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ARS Home » Plains Area » Houston, Texas » Children's Nutrition Research Center » Research » Publications at this Location » Publication #293797
Title: The association between acanthosis nigricans and dysglycemia in an ethnically diverse group of eighth grade students

Author
item RAFALSON, LISA - University Of Buffalo
item PHAM, TRANG - George Washington University
item WILLI, STEVEN - University Of Pennsylvania
item MARCUS, MARSHA - University Of Pittsburgh Medical Center
item JESSUP, ANN - University Of North Carolina
item BARANOWSKI, TOM - Children'S Nutrition Research Center (CNRC)

Submitted to: Obesity
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 9/4/2012
Publication Date: 3/1/2013
Citation: Rafalson, L., Pham, T.H., Willi, S.M., Marcus, M., Jessup, A., Baranowski, T. 2013. The association between acanthosis nigricans and dysglycemia in an ethnically diverse group of eighth grade students. Obesity. 21(3):E328-E333.

Interpretive Summary: Acanthosis nigricans (AN) is a darkening and toughening of the skin on the back around the neck. AN is most common among the obese, and has been considered a precursor to type 2 diabetes. Most work on AN has appeared in Black populations. In light of the obesity epidemic, it is important to establish the prevalence of AN in other ethic groups and to assess its association with risk factors for type 2 diabetes. In a diverse sample of middle school students, AN was detected among 39% of the Black, 30% of the Hispanic, and 5.4% of the White students. The presence of AN was associated with an increased risk of having elevated hemoglobin Alc (an indicator or long term blood sugar control), impaired glucose tolerance, and the ratio of impaired glucose tolerance to impaired fasting glucose. Thus, AN is relatively common in ethnic minority samples, and suggests increased risk for type 2 diabetes.

Technical Abstract: 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. 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%. 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%. 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.