Calcaterra Valeria, De Silvestri Annalisa, Schneider Laura, Acunzo Miriam, Vittoni Viola, Meraviglia Giulia, Bergamaschi Francesco, Zuccotti Gianvincenzo, Mameli Chiara
Pediatric and Adolescent Unit, Department of Internal Medicine, University of Pavia, 27100 Pavia, Italy.
Department of Pediatrics, Children's Hospital "Vittore Buzzi", 20154 Milan, Italy.
Children (Basel). 2021 Aug 18;8(8):710. doi: 10.3390/children8080710.
Acanthosis nigricans (AN) is associated with obesity and type 2 diabetes, where insulin resistance (IR) is considered a predisposing factor. IR can also affect patients with type 1 diabetes (T1D). We evaluated the prevalence of AN in patients with T1D compared to subjects with obesity in order to define the interplay between IR and excess weight. We considered 138 pediatric patients who presented with T1D and 162 with obesity. As controls, 100 healthy normal-weight subjects were included. A physical examination with the detection of AN and biochemical assessments was performed. IR was calculated by using the homeostasis model assessment for IR in patients with obesity and the estimated glucose disposal rate in T1D. The AN prevalence was higher in T1D and obese subjects compared with controls in whom AN was not detected ( = 0.02 and < 0.001, respectively). A greater number of AN cases were observed in subjects with obesity compared with T1D ( < 0.001). Patients with AN were older than subjects without AN ( = 0.005), and they had higher body mass index (BMI) values, waist circumference (WC), fasting triglycerides and blood pressure (all < 0.001). Thirty-five patients with AN exhibited IR with an association between AN presence and IR in patients with obesity ( < 0.001). In T1D, there was an association between AN and being overweight/obese ( = 0.02), independently of IR. AN is a dermatological condition associated with obesity. In T1D, the presence of AN was significantly associated with overweight status or obesity but not IR. The presence of AN in the absence of IR supports the interplay role between impaired insulin signaling, IR and excess weight in the pathogenic mechanism.
黑棘皮病（AN）与肥胖症和2型糖尿病相关，其中胰岛素抵抗（IR）被认为是一个诱发因素。IR也会影响1型糖尿病（T1D）患者。为了明确IR与超重之间的相互作用，我们评估了T1D患者与肥胖受试者中AN的患病率。我们纳入了138例患有T1D的儿科患者和162例肥胖患者。作为对照，纳入了100名健康的正常体重受试者。进行了检测AN的体格检查和生化评估。通过使用肥胖患者的IR稳态模型评估和T1D患者的估计葡萄糖处置率来计算IR。与未检测到AN的对照组相比，T1D患者和肥胖受试者中的AN患病率更高（分别为 = 0.02和 < 0.001）。与T1D患者相比，肥胖受试者中观察到的AN病例更多（< 0.001）。患有AN的患者比未患AN的受试者年龄更大（= 0.005），并且他们的体重指数（BMI）值、腰围（WC）、空腹甘油三酯和血压更高（均 < 0.001）。35例患有AN的患者表现出IR，肥胖患者中AN的存在与IR之间存在关联（< 0.001）。在T1D中，AN与超重/肥胖之间存在关联（= 0.02），与IR无关。AN是一种与肥胖相关的皮肤病。在T1D中，AN的存在与超重状态或肥胖显著相关，但与IR无关。在没有IR的情况下AN的存在支持了胰岛素信号受损、IR和超重在致病机制中的相互作用。
