Abstract
BackgroundInsulin resistance (IR) plays a major role in the pathogenesis of metabolic syndrome. Acanthosis nigricans (AN) is an easily detectable skin condition that is strongly associated with IR. The aims of this study were, firstly, to investigate the prevalence of AN among adults in an urban Sri Lankan community and secondly, to describe its utility to detect metabolic syndrome.FindingsIn a community based investigation, 35-64 year adults who were selected using stratified random sampling, underwent interview, clinical examination, liver ultrasound scanning, and biochemical and serological tests. Metabolic syndrome was diagnosed on revised ATP III criteria for Asian populations. AN was identified by the presence of dark, thick, velvety skin in the neck.2957 subjects were included in this analysis. The prevalence of AN, metabolic syndrome and type 2 diabetes mellitus were 17.4%, 34.8% and 19.6%, respectively. There was a strong association between AN and metabolic syndrome. The sensitivity, specificity, positive predictive value and negative predictive value of AN to detect metabolic syndrome were 28.2%, 89.0%, 45.9% and 79.0% for males, and 29.2%, 88.4%, 65.6% and 62.3% for females, respectively.ConclusionsAN was common in our study population, and although it did not have a high enough sensitivity to be utilized as a screening test for metabolic syndrome, the presence of AN strongly predicts metabolic syndrome.
Highlights
Insulin resistance (IR) plays a major role in the pathogenesis of metabolic syndrome
Acanthosis nigricans (AN) was common in our study population, and it did not have a high enough sensitivity to be utilized as a screening test for metabolic syndrome, the presence of AN strongly predicts metabolic syndrome
3012 subjects participated in the study and 2957 had information on the presence or absence of AN (Table 1, 2). 515 (17.4%) had AN, and 1025 (34.8%) had metabolic syndrome diagnosed by revised ATP III criteria (Table 3, 4)
Summary
Insulin resistance (IR) plays a major role in the pathogenesis of metabolic syndrome. A quantitative scale of AN has been developed by Burke et al [1] This scale takes into consideration the severity of AN in neck and axilla, neck texture, and the presence or absence of AN in knuckles, elbows and knees. A number of studies have shown an association between AN and insulin resistance [3,4] and the recent increase in the prevalence of AN [5,6,7] may well reflect increasing trends in obesity and type 2 diabetes worldwide [1]. A hospital based study from India has reported a prevalence of AN of 65% among diabetics and 40% among healthy people attending non-diabetic patients [9], to our knowledge there are no data on community prevalence of AN from the Indian subcontinent
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