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Acanthosis nigricans: A screening test for insulin resistance - An important risk factor for diabetes mellitus type-2
Meera Bhagyanathan1, Deepak Dhayanithy2, Vijayan Ampaya Parambath3
1Department of Dermatology, Aster MIMS Hospital, Kozhikode, Kerala, India.
Insights
Acanthosis nigricans (AN) is a useful indicator for identifying children with high insulin resistance (IR), a precursor to type-2 diabetes. Early detection through AN screening can help prevent or delay diabetes development.
Area of Science:
- Pediatrics
- Endocrinology
- Metabolic Disorders
Background:
- Acanthosis nigricans (AN) is a clinical sign associated with insulin resistance (IR), a key factor in type-2 diabetes mellitus (DM Type-2) pathogenesis.
- Early detection of IR in children is crucial for timely intervention before DM Type-2 onset and microvascular complications.
- Previous pilot studies indicated a high incidence of IR in children with AN.
Purpose of the Study:
- To evaluate the efficacy of easily observable Acanthosis Nigricans (AN) as a screening tool for elevated insulin resistance (IR) in children.
- To identify children at high risk for developing type-2 diabetes mellitus (DM Type-2) through AN screening.
Main Methods:
- A cross-sectional, observational study involving 507 children aged 10-18 years from two socio-economic backgrounds.
- Physical examination for AN, anthropometric measurements (height, weight, waist circumference), and biochemical tests (fasting glucose, insulin, lipid profile) were performed.
- Homeostatic model assessment for insulin resistance (HOMA-IR) was calculated, and data were analyzed using descriptive and inferential statistics (Chi-square test).
Main Results:
- Acanthosis nigricans (AN) presence positively correlated with high insulin resistance (IR).
- In children with both AN and elevated Body Mass Index (BMI), the incidence of IR reached 80%.
- These findings suggest AN and BMI are valuable parameters for screening high-risk children.
Conclusions:
- Acanthosis nigricans (AN) serves as an effective screening method for identifying children at risk of type-2 diabetes mellitus (DM Type-2) due to its association with high insulin resistance (IR).
- Early identification and intervention strategies in at-risk children can potentially prevent or postpone the onset of diabetes.
- Implementing simple screening criteria like AN can aid in high-throughput screening programs for pediatric diabetes risk.
Background:
Acanthosis nigricans (AN) is one of the signs suggestive of high insulin resistance (IR). IR is one of the mechanisms involved in pathogenesis of diabetes mellitus type-2 (DM Type-2). Thus, early detection of IR in children may allow us time to intervene well before the development of DM Type-2. In this study, 62% of children having AN had high IR. In children having both, AN and high body mass index (BMI), the incidence of IR was about 80%. This suggests that these easily detectable parameters alone can be useful in screening children at high risk of developing DM Type-2 in future. These simple criteria thus hold promise for use in high throughput screening programs for diabetes.
Context:
A pilot study conducted by the authors showed that children with AN have a high incidence of IR. The detection of IR in children may allow us time to intervene well before the development of DM Type-2. Detection of DM Type-2 by hyperglycemia may be too late to prevent the onset of microvascular changes.
Aims:
This study aims to determine whether easily observable presence of AN can be used to screen for increased IR in children, and thereby to detect this important risk factor for DM Type-2.
Settings And Design:
Cross-sectional, observational study. Two schools, one with children belonging to average economic background and the other, a residential school with children of affluent parents. Selection of children was done randomly.
Subjects And Methods:
The study was conducted among 507 children in the age group of 10-18 years. Physical examination for the detection of AN, height and weight measurements, waist circumference, fasting plasma glucose, fasting plasma insulin, and lipid profile was done. Homeostatic model assessment of insulin resistance was calculated.
Statistical Analysis Used:
Data analysis was performed using descriptive statistics and inferential statistical methods. The association between categorical variables was done by Chi-square test.
Results:
The presence of AN positively correlated with high IR, and when combined with increased BMI, the incidence rate of IR is 80%.
Conclusions:
AN can be used as a screening method to identify children at risk of DM Type-2-since those who have high IR have a high possibility of having DM Type-2 in future. Hence, early screening and simple, but effective interventional strategies can be instituted at this age, which may prevent or delay diabetes in the long run.
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