黑棘皮病与糖尿病风险因素：在美国西南部初级保健机构就诊的年轻人中的患病率
Acanthosis nigricans and diabetes risk factors: prevalence in young persons seen in southwestern US primary care practices.
作者信息
Kong Alberta S, Williams Robert L, Smith Melissa, Sussman Andrew L, Skipper Betty, Hsi Andrew C, Rhyne Robert L
机构信息
Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque, NM 87131-0001, USA.
出版信息
Ann Fam Med. 2007 May-Jun;5(3):202-8. doi: 10.1370/afm.678.
PURPOSE
Evidence shows acanthosis nigricans is often associated with hyperinsulinemia and may indicate increased risk of type 2 diabetes mellitus. The purpose of this study was to determine the association of acanthosis nigricans with type 2 diabetes risk factors and disease in young persons.
METHODS
We conducted a cross-sectional study in the Research in Outpatient Settings Network, a practice-based research network in southwestern US communities. Participating clinicians (N = 96) collected data on children and young adults aged 7 to 39 years seen during a 2-week sampling period. The main outcomes were the prevalence of acanthosis nigricans, type 2 diabetes risk factors (ethnicity, family history of type 2 diabetes, hypertension, overweight/obesity), type 2 diabetes, and the relationships among these.
RESULTS
Among 1,133 patients sampled, risk factors for type 2 diabetes were common: 69% had a family history of the disease; 3% of children (aged 7 to 19 years) and 12% of adults had hypertension; 43% of children and 73% of adults were overweight or obese; and 80% were members of ethnic minorities. Acanthosis nigricans was found in 17% of children and 21% of adults. Among children and adults alike, the more type 2 diabetes risk factors that were present, the higher the prevalence of acanthosis nigricans (P <.001). The prevalence ratio for type 2 diabetes in patients with acanthosis nigricans was 1.97 (95% confidence interval, 1.18-3.27; P = .01) after controlling for age, body mass index, and the number of type 2 diabetes risk factors. Clinicians reported that the identification of acanthosis nigricans frequently led to discussions about lifestyle modification for decreasing the risk of type 2 diabetes.
CONCLUSIONS
Patients with acanthosis nigricans are likely to have multiple risk factors for type 2 diabetes. Acanthosis nigricans may be an independent risk factor for this disease. Detection of acanthosis nigricans may help clinicians more rapidly identify high-risk individuals for diabetes counseling.
目的
有证据表明，黑棘皮症常与高胰岛素血症相关，可能预示2型糖尿病风险增加。本研究旨在确定黑棘皮症与年轻人2型糖尿病风险因素及疾病之间的关联。
方法
我们在美国西南部社区基于实践的研究网络“门诊环境研究网络”中开展了一项横断面研究。参与研究的临床医生（N = 96）收集了在为期2周的抽样期间就诊的7至39岁儿童和年轻人的数据。主要结局指标为黑棘皮症的患病率、2型糖尿病风险因素（种族、2型糖尿病家族史、高血压、超重/肥胖）、2型糖尿病以及它们之间的关系。
结果
在1133名抽样患者中，2型糖尿病风险因素很常见：69%有该病家族史；3%的儿童（7至19岁）和12%的成年人患有高血压；43%的儿童和73%的成年人超重或肥胖；80%为少数族裔成员。17%的儿童和21%的成年人患有黑棘皮症。无论儿童还是成年人，存在的2型糖尿病风险因素越多，黑棘皮症的患病率越高（P <.001）。在控制年龄、体重指数和2型糖尿病风险因素数量后，黑棘皮症患者中2型糖尿病的患病率比值为1.97（95%置信区间，1.18 - 3.27；P =.01）。临床医生报告称，黑棘皮症的诊断常常引发关于通过改变生活方式降低2型糖尿病风险的讨论。
结论
黑棘皮症患者可能有多种2型糖尿病风险因素。黑棘皮症可能是该病的一个独立风险因素。黑棘皮症的发现可能有助于临床医生更快地识别出需要糖尿病咨询的高危个体。
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