Presentation
Milder cases of insulin resistance may present with normal fasting concentrations of insulin and glucose. [aafp.org]
[…] muscle and adipose mass. 61 The classical features of IR may be present such as acanthosis and hyperandrogenism presenting as precocious pubertal development. [practicaldiabetes.com]
Three patients are described (one woman and two men) who presented with hypothyroidism and acanthosis nigricans. All the patients had elevated insulin levels in the fasting state and in response to an oral glucose load. [ncbi.nlm.nih.gov]
In 1997, 11 years after initial presentation, the acanthosis nigricans had virtually cleared (figure 2 ). [pmj.bmj.com]
Entire Body System
- Abdominal Obesity
If you are obese (over 30 BMI) and/or have abdominal obesity (a lot of belly fat, over 35 in waist circumference for women, over 40 for males) – you are not out of the woods with a normal fasting blood sugar. 2. [docswholift.com]
Estimate of a predictive cut-off value for serum 25-hydroxyvitamin D reflecting abdominal obesity in Korean adolescents. Nutr Res 2012;32:395–402. Web of Science Crossref Google Scholar 14. [degruyter.com]
Insulin Resistance Symptoms Aside from the well known association of insulin resistance with the metabolic syndrome, abdominal obesity, elevated cholesterol levels, and high blood pressure ; there are several other medical conditions that are associated [emedicinehealth.com]
While the metabolic syndrome links insulin resistance with abdominal obesity, elevated cholesterol, and high blood pressure ; several other medical other conditions are specifically associated with insulin resistance. [medicinenet.com]
Insulin resistance is strongly associated with obesity, and particularly abdominal obesity as measured by waist circumference. [practicaldiabetes.com]
Cardiovascular
- Hypertension
The relationship of AN with hypertension may not be as strong as that with fatty liver and abnormal glucose homeostasis. [hkmj.org]
Seite 378 - Modan, B. (1986) Effect of past and concurrent body mass index on prevalence of glucose intolerance and type 2 (non-insulin-dependent) diabetes and on insulin response: the Israel study of glucose intolerance, obesity and hypertension. [books.google.de]
OTHERS Obesity Male Female Number % Number % Diabetes 6 20 8 26.6 Hypertension 3 10 4 13.3 Thyroid 1 3.3 7 23.3 PCOD 0 0 3 10 TABLE 7 Fig. 4 Fig. 5: Axilla – AN Fig. 6: SITES OF AN Fig. 12: HPE OF ACANTHOSIS NIGRICANS Fig. 13 [jemds.com]
High insulin levels are often associated with central obesity, cholesterol abnormalities, and/or high blood pressure ( hypertension ). When these disease processes occur together, it is called the metabolic syndrome. [medicinenet.com]
Association of hyperinsulinemia with left ventricular hypertrophy and diastolic dysfunction in patients with hypertension. Rev Med Chil 2007;135:1125-31. 11. Bonora E, Targher G, Alberiche M, Bonadonna RC, Saggiani F, Zenere MB, et al. [ijdvl.com]
Skin
- Hirsutism
Of 7 postmenarchal patients, 6 had oligo- or amenorrhea and 6 had hirsutism. None was clinically diabetic. Plasma DHEA and androstenedione were normal in all patients. [nature.com]
Saad, M.D., Ph.D. 5 Citing Articles A 27-year-old woman presented with a 2-year history of acanthosis nigricans (Panels A and B), hirsutism, and amenorrhea. [nejm.org]
Other phenotype of IRAN form includes hirsutism and polycystic ovarian disease in a patient who is usually not obese. There is no distinctive serum marker. [genome.jp]
Acne (left) and hirsutism (right) on chin of patient with HAIR-AN syndrome. FIGURE 1. Acne (left) and hirsutism (right) on chin of patient with HAIR-AN syndrome. [aafp.org]
She had facial acne, sweaty palms, multiple abdominal striae, hirsutism on the arms and legs, a deep voice, and clitoromegaly. [pmj.bmj.com]
- Eruptions
Syn. keratosis nigricans. ac·an·tho·sis ni·gri·cans ( ak-an-thō'sis nī'gri-kanz ) [MIM*100600] Eruption of velvety, warty benign growths and hyperpigmentation on the skin of the axillae, neck, anogenital area, and groin. [medical-dictionary.thefreedictionary.com]
Severe hypertriglyceridaemia, eruptive xanthomata and pancreatitis are common. [diapedia.org]
The severity of acanthosis nigricans correlates with the degree of insulin concentrations.Acanthus (Greek= thorn) and Nigricans (Latin=becoming black). 1 is a symmetric eruption characterized by hyperpigmented, velvety plaques, more commonly over the [jemds.com]
Urogenital
- Phenylketonuria
Ovarian cancer Hirschowitz syndrome Pancreatic cancer Lawrence-Moon-Bardet syndrome Pheochromocytoma Lawrence-Seip syndrome Prostate cancer Lipoatrophic diabetes mellitus Rectal cancer Lupoid hepatitis Testicular cancer Lupus erythematosus Thyroid cancer Phenylketonuria [medscape.com]
Neurologic
- Irritability
Scrubbing the skin does not help and can cause irritation. Acanthosis nigricans is more common in people who have high levels of the hormone insulin in their blood due to insulin resistance. [kidshealth.org]
These products rarely fade AN and can irritate your skin, making AN worse. Find out if you have a medical condition that is causing AN. Diabetes and other medical conditions can cause AN. [aad.org]
Findings may include thickening, unusual roughness and dryness, and/or potentially severe itching (pruritus) and irritation of affected skin regions. [rarediseases.org]
Workup
With the majority of cases of acanthosis nigricans resulting from obesity and insulin resistance, the initial workup should include a glycosylated hemoglobin level or glucose tolerance test. [podiatrytoday.com]
Acanthosis nigricans What is the workup for acanthosis nigricans? It is very important to differentiate acanthosis nigricans related to malignancy from that related to benign conditions. [dermnetnz.org]
Serum
- Hyperinsulinemia
Insulin resistance and hyperinsulinemia seem to be commonly associated with (and perhaps causative of) the acanthosis nigricans that is seen in many endocrine diseases. [ncbi.nlm.nih.gov]
Recent studies reveal that this disorder is directly associated with hyperinsulinemia. A major implication of hyperinsulinemia is insulin resistance — a primary factor in the development of type II diabetes mellitus. [journals.lww.com]
- Insulin Increased
[…] the epidermis. 3 This is clinically manifest as acanthosis nigricans, a cutaneous marker for tissue resistance to insulin with insulinaemia. 1-3 IGF receptors are also present in the ovarian stroma and, when bound by insulin, increased androgen production [pmj.bmj.com]
Obesity increases, because these foods are high in calories and the constantly high insulin levels prevent the burning of fat and converts the sugar just eaten into more fat. [buttermakesyourpantsfalloff.com]
Treatment
Pigmentation in patients with AN was improved after treatment (Figure 1). [hindawi.com]
Identifying acanthosis nigricans in childhood permits the safe and timely treatment of cardiometabolic disorders through careful monitoring and appropriate treatment. [ncbi.nlm.nih.gov]
Acanthosis nigricans Acanthosis nigricans: Overview Acanthosis nigricans: Symptoms Acanthosis nigricans: Causes Acanthosis nigricans: Treatment Acanthosis nigricans: Tips Treatment Acanthosis nigricans: Diagnosis and treatment How do dermatologists diagnose [aad.org]
There is no specific treatment for acanthosis nigricans. Treatments considered are used primarily to improve cosmetic appearance and include topical retinoids, dermabrasion and laser therapy. [dermnetnz.org]
The right diet for prediabetes » Cosmetic treatments If you are concerned with the appearance of your affected skin, there are cosmetic treatments available. [healthline.com]
Prognosis
Thus, the prognosis of Acanthosis Nigricans is excellent with adequate (skin) treatment. [dovemed.com]
However, the prognosis for patients with malignant acanthosis nigricans is often poor. The associated cancer is often advanced and the average survival of these patients is approximately 2 years. See smartphone apps to check your skin. [dermnetnz.org]
Insulin Resistance Prognosis It is only in recent years that insulin resistance has been gaining importance both its own right and as a contributor to the metabolic syndrome. It now appears that intervention can delay the onset of overt diabetes. [emedicinehealth.com]
Prognosis Related to underlying cause of AN Complications Metastasis in malignant AN End-organ damage in untreated hyperinsulinemia-associated AN ( 1 )[ B ] Additional Reading Romo A, Benavides S. [unboundmedicine.com]
Acanthosis nigricans maligna may resolve if the causative tumor is successfully removed. [17] Prognosis [ edit ] Acanthosis nigricans is likely to improve in circumstances where a known cause is removed. [en.wikipedia.org]
Etiology
Etiology and Pathophysiology Obesity induced (pseudo-AN) and insulin resistance ( 2 ) Are the most common etiologies of AN More prevalent in individuals with BMI >30. It is weight dependent and may regress with weight loss. [unboundmedicine.com]
[…] glycosylated hemoglobin level.7 Addison’s disease, hypothyroidism and disorders of androgen excess (Cushing’s disease, polycystic ovarian disease) are also common causes of acanthosis nigricans and the clinician's workup should consider these potential etiologies [podiatrytoday.com]
Mixed-type acanthosis nigricans Mixed-type acanthosis nigricans refers to those situations in which a patient with one of the above types of acanthosis nigricans develops new lesions of a different etiology. [emedicine.medscape.com]
Vrieze and many others Association studies of up to 1.2 million individuals yield new insights into the genetic etiology of tobacco and alcohol use Nature Genetics, Early View January 2019 DOI: 10.1038/s41588-018-0307-5 https://www.nature.com/ar...s/s41588 [tweelingenregister.org]
Etiological approach to characterization of diabetes type: the SEARCH for Diabetes in Youth Study. Diabetes Care 2011; 34: 1628–1633. Article Google Scholar 3 Fagot-Campagna A, Pettitt DJ, Engelgau MM, Burrows NR, Geiss LS, Valdez R et al. [nature.com]
Epidemiology
Bækvad-Hansen, ADHD Working Group of the Psychiatric Genomics Consortium (PGC), Early Lifecourse & Genetic Epidemiology (EAGLE) Consortium, G.E. Davies, E.A. Ehli, I.O. Fedko, M.M. Groen-Blokhuis, A.R. Hammerschlag, J.J. Hottenga, J.J. Hudziak, K.G. [tweelingenregister.org]
Type 2 diabetes among North American children and adolescents: an epidemiologic review and a public health perspective. J Pediatr 2000; 136: 664–672. [nature.com]
Epidemiology AN is more common between the ages of 11 and 40 years and in those with body mass index (BMI) ≥30. It is more common in individuals with diabetes or risk factors for diabetes. [unboundmedicine.com]
Basic science and epidemiological studies are important cornerstones of obesity research. [dovepress.com]
Epidemiological studies support the relationship between obesity and PCOS, further evidenced by observations that modest weight loss can reduce the manifestations of the disease. 13 Insulin resistance appears to be an important contributor to the pathogenesis [practicaldiabetes.com]
Pathophysiology
Review Acanthosis nigricans associated with insulin resistance : pathophysiology and management Trinh Hermanns-Lê et al. Am J Clin Dermatol. 2004. [pubmed.ncbi.nlm.nih.gov]
In addition to the widely recognized association of acanthosis nigricans with insulin resistance, acanthosis nigricans has been associated with numerous syndromes (see the Table in Pathophysiology). [emedicine.medscape.com]
Hyperandrogenism, insulin resistance, and acanthosis nigricans syndrome: A common endocrinopathy with distinct pathophysiologic features. Am J Obstet Gynecol. 1983;147:90-101. Kobaissi H, Weigensberg M, Ball G, Cruz M, Shaibi, Goran M. [ijord.com]
Pathophysiology and pharmacological treatment of insulin resistance. Endocr Rev. 2000;21:58-618. 7. Varthakavi PK, Patel KL, Wadhwa SL, Shopkar U, Sengupta RA, Merchant PC, et al. A study of insulin resistance in subjects Mth acanthosis nigricans. [paediatricaindonesiana.org]
Acanthosis nigricans associated with insulin resistance: pathophysiology and management. Am J Clin Dermatol. 2004;5:199–203. Google Scholar 8. Romo A, Benavides S. Treatment options in insulin resistance obesity-related acanthosis nigricans. [degruyter.com]
Prevention
Can Acanthosis Nigricans Be Prevented? When acanthosis nigricans is related to obesity, weight management is an important part of prevention. A diet that contributes to reduced insulin also can help prevent acanthosis nigricans. [webmd.com]
Insulin Resistance Prevention While there is a significant genetic component to the development of insulin resistance, many things can be done to prevent its onset and progression. [emedicinehealth.com]
Diabetes Prevention Program Research Group. The Diabetes Prevention Program: baseline characteristics of the randomized cohort. Diabetes Care. 2000;23:1619-1629. 20. Einhorn D, Reaven GM, Cobin RH, et al. [pharmacytimes.com]
Detection of DM Type-2 by hyperglycemia may be too late to prevent the onset of microvascular changes. [jfmpc.com]