The association between acanthosis nigricans and dysglycemia in an ethnically diverse group of eighth grade students |
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| Authors: | Lisa Rafalson Trang H Pham Steven M Willi Marsha Marcus Ann Jessup Tom Baranowski |
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| Institution: | 1. Health Service Administration, D'Youville College, Buffalo, New York, USA;2. Departments of Family Medicine and Pediatrics, University at Buffalo, Buffalo, New York, USA;3. The Biostatistics Center, George Washington University, Rockville, Maryland 20852, USA;4. Department of Pediatrics, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA;5. Western Psychiatric Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania 15213, USA;6. School of Nursing, University of North Carolina, Chapel Hill, North Carolina 27599, USA;7. Baylor College of Medicine, Children's Nutrition Research Center, Houston, Texas 77030, USA |
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| 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. Design and 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%. Conclusion: 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. |
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