Abstract

HIRSCHLER, Valeria et al. ¿Es la acantosis nigricans un signo de insulinorresistencia en adolescentes obesos?. Arch. argent. pediatr. [online]. 2004, vol.102, n.2, pp.115-120. ISSN 0325-0075.

Introduction. Acanthosis nigricans was proposed as an insulin-resistance marker in obese adolescents. The purpose of this study was to determine the association between AN and: a) several markers of insulin-resistance (HOMA-IR, IGF1-BP1 levels, basal insulinemia), b) BMI, c) HDL, triglycerides and other predictors of insulin-resistance or type 2 diabetes mellitus. Population, material and methods. One thousand two hundred and fifty multiethnic, mainly caucasic adolescents, mean age 12.4 ± 1.4 years, who consulted for routine check up, between April and November 2001, were evaluated. Two hundred eighty eight were obese, (BMI > percentile 95), of these, we took a randomized sample of 74 obese adolescents (40 females). Data for: birth weight, positive family history for obesity and/or T2DM, BMI, presence of AN, blood pressure and Tanner stage, were obtained. An OGTT test, a lipid profile, insulinemia and IGF1-BP1 tests were performed. Results. From 74 obese adolescents, all were Tanner ≥ 2 and had a positive family history for obesity and/or T2DM. Forty one (55.4%) had AN. (41+) and 33 were AN-. Four were glucose intolerant in the group with AN and in the other, only 2. None of them had type 2 diabetes. There was an univariate association with BMI (rS- 0.45; p= 0.00038), birth weight (rS 0.37 p= 0.0021), basal glucose (rS-0.30; p= 0.009) and HDL (rS -0.25;p= 0.03). There was neither univariate nor multivariate associations between AN and the markers of insulin-resistance: basal insulinemia (rS-016 p= 0.16), HOMA IR (rS-0.2 p= 0.06), and IGF1-BP1 (rS 0.07 p= 0.69). The presence of AN showed a positive correlation with BMI (OR= 1.30p= 0.018) and a negative correlation with birth weight (OR= 0.23, p= 0.03) in the multivariate analysis. Conclusions. This suggests that AN was a marker for severe obesity, but was not a reliable marker for insulin-resistance in our population.

Keywords : Acanthosis nigricans; Insulin-resistance; Type 2 diabetes.

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