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Vol. 105. Issue 2.
Pages e1-e12 Pages 105-212 (March 2014)
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Vol. 105. Issue 2.
Pages e1-e12 Pages 105-212 (March 2014)
Original Article
DOI: 10.1016/j.adengl.2013.09.006
Skin Disorders in Overweight and Obese Patients and Their Relationship With Insulin
Dermatosis en pacientes con sobrepeso y obesidad y su relación con la insulina
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A. Plascencia Gómeza,??
Corresponding author
dontol@hotmail.com

Corresponding author.
, M.E. Vega Memijeb, M. Torres Tamayoc, A.A. Rodríguez Carreónb
a Centro Dermatológico de Yucatan Mérida, Yucatán, Mexico
b Servicio de Dermatología, Hospital General Dr. Manuel Gea González, Mexico DF, Mexico
c Servicio de Endocrinología, Hospital General Dr. Manuel Gea González, Mexico DF, Mexico
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Tables (5)
Table 1. Clinical and Biochemical Characteristics According to Overweight and the Grade of Obesitya
Table 2. Frequency of Diseases Associated With Overweight and Grade of Obesitya
Table 3. Frequency of Skin Disorders and Number of Skin Tags According to Overweight and the Grade of Obesitya
Table 4. Median Values of Insulin and HOMA-IR and Number of Skin Tags According to the Grade of Acanthosis on the Necka
Table 5. Ordinal Regression Analysis to Evaluate the Independence of the Association Between Insulin and the Grade of Acanthosis and the Number of Skin Tagsa
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Abstract
Introduction

The prevalence of obesity has increased worldwide in recent years. Some authors have described skin conditions associated with obesity, but there is little evidence on the association between insulin levels and such disorders.

Objective

To describe the skin disorders present in overweight and obese patients and analyze their association with insulin levels.

Material and methods

The study included nondiabetic male and female patients over 6 years of age who were seen at our hospital between January and April 2011. All the patients were evaluated by a dermatologist, who performed a physical examination, including anthropometry, and reviewed their medical history and medication record; fasting blood glucose and insulin were also measured. The patients were grouped according to degree of overweight or obesity and the data were compared using analysis of variance or the χ2 test depending on the type of variable. The independence of the associations was assessed using regression analysis.

Results

In total, 109 patients (95 adults and 13 children, 83.5% female) were studied. The mean (SD) age was 38 (14) years and the mean body mass index was 39.6±8kg/m2. The skin conditions observed were acanthosis nigricans (AN) (in 97% of patients), skin tags (77%), keratosis pilaris (42%), and plantar hyperkeratosis (38%). Statistically significant associations were found between degree of obesity and AN (P=.003), skin tags (P=.001), and plantar hyperkeratosis. Number of skin tags, AN neck severity score, and AN distribution were significantly and independently associated with insulin levels.

Conclusions

AN and skin tags should be considered clinical markers of hyperinsulinemia in nondiabetic, obese patients.

Keywords:
Obesity
Dermatosis
Insulin
Acanthosis nigricans
Skin tags
Resumen
Introducción

La prevalencia de obesidad se ha incrementado mundialmente en los últimos años. Existen estudios que describen las dermatosis que se asocian con la obesidad; sin embargo, existe poca evidencia de su asociación con los niveles de insulina.

Objetivo

Describir las dermatosis presentes en pacientes con sobrepeso y obesidad y su asociación con los niveles de insulina.

Material y métodos

Se incluyeron pacientes de ambos sexos, mayores de 6 años, no diabéticos que acudieron a la consulta durante los meses de enero a abril de 2011. Todos los sujetos fueron valorados por un dermatólogo, se realizó exploración física, antropometría, historia médica, medicamentos y medición de glucosa e insulina de ayuno. Los pacientes se dividieron de acuerdo a sobrepeso y grado de obesidad y se compararon con Anova o Chi cuadrado, dependiendo del tipo de variable. Se realizó análisis de regresión para evaluar la independencia de las asociaciones.

Resultados

Fueron incluidos 109 pacientes (95 adultos y 13 niños; 83,5% mujeres), con edad media de 38±14 años y un índice de masa corporal de 39,6±8kg/m2. Las dermatosis encontradas fueron: acantosis nigricans (97%), fibromas (77%), queratosis pilar (42%) e hiperqueratosis plantar (38%). Las que se asociaron de forma estadísticamente significativa con el grado de obesidad fueron acantosis nigricans (p=0,003), fibromas (p=0,001) e hiperqueratosis plantar. El grado de acantosis nigricans en el cuello, su topografía y el número de fibromas mostraron asociación significativa e independiente con los niveles de insulina.

Conclusiones

La acantosis y los fibromas deberían considerarse marcadores clínicos de hiperinsulinemia en población obesa y no diabética.

Palabras clave:
Obesidad
Dermatosis
Insulina
Acantosis nigricans
fibromas

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