Acanthosis nigricans in adolescents with polycystic ovary syndrome

Background: In this study we compared the clinical and biochemical variables of adolescent females with PCOS (polycystic ovarian syndrome) and its association with or without acanthosis nigricans (AN).Methods: Adolescent girls (14-19 years) with oligomenorrhoea and hyperandrogenism were studied. Clinical parameters like blood pressure (BP), body mass index (BMI), abdominal circumference (AC), presence or absence of acne and AN and hirsutism score were noted. Biochemical tests included serum total testosterone (TT), sex hormone binding globulin (SHBG) levels and free androgen index (FAI). Postprandial plasma insulin (PPI) and glucose (PPG) levels were measured to assess insulin resistance and glucose tolerance respectively.Results: Significant differences were observed in BMI, AC, DBP, TT and FAI between the two groups. The difference in the prevalence rate of abnormal glucose tolerance and insulin resistance between the two groups was insignificant. Logistic regression modelling with AN as the response variable of interest and BMI, AC, SBP, DBP, testosterone level, PP insulin and PPG levels as its predictors yields BMI, testosterone, PP sugar, PPI, SHBG as main determinants. The model signifies positive impacts of BMI and testosterone level, while negative influence of PP sugar, PPI level and SHBG levels on AN. This analysis was an evidence for a strong relation between BMI and AN.Conclusions: AN in adolescent girl with PCOS is another clinical marker of obesity but not an indicator of underlying insulin resistance or glucose intolerance. Further studies are needed to detect how many of them ultimately develop insulin resistance or diabetes in future.