Cervical Acanthosis Nigricans as a Predictor of Risk of Type 2 Diabetes Mellitus and Cardiovascular Risk in Obese Children and Adolescents
Trabajo Ganador del Primer Lugar en el XXVIII Congreso Peruano de Pediatría. Ica, Perú.
DOI:
https://doi.org/10.61651/rped.2014v67n3p131-138Keywords:
Acanthosis Nigricans, Insulin Resistance, Heart Disease Risk Factors, Pediatric ObesityAbstract
Introduction: There is increasing prevalence of type 2 diabetes mellitus (T2DM) in obese children and adolescents. The pathophysiological mechanism is insulin resistance (IR), determined by the index of insulin resistance (HOMA-IR), biochemical predictor of T2DM. There association between acanthosis nigricans (AN) and HOMA-IR but it is unknown the association with triglycerides / HDL-cholesterol ratio (TG/HDL-C), a predictor of cardiovascular risk (CVR).
Objective: To estimate the prevalence of IR and the association between cervical AN, HOMA-IR and TG/HDL-C in obese children and adolescents. Methods: We included 77 obese patients with AN and without AN 55, matched by sex, age and BMI Z-score. We evaluate anthropometry, glucose, insulin, triglycerides, HDL-C, HOMA-IR, TG / HDL-C. We use as reference the HOMA-IR> 3.1 and the TG / HDL-C≥2.32. We performed bivariate and multivariate statistics.
Results: The prevalence of IR was 50.9% (95% CI 37.1-64.6) in obese without AN and 72.7% (95% CI 61.4-82.3) in obese patients with AN, with a significant difference (p = 0.01). Adjusted for age, sex and BMI Z-score: association between IR and AN (1.1-5.2, p = 0.02 OR=2.4, 95% CI) was found. We found no association between AN, glucose, cholesterol, triglycerides, HDL-C and TG/HDL-C.
Conclusions: IR high prevalence in both groups was found, therefore high risk of developing DM2. Association between AN and HOMA-IR was found, so we recommend using the AN as a clinical predictor of IR and T2D risk and HOMA-IR as a biochemical predictor of IR in patients without AN, to intensify prevention measures DM2. No association between AN and TG/HDL-C ratio as a marker of cardiovascular risk was found.
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