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Acanthosis nigricans predicts the clustering of metabolic syndrome components in Hispanic elementary school-aged children

Abstract Background: Acanthosis nigricans (AN) is a dermatologic condition associated with hyperinsulinemia, a marker of insulin resistance that is the principal abnormality in metabolic syndrome (MetS). We examined the association of AN with the clustering of MetS components. Methods: A cross-sectional study was conducted in an urban school-based health center in New Mexico. Students without diabetes were evaluated for AN, a family history of type 2 diabetes, body mass index (BMI), and MetS components. The clustering of MetS components by BMI category and AN status was assessed by comparing the group means of summed average z-scores of fasting insulin, triglycerides, high-density lipoprotein-cholesterol, and systolic blood pressure among the students. A multivariate model with BMI category and AN status controlling for Tanner stage was performed to identify the variables associated with the clustering of MetS components. Results: Complete data were available for 90 children (age, 9.7±1.4 years; 94% Hispanic; 60% female). In multivariate modeling of MetS cluster z-score, significant differences were found between the students with BMI <85th percentile [–0.27; 95% confidence interval (95% CI)=–0.42 to –0.11] and (a) the students with BMI 85th–94.9th percentile with AN (0.74; 95% CI=0.17–1.31) and (b) the students with BMI ≥95th percentile with AN (0.86; 95% CI=0.54–1.18). No significant differences in the MetS cluster z-score were seen between the students with BMI <85th percentile and those with BMI 85th–94.9th percentile without AN (0.24; 95% CI=–0.33 to 0.81) or those with BMI ≥95th percentile without AN (0.31; 95% CI=–0.13 to 0.75). Conclusions: Overweight/obese Hispanic elementary school-aged children with AN exhibit clustering of MetS components and could benefit from early intervention.