Korean J Fam Pract 2020; 10(5): 332-337  https://doi.org/10.21215/kjfp.2020.10.5.332
Insulin Resistance and Obesity according to Degree of Acanthosis Nigricans in Obese Korean Children and Adolescents
Byung-Gue Lee, Kyung Hee Park*, Young-Gyun Seo, Hye-Mi Noh, Hong-Ji Song, Yu-Jin Paek, Mi-Jeong Park, Ah-Ra Jo
Department of Family Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea
Kyung Hee Park
Tel: +82-31-380-3805, Fax: +82-31-380-1782
E-mail: beloved920@gmail.com
ORCID: https://orcid.org/0000-0001-9806-0076
Received: August 7, 2018; Revised: August 5, 2020; Accepted: August 13, 2020; Published online: October 20, 2020.
© The Korean Academy of Family Medicine. All rights reserved.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background: Recent studies suggest that acanthosis nigricans (AN) is associated with insulin resistance in obese children. However, very few studies have assessed insulin resistance and obesity according to the degree of AN. Therefore, this study aimed to investigate the correlation between the degree of obesity and insulin resistance according to the severity of AN.
Methods: A total of 141 participants (83 boys and 58 girls) aged 6−17 years were recruited for the Intervention for Childhood and Adolescents obesity via Activity and Nutrition study between 2016 and 2017. The participants were categorized into four groups according to the severity of AN: grade 0 (n=69), grade 1 (n=19), grade 2–3 (n=35), and grade 4 (n=18). All participants underwent physical examination and blood tests. We compared the mean homeostatic model assessment (HOMA-IR) and body mass index Z score (BMI Z-score) in each group using ANCOVA and linear regression model.
Results: The HOMA-IR, which represents insulin resistance, increased with increasing AN severity (grade 0 group: 3.25±0.070; grade 1 group: 3.97±0.103; grade 2–3 group: 4.76±0.079; AN grade 4: 6.40±0.107; P for trend<0.001). Similarly, the BMI Z-score, which represents the degree of obesity, increased with increasing AN severity (grade 0 group: 2.29±0.052; grade 1 group: 2.42±0.080; grade 2–3 group: 2.44±0.062, grade 4: 2.67±0.089; P for trend<0.001).
Conclusion: Insulin resistance and the degree of obesity increase with the severity of AN in Korean obese children.
Keywords: Acanthosis Nigricans; Adolescents; Insulin Resistance; Body Mass Index
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