A study of the association of acanthosis nigricans with subclinical atherosclerosis.
BACKGROUND
Hyperinsulinism is related to the presence of acanthosis nigricans and atherosclerosis; however, we were unable to find any study on the prevalence of atherosclerosis in acanthosis nigricans.


OBJECTIVE
To evaluate the prevalence of carotid atherosclerosis and metabolic alterations in Mexican patients with acanthosis nigricans.


METHODS
We carried out a cross-sectional study that included 45 patients with acanthosis nigricans, age- and gender-matched with 45 healthy participants. Volunteers with any comorbidity or taking weight reduction, glucose- and/or lipid-lowering medication or drugs capable of causing acanthosis nigricans were not included in the study. B-mode ultrasound tests were done to measure the carotid intima-media thickness. Body mass index, insulin, glucose and lipid blood serum levels were measured. Chi-square or Fisher's exact test and paired Student t-test were used for statistical analysis.


RESULTS
Carotid intima-media thickness was greater in patients with acanthosis nigricans (mean 0.52 mm vs. 0.46 mm, P = 0.002). The prevalence of abnormal intima-media thickness was higher in patients with acanthosis nigricans versus healthy participants (62.2% vs. 35.5%, P = 0.02). The same occurred with hyperinsulinemia (73.3% vs. 13.3%, P< 0.001), insulin resistance (86.6% vs. 33.3%, P< 0.001), obesity (86.6% vs. 13.3%, P< 0.001) and dyslipidemia (95.5% vs. 77.7%, P = 0.01).


CONCLUSIONS
The sample size is small and serum markers of cardiovascular risk were not measured.


CONCLUSIONS
Acanthosis nigricans is a skin marker for metabolic disturbances and is also associated with carotid atherosclerosis, a finding which is not well documented. We propose that individuals with acanthosis nigricans should be routinely evaluated for these cardiovascular risks.
Department of Dermatology, Dermatologic Institute of Jalisco, Secretary of Health Jalisco, Guadalajara, Jalisco, México.
Elizabeth
E
Guevara-Gutiérrez
Medical Research Division, UMAE Pediatric Hospital, CMNO, IMSS, Guadalajara, Jalisco, México.
Alberto
A
Tlacuilo-Parra
Cardiotest Laboratory of Echocardiography, Bernardette Hospital, Guadalajara, Jalisco, México.
Pedro
P
Gutiérrez-Fajardo
Department of Dermatology, Dermatologic Institute of Jalisco, Secretary of Health Jalisco, Guadalajara, Jalisco, México.
Tania
T
Sánchez-Tenorio
Department of Dermatology, Dermatologic Institute of Jalisco, Secretary of Health Jalisco, Guadalajara, Jalisco, México.
Fernando
F
Barba-Gómez
Cardiovascular Research Unit, CUCS, University of Guadalajara, Guadalajara, Jalisco, México.
Alejandra
A
Miranda-Díaz
D000052:Acanthosis Nigricans / Q000175:diagnosis* / Q000453:epidemiology*; D000328:Adult; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000453:epidemiology; D002340:Carotid Artery Diseases / Q000175:diagnosis* / Q000453:epidemiology*; D017536:Carotid Artery, Common / Q000473:pathology*; D059168:Carotid Intima-Media Thickness; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055815:Young Adult