Clinical Characteristics of Obese Japanese Children with Acanthosis Nigricans

Abstract

Acanthosis nigricans (AN) is a skin lesion characterized by thickening and obvious darkening of the keratin layer of the skin. It has been demonstrated to be associated with hyperinsulinemia, and is used as an empirical marker for elevated risk of type 2 diabetes. The prevalence of school children with simple obesity in Japan has recently increased to over 10%. We investigated the clinical characteristics of AN-positive and AN-negative subjects, and compared 105 obese children (64 males and 41 females) with regard to sex, percentage overweight, age distribution, duration of obesity, standard deviation score (SDS) of height, liver function, birth weight, and family history of diabetes mellitus. Forty-one (27 males, 14 females) (39.0%) of the 105 subjects had AN on the neck and/or in the axilla. There was a significant difference between the AN-positive and AN-negative groups in age (p<0.05), percentage overweight (p <0.0005), duration of obesity (p<0.03), and serum ALT level as a marker of fatty liver (p<0.01). The prevalence of AN was significantly higher in older subjects (≥8 years) and in subjects with higher levels of percentage overweight (≥50%). There was no significant difference in birth weight or family history of diabetes mellitus between the AN-positive and AN-negative groups. It is a very important to determine the frequency with which AN-positive obese subjects develop overt diabetes later in life.

Criteria for medical intervention in obese children: A new definition of ‘Obesity disease’ in Japanese children

“…It was not included in the diagnostic criteria for adults. The one associated with obesity is more usually expressed as ‘acanthosis’ rather than ‘pseudoacantosis’, and is a useful marker of insulin resistance even in children 19 . Thus, it was included as a ‘B problem’ in the present criteria.…”

“…The one associated with obesity is more usually expressed as 'acanthosis' rather than 'pseudoacantosis', and is a useful marker of insulin resistance even in children. 19 Thus, it was included as a 'B problem' in the present criteria. A single reference value for hyperuricemia was obtained from the recently published literature.…”

Acanthosis Nigricans as a Clinical Marker to Detect Insulin Resistance in Caucasian Children From West Virginia

“…8,9 Although the rates of AN and obesity are different among races, a close association between these clinical findings and IR was documented in children from many countries and various ethnicities. 3,9,[10][11][12][13][14][15][16] The investigation of IR status requires a blood withdrawn under fasting condition and is associated with pain, patient's reluctance, and poor compliance. Thus, the clinical dermatological finding of AN may offer an easier solution to detect IR in obese children with better patient's compliance and parents acceptance.…”

Insulin Resistance during Puberty in Non-obese Japanese Children

“…Peripheral fat accumulation has been reported to increase insulin resistance through secretion of adipocytokines from fat cells(7, 8). Some Japanese studies have demonstrated insulin resistance associated with a compensatory increase of insulin secretion in obese children(9, 10). …”