Adriana Sánchez-García, María Eugenia Penados-Ovalle, René Rodríguez-Gutiérrez, Fernando Díaz-González Colmeneros, José Gerardo González-González
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Liver biochemical parameters were measured, hepatic fat was analyzed using the controlled attenuation parameter (CAP), while hepatic stiffness was evaluated in kilopascals (kPA) with the FibrosScan 530 Compact and Smart Exam software. Multiple analyses were performed to determine the relationship between acanthosis nigricans and MASLD.</p><p><strong>Results: </strong>We recruited 251 adult participants. The mean BMI was 29.9 ± 7.3 kg/m<sup>2</sup>, including 40.2% of participants with obesity and 63.7% with AN. Transient elastography evaluation resulted in 65.7% and 6% participants with hepatic steatosis (S3, 48.6%) and fibrosis, respectively. A non-adjusted (OR 2.63, 95% CI 1.57-4.52) and adjusted model (OR 1.97, 95% CI 0.95-4.12) were determined for AN as a risk factor for liver steatosis. Furthermore, the presence of AN in knuckles resulted in an association to predict liver steatosis (OR 2.09, 95% CI 1.01-4.35), while a multivariate analysis indicated that AN predicts a higher steatosis grade (S2 OR = 6.58, CI 95% 1.18-36.53; S3 OR = 2.36, CI 95% 1.04-5.3).</p><p><strong>Conclusions: </strong>Acanthosis nigricans demonstrated to predict a higher steatosis grade in adults with overweight and obesity. Our study supports the clinical applicability of AN as a screening tool for MASLD to identify high-risk subjects in resource-limited settings. Additional studies are needed to define alternative diagnostic tools for the early identification of metabolic risk factors in populations with specific clinical or demographic characteristics.</p>","PeriodicalId":44715,"journal":{"name":"Clinical Medicine Insights-Endocrinology and Diabetes","volume":"18 ","pages":"11795514251345047"},"PeriodicalIF":2.7000,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12166224/pdf/","citationCount":"0","resultStr":"{\"title\":\"Acanthosis Nigricans as a Clinical Risk Marker for Metabolic Dysfunction-Associated Steatotic Liver Disease.\",\"authors\":\"Adriana Sánchez-García, María Eugenia Penados-Ovalle, René Rodríguez-Gutiérrez, Fernando Díaz-González Colmeneros, José Gerardo González-González\",\"doi\":\"10.1177/11795514251345047\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Despite the association of insulin resistance (IR) in the pathophysiology of Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD), few studies have evaluated the utility of acanthosis nigricans (AN) as a clinical predictor for this condition. Thus, we aimed to determine the role of AN as a risk factor and clinical predictor of MASLD.</p><p><strong>Methods: </strong>This cross-sectional study conducted a comprehensive clinical history and physical examination. The presence of acanthosis nigricans was assessed in the neck, elbows, axillae, and knuckles. Liver biochemical parameters were measured, hepatic fat was analyzed using the controlled attenuation parameter (CAP), while hepatic stiffness was evaluated in kilopascals (kPA) with the FibrosScan 530 Compact and Smart Exam software. Multiple analyses were performed to determine the relationship between acanthosis nigricans and MASLD.</p><p><strong>Results: </strong>We recruited 251 adult participants. The mean BMI was 29.9 ± 7.3 kg/m<sup>2</sup>, including 40.2% of participants with obesity and 63.7% with AN. Transient elastography evaluation resulted in 65.7% and 6% participants with hepatic steatosis (S3, 48.6%) and fibrosis, respectively. A non-adjusted (OR 2.63, 95% CI 1.57-4.52) and adjusted model (OR 1.97, 95% CI 0.95-4.12) were determined for AN as a risk factor for liver steatosis. Furthermore, the presence of AN in knuckles resulted in an association to predict liver steatosis (OR 2.09, 95% CI 1.01-4.35), while a multivariate analysis indicated that AN predicts a higher steatosis grade (S2 OR = 6.58, CI 95% 1.18-36.53; S3 OR = 2.36, CI 95% 1.04-5.3).</p><p><strong>Conclusions: </strong>Acanthosis nigricans demonstrated to predict a higher steatosis grade in adults with overweight and obesity. Our study supports the clinical applicability of AN as a screening tool for MASLD to identify high-risk subjects in resource-limited settings. 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引用次数: 0
摘要
背景：尽管胰岛素抵抗（IR）与代谢功能障碍相关的脂肪变性肝病（MASLD）的病理生理有关，但很少有研究评估黑棘皮病（AN）作为该疾病的临床预测因子的效用。因此，我们的目的是确定AN作为MASLD的危险因素和临床预测因子的作用。方法：横断面研究对患者进行了全面的临床病史和体格检查。在颈部、肘部、腋窝和指关节评估黑棘皮病的存在。测量肝脏生化参数，使用控制衰减参数（CAP）分析肝脏脂肪，使用FibrosScan 530 Compact and Smart Exam软件以千帕斯卡（kPA）评估肝脏硬度。进行了多项分析以确定黑棘皮病与MASLD之间的关系。结果：我们招募了251名成人受试者。平均BMI为29.9±7.3 kg/m2，其中40.2%为肥胖，63.7%为AN。瞬时弹性成像评估分别导致65.7%和6%的参与者出现肝脂肪变性（S3, 48.6%）和纤维化。非校正模型（OR 2.63, 95% CI 1.57-4.52）和校正模型（OR 1.97, 95% CI 0.95-4.12）确定AN是肝脂肪变性的危险因素。此外，指关节中AN的存在导致预测肝脏脂肪变性的关联（OR 2.09, 95% CI 1.01-4.35），而多变量分析表明AN预测较高的脂肪变性等级(S2 OR = 6.58, CI 95% 1.18-36.53；S3 or = 2.36, ci 95% 1.04-5.3)。结论：黑棘皮病被证明可以预测超重和肥胖成人较高的脂肪变性程度。我们的研究支持AN作为在资源有限的环境中识别高风险受试者的MASLD筛查工具的临床适用性。需要进一步的研究来确定替代诊断工具，以便在具有特定临床或人口统计学特征的人群中早期识别代谢危险因素。
Acanthosis Nigricans as a Clinical Risk Marker for Metabolic Dysfunction-Associated Steatotic Liver Disease.
Background: Despite the association of insulin resistance (IR) in the pathophysiology of Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD), few studies have evaluated the utility of acanthosis nigricans (AN) as a clinical predictor for this condition. Thus, we aimed to determine the role of AN as a risk factor and clinical predictor of MASLD.
Methods: This cross-sectional study conducted a comprehensive clinical history and physical examination. The presence of acanthosis nigricans was assessed in the neck, elbows, axillae, and knuckles. Liver biochemical parameters were measured, hepatic fat was analyzed using the controlled attenuation parameter (CAP), while hepatic stiffness was evaluated in kilopascals (kPA) with the FibrosScan 530 Compact and Smart Exam software. Multiple analyses were performed to determine the relationship between acanthosis nigricans and MASLD.
Results: We recruited 251 adult participants. The mean BMI was 29.9 ± 7.3 kg/m2, including 40.2% of participants with obesity and 63.7% with AN. Transient elastography evaluation resulted in 65.7% and 6% participants with hepatic steatosis (S3, 48.6%) and fibrosis, respectively. A non-adjusted (OR 2.63, 95% CI 1.57-4.52) and adjusted model (OR 1.97, 95% CI 0.95-4.12) were determined for AN as a risk factor for liver steatosis. Furthermore, the presence of AN in knuckles resulted in an association to predict liver steatosis (OR 2.09, 95% CI 1.01-4.35), while a multivariate analysis indicated that AN predicts a higher steatosis grade (S2 OR = 6.58, CI 95% 1.18-36.53; S3 OR = 2.36, CI 95% 1.04-5.3).
Conclusions: Acanthosis nigricans demonstrated to predict a higher steatosis grade in adults with overweight and obesity. Our study supports the clinical applicability of AN as a screening tool for MASLD to identify high-risk subjects in resource-limited settings. Additional studies are needed to define alternative diagnostic tools for the early identification of metabolic risk factors in populations with specific clinical or demographic characteristics.
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