ASSOCIATION BETWEEN ACANTHOSIS NIGRICANS AND OTHER CARDIOMETABOLIC RISK FACTORS IN CHILDREN AND ADOLESCENTS WITH OVERWEIGHT AND OBESITY

ABSTRACT Objective: To evaluate the presence or absence of acanthosis nigricans and its association with metabolic alterations in a group of obese and overweight children and adolescents. Methods: A cross sectional study of 161 overweight children and adolescents, who were divided into two groups, according to presence or absence of acanthosis nigricans. Anthropometric measurements (body mass index, skinfolds, abdominal circumference), blood pressure, laboratory tests (fasting glycemia, insulin, lipid profile, triglycerides, uric acid, transaminases) and homeostasis model assessment index. Results: The acanthosis nigricans group represented 51.5% of the sample. The mean age was similar between groups. The group with acanthosis nigricans presented higher body mass index, Z score of body mass index, body fat percentage, abdominal circumference (p<0.0001), systolic (p=0.006) and diastolic blood pressure (p=0.002). There was no significant difference in the analysis of lipid profile, except for the high-density cholesterol, which was lower (p=0.003) in the group with acanthosis. On the other hand, uric acid (p<0.0001), fasting glycemia (p=0.006), insulin (p<0.0001), glutamic oxalacetic transaminase (p<0.0001), and homeostasis model assessment index (p<0.0001) were significantly higher in the group with acanthosis nigricans. Conclusions: Acanthosis nigricans in overweight and obese children and adolescents is associated with elevation of body fat, blood pressure, insulin and homeostasis model assessment index, indicating that it is a clinical marker associated with the metabolic syndrome.

摘要
目的：评估超重与肥胖儿童青少年群体中黑棘皮病（acanthosis nigricans）的发病情况，及其与代谢异常的相关性。
方法：本研究为横断面研究，纳入161名超重儿童青少年，根据是否患有黑棘皮病分为两组。采集人体测量学指标（体质量指数、皮褶厚度、腹围）、血压，以及实验室检测指标（空腹血糖、胰岛素、血脂谱、甘油三酯、尿酸、转氨酶），并计算稳态模型评估指数（homeostasis model assessment index）。
结果：黑棘皮病组占总样本的51.5%。两组平均年龄无显著差异。黑棘皮病组的体质量指数、体质量指数Z评分、体脂百分比、腹围均显著升高（p<0.0001），收缩压（p=0.006）与舒张压（p=0.002）亦显著高于对照组。血脂谱分析除高密度脂蛋白胆固醇外无显著组间差异，黑棘皮病组的高密度脂蛋白胆固醇水平更低（p=0.003）。此外，黑棘皮病组的尿酸（p<0.0001）、空腹血糖（p=0.006）、胰岛素（p<0.0001）、谷草转氨酶（glutamic oxalacetic transaminase）及稳态模型评估指数（p<0.0001）均显著升高。
结论：超重及肥胖儿童青少年的黑棘皮病与体脂升高、血压升高、胰岛素及稳态模型评估指数升高密切相关，提示其可作为代谢综合征相关的临床标志物。