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Annals of Family Medicine 5:202-208 (2007)
© 2007 Annals of Family Medicine, Inc.
doi: 10.1370/afm.678
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Acanthosis Nigricans and Diabetes Risk Factors: Prevalence in Young Persons Seen in Southwestern US Primary Care Practices

Alberta S. Kong, MD, MPH1, Robert L. Williams, MD, MPH2, Melissa Smith, BA2, Andrew L. Sussman, PhD, MCRP2, Betty Skipper, PhD2, Andrew C. Hsi, MD, MPH1, Robert L. Rhyne, MD2 On behalf of RIOS Net Clinicians

1 Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque, NM
2 Department of Family and Community Medicine, University of New Mexico School of Medicine, Albuquerque, NM

CORRESPONDING AUTHOR: Alberta S. Kong, MD, MPH, Department of Pediatrics, MSC 10 5590, 1 University of New Mexico, Albuquerque, NM 87131-0001, akong{at}unm.edu

PURPOSE Evidence shows acanthosis nigricans is often associated with hyperinsulinemia and may indicate increased risk of type 2 diabetes mellitus. The purpose of this study was to determine the association of acanthosis nigricans with type 2 diabetes risk factors and disease in young persons.

METHODS We conducted a cross-sectional study in the Research in Outpatient Settings Network, a practice-based research network in southwestern US communities. Participating clinicians (N = 96) collected data on children and young adults aged 7 to 39 years seen during a 2-week sampling period. The main outcomes were the prevalence of acanthosis nigricans, type 2 diabetes risk factors (ethnicity, family history of type 2 diabetes, hypertension, overweight/obesity), type 2 diabetes, and the relationships among these.

RESULTS Among 1,133 patients sampled, risk factors for type 2 diabetes were common: 69% had a family history of the disease; 3% of children (aged 7 to 19 years) and 12% of adults had hypertension; 43% of children and 73% of adults were overweight or obese; and 80% were members of ethnic minorities. Acanthosis nigricans was found in 17% of children and 21% of adults. Among children and adults alike, the more type 2 diabetes risk factors that were present, the higher the prevalence of acanthosis nigricans (P <.001). The prevalence ratio for type 2 diabetes in patients with acanthosis nigricans was 1.97 (95% confidence interval, 1.18–3.27; P = .01) after controlling for age, body mass index, and the number of type 2 diabetes risk factors. Clinicians reported that the identification of acanthosis nigricans frequently led to discussions about lifestyle modification for decreasing the risk of type 2 diabetes.

CONCLUSIONS Patients with acanthosis nigricans are likely to have multiple risk factors for type 2 diabetes. Acanthosis nigricans may be an independent risk factor for this disease. Detection of acanthosis nigricans may help clinicians more rapidly identify high-risk individuals for diabetes counseling.

Key Words: Acanthosis nigricans • diabetes mellitus • practice-based research network • primary care • screening • risk factors • risk reduction




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TRACK Comments:

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Acanthosis nigricans and risk factors for type 2 diabetes
Valeria Hirschler, M.D.
Annals of Family Medicine, 5 Jun 2007 [Full text]
Response to Acanthosis Nigricans and Risk Factors for Type 2 Diabetes
Alberta S. Kong MD MPH, et al.
Annals of Family Medicine, 8 Jun 2007 [Full text]

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