We evaluated 10 girls, ages 5 to 18 years, with acanthosis nigricans and obesity to determine the magnitude of their insulin resistance and hyperandrogenemia. Five patients had a positive family history for this disorder. Obesity was the first physical sign in all patients followed by acanthosis nigricans. Mean weight was 5.52±2.24 SD above the mean for age at the time of study. Of 7 postmenarchal patients, 6 had oligo- or amenorrhea and 6 had hirsutism. None was clinically diabetic.
Plasma DHEA and androstenedione were normal in all patients. Plasma testosterone was normal in all the premenarchal girls but >50 ng/dl in postmenarchal patients (Table). 2 postmenarchal patients had normal testosterone premenarchally. Polycystic ovaries were not demonstrable by ultrasound in any patient.
All patients had insulin resistance (Table) which correlated with a qualitative scoring of acanthosis nigricans.
We conclude that this is a recognizable syndrome in pediatrics with onset of obesity, acanthosis nigricans and insulin resistance before puberty, followed after menarche by hyperandrogenemia, hirsutism and menstrual irregularities.
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Richards, G., Cavallo, A., Meyer, W. et al. ACANTHOSIS NIGRICANS, OBESITY, INSULIN RESISTANCE AND HYPERANDROGENEMIA: NATURAL HISTORY AND PEDIATRIC PERSPECTIVE. Pediatr Res 18, 298 (1984). https://doi.org/10.1203/00006450-198404001-01233