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面部黑棘皮病:代谢综合征的一种形态学标志物。

Facial Acanthosis Nigricans: A Morphological Marker of Metabolic Syndrome.

作者信息

Panda Saumya, Das Anupam, Lahiri Koushik, Chatterjee Manas, Padhi Tanmay, Rathi Sanjay, Dhar Sandipan, Sarma Nilendu

机构信息

Department of Dermatology, KPCMCH, Kolkata, West Bengal, India.

WIZDERM and Department of Dermatology, Apollo Gleneagles Hospitals, Siliguri, West Bengal, India.

出版信息

Indian J Dermatol. 2017 Nov-Dec;62(6):591-597. doi: 10.4103/ijd.IJD_545_17.

Abstract

INTRODUCTION

Acanthosis nigricans (AN) is a frequently encountered entity. Facial AN (FAN) is a subset of AN which is being increasingly recognized. Recently, reports hypothesizing the association of FAN with features of metabolic syndrome have been published.

AIMS AND OBJECTIVES

The aim of this study was to study the clinicodemographic profile of patients with FAN, and to assess the correlation of hypertension, increased waist-hip ratio (WHR), increased body mass index (BMI), type 2 diabetes mellitus, deranged lipid profile, serum insulin, and impaired oral glucose tolerance test (OGTT) (parameters of metabolic syndrome) in these patients, as well as to determine the most significant predictor (highest relative risk) of development of FAN.

METHODS

A multicentric case-control study was conducted (123 cases in each group) over a period of 2 years. Data were obtained on the basis of history, examination, and relevant laboratory investigations. Statistical analysis was done using Statistica version 6 (StatSoft Inc., 2001, Tulsa, Oklahoma, USA), SPSS statistics version 17 (SPSS Inc., 2008, Illinois, Chicago, USA), and GraphPad Prism version 5 (GraphPad Software Inc., 2007, San Diego, California, USA).

RESULTS

Mean age of the patients with FAN was 38.83 ± 8.62 years. Mean age of onset of the disease was 30.93 ± 8.18 years. The most common site of face involved was the forehead and temporal region. The most common pigmentation was brown-black. Male sex, positive OGTT, increased WHR, and increased BMI were most significantly related to FAN. Smoking was found to have a protective effect against the development of FAN.

CONCLUSION

Here, we document a significant association between male patients with positive OGTT, increased WHR, and BMI and FAN. Thus, we propose that FAN could be considered a morphological marker of metabolic syndrome.

摘要

引言

黑棘皮病(AN)是一种常见病症。面部黑棘皮病(FAN)是AN的一个亚型,其越来越受到认可。最近,有报道推测FAN与代谢综合征的特征有关。

目的

本研究旨在探讨FAN患者的临床人口统计学特征,并评估这些患者中高血压、腰臀比(WHR)增加、体重指数(BMI)增加、2型糖尿病、血脂异常、血清胰岛素以及口服葡萄糖耐量试验(OGTT)受损(代谢综合征参数)之间的相关性,同时确定FAN发生的最显著预测因素(最高相对风险)。

方法

进行了一项为期2年的多中心病例对照研究(每组123例)。通过病史、检查和相关实验室检查获取数据。使用Statistica 6版(StatSoft公司,2001年,美国俄克拉荷马州塔尔萨)、SPSS统计17版(SPSS公司,2008年,美国伊利诺伊州芝加哥)和GraphPad Prism 5版(GraphPad软件公司,2007年,美国加利福尼亚州圣地亚哥)进行统计分析。

结果

FAN患者的平均年龄为38.83±8.62岁。疾病的平均发病年龄为30.93±8.18岁。面部最常受累的部位是前额和颞部区域。最常见的色素沉着为棕黑色。男性、OGTT阳性、WHR增加和BMI增加与FAN最显著相关。发现吸烟对FAN的发生有保护作用。

结论

在此,我们记录了OGTT阳性、WHR增加和BMI增加的男性患者与FAN之间存在显著关联。因此,我们建议FAN可被视为代谢综合征的一种形态学标志物。

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