title: The association between acanthosis nigricans and dysglycemia in an ethnically diverse group of eighth grade students.
abstract: OBJECTIVE
  The purpose of this study was to describe the prevalence of acanthosis nigricans (AN) and to quantify its association with dysglycemia in an ethnically diverse group of eighth-grade students.
  
  
  METHODS
  Data were collected in 2003 from a cross-sectional study of students from 12 middle schools in three US states. Sex, race/ethnicity, and pubertal status were self-reported. Anthropometric measures were recorded. Trained staff identified the presence and severity of AN by inspection of the back of the neck. Fasting and 2 h blood samples were analyzed for impaired fasting glucose (IFG), impaired glucose tolerance (IGT), and high-risk glycated hemoglobin (A1C), respectively, defined as ≥100 mg/dl, ≥140 mg/dl, and ≥ 5.7-6.4%.
  
  
  RESULTS
  Overall, 25.0%, 58.2%, and 16.8% were Black, Hispanic, and White, respectively. AN was present among 406/1,438 (28.2%) of students: 39% among Black, 30% among Hispanic, and 5.4% among White. IGT and high-risk A1C were present among 2.1%, and 12.4%, respectively. In multivariate logistic modeling after adjusting for gender, family history of diabetes, BMI percentile, and pubertal staging, the presence (vs. absence) of AN was associated with a 59% increased likelihood of high-risk A1C: (P = 0.04), twice the likelihood of IGT (P = 0.06), and 47% greater likelihood of IGT/IFG combined (P < 0.0001). Adjustment for insulin attenuated the ORs by 25-70%.
  
  
  CONCLUSIONS
  In a racially/ethnically diverse sample of US adolescents, AN was common, occurring in 28% of the sample. AN was associated with a 50-100% increased likelihood of dysglycemia even after consideration of established diabetes risk factors.
authors.affiliation: Health Service Administration, D'Youville College, Buffalo, New York, USA. rafalson@dyc.edu
authors.forename: Lisa
authors.initials: L
authors.lastname: Rafalson
authors.forename: Trang H
authors.initials: TH
authors.lastname: Pham
authors.forename: Steven M
authors.initials: SM
authors.lastname: Willi
authors.forename: Marsha
authors.initials: M
authors.lastname: Marcus
authors.forename: Ann
authors.initials: A
authors.lastname: Jessup
authors.forename: Tom
authors.initials: T
authors.lastname: Baranowski
mesh_terms: D000052:Acanthosis Nigricans / Q000097:blood* / Q000453:epidemiology*; D000293:Adolescent; D001741:Black or African American; D000886:Anthropometry; D001786:Blood Glucose / Q000032:analysis; D003430:Cross-Sectional Studies; D005215:Fasting; D005260:Female; D018149:Glucose Intolerance / Q000097:blood / Q000453:epidemiology*; D006442:Glycated Hemoglobin / Q000032:analysis / Q000378:metabolism; D006630:Hispanic or Latino; D006706:Homeostasis; D006801:Humans; D007328:Insulin / Q000097:blood; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D011203:Poverty; D015995:Prevalence; D012307:Risk Factors; D013334:Students; D014481:United States / Q000453:epidemiology; D044465:White People
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007328:Insulin