Body mass index percentile more sensitive than acanthosis Nigricans for screening native American children for diabetes risk

Phyllis A. Nsiah-Kumi, Jennifer Beals, Sylvia Lasley, Mary Whiting, Connie Brushbreaker, Judi Erickson, Fang Qiu, Fang Yu, Gay Canaris, Jennifer Lynn Larsen

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)944-949
Number of pages6
JournalJournal of the National Medical Association
Volume102
Issue number10
DOIs
StatePublished - Oct 2010

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Acanthosis Nigricans
North American Indians
Body Mass Index
Insulin Resistance
Type 2 Diabetes Mellitus
Population Groups
Sensitivity and Specificity

Keywords

  • Diabetes mellitus
  • Health disparities

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Body mass index percentile more sensitive than acanthosis Nigricans for screening native American children for diabetes risk. / Nsiah-Kumi, Phyllis A.; Beals, Jennifer; Lasley, Sylvia; Whiting, Mary; Brushbreaker, Connie; Erickson, Judi; Qiu, Fang; Yu, Fang; Canaris, Gay; Larsen, Jennifer Lynn.

In: Journal of the National Medical Association, Vol. 102, No. 10, 10.2010, p. 944-949.

Research output: Contribution to journalArticle

Nsiah-Kumi, Phyllis A. ; Beals, Jennifer ; Lasley, Sylvia ; Whiting, Mary ; Brushbreaker, Connie ; Erickson, Judi ; Qiu, Fang ; Yu, Fang ; Canaris, Gay ; Larsen, Jennifer Lynn. / Body mass index percentile more sensitive than acanthosis Nigricans for screening native American children for diabetes risk. In: Journal of the National Medical Association. 2010 ; Vol. 102, No. 10. pp. 944-949.
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abstract = "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.",
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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 Lynn

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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.

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