Acanthosis nigricans: a warning sign of lower urinary tract dysfunction in obese children?

Abstract

There have been very few studies on the relationship between lower urinary tract dysfunction (LUTD) and obesity-related metabolic disorders in the pediatric age group. This study investigated the relationship between LUTD and metabolic disturbances in obese children. Four-hundred obese children (body mass index ≥ 95th percentile) were included in the present study. Anthropometric, clinical, and biochemical parameters were evaluated. The Dysfunctional Voiding and Incontinence Scoring System (DVISS) questionnaire was administered and scores over 8.5 were considered to be reflective of LUTD. Subjects were stratified into two groups based on DVISS symptom scores - obese children with and without LUTD. The homeostasis assessment model was used to evaluate insulin resistance and the International Diabetes Federation criteria to identify metabolic syndrome. Lower urinary tract dysfunction was detected in 19% of the study population. There were no significant differences between the two groups in terms of laboratory results. No statistically significant relationship was found between LUTD and the presence of metabolic syndrome or insulin resistance; however, a significant association was observed between LUTD and acanthosis nigricans. Regression analysis revealed that only the presence of acanthosis nigricans significantly increased the risk of lower urinary tract dysfunction by 1.75-fold (p < 0.05). The presence of acanthosis nigricans in obese children may suggest the concurrent occurrence of lower urinary tract dysfunction and should be investigated accordingly.