Skip to main content

Main menu

  • Home
  • Content
    • Current Issue
    • Online First
    • Multimedia
    • Collections
    • Past Issues
    • Articles by Subject
    • Articles by Type
    • Supplements
    • The Issue in Brief (Plain Language Summaries)
  • Info for
    • Authors
    • Reviewers
    • Media
    • Job Seekers
  • About
    • Annals of Family Medicine
    • Editorial Staff & Boards
    • Sponsoring Organizations
    • Copyrights & Permissions
    • Announcements
  • Engage
    • Engage
    • e-Letters (Comments)
    • Subscribe
    • RSS
    • Email Alerts
    • Journal Club
  • Contact
    • Feedback
    • Contact Us
  • Careers

User menu

  • My alerts

Search

  • Advanced search
Annals of Family Medicine
  • My alerts
Annals of Family Medicine

Advanced Search

  • Home
  • Content
    • Current Issue
    • Online First
    • Multimedia
    • Collections
    • Past Issues
    • Articles by Subject
    • Articles by Type
    • Supplements
    • The Issue in Brief (Plain Language Summaries)
  • Info for
    • Authors
    • Reviewers
    • Media
    • Job Seekers
  • About
    • Annals of Family Medicine
    • Editorial Staff & Boards
    • Sponsoring Organizations
    • Copyrights & Permissions
    • Announcements
  • Engage
    • Engage
    • e-Letters (Comments)
    • Subscribe
    • RSS
    • Email Alerts
    • Journal Club
  • Contact
    • Feedback
    • Contact Us
  • Careers
  • Follow annalsfm on Twitter
  • Visit annalsfm on Facebook
Research ArticleOriginal ResearchA

Acanthosis Nigricans and Diabetes Risk Factors: Prevalence in Young Persons Seen in Southwestern US Primary Care Practices

Alberta S. Kong, Robert L. Williams, Melissa Smith, Andrew L. Sussman, Betty Skipper, Andrew C. Hsi, Robert L. Rhyne and ; On behalf of RIOS Net Clinicians
The Annals of Family Medicine May 2007, 5 (3) 202-208; DOI: https://doi.org/10.1370/afm.678
Alberta S. Kong
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Robert L. Williams
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Melissa Smith
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Andrew L. Sussman
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Betty Skipper
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Andrew C. Hsi
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Robert L. Rhyne
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Data
  • Info & Metrics
  • eLetters
  • PDF
Loading

Published eLetters

If you would like to comment on this article, click on Submit a Response to This article, below. We welcome your input.

Submit a Response to This Article
Compose eLetter

More information about text formats

Plain text

  • No HTML tags allowed.
  • Web page addresses and e-mail addresses turn into links automatically.
  • Lines and paragraphs break automatically.
Author Information
First or given name, e.g. 'Peter'.
Your last, or family, name, e.g. 'MacMoody'.
Your email address, e.g. higgs-boson@gmail.com
Your role and/or occupation, e.g. 'Orthopedic Surgeon'.
Your organization or institution (if applicable), e.g. 'Royal Free Hospital'.
Statement of Competing Interests

Vertical Tabs

Jump to comment:

  • Response to Acanthosis Nigricans and Risk Factors for Type 2 Diabetes
    Alberta S. Kong MD MPH
    Published on: 08 June 2007
  • Acanthosis nigricans and risk factors for type 2 diabetes
    Valeria Hirschler, M.D.
    Published on: 05 June 2007
  • Published on: (8 June 2007)
    Page navigation anchor for Response to Acanthosis Nigricans and Risk Factors for Type 2 Diabetes
    Response to Acanthosis Nigricans and Risk Factors for Type 2 Diabetes
    • Alberta S. Kong MD MPH, Albuquerque, USA
    • Other Contributors:

    We appreciate Dr. Hirschler’s observation that “acanthosis nigricans is simpler and easier to screen compared with other risk factors for diabetes.” Her insight to the difficulty of obtaining valid assessments of traditional type 2 diabetes risk factors such as family history, body mass index and blood pressure within the clinical encounter is a sentiment felt by many primary care clinicians. We note with some sad irony...

    Show More

    We appreciate Dr. Hirschler’s observation that “acanthosis nigricans is simpler and easier to screen compared with other risk factors for diabetes.” Her insight to the difficulty of obtaining valid assessments of traditional type 2 diabetes risk factors such as family history, body mass index and blood pressure within the clinical encounter is a sentiment felt by many primary care clinicians. We note with some sad irony Dr. Hirschler’s statement that overweight was “overrepresented” in our sample. The sample obtained during a consecutive two week period in primary care practices throughout New Mexico is an unfortunate, but valid representation of the patients we serve and the extent of the problem of overweight/obesity. Our study was not designed to assess the association of acanthosis nigricans with insulin resistance. While Dr. Hirshler’s work has suggested that there is no such independent association (1), a number of other studies provide evidence of an association (2-8). Our finding that acanthosis nigricans was independently associated with diagnosed type 2 diabetes in this young population would suggest that this group is indeed at high risk for insulin resistance. Further studies of the relationship of acanthosis nigricans to diabetes and to metabolic markers of prediabetic states may help to clarify the value of this skin condition to clinicians and patients in prevention of type 2 diabetes.

    References

    1. Hirschler V, Aranda C, Oneto A, Gonzalez C, Jadzinsky M. Is acanthosis nigricans a marker of insulin resistance in obese children? Diabetes Care 2002;25(12):2353.

    2. Copeland K, Pankratz K, Cathey V, et al. Acanthosis Nigricans, insulin resistance (HOMA) and dyslipidemia among Native American children. J Okla State Med Assoc 2006;99(1):19-24.

    3. Hud JA, Jr., Cohen JB, Wagner JM, Cruz PD, Jr. Prevalence and significance of acanthosis nigricans in an adult obese population. Arch Dermatol 1992;128(7):941-4.

    4. Kobaissi HA, Weigensberg MJ, Ball GD, Cruz ML, Shaibi GQ, Goran MI. Relation between acanthosis nigricans and insulin sensitivity in overweight Hispanic children at risk for type 2 diabetes. Diabetes Care 2004;27(6):1412-6.

    5. Mukhtar Q, Cleverley G, Voorhees RE, McGrath JW. Prevalence of acanthosis nigricans and its association with hyperinsulinemia in New Mexico adolescents. J Adolesc Health 2001;28(5):372-6.

    6. Stoddart ML, Blevins KS, Lee ET, Wang W, Blackett PR. Association of acanthosis nigricans with hyperinsulinemia compared with other selected risk factors for type 2 diabetes in Cherokee Indians: the Cherokee Diabetes Study. Diabetes Care 2002;25(6):1009-14.

    7. Stuart CA, Pate CJ, Peters EJ. Prevalence of acanthosis nigricans in an unselected population. Am J Med 1989;87(3):269-72.

    8. Stuart CA, Smith MM, Gilkison CR, Shaheb S, Stahn RM. Acanthosis Nigricans among Native Americans: an indicator of high diabetes risk. Am J Public Health 1994;84(11):1839-42.

    Competing interests:   None declared

    Show Less
    Competing Interests: None declared.
  • Published on: (5 June 2007)
    Page navigation anchor for Acanthosis nigricans and risk factors for type 2 diabetes
    Acanthosis nigricans and risk factors for type 2 diabetes
    • Valeria Hirschler, M.D., Buenos Aires, Argentina

    Acanthosis Nigricans is a skin condition observed on the back of the neck, axillae and flexural areas in obese subjects (1). Using a cross- sectional design, this study examined 1133 young individuals, 43% of them being children. Authors were interested in analyzing whether acanthosis nigricans was associated with the risk factors for type 2 diabetes. Family history for type 2 diabetes, overweight, hypertension and minorit...

    Show More

    Acanthosis Nigricans is a skin condition observed on the back of the neck, axillae and flexural areas in obese subjects (1). Using a cross- sectional design, this study examined 1133 young individuals, 43% of them being children. Authors were interested in analyzing whether acanthosis nigricans was associated with the risk factors for type 2 diabetes. Family history for type 2 diabetes, overweight, hypertension and minority ethnicity were considered as risk factors. The presence of acanthosis nigricans on the neck was recorded by primary care clinicians at the office. Authors reported that acanthosis increased with the increased of BMI, hypertension and the number of risk factors for type 2 diabetes. Consistent with this study, a large study of hypertension among elementary school children showed those with overweight and acanthosis were at least twice as likely to present hypertension after controlling for confounding factors (2). A recent study also showed that acanthosis nigricans increased with child BMI z-score (3). Using regression analysis, this study showed that acanthosis was independently associated with type 2 diabetes adjusted for BMI, age, and the number of diabetes risk factors.

    Acanthosis is simpler and easier to screen compared with other risk factors for diabetes. The risk factor family history for type 2 diabetes is difficult to screen because of the bias of the recall. BMI requires accurate weighing with removal of shoes and most clothing. It also requires the use of a high-quality scale that should be calibrated. Blood pressure needs to be measured in children at least three times while the subjects are seated (4). BMI and blood pressure percentiles should be done for analysis. These risk factors take more time to screen and many clinicians do not record them, increasing rates of undiagnosed overweight and hypertension. Acanthosis is a non-invasive method for identifying individuals at risk for type 2 diabetes (5). However, there are a number of issues in the manuscript that are incompletely addressed. Overweight was overrepresented in the sample, (73% of adults) and as the design did not include blood sample, authors were not able to associate acanthosis with insulin-resistance.

    This study demonstrates that acanthosis is associated with type 2 diabetes after controlling for other risk factors. Their findings confirm previous relationships seen in other studies and emphasize the importance of acanthosis as a risk factor for type 2 diabetes in a group of young individuals.

    1- Stuart Ch, Gikinson CH, Smith M, Bosma A, Bruce K, Nagamani M. Acantthosis Nigricans as a Risk Factor for Non Insulin Dependent Diabetes Mellitus. Clin Pediatr. 1998; 37:73-80.

    2- Urrutia-Rojas X, Egbuchunam CU, Bae S, Menchaca J, Bayona M, Rivers PA, Singh KP. High blood pressure in school children: prevalence and risk factors. BMC Pediatr. 2006 Nov 16; 6:32.

    3- Bell LM, Byrne S, Thompson A, Ratnam N, Blair E, Bulsara M, Jones TW, Davis EA. Increasing body mass index z-score is continuously associated with complications of overweight in children, even in the healthy weight range. J Clin Endocrinol Metab. 2007 Feb; 92(2):517-22.

    4- National High Blood Pressure Education Working Group on High Blood Pressure in Children and Adolescents: The Fourth Report on the Diagnosis, Evaluation and Treatment on High Blood Pressure in Children and Adolescents. Pediatrics. 2004; 114:555–576.

    5- Stuart Ch, Driscoll MS, Lundquist Kf, Gilkinsob CR, Shaheb S, Smith MM. Acanthosis Nigricans. J Basic Clin Physiol Pharmacol. 1998; 9(2- 4):407-418.

    Competing interests:   None declared

    Show Less
    Competing Interests: None declared.
PreviousNext
Back to top

In this issue

The Annals of Family Medicine: 5 (3)
The Annals of Family Medicine
Vol. 5, Issue 3
1 May 2007
  • Table of Contents
  • Index by author
  • In Brief
Print
Download PDF
Article Alerts
Sign In to Email Alerts with your Email Address
Email Article

Thank you for your interest in spreading the word on Annals of Family Medicine.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Acanthosis Nigricans and Diabetes Risk Factors: Prevalence in Young Persons Seen in Southwestern US Primary Care Practices
(Your Name) has sent you a message from Annals of Family Medicine
(Your Name) thought you would like to see the Annals of Family Medicine web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
1 + 1 =
Solve this simple math problem and enter the result. E.g. for 1+3, enter 4.
Citation Tools
Acanthosis Nigricans and Diabetes Risk Factors: Prevalence in Young Persons Seen in Southwestern US Primary Care Practices
Alberta S. Kong, Robert L. Williams, Melissa Smith, Andrew L. Sussman, Betty Skipper, Andrew C. Hsi, Robert L. Rhyne
The Annals of Family Medicine May 2007, 5 (3) 202-208; DOI: 10.1370/afm.678

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Get Permissions
Share
Acanthosis Nigricans and Diabetes Risk Factors: Prevalence in Young Persons Seen in Southwestern US Primary Care Practices
Alberta S. Kong, Robert L. Williams, Melissa Smith, Andrew L. Sussman, Betty Skipper, Andrew C. Hsi, Robert L. Rhyne
The Annals of Family Medicine May 2007, 5 (3) 202-208; DOI: 10.1370/afm.678
del.icio.us logo Digg logo Reddit logo Twitter logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Jump to section

  • Article
    • Abstract
    • INTRODUCTION
    • METHODS
    • RESULTS
    • DISCUSSION
    • Footnotes
    • REFERENCES
  • Figures & Data
  • Info & Metrics
  • eLetters
  • PDF

Related Articles

  • PubMed
  • Google Scholar

Cited By...

  • No citing articles found.
  • Google Scholar

More in this TOC Section

  • COPD Population in US Primary Care: Data From the Optimum Patient Care DARTNet Research Database and the Advancing the Patient Experience in COPD Registry
  • Remote Delivery in Reproductive Health Care: Operation of Direct-to-Patient Telehealth Medication Abortion Services in Diverse Settings
  • Strategies Associated With Reducing Benzodiazepine Prescribing to Older Adults: A Mixed Methods Study
Show more Original Research

Similar Articles

Subjects

  • Domains of illness & health:
    • Chronic illness
    • Prevention
  • Person groups:
    • Children's health
  • Methods:
    • Quantitative methods
  • Other research types:
    • PBRN research
    • POEMs

Content

  • Current Issue
  • Past Issues
  • Past Issues in Brief
  • Multimedia
  • Articles by Type
  • Articles by Subject
  • Multimedia
  • Supplements
  • Online First

Info for

  • Authors
  • Reviewers
  • Media
  • Job Seekers

Engage

  • E-mail Alerts
  • e-Letters (Comments)
  • RSS
  • Journal Club
  • Submit a Manuscript
  • Subscribe
  • Family Medicine Careers

About

  • About Us
  • Editorial Board & Staff
  • Sponsoring Organizations
  • Copyrights & Permissions
  • Contact Us
  • eLetter/Comments Policy

© 2022 Annals of Family Medicine