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超重儿童和青少年的黑棘皮病与胰岛素抵抗

Acanthosis nigricans and insulin resistance in overweight children and adolescents.

作者信息

Kluczynik Caroline Evelin Nascimento, Mariz Larissa Soares, Souza Larissa Camila Ferreira, Solano Gabriela Beserra, Albuquerque Fernanda Cruz de Lira, Medeiros Carla Campos Muniz

机构信息

School of Nursing, Federal University of Rio Grande do Norte, Natal, Brazil.

出版信息

An Bras Dermatol. 2012 Jul-Aug;87(4):531-7. doi: 10.1590/s0365-05962012000400002.

Abstract

BACKGROUND

Studies have suggested an association between the presence of acanthosis nigricans (AN) and the development of diabetes.

OBJECTIVE

To investigate the association between AN and insulin resistance (IR) in overweight children and adolescents receiving care at the Center for Childhood Obesity, Campina Grande, PB.

METHODS

This cross-sectional study was conducted between April 2009 and April 2010 including 194 individuals of 2 to 18 years of age receiving care within the Brazilian national health network. The presence of acanthosis nigricans was verified and anthropometric measurements were taken. The following tests were performed: insulin, triglycerides, HDL-cholesterol, glucose and homeostasis model of assessment - insulin resistance (HOMA-IR). Statistical analyses were performed using the SPSS software program, version 17.0.

RESULTS

There was a greater prevalence of females (66%), brown-skinned individuals (63.4%), adolescents (61.3%) and severely obese individuals (66.5%). Acanthosis nigricans was identified in 58.2% and IR in 42.7% of the participants. Acanthosis nigricans was associated with being non-white (p = 0.003), with being an adolescent (p = 0.003) and with IR (p = 0.001). Non-white individuals, adolescents and those with insulin resistance were 5.4, 2.47 and 2.66 times more likely to have acanthosis nigricans, respectively.

CONCLUSION

The results of this study indicate a need to train healthcare professionals to identify acanthosis nigricans, since this condition is associated with IR. Identifying acanthosis nigricans in childhood permits the safe and timely treatment of cardiometabolic disorders through careful monitoring and appropriate treatment.

摘要

背景

研究表明黑棘皮病(AN)的存在与糖尿病的发生之间存在关联。

目的

调查在巴西帕拉伊巴州坎皮纳格兰德市儿童肥胖中心接受治疗的超重儿童及青少年中,黑棘皮病与胰岛素抵抗(IR)之间的关联。

方法

这项横断面研究于2009年4月至2010年4月进行,纳入了194名年龄在2至18岁之间、在巴西国家卫生网络接受治疗的个体。核实是否存在黑棘皮病并进行人体测量。进行了以下检测:胰岛素、甘油三酯、高密度脂蛋白胆固醇、血糖以及胰岛素抵抗稳态模型评估(HOMA-IR)。使用SPSS 17.0软件程序进行统计分析。

结果

女性(66%)、棕色皮肤个体(63.4%)、青少年(61.3%)和重度肥胖个体(66.5%)的患病率更高。58.2%的参与者被诊断为黑棘皮病,42.7%的参与者存在胰岛素抵抗。黑棘皮病与非白种人(p = 0.003)、青少年(p = 0.003)以及胰岛素抵抗(p = 0.001)相关。非白种人、青少年和胰岛素抵抗者患黑棘皮病的可能性分别是其他人的5.4倍、2.47倍和2.66倍。

结论

本研究结果表明需要培训医疗保健专业人员以识别黑棘皮病,因为这种情况与胰岛素抵抗相关。在儿童期识别黑棘皮病,通过仔细监测和适当治疗,可以安全、及时地治疗心脏代谢紊乱。

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