Severe Quantitative Scale of Acanthosis Nigricans in Neck is Associated with Abdominal Obesity, HOMA‐IR, and Hyperlipidemia in Obese Children from Mexico City: A Cross‐Sectional Study

Burguete-García, Ana I.; Valverde, Alan Gilberto Ramírez; Espinoza-León, Meztli; Vázquez, I.; Ramírez, Evelyn Yazmín Estrada; Maldonado-López, Itzel; Lagunas‐Martínez, Alfredo; Díaz-Benítez, Cinthya Estefhany; Karam-Araujo, Roberto; Fernández-Madinaveitia, Diana Edith; Fonseca, Adriana E. Anides; Cruz-López, Miguel; Peralta‐Romero, Jesús

doi:10.1155/2022/2906189

Cited by 6 publications

(4 citation statements)

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“…Cardiometabolic risk factors associated with obesity may include acanthosis nigricans, insulin resistance (IR), elevated blood pressure, and dyslipidemia, which may later lead to CVD and T2DM. A recent study by Garcia et al ( 10 ) found that children affected by obesity with grade 3 acanthosis nigricans (the degree of severity in the neck by Burke's scale) were associated with increased waist circumference (WC), triglycerides (TGs), low-density lipoprotein cholesterol (LDL-C), total cholesterol, and homeostatic model assessment for IR (HOMA-IR), which might lead to vascular alterations. Similarly, our group also previously found that the majority of children with acanthosis nigricans (43%) were in the upper tertiles of the ratio of triglycerides to high-density lipoprotein cholesterol (TG: HDL-C) ( 11 ).…”

Section: Introductionmentioning

confidence: 99%

Cardiometabolic risk factors among children who are affected by overweight, obesity and severe obesity

Iwani

Jalaludin

Roslan

et al. 2023

Front. Public Health

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BackgroundThe increasing severity of obesity is expected to lead to more serious health effects. However, there is limited information on the prevalence and clinical characteristics of cardiometabolic risk factors in severely children affected by obesity in Malaysia. This baseline study aimed to investigate the prevalence of these factors and their association with obesity status among young children.MethodsIn this study, a cross-sectional design was employed using the baseline data obtained from the My Body Is Fit and Fabulous at school (MyBFF@school) intervention program involving obese school children. Obesity status was defined using the body mass index (BMI) z-score from the World Health Organization (WHO) growth chart. Cardiometabolic risk factors presented in this study included fasting plasma glucose (FPG), triglycerides (TGs), total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), blood pressure, acanthosis nigricans, insulin resistance (IR), and MetS. MetS was defined using the International Diabetes Federation (IDF) 2007 criteria. Descriptive data were presented accordingly. The association between cardiometabolic risk factors, such as obesity status, and acanthosis nigricans with MetS was measured using multivariate logistic regression, which was adjusted for gender, ethnicity, and strata.ResultsOut of 924 children, 38.4% (n = 355) were overweight, 43.6% (n = 403) were obese, and 18% (n = 166) were severely obese. The overall mean age was 9.9 ± 0.8 years. The prevalence of hypertension, high FPG, hypertriglyceridemia, low HDL-C, and the presence of acanthosis nigricans among severely children affected by obesity was 1.8%, 5.4%, 10.2%, 42.8%, and 83.7%, respectively. The prevalence of children affected by obesity who were at risk of MetS in <10-year-old and MetS >10-year-old was observed to be similar at 4.8%. Severely children affected by obesity had higher odds of high FPG [odds ratio (OR) = 3.27; 95% confdence interval (CI) 1.12, 9.55], hypertriglyceridemia (OR = 3.50; 95%CI 1.61, 7.64), low HDL-C (OR = 2.65; 95%CI 1.77, 3.98), acanthosis nigricans (OR = 13.49; 95%CI 8.26, 22.04), IR (OR = 14.35; 95%CI 8.84, 23.30), and MetS (OR = 14.03; 95%CI 3.97, 49.54) compared to overweight and children affected by obesity. The BMI z-score, waist circumference (WC), and percentage body fat showed a significant correlation with triglycerides, HDL-C, the TG: HDL-C ratio, and the homeostatic model assessment for IR (HOMA-IR) index.ConclusionsSeverely children affected by obesity exhibit a higher prevalence of and are more likely to develop cardiometabolic risk factors compared to overweight and children affected by obesity. This group of children should be monitored closely and screened periodically for obesity-related health problems to institute early and comprehensive intervention.

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Section: Introductionmentioning

confidence: 99%

Cardiometabolic risk factors among children who are affected by overweight, obesity and severe obesity

Iwani

Jalaludin

Roslan

et al. 2023

Front. Public Health

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“…Children in Northern India with obesity and AN had greater HOMA-IR scores and lower adiponectin concentrations compared to children with obesity but without AN [25]. Additionally, Burguete-García et al reported similar results, where Mexican children with a Burke Score of 3 had significantly greater HOMA-IR values than children with lower Burke scores [61]. Nithun et al also reported that AN and the Burke Scores were also associated with HOMA-IR values in patients 2-24 years of age [27].…”

Section: Discussionmentioning

confidence: 94%

“…A previous analysis of NHANES data indicated that adult men and women who self-identified with diabetes had 2.1 and 3.9 times greater risk, respectively, for underreporting energy intake [ 50 , 60 ]. Evidence that AN is associated with insulin resistance comes from several studies [ 25 , 27 , 61 , 62 ]. Children in Northern India with obesity and AN had greater HOMA-IR scores and lower adiponectin concentrations compared to children with obesity but without AN [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

Diet and Acanthosis Nigricans over a Two-Year Period in Children of the Pacific Region

et al. 2023

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Background: The impact that dietary carbohydrates have on children developing type 2 diabetes remains controversial. Furthermore, there are limited pediatric longitudinal studies on changes in body mass index (BMI) and diet related to the development of acanthosis nigricans (AN), a risk factor associated with type 2 diabetes. Methods: Two 24 h dietary records were collected for 558 children, 2–8 years of age, at baseline and at a 2-year follow-up. Data on age, sex, BMI, and the presence of AN were also collected at each time point from the Children’s Healthy Living Program. Logistic regression was used to determine factors associated with the presence of AN at follow-up. Multinominal regression was used to determine factors associated with changes in AN status. Linear regression was used to measure the associations between changes in dietary intake and in the Burke Score for AN. Results: AN was present in 28 children at baseline and 34 children at follow-up. Adjusting for the presence of AN at baseline, age, sex, study group, baseline BMI, change in BMI z-score, time between assessments, and baseline intake, an increase from baseline for each teaspoon of sugar and serving of carbohydrate-rich food increased the risk for having AN at follow-up by 9% and 8%, respectively (p ≤ 0.05). An increased intake of added sugar (teaspoons) increased the risk of developing AN by 13% (p ≤ 0.01) and an increase in servings of foods rich in starch increased the risk of developing AN by 12% (p ≤ 0.01) compared to children who never had AN. Increasing the intake of fruit was also associated with decreased Burke Scores using multiple regression. However, the intake of energy and macronutrients were not associated with AN. Conclusions: Added sugar and foods rich in starch were independently associated with the occurrence of AN, suggesting the type of carbohydrates consumed is a factor in AN occurrence.

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“…Another study on 95 obese school-aged patients showed that severity of neck AN, according to Burke’s scale, correlated with diastolic blood pressure ( p = 0.001) and blood levels of triglycerides ( p = 0.02), and inversely correlated with adiponectin ( p = 0.02) [ 60 ]. The majority of data show that subgroups of subjects with AN have the most severe IR profiles, as expected.…”

Section: An and Irmentioning

confidence: 99%

Acanthosis Nigricans: Pointer of Endocrine Entities

et al. 2022

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Acanthosis nigricans (AN) has been reported in relation to insulin resistance (IR). We aim to review AN through an endocrine and metabolic perspective focusing on IR in association with metabolic complications such as obesity, diabetes mellitus (DM), and metabolic syndrome (MS) with/without polycystic ovary syndrome (PCOS). We revised English papers on PubMed covering publications from the last 5 years. The current prevalence of AN varies from 4.5 to 74% (or even 100%, depending on the studied population), with equal distribution among females and males. Despite higher incidence with an age-dependent pattern, an alarming escalation of cases has been noted for obesity and MS in younger populations . Most frequent IR-associated sites are the neck, axilla, and knuckles, but unusual locations such as the face have also been reported. Quantitative scales such as Burke have been used to describe the severity of the dermatosis, particularly in correlation with IR elements. Dermoscopic examination are required, for instance, in cases with sulcus cutis, hyperpigmented spots, crista cutis, and papillary projections. A skin biopsy may be necessary, but it is not the rule. Both IR that clinically manifests with or without obesity/MS correlates with AN; most studies are cross-sectional, with only a few longitudinal. The approach varied from screening during school periodic checkups/protocols/programs to subgroups of individuals who were already known to be at high cardio-metabolic risk. AN was associated with type2DM, as well as type 1DM. Females with PCOS may already display metabolic complications in 60–80% of cases, with AN belonging to the associated skin spectrum. AN management depends on underlying conditions, and specific dermatological therapy is not generally required, unless the patient achieves metabolic control, has severe skin lesions, or desires cosmetic improvement. In IR cases, lifestyle interventions can help, including weight control up to bariatric surgery. In addition, metformin is a key player in the field of oral medication against DM type 2, a drug whose indication is extended to PCOS and even to AN itself, outside the specific panel of glucose anomalies. In terms of cosmetic intervention, limited data have been published on melatonin, urea cream, topical retinoids, vitamin D analogs, or alexandrite laser. In conclusion, awareness of IR and its associated clinical features is essential to provide prompt recognition of underlying conditions. AN represents a useful non-invasive surrogate marker of this spectrum in both children and adults. The pivotal role of this dermatosis could massively improve endocrine and metabolic assessments.

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Severe Quantitative Scale of Acanthosis Nigricans in Neck is Associated with Abdominal Obesity, HOMA‐IR, and Hyperlipidemia in Obese Children from Mexico City: A Cross‐Sectional Study

Cited by 6 publications

References 56 publications

Cardiometabolic risk factors among children who are affected by overweight, obesity and severe obesity

Cardiometabolic risk factors among children who are affected by overweight, obesity and severe obesity

Diet and Acanthosis Nigricans over a Two-Year Period in Children of the Pacific Region

Acanthosis Nigricans: Pointer of Endocrine Entities

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