A study of the association of acanthosis nigricans with subclinical atherosclerosis.

Abstract

Hyperinsulinism is related to the presence of acanthosis nigricans and atherosclerosis; however, we were unable to find any study on the prevalence of atherosclerosis in acanthosis nigricans. To evaluate the prevalence of carotid atherosclerosis and metabolic alterations in Mexican patients with acanthosis nigricans. We carried out a cross-sectional study that included 45 patients with acanthosis nigricans, age- and gender-matched with 45 healthy participants. Volunteers with any comorbidity or taking weight reduction, glucose- and/or lipid-lowering medication or drugs capable of causing acanthosis nigricans were not included in the study. B-mode ultrasound tests were done to measure the carotid intima-media thickness. Body mass index, insulin, glucose and lipid blood serum levels were measured. Chi-square or Fisher's exact test and paired Student t-test were used for statistical analysis. Carotid intima-media thickness was greater in patients with acanthosis nigricans (mean 0.52 mm vs. 0.46 mm, P = 0.002). The prevalence of abnormal intima-media thickness was higher in patients with acanthosis nigricans versus healthy participants (62.2% vs. 35.5%, P = 0.02). The same occurred with hyperinsulinemia (73.3% vs. 13.3%, P< 0.001), insulin resistance (86.6% vs. 33.3%, P< 0.001), obesity (86.6% vs. 13.3%, P< 0.001) and dyslipidemia (95.5% vs. 77.7%, P = 0.01). The sample size is small and serum markers of cardiovascular risk were not measured. Acanthosis nigricans is a skin marker for metabolic disturbances and is also associated with carotid atherosclerosis, a finding which is not well documented. We propose that individuals with acanthosis nigricans should be routinely evaluated for these cardiovascular risks.