Prevalence of acanthosis Nigerians in patients with HIV infection and its relation with Metabolic Syndrome

Abstract

According to International Diabetes Federation (IDF) prevalence of diabetes in India is 8.8%. Acanthosis Nigerians is one of the marker of insulin resistance which is easy to detect. There are not many studies which have correlated this ubiquitous clinical marker with metabolic syndrome and moreover there is no study on HIV positive patients: To study the prevalence of acanthosis Nigerians in patients with HIV-infection, attending ART clinic or admitted at a tertiary care centre and to study its relationship with metabolic syndrome.This is a cross sectional observational study done for 18 months including 300 patients. All patients with HIV-infection attending ART clinic or admitted were included in the study. Acanthosis Nigerians was found more in males as compared to females (15.35 vs 9.52%) though the difference was not statistically significant while metabolic syndrome was found in 12.7% of the patients. Comparative analysis of anthropometric data of metabolic syndrome patients with and without acanthosis Nigerians revealed larger waist circumference in patients with acanthosis Nigerians (85.44 vs 81.75) and it was statistically significant (p value 0.037). Sensitivity and specificity analysis of acanthosis Nigerians and metabolic syndrome revealed low sensitivity of acanthosis Nigerians in predicting presence of metabolic syndrome (17 %) and low positive predictive value (18.42 %). However it revealed high specificity (87.98 %) and a negative predictive value (86.97 %). Odds ratio of metabolic syndrome in presence of acanthosis Nigerians was 1.5. The CD4 count values were not significantly different in those with or without acanthosis Nigerians. The age, sex, duration of the therapy or the ART regimen did not statistically influenced occurance of acanthosis NigeriansAcanthosis Nigerians is a common and easily accessible dermatological condition. Increased waist circumference and waist hip ratio are strong predictors of acanthosis Nigerians. Acanthosis Nigerians can be used to predict occurrence of metabolic syndrome with high specificity and patients should be thoroughly evaluated for metabolic syndrome in its presence.