Relationship of acanthosis nigricans with metabolic syndrome in obese children
-
Munise Daye
und
Mehmet Emre Atabek
Abstract
Objectives
Acanthosis nigricans is a skin symptom in obesity that helps to identify patients at high risk for dyslipidemia, hypertension, insulin resistance, and diabetes. It is the most important complication of obesity in metabolic syndrome. Studies investigating the relationship between acanthosis nigricans and metabolic syndrome in obese children are insufficient. In our study, the relationship of acanthosis nigricans and metabolic syndrome was evaluated in children.
Methods
Obese children aged between 6 and 18 years old, who were examined in the pediatric endocrinology outpatient clinic, were included. The patients’ anthropometric measurements and laboratory results were recorded. Modified IDF (International Diabetes Federation) criteria for children were used in metabolic syndrome classification.
Results
A hundred and forty-eight obese children were evaluated. The mean age of the cases was 11.91 ± 2.94 years old. Of the cases, 56.1% were female (n=83) 43.9% (n=65) were male. In 39.9% (n=59) of cases, acanthosis nigricans was determined. Acanthosis nigricans was mostly located in the axillary area (27.1%) and the neck (16.9%). In 55.9% of the cases, it was located in more than one area. The relation of regionally detected acanthosis nigricans and metabolic syndrome was not significant (p=0.291). Metabolic syndrome was detected in 14% of 136 patients according to IDF criteria. Acanthosis nigricans and metabolic syndrome combination was present in 27.7%; however, 6.7% of the metabolic syndrome patients did not have acanthosis nigricans. There was a strong relation between metabolic syndrome and the presence of acanthosis nigricans (p=0.003).
Conclusions
In our study, a correlation between acanthosis nigricans and metabolic syndrome was detected. Acanthosis nigricans is a skin sign that can be easily detected by clinician. It is an important and easy-to-detect dermatosis that helps determine patients at risk of metabolic syndrome in obese children.
Research funding: None declared.
Author contributions: Munise Daye: Determination of study subject, data collection, data analysis, interpretation of data and acanthosis nigricans, writing the manuscript. Beray Selver Eklioglu: Determination of study subject, data collection, interpretation of statistical results, academic support in article writing. Mehmet Emre Atabek: Academic contribution to the article.
Competing interests: No funding organizations played a role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
References
1. Bao, W, Srinivasan, SR, Wattigney, WA, Berenson, GS. Persistence of multiple cardiovascular risk clustering related to syndrome X from childhood to young adulthood: the Bogalusa Heart Study. Arch Intern Med 1994;154:1842–7. https://doi.org/10.1001/archinte.1994.00420160079011.Suche in Google Scholar
2. Grundy, SM. Metabolic syndrome. Part I and II. Endorinol Metab Clin N Am 2004;33. https://doi.org/10.1016/j.ecl.2004.03.018.Suche in Google Scholar
3. Bonora, E, Kiechl, S, Willeit, J, Oberhollenzer, F, Egger, G, Targheret, G, et al.. Prevalence of insulin resistance in metabolic disorders: the Bruneck Study. Diabetes 1998;47:1643–9. https://doi.org/10.2337/diabetes.47.10.1643.Suche in Google Scholar
4. Atabek, ME, Eklioglu, BS, Akyurek, N. Reevaluation of the prevalence of metabolic syndrome in an urban area of Turkey. J Clin Res Pediatr Endocrinol 2013;5:50–4. https://doi.org/10.4274/Jcrpe.778.Suche in Google Scholar
5. Zimmet, P, Alberti, KG, Kaufman, F, Tajima, N, Silink, M, Arslanian, S, et al.. The metabolic syndrome in children and adolescents—an IDF consensus report. Pediatr Diabetes 2007;8:299–306. https://doi.org/10.1111/j.1399-5448.2007.00271.x.Suche in Google Scholar
6. Koh, YK, Lee, JH, Kim, EY, Moon, KR. Acanthosis nigricans as a clinical predictor of insulin resistance in obese children. Pediatr Gastroenterol Hepatol Nutr 2016;19:251–8. https://doi.org/10.5223/pghn.2016.19.4.251.Suche in Google Scholar
7. Schwartz, RA. Acanthosis nigricans. J Am Acad Dermatol 1994;31:1–19. https://doi.org/10.1016/s0190-9622(94)70128-8.Suche in Google Scholar
8. Ng, HY, Young, JHM, Huen, KF, Chan, LTW. Acanthosis nigricans in obese Chinese children. Hong Kong Med J 2014;20:290–6. https://doi.org/10.12809/hkmj134071.Suche in Google Scholar
9. Nguyen, TT, Keil, MF, Russell, DL, Pathomvanich, A, Uwaifo, GI, Sebring, NG, et al.. Relation of acanthosis nigricans to hyperinsulinemia and insulin sensitivity in overweight African American and white children J. An Pediatr 2001;138:474–80. https://doi.org/10.1067/mpd.2001.112657.Suche in Google Scholar
10. Kahn, CR, Flier, JS, Bar, RS, Archer, JA, Gorden, P, Martin, MM, et al.. The syndromes of insulin resistance and acanthosis nigricans. Insulin-receptor disorders in man. N Engl J Med 1976;294:739–45. https://doi.org/10.1056/nejm197604012941401.Suche in Google Scholar
11. Type 2 diabetes in children and adolescents. American diabetes association. Diabetes Care 2000;23:381–9. https://doi.org/10.2337/diacare.23.3.381.Suche in Google Scholar
12. Maitra, SK, Payne, CM. The obesity syndrome and acanthosis nigricans. Acanthosis nigricans is a common cosmetic problem providing epidemiological clues to the obesity syndrome, the insulin-resistance syndrome, the thrifty metabolism, dyslipidemia, hypertension and diabetes mellitus Type II. J Cosmet Dermatol 2004;3:202–10. https://doi.org/10.1111/j.1473-2130.2004.00078.x.Suche in Google Scholar
13. Bundak, R, Furman, A, Gunoz, H, Darendeliler, F, Bas, F, Neyzi, O. Body mass index references for Turkish children. Acta Paediatr 2006;95:194–8. https://doi.org/10.1080/08035250500334738.Suche in Google Scholar
14. Kuczmarski, RJ, Ogden, CL, Guo, SS, Grummer-Strawn, LM, Flegal, KM, Mei, Z, et al.. CDC Growth Charts for the United States: methods and development. Vital Health Stat 11 2000;2002:1–190.Suche in Google Scholar
15. Hatipoglu, N, Ozturk, A, Mazicioglu, MM, Kurtoglu, S, Seyhan, S, Lokoglu, F. Waist circumference percentiles for 7- to 17-year-old Turkish children and adolescents. Eur J Pediatr 2008;167:383–9. https://doi.org/10.1007/s00431-007-0502-3 [Epub 2007 May 9].Suche in Google Scholar
16. National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents. The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics 2004;114:555–76.10.1542/peds.114.S2.555Suche in Google Scholar
17. Marshall, WA, Tanner, JM. Variations in the pattern of pubertal changes in boys. Arch Dis Child 1970;45:13–23. https://doi.org/10.1136/adc.45.239.13.Suche in Google Scholar
18. Marshall, WA, Tanner, JM. Variations in pattern of pubertal changes in girls. Arch Dis Child 1969;44:291–303. https://doi.org/10.1136/adc.44.235.291.Suche in Google Scholar
19. Keskin, M, Kurtoglu, S, Kendirci, M, Atabek, ME, Yazici, C. Homeostasis model 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;115:500–3. https://doi.org/10.1542/peds.2004-1921.Suche in Google Scholar
20. Conwell, LS, Trost, SG, Brown, WJ, Batch, JA. Indexes of insulin resistance and secretion in obese children and adolescents: a validation study. Diabetes Care 2004;27:314–9. https://doi.org/10.2337/diacare.27.2.314.Suche in Google Scholar
21. Güven, Ş, Aktepe, U, Yazar, AS, Erdem, A, Karakayalı, B, Başat, S. The prevalence of metabolic syndrome among obese and overweight children according to the different criteria. Haydarpaşa Numune Eğitim ve Araştırma Hastanesi Tıp Dergisi 2015;55:168–78.Suche in Google Scholar
22. Yosipovitch, G, DeVore, A, Dawn, A. Obesity and the skin: skin physiology and skin manifestations of obesity. J Am Acad Dermatol 2007;56:917–20. https://doi.org/10.1016/j.jaad.2006.12.004.Suche in Google Scholar
23. Güngör, NK. Overweight and obesity in children and adolescents. J Clin Res Pediatr Endocrinol 2014;6:129–43. https://doi.org/10.4274/Jcrpe.1471.Suche in Google Scholar
24. Brickman, WJ, Huang, J, Silverman, BL, Metzger, BE. Acanthosis nigricans identifies youth at high risk for metabolic abnormalities. J Pediatr 2010;156:87–92. https://doi.org/10.1016/j.jpeds.2009.07.011.Suche in Google Scholar
25. Sayarifad, F, Sayarifard, A, Allahverdi, B, Ipekchi, S, Moghtaderi, M, Yagmaeı, B. Prevalence of acanthosis nigricans and related factors in Iranian obese children. J Clin Diagn Res 2017;11:SC05–SC07.10.7860/JCDR/2017/24902.10203Suche in Google Scholar PubMed PubMed Central
26. Ho, M, Garnett, SP, Baur, LA, Obesity childhood, resistance insulin. How should it Be managed?. Curr Treat Options Cardiovasc Med 2014;16:351. https://doi.org/10.1007/s11936-014-0351-0.Suche in Google Scholar
27. Maclaren, NK, Gujral, S, Ten, S. MotaghetiR.Childhood obesity and insulin resistance. Cell Biochem Biophys 2007;48:73–8. https://doi.org/10.1007/s12013-007-0017-6.Suche in Google Scholar
28. Reinehr, T, de Sousa, G, Toschke, AM, Andler, W. Comparison of metabolic syndrome prevalence using eight different definitions: acritical approach. Arch Dis Child 2007;92:1067–72. https://doi.org/10.1136/adc.2006.104588.Suche in Google Scholar
29. Fang, J, Zhang, JP, Luo, CX, Yu, XM, Lv, LQ. Carotid Intima-media thickness in childhood and adolescent obesity relations to abdominal obesity, high triglyceride level and insulin resistance. Int J Med Sci 2010;7:278–83. https://doi.org/10.7150/ijms.7.278.Suche in Google Scholar
30. Kerem, N, Guttmann, H, Hochberg, Z. The autosomal dominant trait of obesity, acanthosis nigricans, hypertension, ischemic heart disease and diabetes type 2. Horm Res 2001;55:298–304. https://doi.org/10.1159/000050017.Suche in Google Scholar
31. Saki, F, Karamizadeh, Z. Metabolic syndrome, insulin resistance and Fatty liver in obese Iranian children. Iran Red Crescent Med J 2014;16:e6656. https://doi.org/10.5812/ircmj.6656.Suche in Google Scholar
32. Ayaz, T, Baydur Şahin, S, Şahin, OZ. Relation of Acanthosis nigricans to metabolic syndrome in overweight and obese women. Metab Syndr Relat Disord 2014;12:320–3. https://doi.org/10.1089/met.2013.0145.Suche in Google Scholar
33. Kong, AS, Vanderbloemen, L, Skipper, B, Leggott, J, Sebesta, E, Glew, R, et al.. Acanthosis nigricans predicts the clustering of metabolic syndrome components in hispanic elementary school-aged children. J Pediatr Endocrinol Metab 2012;25:1095–102. https://doi.org/10.1515/jpem-2012-0117.Suche in Google Scholar
34. Stefanadi, EC, Dimitrakakis, G, Antoniou, CK, Challoumas, D, Punjabi, N, Dimitrakaki, IA, et al.. Metabolic syndrome and the skin: a more than superficial association. Reviewing the association between skin diseases and metabolic syndrome and a clinical decision algorithm for high risk patients. Diabetol Metab Syndrome 2018;10:9. https://doi.org/10.1186/s13098-018-0311-z.Suche in Google Scholar
© 2020 Walter de Gruyter GmbH, Berlin/Boston
Artikel in diesem Heft
- Frontmatter
- Review Article
- Papillary thyroid carcinoma in children with Hashimoto’s thyroiditis – a review of the literature between 2000 and 2020
- Original Articles
- Tyrosine metabolism in health and disease: slow-release amino acids therapy improves tyrosine homeostasis in phenylketonuria
- Evolution of Hashimoto thyroiditis in children with type 1 diabetes mellitus (TIDM)
- Glycated hemoglobin variability and microvascular complications in patients with type 1 diabetes mellitus
- Delineation of the genetic and clinical spectrum, including candidate genes, of monogenic diabetes: a multicenter study in South Korea
- Can we use copeptin as a biomarker for masked hypertension or metabolic syndrome in obese children and adolescents?
- Relationship of acanthosis nigricans with metabolic syndrome in obese children
- Daily intake of macronutrients and energy in childhood and its association with cardiometabolic risk factors in Colombians
- The effect of treatment with recombinant human growth hormone (rhGH) on linear growth and adult height in children with idiopathic short stature (ISS): a systematic review and meta-analysis
- Growth in achondroplasia, from birth to adulthood, analysed by the JPA-2 model
- Short Communication
- Assessing disparities in barriers to attending pediatric diabetes camp
- Letter to the Editor
- Severity in pediatric type 1 diabetes mellitus debut during the COVID-19 pandemic
- Case Reports
- The use of glimepiride for the treatment of neonatal diabetes mellitus caused by a novel mutation of the ABCC8 gene
- Effect of recombinant human insulin-like growth factor 1 therapy in a child with 3-M syndrome-1 with CUL7 gene mutation
- A nonsense variant in FGFR1: a rare cause of combined pituitary hormone deficiency
- Treatment response to long term antiresorptive therapy in osteogenesis imperfecta type VI: does genotype matter?
Artikel in diesem Heft
- Frontmatter
- Review Article
- Papillary thyroid carcinoma in children with Hashimoto’s thyroiditis – a review of the literature between 2000 and 2020
- Original Articles
- Tyrosine metabolism in health and disease: slow-release amino acids therapy improves tyrosine homeostasis in phenylketonuria
- Evolution of Hashimoto thyroiditis in children with type 1 diabetes mellitus (TIDM)
- Glycated hemoglobin variability and microvascular complications in patients with type 1 diabetes mellitus
- Delineation of the genetic and clinical spectrum, including candidate genes, of monogenic diabetes: a multicenter study in South Korea
- Can we use copeptin as a biomarker for masked hypertension or metabolic syndrome in obese children and adolescents?
- Relationship of acanthosis nigricans with metabolic syndrome in obese children
- Daily intake of macronutrients and energy in childhood and its association with cardiometabolic risk factors in Colombians
- The effect of treatment with recombinant human growth hormone (rhGH) on linear growth and adult height in children with idiopathic short stature (ISS): a systematic review and meta-analysis
- Growth in achondroplasia, from birth to adulthood, analysed by the JPA-2 model
- Short Communication
- Assessing disparities in barriers to attending pediatric diabetes camp
- Letter to the Editor
- Severity in pediatric type 1 diabetes mellitus debut during the COVID-19 pandemic
- Case Reports
- The use of glimepiride for the treatment of neonatal diabetes mellitus caused by a novel mutation of the ABCC8 gene
- Effect of recombinant human insulin-like growth factor 1 therapy in a child with 3-M syndrome-1 with CUL7 gene mutation
- A nonsense variant in FGFR1: a rare cause of combined pituitary hormone deficiency
- Treatment response to long term antiresorptive therapy in osteogenesis imperfecta type VI: does genotype matter?
