Arterial stiffening, insulin resistance and acanthosis nigricans in a community sample of adolescents with obesity


Acanthosis Nigricans (AN) is a common finding in adolescents with obesity. Little is known about its relevance for cardiovascular (CVS) risk, in particular arterial stiffening. We investigated associations between AN, conventional markers of CVS risk and carotid-radial pulse wave velocity (PWV) in a community sample of adolescents with obesity aged 12–19 recruited to an obesity trial. AN was present in 63% of subjects and 43% had severe grading. Presence of AN and severe AN were associated with z-score of body mass index (BMIz). Presence of AN (but not severity) was associated with abnormal or fasting hyperinsulinaemia but not after adjustment for BMIz. PWV data were available for 147 (84% of participants). Severe-grade AN was associated with PWV (co-efficient 0.51, 95% CI 0.13–0.89, P=0.01) but not when adjusted for BMIz, ethnic grouping and age. In our study presence and severity of AN offered little additional information on CVS risk beyond the degree of obesity itself. The relevance of AN for CVS risk should be interpreted with caution.

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  1. 1

    Kutlubay Z, Engin B, Bairamov O, Tuzun Y . Acanthosis nigricans: a fold (intertriginous) dermatosis. Clin Dermatol 2015; 33: 466–470.

  2. 2

    Dabelea D, Pihoker C, Talton JW, D'Agostino Jr RB, Fujimoto W, Klingensmith GJ et al. Etiological approach to characterization of diabetes type: the SEARCH for Diabetes in Youth Study. Diabetes Care 2011; 34: 1628–1633.

  3. 3

    Fagot-Campagna A, Pettitt DJ, Engelgau MM, Burrows NR, Geiss LS, Valdez R et al. Type 2 diabetes among North American children and adolescents: an epidemiologic review and a public health perspective. J Pediatr 2000; 136: 664–672.

  4. 4

    Kluczynik CE, Mariz LS, Souza LC, Solano GB, Albuquerque FC, Medeiros CC . Acanthosis nigricans and insulin resistance in overweight children and adolescents. An Bras Dermatol 2012; 87: 531–537.

  5. 5

    Brickman WJ, Huang J, Silverman BL, Metzger BE . Acanthosis nigricans identifies youth at high risk for metabolic abnormalities. J Pediatr 2010; 156: 87–92.

  6. 6

    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: 1095–1102.

  7. 7

    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: 1412–1416.

  8. 8

    Ben-Shlomo Y, Spears M, Boustred C, May M, Anderson SG, Benjamin EJ et al. Aortic pulse wave velocity improves cardiovascular event prediction: an individual participant meta-analysis of prospective observational data from 17,635 subjects. J Am Coll Cardiol 2014; 63: 636–646.

  9. 9

    Vlachopoulos C, Aznaouridis K, Stefanadis C . Prediction of cardiovascular events and all-cause mortality with arterial stiffness: a systematic review and meta-analysis. J Am Coll Cardiol 2010; 55: 1318–1327.

  10. 10

    McLeod AL, Uren NG, Wilkinson IB, Webb DJ, Maxwell SR, Northridge DB et al. Non-invasive measures of pulse wave velocity correlate with coronary arterial plaque load in humans. J Hypertens 2004; 22: 363–368.

  11. 11

    Hudson L, Rapala A, Khan T, Williams B, Viner RM . Evidence for contemporary arterial stiffening in obese children and adolescents using pulse wave velocity: a systematic review and meta-analysis. Athersclerosis 2015; 241: 376–386.

  12. 12

    Cote AT, Phillips AA, Harris KC, Sandor GG, Panagiotopoulos C, Devlin AM . Obesity and arterial stiffness in children: systematic review and meta-analysis. Arterioscler Thromb Vasc Biol 2015; 35: 1038–1044.

  13. 13

    Christie D, Hudson L, Mathiot A, Cole TJ, Karlsen S, Kessel A et al. Assessing the efficacy of the healthy eating and lifestyle programme (HELP) compared with enhanced standard care of the obese adolescent in the community: study protocol for a randomized controlled trial. Trials 2011; 12: 242.

  14. 14

    Taylor SJ, Whincup PH, Hindmarsh PC, Lampe F, Odoki K, Cook DG . Performance of a new pubertal self-assessment questionnaire: a preliminary study. Paediatr Perinat Epidemiol 2001; 15: 88–94.

  15. 15

    Cole TJ, Freeman JV, Preece MA . Body mass index reference curves for the UK, 1990. Arch Dis Child 1995; 73: 25.

  16. 16

    Viner RM, White B, Barrett T, Candy DC, Gibson P, Gregory JW et al. Assessment of childhood obesity in secondary care: OSCA consensus statement. Arch Dis Child Educ Pract Ed 2012; 97: 98–105.

  17. 17

    Burke JP, Hale DE, Hazuda HP, Stern MP . A quantitative scale of acanthosis nigricans. Diabetes Care 1999; 22: 1655–1659.

  18. 18

    Viner RM, White B, Barrett T, Candy DCA, Gibson P, Gregory JW et al. Assessment of childhood obesity in secondary care: OSCA consensus statement. Arch Dis Child Educ Pract Ed 2012; 97: 98–105.

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The data come from an adolescent obesity intervention funded by the National Institute for Health Research, UK (RP-PG-0608-10035).

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Correspondence to L D Hudson.

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Hudson, L., Kinra, S., Wong, I. et al. Arterial stiffening, insulin resistance and acanthosis nigricans in a community sample of adolescents with obesity. Int J Obes 41, 1454–1456 (2017).

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