The Association between Acanthosis Nigricans and Dysglycemia in an Ethnically Diverse Group of Eighth Grade Students

The purpose of this study was to describe the prevalence of acanthosis nigricans (AN) and to quantify its association with dysglycemia in an ethnically diverse group of eighth grade students. Data were collected in 2003 from a cross-sectional study of students from 12 middle schools in three U.S. states. Sex, race/ethnicity and pubertal status were self-reported. Anthropometric measures were recorded. Trained staff identified the presence and severity of AN by inspection of the back of the neck. Fasting and 2hr blood samples were analyzed for impaired fasting glucose (IFG), impaired glucose tolerance (IGT), and high-risk glycated hemoglobin (A1C), respectively defined as ≥100 mg/dl, ≥140 mg/dl, and ≥ 5.7-6.4%. Overall, 25.0%, 58.2%, and 16.8% were Black, Hispanic and White, respectively. AN was present among 406 /1438 (28.2%) of students: 39% among Black, 30% among Hispanic, and 5.4% among White. IGT and highArisk A1C were present among 2.1%, and 12.4%, respectively. In multivariate logistic modeling after adjusting for gender, family history of diabetes, BMI percentile and pubertal staging, the presence (vs. absence) of AN was associated with a 59% increased likelihood of highArisk A1C: (P = 0.04), twice the likelihood of IGT (P=0.06), and 47% greater likelihood of IGT/IFG combined (P<0.0001). Adjustment for insulin attenuated the ORs by 25-70%. In a racially/ethnically diverse sample of U.S. adolescents, AN was common, occurring in 28% of the sample. AN was associated with a 50-100% increased likelihood of dysglycemia even after consideration of established diabetes risk factors.