TY - JOUR
T1 - Body mass index percentile more sensitive than acanthosis Nigricans for screening native American children for diabetes risk
AU - Nsiah-Kumi, Phyllis A.
AU - Beals, Jennifer
AU - Lasley, Sylvia
AU - Whiting, Mary
AU - Brushbreaker, Connie
AU - Erickson, Judi
AU - Qiu, Fang
AU - Yu, Fang
AU - Canaris, Gay
AU - Larsen, Jennifer L.
N1 - Funding Information:
Funding/support: This study was supported by the National Institutes of Health through a Native American Research Center for Health grant with funding from National Institute of Diabetes and Digestive and Kidney Diseases (U26IHS300002). Dr Nsiah-Kumi was supported by the National Center on Minority Health and Health Disparities’ loan repayment program.
PY - 2010/10
Y1 - 2010/10
N2 - Background: Many Native American tribes use acanthosis nigricans to screen for type 2 diabetes risk. We hypothesized that acanthosis nigricans misses many children at risk for type 2 diabetes. Methods: We evaluated 5- to 18-year-old Native American children and youth to assess the sensitivity and specificity of acanthosis nigricans as a marker for insulin resistance. Results: In a cohort of 161 youth (72 males/89 females), mean age was 10.7 years + 3.9. Mean body mass index (BMI) percentile was 76.8 ± 23.3, and 54% had a BMI at or above the 85th percentile. Acanthosis nigricans was present in 21.7% of the participants and was more common in 12- to 18-year-olds than in 5- to 11-year-olds (p = .02). Of those with acanthosis nigricans, 82.4% had insulin resistance (homeostatic model assessment of insulin resistance >4), but only 48.3% of those with insulin resistance had acanthosis nigricans. In contrast, BMI at or above the 85th percentile had a high sensitivity (74%) for insulin resistance, even though its specificity was lower (58%). Conclusions: The presence of acanthosis nigricans alone was a specific, but not a sensitive, screening tool for identifying youth with insulin resistance. BMI at or above the 85th percentile was a more sensitive screening tool than acanthosis nigricans alone, or acanthosis nigricans and BMI together for identifying children and youth with IR who are at increased risk for type 2 diabetes.
AB - Background: Many Native American tribes use acanthosis nigricans to screen for type 2 diabetes risk. We hypothesized that acanthosis nigricans misses many children at risk for type 2 diabetes. Methods: We evaluated 5- to 18-year-old Native American children and youth to assess the sensitivity and specificity of acanthosis nigricans as a marker for insulin resistance. Results: In a cohort of 161 youth (72 males/89 females), mean age was 10.7 years + 3.9. Mean body mass index (BMI) percentile was 76.8 ± 23.3, and 54% had a BMI at or above the 85th percentile. Acanthosis nigricans was present in 21.7% of the participants and was more common in 12- to 18-year-olds than in 5- to 11-year-olds (p = .02). Of those with acanthosis nigricans, 82.4% had insulin resistance (homeostatic model assessment of insulin resistance >4), but only 48.3% of those with insulin resistance had acanthosis nigricans. In contrast, BMI at or above the 85th percentile had a high sensitivity (74%) for insulin resistance, even though its specificity was lower (58%). Conclusions: The presence of acanthosis nigricans alone was a specific, but not a sensitive, screening tool for identifying youth with insulin resistance. BMI at or above the 85th percentile was a more sensitive screening tool than acanthosis nigricans alone, or acanthosis nigricans and BMI together for identifying children and youth with IR who are at increased risk for type 2 diabetes.
KW - Diabetes mellitus
KW - Health disparities
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U2 - 10.1016/S0027-9684(15)30714-8
DO - 10.1016/S0027-9684(15)30714-8
M3 - Article
C2 - 21053710
AN - SCOPUS:78149293293
SN - 0027-9684
VL - 102
SP - 944
EP - 949
JO - Journal of the National Medical Association
JF - Journal of the National Medical Association
IS - 10
ER -