Submitted to: Journal of Children's Health
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 7/1/2003
Publication Date: 8/1/2003
Citation: Wong, W.W., Hollier, D.R., Myres, D., Fraley, K.J., Smith, O.E., Klish, W.J. 2003. Prevalence of acanthosis nigricans in a multiethnic pediatric population. Journal of Children's Health. 1(3):323-331.
Interpretive Summary: Acanthosis nigricans (AN) is a skin disorder that researchers have connected to high levels of blood insulin and a tendency to develop type II diabetes. It looks like a dark, thickened patch of skin, and is most commonly seen around the back of the neck. It has been seen more often in children and adults who are obese than those who are normal-weight. We wanted to determine the incidence of AN among children in the Houston Independent School District. In a large sample of children at HISD schools, we asked parents to check for signs of AN in their children and to disclose whether there was a family history of diabetes. About 3 percent of the nearly 2,000 children had AN. The prevalence was higher among students with a family history of diabetes, especially a maternal history. By ethic group, the prevalence was highest among African-Americans, followed by Hispanics, and then Asians. Caucasians had the lowest incidence. The incidence was higher among students who were overweight, and still higher among the subset of children who were obese. We conclude that further attention should be paid to the significance of this skin disorder, particularly given the rampant U.S. epidemic of childhood overweight and obesity, since children who have signs of AN might have high blood insulin and be at risk for developing diabetes.
Technical Abstract: Background. Acanthosis nigricans, a skin disorder that has been linked to insulin resistance and a propensity to develop type II diabetes, has an increased incidence among children with excess body weight, whose numbers are growing in epidemic proportions in the United States. This study was designed to determine the prevalence of acanthosis nigricans and its association with excess body weight, ethnicity, family history of diabetes and gender among students in the Houston Independent School District (HISD), the largest public school system in Texas, with diverse ethnic and socioeconomic characteristics mirroring those of children nationwide. Methods. The parents of 1,917 students between 6 and 17 years of age completed a survey designed to determine whether the student had a family history of diabetes and whether acanthosis nigricans was present on the most common site, the back of the neck. Results. Approximately 3.0% of the 1,917 HISD students were reported to have acanthosis nigricans. The prevalence was higher among students who were overweight and obese (p < 0.001 for both); higher among African-Americans (6.1%), Hispanics (4.3%), and Asians (3.1%) than among Caucasians (0.6%, p < 0.001); and higher among those who had a family history of diabetes (p = 0.06). Importantly, acanthosis nigricans was reported in 1.9% of the children at 6 years of age. No difference in prevalence was found with regard to gender. Conclusion. Further attention to the significance of childhood acanthosis nigricans is warranted with regard to the associated risks of insulin resistance and type II diabetes, particularly given the soaring numbers of U. S. minority children with excess body weight.