비만한 한국 소아청소년에서 흑색가시세포증 정도에 따른 인슐린 저항성과 비만 정도 = Insulin Resistance and Obesity according to Degree of Acanthosis Nigricans in Obese Korean Children and Adolescents

다국어 초록 (Multilingual Abstract)

Background: Recent studies suggest that acanthosis nigricans (AN) is associated with insulin resistance in obese children. However, very few studieshave assessed insulin resistance and obesity according to the degree of AN. Therefore, this study aimed to investigate the correlation between thedegree of obesity and insulin resistance according to the severity of AN.
Methods: A total of 141 participants (83 boys and 58 girls) aged 6−17 years were recruited for the Intervention for Childhood and Adolescents obesityvia Activity and Nutrition study between 2016 and 2017. The participants were categorized into four groups according to the severity of AN: grade 0(n=69), grade 1 (n=19), grade 2–3 (n=35), and grade 4 (n=18). All participants underwent physical examination and blood tests. We compared themean homeostatic model assessment (HOMA-IR) and body mass index Z score (BMI Z-score) in each group using ANCOVA and linear regressionmodel.
Results: The HOMA-IR, which represents insulin resistance, increased with increasing AN severity (grade 0 group: 3.25±0.070; grade 1 group:3.97±0.103; grade 2–3 group: 4.76±0.079; AN grade 4: 6.40±0.107; P for trend<0.001). Similarly, the BMI Z-score, which represents the degree ofobesity, increased with increasing AN severity (grade 0 group: 2.29±0.052; grade 1 group: 2.42±0.080; grade 2–3 group: 2.44±0.062, grade 4:2.67±0.089; P for trend<0.001).
Conclusion: Insulin resistance and the degree of obesity increase with the severity of AN in Korean obese children.

국문 초록 (Abstract)

연구배경: 비만한 소아에서 흑색가시세포증과 인슐린 저항성의 연관성은 많이 보고되었으나 흑색가시세포증의 정도에 따른 인슐린저항성 및 비만정도에 대한 연구는 많지 않으며, 국내 연구자료는부족한 실정이다. 이에 본 연구에서는 국내의 비만한 소아에서 흑색가시세포증 정도에 따른 비만정도와 인슐린 저항성 정도의 상관관계를 살펴보고자 하였다.
방법: 본 연구는 소아청소년 고도비만 중재 프로그램(ICAANproject)에 참여한 6–17세 소아 청소년 141명(남아 83명, 여아 58명)을분석 하였으며, 모든 대상자의 신체계측과 공복 인슐린을 포함한 혈액검사를 시행하였다. 흑색가시세포증의 중증도에 따라 4개의 군으로 나누어 중증도와 HOMA-IR과 BMI Z-score의 선형관계 여부를확인하였다.
결과: 흑색가시세포증의 중증도에 따라 4개의 군으로 나누고 성별,나이를 보정하여 비교한 결과 HOMA-IR의 평균값(AN grade 0 group:3.25±0.070, AN grade 1 group: 3.97±0.103, AN grade 2–3 group: 4.76±0.079, AN grade 4: 6.40±0.107, P for trend<0.001)과 BMI Z-score의평균값(AN grade 0 group: 2.29±0.052, AN grade 1 group: 2.42±0.080,AN grade 2–3 group: 2.44±0.062, AN grade 4: 2.67±0.089, P for trend<0.001)에서 각 군 평균값의 유의미한 양의 상관관계를 확인하였다.
결론: 우리나라의 비만한 소아 및 청소년들에서 흑색가시세포증은제 2형 당뇨병의 발생 위험군을 조기에 찾아내는 유용한 지표로써사용될 수 있을 것으로 생각되며, 추후 흑색가시세포증의 중증도평가를 위한 객관적 지표 개발뿐만 아니라 인슐린 저항성의 변화에따른 흑색가시세포증의 중증도 변화에 대한 추가 연구가 필요할 것으로 보인다.

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