Acanthosis nigricans and diabetes risk factors: prevalence in young persons seen in southwestern US primary care practices.
OBJECTIVE
Evidence shows acanthosis nigricans is often associated with hyperinsulinemia and may indicate increased risk of type 2 diabetes mellitus. The purpose of this study was to determine the association of acanthosis nigricans with type 2 diabetes risk factors and disease in young persons.


METHODS
We conducted a cross-sectional study in the Research in Outpatient Settings Network, a practice-based research network in southwestern US communities. Participating clinicians (N = 96) collected data on children and young adults aged 7 to 39 years seen during a 2-week sampling period. The main outcomes were the prevalence of acanthosis nigricans, type 2 diabetes risk factors (ethnicity, family history of type 2 diabetes, hypertension, overweight/obesity), type 2 diabetes, and the relationships among these.


RESULTS
Among 1,133 patients sampled, risk factors for type 2 diabetes were common: 69% had a family history of the disease; 3% of children (aged 7 to 19 years) and 12% of adults had hypertension; 43% of children and 73% of adults were overweight or obese; and 80% were members of ethnic minorities. Acanthosis nigricans was found in 17% of children and 21% of adults. Among children and adults alike, the more type 2 diabetes risk factors that were present, the higher the prevalence of acanthosis nigricans (P <.001). The prevalence ratio for type 2 diabetes in patients with acanthosis nigricans was 1.97 (95% confidence interval, 1.18-3.27; P = .01) after controlling for age, body mass index, and the number of type 2 diabetes risk factors. Clinicians reported that the identification of acanthosis nigricans frequently led to discussions about lifestyle modification for decreasing the risk of type 2 diabetes.


CONCLUSIONS
Patients with acanthosis nigricans are likely to have multiple risk factors for type 2 diabetes. Acanthosis nigricans may be an independent risk factor for this disease. Detection of acanthosis nigricans may help clinicians more rapidly identify high-risk individuals for diabetes counseling.
Kong
Alberta S
AS
Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque, NM 87131-0001, USA. akong@unm.edu
Williams
Robert L
RL
Smith
Melissa
M
Sussman
Andrew L
AL
Skipper
Betty
B
Hsi
Andrew C
AC
Rhyne
Robert L
RL
D000052:Acanthosis Nigricans / Q000150:complications / Q000453:epidemiology*; D000293:Adolescent; D000328:Adult; D002648:Child; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000209:etiology*; D006801:Humans; D006949:Hyperlipidemias / Q000150:complications / Q000453:epidemiology*; D006973:Hypertension / Q000150:complications / Q000453:epidemiology*; D009765:Obesity / Q000150:complications / Q000453:epidemiology*; D015995:Prevalence; D011320:Primary Health Care; D012307:Risk Factors; D015206:Southwestern United States