Acanthosis nigricans and diabetes
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Acanthosis Nigricans as a Marker for Diabetes and Insulin Resistance
Acanthosis nigricans (AN) is a skin condition characterized by dark, thickened patches, often found on the neck, axillae, and other body folds. Research consistently shows a strong association between AN, insulin resistance, and type 2 diabetes mellitus (T2DM) Kong2007Callanan2022Kumar2017+5 MORE.
Prevalence of Acanthosis Nigricans in Diabetes
Studies across different populations report that AN is common among individuals with T2DM. Prevalence rates range from about 17% to over 36% in adults and children with diabetes or at high risk for diabetes Kong2007Butt2022Litonjua2004+1 MORE. In newly diagnosed T2DM patients, AN was found in 36.1%, with higher rates among those with obesity and certain ethnic groups, such as African-Americans and Latin-Americans . In another study, about a quarter of T2DM patients had AN, regardless of age, gender, BMI, or disease duration . Among children and young adults, the presence of more diabetes risk factors increased the likelihood of having AN .
Acanthosis Nigricans and Insulin Resistance
AN is closely linked to insulin resistance, a key factor in the development of T2DM. Individuals with both obesity and AN have significantly higher levels of insulin resistance compared to those with obesity alone Callanan2022Kumar2017Karadağ2017+1 MORE. This is supported by higher fasting insulin levels and HOMA-IR scores in those with AN Callanan2022Kumar2017. AN is also associated with other metabolic disturbances, such as higher blood pressure, triglycerides, and cholesterol Kumar2017Calcaterra2021Moorthy2018+1 MORE.
Pathophysiology: Why Does Acanthosis Nigricans Occur in Diabetes?
The development of AN in diabetes is primarily due to high insulin levels (hyperinsulinemia), which stimulate skin cells (keratinocytes and fibroblasts) through insulin and growth factor receptors, leading to the characteristic skin changes Karadağ2017Eggiman2024Kahn1976. In rare cases, genetic or autoimmune defects in insulin receptors can also cause severe insulin resistance and AN .
Acanthosis Nigricans in Type 1 Diabetes and Obesity
While AN is most commonly associated with T2DM and obesity, it can also be seen in children with type 1 diabetes (T1D), especially if they are overweight or obese. In T1D, AN is more closely linked to excess weight than to insulin resistance itself .
Clinical Significance and Screening
AN is a visible and easily recognized marker that can help clinicians identify individuals at high risk for insulin resistance and T2DM Kong2007Callanan2022Litonjua2004+3 MORE. Its presence often prompts discussions about lifestyle changes and early interventions to reduce diabetes risk Kong2007Eggiman2024. Screening for AN, especially in high-risk groups, can be a valuable tool in diabetes prevention and management Moorthy2018Eggiman2024.
Conclusion
Acanthosis nigricans is a common and important clinical marker of insulin resistance and type 2 diabetes, especially in overweight and obese individuals. Its presence should prompt further evaluation for metabolic risk factors and early intervention to prevent or manage diabetes. Recognizing AN can help improve early detection and outcomes for those at risk of diabetes and related metabolic disorders Kong2007Callanan2022Kumar2017+5 MORE.
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Most relevant research papers on this topic
Single-centre case–control study investigating the association between acanthosis nigricans, insulin resistance and type 2 diabetes in a young, overweight, UK population
Canthosis nigricans and obesity significantly increase the risk of insulin resistance in young people, potentially acting as a visible marker for type 2 diabetes.
Prevalence of acanthosis nigricans in newly-diagnosed type 2 diabetes.
Acanthosis nigricans is a common and easily visible marker of hyperinsulinemia in newly diagnosed type 2 diabetes patients, with its prevalence influenced by ethnicity and BMI.
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