Association between acanthosis nigricans and overweight with hypertension in children and adolescents from low-income families

Victorino, Camila Augusta; Faria, João Carlos Pina; Sawamura, Luciana Satiko; Souza, Fabíola Isabel Suano de; Sarni, Roseli Oselka Saccardo

doi:10.1590/1806-9282.20220852

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Revista da Associação Médica Brasileira

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Original Article • Rev. Assoc. Med. Bras. 68 (12) • 2022 • https://doi.org/10.1590/1806-9282.20220852 copy

Association between acanthosis nigricans and overweight with hypertension in children and adolescents from low-income families

Authorship SCIMAGO INSTITUTIONS RANKINGS

SUMMARY

OBJECTIVE:

This study aimed to describe the prevalence of acanthosis nigricans and high blood pressure in children and adolescents from low-income families, and to verify the association of elevated blood pressure with nutritional status and the presence of acanthosis nigricans.

METHODS:

This is a cross-sectional and controlled study with 232 children and adolescents from an institution for low-income families. Pubertal stage, body mass index Z-score, waist-to-height circumference ratio (increased waist-to-height circumference ratio >0.5), the presence of acanthosis nigricans, and blood pressure were assessed.

RESULTS:

The prevalence of excess weight and the change in waist-to-height circumference ratio was 37.9%. Acanthosis nigricans and increased blood pressure occurred in 20.3 and 34.8%, respectively. The prevalence of acanthosis nigricans and hypertension was higher in individuals with excess weight (p<0.001; p<0.001) and with an increased waist-to-height circumference ratio (p=0.009; p<0.001). Logistic regression showed a significant and independent association of body mass index Z-score (OR 2.35; 95%CI 1.52–3.65; p<0.001) and the presence of acanthosis nigricans (OR 2.43; 95%CI 1.12–5.23; p=0.023) with elevated blood pressure.

CONCLUSION:

Acanthosis nigricans and elevated blood pressure occurred in one-fifth and one-third of the individuals in an institution for children from low-income families. Overweight and the presence of acanthosis nigricans increased the risk of high blood pressure more than twofold.

Keywords
Acanthosis nigricans; Arterial pressure; Pediatric obesity; Cardiometabolic risk factors

		n	%
Sex	Male	124	53.5
Sex	Female	108	46.5
Age	<10 years	151	65.1
Age	≥10 years	81	34.9
Puberty	Prepubescent	164	70.7
Puberty	Pubescent	68	29.3
zBMI	Normal weight	144	62.1
	Overweight	49	21.1
	Obesity	28	12.1
	Severe obesity	11	4.7
WHtR	<0.5	144	62.1
WHtR	≥0.5	88	37.9
Acanthosis nigricans	Absent	185	79.7
Acanthosis nigricans	Present	47	20.3
Blood pressure	Normal	151	65.1
	Elevated	37	15.9
	Hypertension stage 1	37	15.9
	Hypertension stage 2	7	3

		Absent AN (n=185)	Present AN (n=47)	p-value	Normal BP (n=151)	Elevated BP (n=81)	p-value
Sex	Male	101	23	0.595	79	45	0.738
Sex	Female	84	24	0.595	72	36	0.738
Age	<10 years	118	33	0.512	103	48	0.222
Age	≥10 years	67	14	0.512	48	33	0.222
Puberty	Prepubescent	131	33	1	110	54	0.403
Puberty	Pubescent	54	14	1	41	27	0.403
zBMI	Normal weight	131	13	<0.001*	116	28	<0.001*
zBMI	Overweight	54	34	<0.001*	35	53	<0.001*
WHtR	<0.5	123	21	0.009*	107	37	<0.001*
WHtR	≥0.5	62	26	0.009*	44	44	<0.001*
AN	Absent				134	51	<0.001*
AN	Present				17	30	<0.001*

	OR	95%CI		p-value
zBMI	2.35	1.52	3.65	<0.001*
WHtR	1.23	0.60	2.49	0.567
Presence of AN	2.43	1.12	5.23	0.023*

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[1] *Corresponding author: jocapf79@gmail.com