Abstract
Compared with the US white, non-Hispanic population, the African-American population has a nearly two-fold higher prevalence of noninsulin-dependent diabetes mellitus (NIDDM). Obesity, which usually precedes NIDDM, is associated with the skin lesion acanthosis nigricans in African Americans. This study was undertaken to determine what the relationship of acanthosis nigricans was to hyperinsulinemia, a major risk factor for NIDDM. Eighty-nine African-American subjects with acanthosis nigricans and 25 others without the skin lesion were evaluated using oral glucose tolerance testing and responsiveness to insulin. Noninsulin-dependent diabetes mellitus was present in 19 of the subjects with acanthosis nigricans. The prevalence of NIDDM in this group increased with increasing age, reaching 50% among those in their 40s. Fasting plasma insulin concentration was in direct proportion to the severity of the acanthosis nigricans involvement of the neck. These data suggest that among African Americans, this skin lesion is a marker for hyperinsulinemia and insulin resistance. Furthermore, the presence of acanthosis nigricans identifies a subset with a much higher prevalence of NIDDM than is present in African Americans in the general population.
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- Austin J. P., Aziz H., Potters L., Thelmo W., Chen P., Choi K., Brandys M., Macchia R. J., Rotman M. Diminished survival of young blacks with adenocarcinoma of the prostate. Am J Clin Oncol. 1990 Dec;13(6):465–469. doi: 10.1097/00000421-199012000-00002. [DOI] [PubMed] [Google Scholar]
- Bang K. M., White J. E., Gause B. L., Leffall L. D., Jr Evaluation of recent trends in cancer mortality and incidence among blacks. Cancer. 1988 Mar 15;61(6):1255–1261. doi: 10.1002/1097-0142(19880315)61:6<1255::aid-cncr2820610634>3.0.co;2-7. [DOI] [PubMed] [Google Scholar]
- Baquet C. R., Horm J. W., Gibbs T., Greenwald P. Socioeconomic factors and cancer incidence among blacks and whites. J Natl Cancer Inst. 1991 Apr 17;83(8):551–557. doi: 10.1093/jnci/83.8.551. [DOI] [PubMed] [Google Scholar]
- DeFronzo R. A., Ferrannini E. Insulin resistance. A multifaceted syndrome responsible for NIDDM, obesity, hypertension, dyslipidemia, and atherosclerotic cardiovascular disease. Diabetes Care. 1991 Mar;14(3):173–194. doi: 10.2337/diacare.14.3.173. [DOI] [PubMed] [Google Scholar]
- Franckson J. R., Malaise W., Arnould Y., Rasio E., Ooms H. A., Balasse E., Conard V., Bastenie P. A. Glucose kinetics in human obesity. Diabetologia. 1966 Sep;2(2):96–103. doi: 10.1007/BF00423017. [DOI] [PubMed] [Google Scholar]
- Freeman H. P., Wasfie T. J. Cancer of the breast in poor black women. Cancer. 1989 Jun 15;63(12):2562–2569. doi: 10.1002/1097-0142(19890615)63:12<2562::aid-cncr2820631234>3.0.co;2-0. [DOI] [PubMed] [Google Scholar]
- Gillum R. F., Liu K. C. Coronary heart disease mortality in United States blacks, 1940-1978: trends and unanswered questions. Am Heart J. 1984 Sep;108(3 Pt 2):728–732. doi: 10.1016/0002-8703(84)90665-3. [DOI] [PubMed] [Google Scholar]
- Haffner S. M., Stern M. P., Hazuda H. P., Pugh J. A., Patterson J. K. Hyperinsulinemia in a population at high risk for non-insulin-dependent diabetes mellitus. N Engl J Med. 1986 Jul 24;315(4):220–224. doi: 10.1056/NEJM198607243150403. [DOI] [PubMed] [Google Scholar]
- Harris M. I., Hadden W. C., Knowler W. C., Bennett P. H. International criteria for the diagnosis of diabetes and impaired glucose tolerance. Diabetes Care. 1985 Nov-Dec;8(6):562–567. doi: 10.2337/diacare.8.6.562. [DOI] [PubMed] [Google Scholar]
- Harris M. I., Hadden W. C., Knowler W. C., Bennett P. H. Prevalence of diabetes and impaired glucose tolerance and plasma glucose levels in U.S. population aged 20-74 yr. Diabetes. 1987 Apr;36(4):523–534. doi: 10.2337/diab.36.4.523. [DOI] [PubMed] [Google Scholar]
- Hayward R. A., Shapiro M. F., Freeman H. E., Corey C. R. Who gets screened for cervical and breast cancer? Results from a new national survey. Arch Intern Med. 1988 May;148(5):1177–1181. [PubMed] [Google Scholar]
- Kahn C. R., Flier J. S., Bar R. S., Archer J. A., Gorden P., Martin M. M., Roth J. The syndromes of insulin resistance and acanthosis nigricans. Insulin-receptor disorders in man. N Engl J Med. 1976 Apr 1;294(14):739–745. doi: 10.1056/NEJM197604012941401. [DOI] [PubMed] [Google Scholar]
- Kumanyika S. Obesity in black women. Epidemiol Rev. 1987;9:31–50. doi: 10.1093/oxfordjournals.epirev.a036307. [DOI] [PubMed] [Google Scholar]
- Kuzuya H., Blix P. M., Horwitz D. L., Steiner D. F., Rubenstein A. H. Determination of free and total insulin and C-peptide in insulin-treated diabetics. Diabetes. 1977 Jan;26(1):22–29. doi: 10.2337/diab.26.1.22. [DOI] [PubMed] [Google Scholar]
- Lillioja S., Bogardus C. Obesity and insulin resistance: lessons learned from the Pima Indians. Diabetes Metab Rev. 1988 Aug;4(5):517–540. doi: 10.1002/dmr.5610040508. [DOI] [PubMed] [Google Scholar]
- Peters E. J., Stuart C. A., Prince M. J. Acanthosis nigricans and obesity: acquired and intrinsic defects in insulin action. Metabolism. 1986 Sep;35(9):807–813. doi: 10.1016/0026-0495(86)90220-9. [DOI] [PubMed] [Google Scholar]
- Sawyer J. A., Earp J., Fletcher R. H., Daye F. F., Wynn T. M. Pap tests of rural black women. J Gen Intern Med. 1990 Mar-Apr;5(2):115–119. doi: 10.1007/BF02600510. [DOI] [PubMed] [Google Scholar]
- Stuart C. A., Pate C. J., Peters E. J. Prevalence of acanthosis nigricans in an unselected population. Am J Med. 1989 Sep;87(3):269–272. doi: 10.1016/s0002-9343(89)80149-4. [DOI] [PubMed] [Google Scholar]
- Stuart C. A., Peters E. J., Prince M. J., Richards G., Cavallo A., Meyer W. J., 3rd Insulin resistance with acanthosis nigricans: the roles of obesity and androgen excess. Metabolism. 1986 Mar;35(3):197–205. doi: 10.1016/0026-0495(86)90201-5. [DOI] [PubMed] [Google Scholar]