Acanthosis Nigricans in Children and Adolescents with Type 1 Diabetes or Obesity: The Potential Interplay Role between Insulin Resistance and Excess Weight
Abstract
:1. Introduction
2. Patients and Methods
2.1. Patients
2.2. Anthropometric Measurements
2.3. Metabolic Profile
2.4. Insulin Resistance Measurement
2.5. Metabolic Syndrome Definition
- (1)
- Waist circumference was ≥ 90th percentile;
- (2)
- Serum triglyceride levels 150 mg/dl or treatment for hypertriglyceridemia;
- (3)
- Serum HDL cholesterol levels < 40 mg/dL or on drug treatment;
- (4)
- Blood systolic pressure ≥ 130 mmHg and/or blood diastolic pressure ≥ 85 mmHg or on anti-hypertensive medication;
- (5)
- Fasting plasma glucose ≥ 100 mg/dL and/or HOMA-IR > 97.5th percentile in patients with obesity and controls. As markers of glucometabolic derangement, we also used it because it precedes glucose abnormalities by playing a crucial role in the pathogenesis of impaired glucose tolerance transition [28].
3. Statistical Analysis
4. Results
4.1. Distribution of Acantosis Nigricans
4.2. Acanthosis Nigricans and Clinical and Biochemical Parameters
5. Discussion
6. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Features | Controls (n = 100) | Type 1 Diabetes (n = 138) | Obesity (n = 162) | p ^ |
---|---|---|---|---|
Age (years) | 12.1 ± 2.6 | 12.5 ± 4.5 | 12.1 ± 4.1 | ns |
Sex (M/F) | 61/49 | 65/73 | 86/76 | ns |
Body mass index (Kg/m2) | 17.6 ± 2.7 | 20.7 ± 4.3 | 27.9 ± 5.3 | <0.001 a b c |
Waist circumference (cm) | 63.3 ± 8.6 | 69.9 ± 13.7 | 87.3 ± 12.6 | <0.001 a b c |
HbA1c (%) | 4.9 ± 0.4 | 7.9 ± 1.3 | 4.9 ± 1.2 | <0.001 a c |
Fasting blood glucose (mg/dL) | 74.6 ± 7.7 | 124.5 ± 46.1 | 79.4 ± 11.5 | <0.001 a c |
Fasting insulin (IU/mL) | 6.3 ± 4.1 | np | 14.3 ± 4.2 | <0.001 |
HOMA-IR (%) | 1.2 ± 0.8 | np | 2.8 ± 2.5 | <0.001 |
Estimated glucose disposal rate (mg kg−1 min−1) | np | 10.5 ± 1.5 | np | np |
Fasting triglycerides (mg/dL) | 54.3 ± 22.3 | 70.0 ± 40.9 | 67.2 ± 33.8 | 0.003 a b |
Total cholesterol (mg/dL) | 156.4 ± 28.4 | 166.6 ± 33.5 | 157.7 ± 29.2 | 0.017 a c |
HDL cholesterol (mg/dL) | 54.7 ± 10.8 | 57.7 ± 12.0 | 65.3 ± 35.5 | 0.003 b c |
Systolic blood pressure (mmHg) | 100.7 ± 9.9 | 108.8 ± 12.7 | 110.8 ± 15.0 | <0.001 a b |
Diastolic blood pressure (mmHg) | 63.1 ± 8.7 | 68.0 ± 8.1 | 67.6 ± 10.1 | <0.001 a b |
Parameters | Acanthosis Nigricans | p * Obesity | p * Type 1 Diabetes | |||||
---|---|---|---|---|---|---|---|---|
Yes N = 63 (Type 1 Diabetes n = 7; Obesity n = 56) | No N = 337 (Type 1 Diabetes n = 131; Obesity n = 106) | |||||||
Total | Type 1 Diabetes | Obesity | Total | Type 1 Diabetes | Obesity | |||
Age (years) | 13.77 ± 2.30 | 14.49 ± 3.77 | 13.69 ± 2.09 | 12.19 ± 4.41 | 12.50 ± 5.61 | 11.60 ± 3.66 | <0.001 | ns |
Body mass Index (kg/m2) | 31.62 ± 5.51 | 23.86 ± 4.95 | 32.60 ± 4.84 | 25.94 ± 3.92 | 20.56 ± 4.21 | 25.50 ± 3.74 | <0.001 | 0.047 |
Waist circumference (cm) | 94.34 ± 14.59 | 72.79 ± 18.92 | 97.25 ± 11.31 | 71.74 ± 13.50 | 69.80 ± 13.53 | 82.3 ± 9.99 | <0.001 | ns |
Pubertal stage | 0.033 | ns | ||||||
Early | 5 | 2 | 3 | 59 | 44 | 15 | ||
Middle | 11 | 3 | 8 | 55 | 28 | 27 | ||
late | 47 | 2 | 45 | 123 | 59 | 64 | ||
HbA1c (%) | np | 8.81 ± 1.64 | 5.05 ± 0.38 | np | 7.85 ± 1.31 | 4.91 ± 0.28 | ns | ns |
Fasting blood glucose | np | 1180 ± 28.3 | 81.09 ± 13.92 | np | 122.0 ± 35.1 | 79.60 ± 10.01 | ns | ns |
Fasting insulin | np | np | 21.25 ± 12.83 | np | np | 10.58 ± 6.64 | <0.001 | np |
HOMA-IR | np | np | 4.32 ± 3.19 | np | np | 2.02 ± 1.54 | <0.001 | np |
Estimated glucose disposal rate (mg kg−1 min−1) | np | 9.26 ± 2.01 | np | np | 10.55 ± 1.52 | np | np | 0.033 |
Fasting triglycerides (mg/dL) | 82.60 ± 38.85 | 83.71 ± 21.58 | 82.46 ± 40.70 | 61.19 ± 32.88 | 69.30 ± 41.66 | 57.10 ± 25.45 | <0.001 | ns |
Total cholesterol (mg/dL) | 160.48 ± 31.53 | 165.64 ± 33.63 | 158.36 ± 26.60 | 161.46 ± 27.72 | 185.00 ± 26.39 | 157.4 ± 30.77 | ns | ns |
HDL cholesterol (mg/dL) | 60.55 ± 29.63 | 59.57 ± 21.82 | 60.74 ± 31.10 | 59.04 ± 21.04 | 57.57 ± 11,41 | 68.03 ± 37.81 | ns | ns |
Systolic blood pressure (mmHg) | 116.77 ± 11.93 | 112.86 ± 12.54 | 117.27 ± 11.89 | 105.68 ± 13.28 | 108.53 ± 12.70 | 107.27 ± 15.40 | <0.001 | ns |
Diastolic blood pressure (mmHg) | 70.60 ± 7.70 | 75.00 ± 5.00 | 70.05 ± 7.84 | 65.78 ± 9.47 | 67.63 ± 8.13 | 66.29 ± 11.01 | 0.025 | 0.020 |
Parameters | Odds Ratio | p | 95% Conf. Interval |
---|---|---|---|
Type 1 Diabetes | |||
Overweight/obesity * | 4.26 | 0.04 | 1.66–10.9 |
Estimated glucose disposal rate | 0.73 | 0.37 | 0.37–1.45 |
Diastolic blood pressure | 1.14 | 0.17 | 0.94–1.38 |
Obesity | |||
Body Mass Index | 2.00 | <0.001 | 1.49–2.69 |
HOMA-IR | 1.12 | 0.33 | 0.88–1.42 |
Age | 1.01 | 0.93 | 0.77–1.31 |
Triglycerides | 1.02 | 0.007 | 1.00–1.03 |
Systolic blood pressure | 1.00 | 0.73 | 0.97–1.04 |
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Calcaterra, V.; De Silvestri, A.; Schneider, L.; Acunzo, M.; Vittoni, V.; Meraviglia, G.; Bergamaschi, F.; Zuccotti, G.; Mameli, C. Acanthosis Nigricans in Children and Adolescents with Type 1 Diabetes or Obesity: The Potential Interplay Role between Insulin Resistance and Excess Weight. Children 2021, 8, 710. https://doi.org/10.3390/children8080710
Calcaterra V, De Silvestri A, Schneider L, Acunzo M, Vittoni V, Meraviglia G, Bergamaschi F, Zuccotti G, Mameli C. Acanthosis Nigricans in Children and Adolescents with Type 1 Diabetes or Obesity: The Potential Interplay Role between Insulin Resistance and Excess Weight. Children. 2021; 8(8):710. https://doi.org/10.3390/children8080710
Chicago/Turabian StyleCalcaterra, Valeria, Annalisa De Silvestri, Laura Schneider, Miriam Acunzo, Viola Vittoni, Giulia Meraviglia, Francesco Bergamaschi, Gianvincenzo Zuccotti, and Chiara Mameli. 2021. "Acanthosis Nigricans in Children and Adolescents with Type 1 Diabetes or Obesity: The Potential Interplay Role between Insulin Resistance and Excess Weight" Children 8, no. 8: 710. https://doi.org/10.3390/children8080710