Philip Nicely E, Girisha Banavasi S, Shetty Shricharith, Pinto Ashna M, Noronha Tonita M
Department of Dermatology, KS. Hegde Medical Academy, Nitte (Deemed to be University), Mangalore, Karnataka, India.
Indian J Dermatol. 2022 Jan-Feb;67(1):92. doi: 10.4103/ijd.ijd_442_21.
Acanthosis nigricans is characterized by hyperpigmentation and velvet-like thickening of the skin. It symmetrically involves the neck, axilla, groins, antecubital and popliteal fossae, umbilical, and perianal areas. Acanthosis nigricans is a marker for insulin resistance and is increasingly found to be associated with metabolic syndrome. We conducted this study to estimate the frequency of metabolic syndrome in acanthosis nigricans.
In this hospital-based, cross-sectional study, we evaluated 60 patients with acanthosis nigricans with neck involvement. They were examined for other areas of involvement by acanthosis nigricans. Axillary and neck severity was graded based on the scale described by Burke . Insulin resistance was interpreted using homeostatic model assessment (HOMA-IR). Metabolic syndrome was diagnosed according to the SAM-NCEP criteria. Collected data were analyzed using IBM SPSS Statistics, Version 22 (Armonk, NY: IBM Corp).
Axilla was the most common site involved in 51 patients (85%) followed by knuckles (55%). Metabolic syndrome was found in 78.3% of our patients, and 56.66% had insulin resistance. A statistically significant association of severity grading of axillary acanthosis nigricans with both metabolic syndrome ( = 0.001) and insulin resistance ( = 0.03) was noted. However, no meaningful association was found between the severity grading of neck acanthosis nigricans with both metabolic syndrome ( = 0.4) and insulin resistance ( = 0.08). The association of neck texture grading of acanthosis nigricans with insulin resistance was statistically significant ( = 0.005).
Metabolic syndrome was seen in 78.3% of acanthosis nigricans. Axillary severity grading was associated with metabolic syndrome.
黑棘皮病的特征为皮肤色素沉着及天鹅绒样增厚。其对称累及颈部、腋窝、腹股沟、肘窝和腘窝、脐部及肛周区域。黑棘皮病是胰岛素抵抗的一个标志，且越来越多地被发现与代谢综合征相关。我们开展本研究以评估黑棘皮病患者中代谢综合征的发生率。
在这项基于医院的横断面研究中，我们评估了60例有颈部受累的黑棘皮病患者。对他们进行了黑棘皮病其他受累部位的检查。根据伯克描述的量表对腋窝和颈部的严重程度进行分级。使用稳态模型评估（HOMA-IR）来解释胰岛素抵抗。根据美国国家胆固醇教育计划成人治疗组第三次报告（ATP III）标准诊断代谢综合征。使用IBM SPSS Statistics 22版（纽约州阿蒙克市：IBM公司）对收集的数据进行分析。
腋窝是最常受累的部位，有51例患者（85%）受累，其次是指关节（55%）。我们的患者中有78.3%患有代谢综合征，56.66%有胰岛素抵抗。注意到腋窝黑棘皮病严重程度分级与代谢综合征（P = 0.001）和胰岛素抵抗（P = 0.03）之间存在统计学显著关联。然而，未发现颈部黑棘皮病严重程度分级与代谢综合征（P = 0.4）和胰岛素抵抗（P = 0.08）之间有有意义的关联。黑棘皮病颈部质地分级与胰岛素抵抗之间的关联具有统计学显著性（P = 0.005）。
78.3%的黑棘皮病患者患有代谢综合征。腋窝严重程度分级与代谢综合征相关。
