Obesity and type 2 diabetes is becoming a major health problem affecting children and adolescents in the United States. This article reviews the current literature examining the association between the presence of acanthosis nigricans (AN) and risk for developing type 2 diabetes mellitus (T2DM) in obese children and adolescents. Ethnicity, family history of diabetes, and emergence of obesity are contributing factors for development of hyperinsulinemia, and insulin resistance, and ensuing visible changes on skin which is known as the AN. The purpose of this review was to assess the validity of AN as an early indicator of T2DM. Nineteen articles that were published from 1994 to 2010 were included for this review and reported an association between AN, hyperinsulinemia, and hyperglycemia. Nurses and advanced nurse practitioners working with children and adolescents have a tremendous role in identifying the risk factors, counseling, role modeling, and referring them to available community resources to promote healthy living. Early initiatives focusing on lifestyle changes may halt the progress, chronicity, and burden of T2DM in children and adolescents.
BentK.ShusterG.HurlyJ.FryeD.LoflinP.BrubakerC. (1998). Acanthosis nigricans as an early clinical proxy marker of increased risk for type 2 diabetes. Public Health Nursing, 15, 415-421.
2.
BrickmanW.HuangJ.SilvermanB.MetzgerB. (2010). Acanthosis nigricans identifies youth at risk for metabolic abnormalities. The Journal of Pediatrics, 156, 87-92. doi:10.1016/j.peds.2009.07.011.
3.
BurkeJ.HaleD.HazudaH.SternM. (1999). A quantitative scale of acanthsis nigricans. Diabetes Care, 22, 1655-1659.
4.
CaceresM.TeranC.RodriguezS.MedinaM. (2008). Prevalence of insulin resistance and its association with metabolic syndrome criteria among Bolivian children and adolescents with obesity. Bio Med Central Pediatrics, 8, 31. doi:10.1186/1471-2431/8/31.
5.
CampbellR.MartinT. (2009). The chronic burden of diabetes. The American Journal of Managed Care, 15, 248-254.
6.
Centers for Disease Control and Prevention. (2011). National diabetes fact sheet; National estimate and general information on diabetes and prediabetes in the United States. Atlanta, GA: Centers for Disease Control and Prevention.
7.
ChangY.WooH.SungE.KimC.H.KangH.JuY.S.ParkK. H. (2008). Prevalence of of acanthosis nigricans in relation to anthropometric measures: Community based cross–sectional study in Korean pre-adolescent school children. Pediatric International, 50, 667-673. doi:10.1111/j.1442-200x.2008.02638.x.
8.
DrobacS.BrickmanW.SmithT.BinnsH. (2004). Evaluation of Type 2 Diabetes screening protocol in an urban pediatric clinic. Pediatrics, 114, 141-148.
9.
GarnettS. P.SrinivasanS.BrittS. G.AmblerG.LawrietE. A.CowellC. T.CraigM. E. (2010). Evaluation of glycemic status in young people with clinical insulin resistance, fasting glucose, fasting insulin or an oral glucose tolerence test?Clinical Endocrinology, 72, 475-480. doi:10.1111/j.1365-2265.2009.03677.x
10.
GrandheN.BhansaliA.DograS.KumarB. (2004). Acanthosis nigricans: Relation with Type2 diabetes mellitus, anthropometric varibles and body mass in Indians. Post Graduate Medical Journal, 81, 541-544. doi: 10.1136/pgmi.2004.028308
11.
GuranT.TuranS.AkcayT.BereketA. (2008). Significance of acanthosis nigricans in childhood obesity. Journal of Pediatric and Child Health, 44, 338-441. doi:10.1111/j1440-1754.2007.01272.x
12.
HirschlerV.ArandaC.OnetoA.GonzalezC.JadzinskyM. (2002). Is acanthosis nigricans a marker of insulin resistance in obese children?Diabetes Care, 25, 2353. doi:10.2337/diacare.25.12.2353
13.
HuF. (2011). Globalization of diabetes: The role of diet, lifestyle and genes. Diabetes Care, 34, 1249-1257, doi: 10.2337/dc11-0442
14.
IceC.MurphyE. V.NealW. (2009). Metabolic syndrom in fifth grade children with acanthosis nigricans: Results from the CARDIAC project. World Journal Pediatrcs, 5, 23-30. doi: 10.1007/s12519-009-0004-7
15.
JonesL.FiccaM. (2007). Is Acanthosis Nigricans a reliable indicator for risk of Type 2 Diabetes?The Journal of School of Nursing, 23, 247-251.
16.
KaufmanF. (2005). Type 2 Diabetes in children and youth. Endocrinology & Metabolism Clinics of North America, 34, 659-676. doi:10.1016/j.ecl.2005.04.010
17.
KobaissiH.WeigensbergM.BallG.CruzM.ShaibiG.GoranM. (2004). Relationship between acanthosis nigricans and insulin sensitivity in over weight Hispanic children at risk for type 2 diabetes. Diabetes Care, 27, 1412-1416.
18.
KongA.WilliamsR.SmithM.SussmanA.SkipperB.HsiA.& RbyneR. LRIOSNet Clinicians. (2007). Acanthosis nigricans and diabetes risk factors: Prevalence in young persons seen in Southwestern US primary care practices. Annals og Family Medicine, 5, 202-208.
19.
KongA.WilliamsR.Urias-SandovalV.CardinaliG.WellerN.SkipperB.… McPhersonLPRIME Net Clinicians. (2010). Acanthosis Nigricans: High prevalence and association with diabetes in a practice-based research network consortium-Aprimary care multiethnic network (PRIME Net) study. Journal of the American Board of Family Medicine, 23, 476-485.
20.
LeT.ScheenA.PierardG. (2004). Acanthosis Nigricans associated with Insulin resistance–pathophysiology and management. American Journal of Clinnical Dermatology, 5. 199-203.
21.
MeetooD.McGovernP.SafadiR. (2007). An epidemiological overview of diabetes across the world. British Journal of Nursing, 16, 1002-1007.
22.
MeyerS.HoffmanR. (2011). Retrospective chart review of children with Type RT2DMevaluating the efficacy of Metformin vs Insulin vs combination Insulin vs Metformin. The Southern Medical Association, 104, 682-688.
MiuraN.IkezakiA.IwamaS.MatsuokaH.ItoK.SugihraS. (2006). Genetic factors and clinical significance ofacanthosis nigricans in obese Japanese children and adolescents. Acta Pediatrica, 95, 170-175. doi:10.1080/08035250500294015
25.
MukhtarQ.CleverleyG.VoorheesR.McGarthJ. (2001). Prevalence of acanthosis nigricans and its association with hyperinsulinemia in New Mexico Adolescents. Journal of Adolescent Health, 28, 372-376.
26.
NarayanK.BoyleJ.ThompsonT.SorensenS.WilliamsonD. (2003). Lifetime risk for diabetes mellitus in the United States. Journal of American Medical Association, 290, 1884-1890.
27.
OgdenC.CarrollM.CurtinL.LambM.FlegalK. (2010). Prevalence of high body mass index in U.S children and adolescents, 2007-2008. The Journal of American Medical Association, 303, 242-249. doi: 10.1001.jama.2009.2012
28.
PetersonS.ShefferS.Long RothS.BennettP.LioydL. (2010). Noninvasive screening for risk factors of T2 Diabetes in young, rural, Caucasiansan children. The Journal of School of Nursing, 26, 301-309. doi:10.1177/1059840510366021.
29.
RodbardH. (2008). Diabetes screening, diagnosis and therapy in pediatric with Type 2 Diabetes. The Medscape Journal of Medicine, 10, 184.
30.
SilvaD.MirandaW.ChacraA.DibS. (2007). Insulin resistance, β-cell function, and glucose tolerance in Brazilian adolescents with obesity or risk factors for T2DM. Journal of Diabetes and Its Complications, 21, 84-92. doi:10.1016/j.jdiacomp.2005.11.006
31.
SinhaS.SachwartzR. (2007). Juvenile acanthosis nigricans. Journal of American Academy of Dermatology, 57, 502-508. doi:10.1016/jaad.2006.08.016
32.
StoddartM.BlevinsK.LeeE.WangW.BlackettP. (2002). Association of Acanthosis nigricans with hyperinsulinemia compared with other selected risk factors for Type 2 Diabetes in Cherokee Indians. Diabetes Care, 25, 1009-1013.
33.
StuartC.SmithM.GilkisonC.ShahebS.StahnR. (1994). Acanthosis Nigricans among Native Americans: An indicator of high diabetic risk. American Journal of Public Health, 84, 1839-1842.
34.
University of Texas Pan American Border Health Offfice. (2009). Texas risk assessment for type 2 diabetes in children: A report to the governor and 81st legislature of the state of texas. Texas Retrieved from https://rfes.utpa.edu/resources/TRAT2D_Legislative_Report_2009.pdf.
35.
WhitakerJ.DavisK.LauerC. (2004). Is there a need for screening for Type 2 Diabetes in seventh graders?Journal of American Academy of Nurse Practitioners, 16, 496-501.
36.
YamazakiH.ItoS.YoshidaH. (2003). Acanthosis nigricans is a reliable cutaneous marker of insulin resistance in obese Japanese children. Pediatric International, 45, 701-705.
