title: Prevalence of Acanthosis Nigricans in an urban population in Sri Lanka and its utility to detect metabolic syndrome.
abstract: BACKGROUND
  Insulin resistance (IR) plays a major role in the pathogenesis of metabolic syndrome. Acanthosis nigricans (AN) is an easily detectable skin condition that is strongly associated with IR. The aims of this study were, firstly, to investigate the prevalence of AN among adults in an urban Sri Lankan community and secondly, to describe its utility to detect metabolic syndrome.
  
  
  RESULTS
  In a community based investigation, 35-64 year adults who were selected using stratified random sampling, underwent interview, clinical examination, liver ultrasound scanning, and biochemical and serological tests. Metabolic syndrome was diagnosed on revised ATP III criteria for Asian populations. AN was identified by the presence of dark, thick, velvety skin in the neck.2957 subjects were included in this analysis. The prevalence of AN, metabolic syndrome and type 2 diabetes mellitus were 17.4%, 34.8% and 19.6%, respectively. There was a strong association between AN and metabolic syndrome. The sensitivity, specificity, positive predictive value and negative predictive value of AN to detect metabolic syndrome were 28.2%, 89.0%, 45.9% and 79.0% for males, and 29.2%, 88.4%, 65.6% and 62.3% for females, respectively.
  
  
  CONCLUSIONS
  AN was common in our study population, and although it did not have a high enough sensitivity to be utilized as a screening test for metabolic syndrome, the presence of AN strongly predicts metabolic syndrome.
authors.affiliation: Faculty of Medicine, University of Keleniya, Ragama, Sri Lanka. hjdes@sltnet.lk.
authors.forename: Anuradha S
authors.initials: AS
authors.lastname: Dassanayake
authors.forename: Anuradhani
authors.initials: A
authors.lastname: Kasturiratne
authors.forename: Madunil A
authors.initials: MA
authors.lastname: Niriella
authors.forename: Udaya
authors.initials: U
authors.lastname: Kalubovila
authors.forename: Shaman
authors.initials: S
authors.lastname: Rajindrajith
authors.forename: Arjuna P
authors.initials: AP
authors.lastname: de Silva
authors.forename: Norihiro
authors.initials: N
authors.lastname: Kato
authors.forename: A Rajitha
authors.initials: AR
authors.lastname: Wickremasinghe
authors.forename: H Janaka
authors.initials: HJ
authors.lastname: de Silva