Portillo PA, Núñez OMA, Figueroa NB, Gómez AC, Mejía RO

Language: Spanish
References: 15
Page: 31-34
PDF size: 188.35 Kb.

ABSTRACT

Objective: to identify the relation of Acantosis nigricans (AN) with obesity and Insulin Resistance (IR) in children and adolescents from 10 to 16 years old. Material and methods: descriptive, cross sectional study. After signing an informed consent which included a non random sample of convenience of 146 children and adolescents aged 10 to 16 from May 2008 to June 2009; the sample was categorized in two groups: 69 with AN and 77 without AN. The following variables were assessed: glucose and insulin in fasting and postprandial triglycerides, cholesterol, high density lipoprotein, blood pressure, weight, height, Body Mass Index (BMI) and body composition; subsequently the HOMA index (Homeostasis Model Assessment) was calculated. Cutoff points were established according to the ATP III (Adult Treatment Panel), and differences between groups were analyzed with the Student t test. Results: the age of the sample studied did not show important differences between adolescents with AN 12.9±1.9 and without AN 13.05±2.1. Important differences were found in the following variables: weight: AN 66.1±14.1, without AN 60.53±15.7 p=.01; BMI: AN 27.5±3.9, without AN 24.8±7.3 p=.008; HOMA: AN 3.9±2.5, without AN 2.8±3.2 p=.034; cholesterol: AN 173.5±32.8, without AN 160.9±37.6 p=.03; triglycerides: AN 150.9±63.3, without AN 119.5 ± 66.5 p=.004; High Density Lipoprotein (HDL): AN 35.1±7.3, without AN 41.0±8.9 p=.00; Systolic Blood Pressure (SBP): AN 115.7±11.6, without AN 111.74±10.4 p=.02; Diastolic Blood Pressure (DBP): AN 4.0±9.5, without AN 69.19±8.5 p=.001. Conclusions: 100% of the children and adolescents with AN presented some changes either clinical or biochemical, in these adolescents it is imperative to have a complete clinical evaluation and an immediate medical care.

REFERENCES

1. Stoddart M, Blevins K, Lee E, Wang W, Blackett P. Association of Acanthosis Nigricans with Hyperinsulinemia compared with other selected risk factors for type 2 Diabetes in Cherokee Indians. Diabetes Care 2002; 25: 1009-14.

2. Hermanns-Lé T, Hermanns JF, Piérard GE. Juvenile Acanthosis Nigricans and Insulin Resistance. Pediatric Dermatology 2002; 19:12-4.

3. Steinberg J, Daniels SR. Obesity, insulin resistance, diabetes, and cardiovascular risk in children. Circulation 2003; 107: 1448-53.

4. Cruz PDJ, Hud JAJ. Excess insulin binding to insulin-like growth factor receptors: Proposed mechanism for acanthosis nigricans. J Invest Dermatol 2002; 98: 82-8.

5. Organización Mundial de la Salud. Sobrepeso y obesidad; nota descriptiva No. 311, septiembre de 2006. Disponible en: http://www.who.int/mediacentre/factsheets/fs311/es/index.html

6. Instituto Nacional de Salud Pública. Encuesta Nacional de Salud 2000. Cuernavaca, Morelos, México: Instituto Nacional de Salud Publica-Secretaría de Salud, 2003; 11-129.

7. Instituto Nacional de Salud Pública. Encuesta Nacional de Salud y Nutrición 2006. Resultados por entidad federativa, Michoacán. Cuernavaca, México: Instituto Nacional de Salud Pública-Secretaría de Salud, 2007; 11-121.

8. Mukhtar Q, Cleverley G, Voorhees R, McGrath J. Prevalence of acanthosis nigricans and its association with hyperinsulinemia in New Mexico adolescents. J Adolesc Health 2001; 28: 372-376.

9. Stuart CA, Pate CJ, Peters EJ. Prevalence of acanthosis nigricans in an unselected population. Am J Med 2006; 87: 269-72.

10. Aranibar MJ. Acanthosis nigricans and hyperinsulinemia in obese children and adolescents. Paediatrica 2006; 8 (1): 1-4.

11. Instituo Mexicano del Seguro Social. Guía de práctica clínica para el diagnóstico y tratamiento en pacientes pediátricos con Diabetes Mellitus. 2008; 1-45.

12. Cook S, Weitzman M, Auinger P, Nguyen H, Dietz WH. Prevalence of metabolic syndrome phenotype in adolescents: findings from the third national health and nutrition examination survey, 1988-1994. Arch Pediatr Adolesc Med. 2003; 157:821-27.

13. Department of Health Western Australia. Type 2 diabetes in children and adolescents of Care and Clinical Practice Guideline. Perth: Princess Margaret Hospital and Health Networks Branch, Department of Health, Western Australia; 2009:2-37.

14. Keskin M, Kurtoglu S, Kendirci M, Atabek E, Yazici C. Homeostasis Model Assesment is more reliable than the fasting glucose, insulin ratio and quantitative insulin sensitivity check index for assessing insulin resistance among obese children and adolescents. Pediatrics. 2005; 115: 500-3.

15. Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on detection evaluation and treatment of high blood cholesterol in adolescents and adults (Adult Treatment Panel III) final report. Circulation 2002; 106:3143-421.