Evidence Against Mass Screening for Acanthosis Nigricans: Relationships with Insulin Resistance, and Waist Circumference in Mexican American Adolescents

2.50
Hdl Handle:
http://hdl.handle.net/10755/151443
Type:
Presentation
Title:
Evidence Against Mass Screening for Acanthosis Nigricans: Relationships with Insulin Resistance, and Waist Circumference in Mexican American Adolescents
Abstract:
Evidence Against Mass Screening for Acanthosis Nigricans: Relationships with Insulin Resistance, and Waist Circumference in Mexican American Adolescents
Conference Sponsor:Sigma Theta Tau International
Conference Year:2006
Author:Rentfro, Anne R., MSN, RN
P.I. Institution Name:The University of Texas at Brownsville and Texas Southmost College
Title:Associate Professor
Co-Authors:Wendy Innis-Whitehouse, PhD; Rosa Maria Pones, MPH, RN; Jeanette Nino, BS; Cristina Barroso, DrPH; Susan Fisher-Hoch, MD, MSc
Background/Purpose: Acanthosis Nigricans (AN) is characterized by increased pigmentation, principally on the posterior neck. School nurses use mass screening for AN as a marker for diseases associated with insulin resistance (IR).  AN is common in Mexican Americans (MAs), possibly due to their genetic makeup.  With the ambiguous relationships among AN, IR, and type 2 diabetes we sought to clarify associations in a high risk adolescent population. Methods:  AN, IR, body mass index, waist circumference were determined for 320 MA high school students.  A validated survey tool was used to collect demographic characteristics, physical activity and nutritional habits.  Fasting laboratory values were obtained for blood glucose and insulin. Results: Participants were 35.6% (114/320) male, 64.4% (206/320) female with a mean age of 16 (range: 14-9). Over 50% of the sample was overweight or at risk for overweight; 36.5% (114/312) had central obesity (CO); 31% (96/308) had AN detected; and 28% (83/297) had insulin resistance (IR). Of the participants with AN, 50% (47/94) were overweight and 28% (21/76) were insulin resistant. Of the overweight students, 92% (76/83) had CO. IR was not significantly associated with AN (Odds Ratio [OR] 0.9, 95% confidence interval [CI] 0.5-1.6) nor CO (OR 1.4, 95% CI 0.8-2.4).  AN, however, was significantly associated with CO (OR 3.96, 95% CI 2.4-6.7). Conclusion: No significant association was found between AN and IR, supporting the Centers for Disease Control and Prevention recommendation to eliminate mass screening for AN.  Central obesity was associated with AN, but not with IR. We found central obesity to be a less controversial measure with minimal racial connotations and a more easily standardized tool than AN. These findings support an evidence based approach for the use of waist circumference measurement rather than AN for screening in schools.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleEvidence Against Mass Screening for Acanthosis Nigricans: Relationships with Insulin Resistance, and Waist Circumference in Mexican American Adolescentsen_GB
dc.identifier.urihttp://hdl.handle.net/10755/151443-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Evidence Against Mass Screening for Acanthosis Nigricans: Relationships with Insulin Resistance, and Waist Circumference in Mexican American Adolescents</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Sigma Theta Tau International</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2006</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Rentfro, Anne R., MSN, RN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">The University of Texas at Brownsville and Texas Southmost College</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Associate Professor</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">Anne.Rentfro@utb.edu</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Wendy Innis-Whitehouse, PhD; Rosa Maria Pones, MPH, RN; Jeanette Nino, BS; Cristina Barroso, DrPH; Susan Fisher-Hoch, MD, MSc</td></tr><tr><td colspan="2" class="item-abstract">Background/Purpose: Acanthosis Nigricans (AN)&nbsp;is characterized by increased pigmentation, principally on the posterior neck. School nurses use mass screening for AN as a marker for diseases associated with insulin resistance (IR).&nbsp; AN is common in Mexican Americans (MAs), possibly due to their genetic makeup.&nbsp; With the ambiguous relationships among AN, IR, and type 2 diabetes we sought to clarify associations in a high risk adolescent population. Methods:&nbsp; AN, IR, body mass index, waist circumference were determined for 320 MA high school students.&nbsp; A validated survey tool was used to collect demographic characteristics, physical activity and nutritional habits.&nbsp; Fasting laboratory values were obtained for blood glucose and insulin. Results:&nbsp;Participants were 35.6% (114/320) male, 64.4% (206/320) female with a mean age of 16 (range: 14-9). Over 50% of the sample was overweight or at risk for overweight; 36.5% (114/312) had central obesity (CO); 31% (96/308) had AN detected; and 28% (83/297) had insulin resistance (IR). Of the participants with AN, 50% (47/94) were overweight and 28% (21/76) were insulin resistant. Of the overweight students, 92% (76/83) had CO. IR was not significantly associated with AN (Odds Ratio [OR] 0.9, 95% confidence interval [CI] 0.5-1.6) nor CO (OR 1.4, 95% CI 0.8-2.4).&nbsp; AN, however, was significantly associated with CO (OR 3.96, 95% CI 2.4-6.7). Conclusion: No significant association was found between AN and IR, supporting the Centers for Disease Control and Prevention recommendation to eliminate mass screening for AN.&nbsp; Central obesity was associated with AN, but not with IR. We found central obesity to be a less controversial measure&nbsp;with minimal racial connotations and a more easily standardized&nbsp;tool than AN. These findings support an evidence based approach for the use of waist circumference measurement&nbsp;rather than AN for screening in schools.</td></tr></table>en_GB
dc.date.available2011-10-26T11:02:31Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T11:02:31Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
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