MON-LB034 Acanthosis Nigricans: A Predictor of Developing Type 2 Diabetes in a High Risk Population?

Abstract

Background: Indigenous Australians are at an increased risk of developing type 2 diabetes at a younger age, contributing significantly to the mortality gap present between Indigenous and non-Indigenous Australians. Acanthosis nigricans (AN), once considered a rare paraneoplastic dermatosis, has been shown to be associated with insulin resistance. It has been proposed as an easily identified clinical marker, to assist in the early identification of those at risk. Methods: Established longitudinal birth cohorts, Indigenous (n=686) and non-Indigenous (n=196) with follow-ups at age of 18.4 years (adolescence; n=665) and 25.2 years (adulthood; n=576). Face-to-face physical examination including presence of acanthosis nigricans (AN) by a physician, height & weight used to calculate body mass index (BMI), and biomarkers including HbA1c. Diabetes (DM) was defined as HbA1c≥6.5% and prediabetes as HbA1c between 5.8-6.4%. BMI categorised as underweight ≤18.5, normal 18.6-24.9, overweight 25-29.9, obese ≥30. Results: Complete data was available for 394 people (Indigenous 302, non-Indigenous 91). At adolescence, low levels of DM were present (Indigenous 1, non-Indigenous 1). AN rates were higher in Indigenous (219 vs 2). Of those with AN, 208 had a normal HbA1c and 21 prediabetes. By adulthood, DM rates had increased to 14 (Indigenous 13, non-Indigenous 1). Rates of AN decreased (Indigenous 177, non-Indigenous 0), with AN no longer present in 74/221. Of those with DM in adulthood, AN was present in 10/14 in adolescence and 11/14 in adulthood. At adolescence, no relationship between AN and BMI category was seen; with AN present in 54% (37/68) of underweight, 36% (65/182) of normal, 52% (50/96) of overweight and 52% (25/48) of obese. However, in adulthood, current BMI was associated with DM; odds ratio increasing from 5.9 (CI: 1.2-30; p .031) with overweight to 12.8 (CI: 2.5-66; p .002) with obesity compared to normal BMI. Conclusions: AN was common in this high risk population, at a young age. The proportion of people with AN was higher at adolescence than young adulthood. Of those who developed Type 2 DM by adulthood, 79% (11/14) had AN. However, 85% of those with AN at adolescence had a normal HbA1c up to 7 years after AN was identified, with only 2/221 having DM at that time and <1% having developed DM by adulthood. In this high risk population, the presence of AN was not a good predictor of current or future diabetes risk. Unless otherwise noted, all abstracts presented at ENDO are embargoed until the date and time of presentation. For oral presentations, the abstracts are embargoed until the session begins. s presented at a news conference are embargoed until the date and time of the news conference. The Endocrine Society reserves the right to lift the embargo on specific abstracts that are selected for promotion prior to or during ENDO.