Acanthosis nigricans and insulin resistance in obese children

  • Kristellina Sangirta Tirtamulia Department of Child Health, Sam Ratulangi University Medical School/Prof. Dr. R. D. Kandou Hospital, Manado
  • Adrian Umboh Department of Child Health, Sam Ratulangi University Medical School/Prof. Dr. R. D. Kandou Hospital, Manado
  • Sarah Maria Warouw Department of Child Health, Sam Ratulangi University Medical School/Prof. Dr. R. D. Kandou Hospital, Manado
  • Vivekenanda Pateda Department of Child Health, Sam Ratulangi University Medical School/Prof. Dr. R. D. Kandou Hospital, Manado
  • Frecillia Regina Department of Child Health, Sam Ratulangi University Medical School/Prof. Dr. R. D. Kandou Hospital, Manado
Keywords: acanthosis nigricans, insulin resistance, obese

Abstract

Background Acanthosis nigricans (AN) is a skin condition characterized by darkening and thickening of skin. AN has been reported to be linked to insulin resistance (IR), that associated with type 2 diabetes, in obese children in many country.

Objective To determine the relation between acanthosis nigricans and insulin resistance in obese children.

Methods We conducted a cross sectional study in Wenang District, Manado, from October 2009 until January 2010. We examined 54 obese children aged 10-14  years for insulin resistance using Homeostasis Model Assessment of Insulin Resistance Index (HOMA-IR). We analyzed the results byT-test and phi coefficient correlation. The value of P<O.05 was significant in statistical analysis.

Results Acanthosis nigricans was positive in 33 children. Insulin resistance was found in 34 from 54 subjects, 28 of them has AN and 6has no AN. Obese children with AN had higher HOMA-IR than children without AN. Presence of AN was associated with IR (P<O.OOl, r=0.57).

Conclusions There is a weak correlation between AN and IR in obese children. It is important to identify obese children with IR for early intervention and prevention of type  2 diabetes, but AN could not be a reliable marker of IR.

References

1. Morelli JG. Diseases of the epidennis. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, editors. Nelson textbook of pediatrics. 18th ed. Philadelphia: WB Saunders,
2007. p. 2708,14.
2. Kong AS, Williams RL, Smith M, Sussman AL, Skipper B, His AC, et al. Acanthosis nigricans and diabetes risk factors: prevalence in young person seen in Southwestern US primary care practises. Ann Fam Med. 2007;5:20-8.
3. Kobaissi HA, Weigensberg MJ, Ball GDC, Cruz ML, Shaibi GQ, Goran MI. Relation between acanthosis nigricans and insulin sensitivity in overweight hispanic children at risk for type 2 diabetes. Diabetes Care. 2004;27:141-6.
4. Guran T, Turan S, Akcay T, Bereket A. Significance of acanthosis nigricans in childhood obesity. J Paediatr Child Health. 2008;44,338-41.
5. Yamazaki H, Ito S, Yoshida H. Acanthosis nigricans is a reliable cutaneous marker of insulin resistance in obese Japanese children. Pediatr Int. 2003;45:70-5.
6. Matthaei S, Stumvoll M, Kellerer M, Haring HU. Pathophysiology and pharmacological treatment of insulin resistance. Endocr Rev. 2000;21:58-618.
7. Varthakavi PK, Patel KL, Wadhwa SL, Shopkar U, Sengupta RA, Merchant PC, et al. A study of insulin resistance in subjects Mth acanthosis nigricans. J Assoc Physicians India. 2001;49:705-12.
8. Hettihewa LM, Palangasinghe S, J ayasinghe SS, Gunasekara Sw, Weerarathna TP. Comparison of insulin resistance by indirect methods - HOMA, QUICKI and McAuley – Mth fasting insulin in patients Mth type 2 diabetes in Galle, Sri Lanka, a pilot study. OjHAS. 2006;5:1-8.
9. Katz AS, Goff DC, Feldma SR. Acanthosis nigricans in obese patients: presentation and implications for prevention of atherosclerotic vascular disease. Dermatol Online J.
2000;6:1-7.
10. Ikezaki A, Miura N, Kikuoka N, Hye SK, Matsuoka H, Ito K , et al. Clinical characteristics of obese Japanese children Mth acanthosis nigricans. Clin Pediatr Endocrinol. 2001;10:4-52.
11. Hardin DS. Screening for type 2 diabetes in children Mth acanthosis nigricans. Diabetes Educ. 2006;32:54-52.
12. Atabek ME, Pirgon O. Assessment of insulin sensitivity from measurements in fasting state and during an oral glucose tolerance test in obese children. J Pediatric Endocrinol Metab. 2007;20:187-95.
13. Gungor N, Saad R, Janosky J, Arslanian S. Validation of surrogate estimates of insulin sensitivity and insulin secretion in children and adolescents. J Pediatrics. 2004; 144:47-55.
14. Keskin M, Kurtoglu S, Kendirci M, Atabek ME, Yazici C. Homeostasis mooel assessment is more reliable than the fasting glucose/insulin ratio and quantitative insulin sensitivity check index for assessing insulin resistance among obese children
and adolescents. Pediatrics. 2005; 115 :e500-3.
15. Nguyen IT, Keil MF, Russell DL, Pathomvanich A, Uwaifo Gr, Sebring NG, et al. Relation of acanthosis nigricans to hyperinsulinemia and insulin sensitivity in overweight African American and white children.J Pediatr. 2001;138:474-80.
16. Menon VU, Kumar KY, Gilchrist A, Sundaram KR, J ayakumar RV, Nair V, et al.A canthosis nigricans and insulin levels in a south Indian population (ADEPS paper 2). Obesity Res Clin Practice.2008;2:43-50.
Published
2010-10-30
How to Cite
1.
Tirtamulia K, Umboh A, Warouw S, Pateda V, Regina F. Acanthosis nigricans and insulin resistance in obese children. PI [Internet]. 30Oct.2010 [cited 21Feb.2024];50(5):274-. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/997
Received 2016-11-01
Accepted 2016-11-01
Published 2010-10-30