Acanthosis nigricans: a clinical marker of insulin resistance
DOI:
https://doi.org/10.18203/issn.2455-4529.IntJResDermatol20171497Keywords:
Acanthosis nigricans, Insulin resistanceAbstract
Background: Very little information is available regarding the association of acanthosis nigricans with insulin resistance from rural areas of India. Therefore this study was carried out with the aim and objectives to study the association between acanthosis nigricans and insulin resistance and to evaluate correlation of acanthosis nigricans severity, neck severity and neck texture severity with fasting blood sugar & serum insulin especially in this rural part of central India.
Methods: In this cross sectional study with comparative group, total 162 age and sex matched subjects were divided into two groups of cases (81) with acanthosis nigricans and comparative subjects (81) without acanthosis nigricans. The severity acanthosis nigricans was assessed using the Burke’s quantitative scale. Fasting blood sugar and fasting insulin levels were estimated to know the Homeostasis model assessment of insulin resistance (HOMA-IR) values. Data was analyzed by using appropriate statistical tests.
Results: The age range was 20 to 55 years with the mean of 32.82 ± 10.19 years for cases and 33.67 ± 8.09 for comparative subjects. Univariate analysis which showed significant association of acanthosis nigricans with fasting insulin and HOMA-IR with significant odds ratios and p value (p =0.0001) respectively. Fasting blood sugar showed greater risk of association in cases but it was statistically insignificant with p-value of (p =0.32). Spearman rank coefficient correlation showed weak correlation of HOMA-IR with acanthosis nigricans severity, neck severity and neck texture severity, but showed positive correlation of fasting insulin with acanthosis nigricans severity, neck severity and neck texture severity, with statistically significant P-value (p <0.05).
Conclusions: Acanthosis nigricans was strongly associated with insulin resistance with significant odds ratio and statistical significant p value (P < 0.05). Acanthosis nigricans severity, neck severity and neck texture severity showed positive correlation with fasting serum insulin with statistically significant p value (P <0.05).
References
Brown J, Winkelmann RK. Acanthosis nigricans: A study of 90 cases. Medicine (Baltimore). 1968;47:33-51.
Barbieri RL, Ryan KJ. Hyperandrogenism, insulin resistance, and acanthosis nigricans syndrome: A common endocrinopathy with distinct pathophysiologic features. Am J Obstet Gynecol. 1983;147:90-101.
Kobaissi H, Weigensberg M, Ball G, Cruz M, Shaibi, Goran M. Relation between acanthosis nigricans and insulin sensitivity in overweight Hispanic children at risk for type 2 diabetes. Diabetes Care. 2004;27:1412–6.
Stoddart M, Blevins K, Lee E, Wang W, Blackett P. Association of acanthosis nigricans with hyperinsulinemia compared with other selected risk factors for type 2 diabetes in Cherokee Indians: the Cherokee Diabetes Study. Diabetes Care. 2002;25:1009–14.
Guran T, Turan S, Akcay T, Bereket A. Significance of acanthosis nigricans in childhood obesity. J Paediatr Child Health. 2008;44:338–41.
Nguyen T, Keil M, Russell D, Pathomvanich A, Uwaifo G, Sebring N, et al. Relation of acanthosis nigricans to hyperinsulinemia and insulin sensitivity in overweight African American and White children. J Pediatr. 2001;138:474–80.
Hirschler V, Aranda C, Oneto A, Gonzalez C, Jadzinsky M. Is acanthosis nigricans a marker of insulin resistance in obese children? Diabetes Care. 2002;25:23-53.
Burke JP, Hale DE, Hazuda HP, Stern MP. A Quantitative Scale of Acanthosis Nigricans. Diabetes Care. 1999;22:1655-9.
Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. Homeostasis model assessment: Insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985;28:412-9.
Shah D, Puthran S. Diagnosis of hyperinsulinaemia in a normoglycaemic healthy Indian Population--developing ethnic reference ranges. J Assoc Physicians India. 2014;5:394-9.
Viswanathan V, Tilak P, Meerza R, Kumpatla S. Insulin resistance at different stages of diabetic kidney disease in India. J Assoc Physicians India. 2010;58:612-5.
Ayaz T, Baydur Şahin S, Şahin OZ. Relation of Acanthosis nigricans to metabolic syndrome in overweight and obese women. Metab Syndr Relat Disord. 2014;12:320-3.
Venkatswami S, Anandam S. Acanthosis nigricans: a flag for insulin resistance. JEMDSA. 2014;19:68-74.
Abeer KM, Maha HA, Mona IY. Relation between the severity of acanthosis nigricans and metabolic syndrome components. JEWDS. 2013;10:75–80.
Patidar PP, Ramachandra P, Philip R, Saran S, Agarwal P, Gutch M, et al. Correlation of acanthosis nigricans with insulin resistance, anthropometric, and other metabolic parameters in diabetic Indians. Indian J Endocrinol Metab. 2012;16:436–7.
Acharya R, Rijal A. Occurrence of acanthosis nigricans, a benign condition or associated with systemic disease. A case control study. NJDVL. 2016;4:37-43.
