria and were included in the data extraction .…”

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

“…11 Another study examined the association of AN and metabolic syndrome and concluded that early intervention in children with AN can be beneficial in decreasing future health complications. 12 AN in childhood is associated with an increased risk of obesity, hypertension, hyperinsulinemia, insulin resistance, and type II diabetes. 9…”