Presence of Cutaneous Signs of Insulin Resistance with Central Obesity (CO-CSIR) in Asian Indians is a sensitive physical sign of Metabolic Syndrome (MetS)

Abstract Aim and objectives: To investigate cutaneous sign of insulin resistance, acanthosis nigricans (AN) and acrochordon (AC) in individual of central obesity (CO-CSIR) as a physical sign for prediction of metabolic syndrome (MetS) and the underlying adipose tissue pathology and the consequent pathophysiological trait in Asian Indians. Methods: Design: Single center cross sectional study. Study subjects: 371 (aged 51.7±12.4; M: F ratio 210:161). Following parameters were investigated: Physical signs: cutaneous signs of insulin resistance, BMI, WC, HC, WHR, blood pressure. Biochemical parameters: FBG, lipid profile, HbA1c, HOMA-β. HOMA-IR. Radiological parameters: Abdominal visceral, subcutaneous and ectopic liver fat by MRI. Molecular Parameters: Genome wide transcription profile of adipose tissue biopsies in 85 individuals undergoing surgery for other indications. Results: AN, AC and both were present respectively 50(13.3%), 27(7.2%) and 75(20.2%) individuals and they absent 216 individuals. Presence of AN and AC were associated with significantly higher BMI (6.4 X10⁻⁵), W:H ratio (0.04), WC (9.5 X 10⁻⁷), HOMA-IR (0.0002), glucose (1.11 x 10⁻¹⁰) and prevalence of T2D (100%) and MetS (83%). AC as compared to AN was associated with more ectopic fat and higher IR.CO-CSIR was found to be the best physical sign of MetS (94.8% sensitivity,57.5 % specificity, 86.4 precision with 95.1F1 score). MetS negative CO-CSIR individuals show high IR, ectopic fat deposition, hyperglycemia and prevalence of T2D. Conclusion: CO-CSIR a promising physical sign of MetS and the underlying adipose tissue driven dysmetabolism in Asian Indians.