Acantose nigricante nos pacientes obesos : estudo metabolico e histopatologico

AUTOR(ES)
DATA DE PUBLICAÇÃO

1998

RESUMO

Benign Acanthosis Nigricans (AN) is associated to many endocrinopathies and metabolic disturbs, specially insulin resistance. The dermatosis is more ftequently found in obese patients, and obesity is a condition of insulin resistance. Some papers have shown allociatiôn ôf inlulin reli tanoê e:rtd preliênoe of muoopolyaacoharidês in detmiíl on histological slides of AN. This study was performed to. evaluate the insulin response to the oral test of glucose tolerance in obese patientes with AN comparing with control groups, and to correlate it with histopathological and histochemical findings. For this purpose, 33 patientes were studied in 3 groups: 14 obese with AN (Group 1),9 normal obese (Group 2) and 10 nomallean (qt"oup 3). For histological analyzes, 13 patients were studied in group I, 8 patients in group 2 and 9 patients in group 3. Insulin levels at O , 120 , insulin area, insulinogen index (at O , 120 and area) were evaluated. Skin biopsies were performed by the colloidal iron method to evaluate mucopolysaccharide presence in skin lesions of AN and incontrol. groups, in the same anatomic site. There was statistically difference on insulin of 2 hours after glucose overload between groups 1 and 2 (p<0,05), and the insulinogen index of 2 hours after glucose overload were near the significance limit (p<0,053). When the 3 groups were analysed together, there was positive linearcorrelation between insulin levels (at 120 , insulinogen index at 120 , insulin area and insulinogen index of area) and epitheliuÍn and homy layer thickness (p<0,05), and between papilla measurement and area insulinogen index. There wasn t difference at colloidal iron staining in AN slides, comparing with control groups. Obese patients without AN shows higher instllin area, comparing with lean patients without AN (p<0,05) in spite of close epithelium and papilla measurements, wich is suggestive that only high insulin levels does not justify the dermatologic lesion. In conclusion, obese patients with AN shows more insulin resistance than obese patients without AN, insulin resistance is not associated to more amount of mucopolysaccharides in dermis and insulin levels are correlated to . epithelium and homy layer thickness. In counterpart, on1y lúgh insulin levels does not justify the dermatologic lesion. Mucopolysaccharides in dermal papilla ofaxilar region is a normal finding. Tlús work suggests insulin influence on epithelial growth. Keywords: Acanthosis Nigricans, Mucopolysaccharides, Insulin Resistance, Obesity, Colloidal Iron

ASSUNTO(S)

fibroblasto diabetes insulina - receptores

ACESSO AO ARTIGO

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