Relation between acanthosis nigricans and insulin sensitivity in overweight Hispanic children at risk for type 2 diabetes.
OBJECTIVE
To investigate in a population of Hispanic children if 1) the presence of acanthosis nigricans (AN) is related to insulin sensitivity (S(i)) independent of adiposity and 2) scale scoring AN severity adds to the clinical estimation of insulin sensitivity, above and beyond the presence or absence AN alone.


METHODS
The study population, 131 Hispanic overweight children (mean BMI percentile 97.0 +/- 3.1, 72 boys, 59 girls, ages 8-13 years, mean Tanner stage 2.4 +/- 1.5) with a family history of type 2 diabetes, underwent a physical examination of the neck to determine AN absence or presence (0-1), AN extent score (0-4 scale), AN texture score (0-3 scale), and an AN combined score (extent + texture; 0-7 scale). S(i) was measured by the frequently sampled intravenous glucose tolerance test and minimal modeling. Multivariate linear regression analysis was used to determine the role of BMI and AN in predicting S(i).


RESULTS
BMI was the main predictor of S(i), explaining approximately 41% of the variance. The presence of AN explained an additional 4% of the variability in S(i); scale scoring of AN extent or texture did not significantly improve the prediction.


CONCLUSIONS
Although AN is an independent risk factor for insulin resistance in overweight Hispanic children at risk for type 2 diabetes, body adiposity is the primary determinant of insulin sensitivity. In addition, scale scoring AN seems of minimal usefulness in clinically estimating the severity of insulin resistance over and above assessing the presence or absence of AN and calculating BMI.
Kobaissi
Hassan A
HA
Department of Preventive Medicine, Keck School of Medicine, University of Southern California Health Sciences Campus, 1540 Alcazar Street, Rm. 208-D, Los Angeles, CA 90033, USA.
Weigensberg
Marc J
MJ
Ball
Geoff D C
GD
Cruz
Martha L
ML
Shaibi
Gabriel Q
GQ
Goran
Michael I
MI
D000052:Acanthosis Nigricans / Q000453:epidemiology* / Q000503:physiopathology; D015992:Body Mass Index; D049628:Body Size; D002140:California; D002648:Child; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D008297:Male; D008954:Models, Biological; D009765:Obesity / Q000453:epidemiology*; D012044:Regression Analysis; D012307:Risk Factors; D012727:Sex Characteristics