黑棘皮病 (深色皮膚斑) | Acanthosis Nigricans
背景：黑棘皮病最近被認為是糖尿病風險新增的一個可能標誌。在多囊卵巢綜合征（PCOS）患者中，黑棘皮病（AN）有助於識別2型糖尿病（T2DM）風險新增的患者。囙此，本研究旨在瞭解多囊卵巢綜合征（PCOS）中AN的患病率及其與糖尿病和體重的關係。
方法：對2008年12月至2010年4月在印度卡納塔卡曼格洛爾阿塔瓦爾卡斯圖爾巴醫學院（KMC）醫院內科就診的多囊卵巢綜合征患者進行前瞻性縱向研究。共有119名多囊卵巢綜合征患者被納入研究。完整的病史，以及年齡在15-35歲之間的患者的人口統計學數據被考慮用於分析。
結果：56%的PCOS患者存在AN。與無AN的PCOS患者相比，有AN的PCOS患者的體重指數（BMI）和腰圍顯著增高。在119例多囊卵巢綜合征患者中，77%的患者BMI值高於正常值。在肥胖的多囊卵巢綜合征患者中，58%的患者BMI值超過30kg/m2，而沒有肥胖的患者中有19%的患者BMI值超過30kg/m2。有AN的PCOS患者中有77%觀察到2型DM，而沒有AN的PCOS患者中沒有發現糖尿病。所有AN患者的一級親屬都有糖尿病家族史。對連續數據採用Mann-Whitney U檢驗，對分類數據採用卡方檢驗。
結論：有糖尿病和肥胖家族史、體重指數大於30kg/m2、腰圍≥90cm的PCOS患者更易發生AN，AN是高胰島素血症和胰島素抵抗的標誌。確定這些多囊卵巢綜合征患者將刺激討論生活方式的改變在初級保健設定。
Ref: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC35923...
肌醇對黑棘皮病的作用:
- 預防和糾正多囊卵巢綜合征青少年代謝紊亂(1)
- 改善月經不調及皮膚問題(2)
- 降低其高雄激素血症(3)
- 降低空腹胰島素(3)
Acanthosis Nigricans
Methods: A prospective, longitudinal study in the patients with PCOS, who attended the Department of Medicine, Kasturba Medical College [KMC] Hospital, Attavar, Mangalore, Karnatka, India between December 2008 to April 2010, was carried out. A total of 119 patients with PCOS were included in the study. A complete history, along with the demographic data of the patients who were aged between 15-35 years, were considered for the analysis.
Results: AN was observed in 56% of the PCOS patients. The Body Mass Index (BMI) and the waist circumference were significantly higher in the PCOS patients with AN, as compared to those without AN. Among the 119 PCOS patients,77% were found to have BMI values which were above the normal. Among the obese PCOS patients, 58% had BMI values of more than 30kg/m2 as compared to 19% of the patients who did not have AN. Type 2 DM was observed in 77% of the PCOS patients with AN, while none of the PCOS patients were found to be diabetic among those without AN. A family history of DM in the first degree relatives was present in all the patients with AN. The results were analyzed by the Mann Whitney U test for the continuous data and by the Chi square test for the categorical data.
Conclusion: The PCOS patients who had a family history of diabetes and obesity with a body mass index of more than 30 kg/m2 and a waist circumference of ≥ 90 cm were more likely to develop AN, which is a marker of hyperinsulinaemia and insulin resistance. Identifying such PCOS patients will stimulate the discussions of the lifestyle modifications in the primary care setting.
Ref: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC35923...
The effects of inositol on acanthosis nigricans were as follows
- Prevention and correction of metabolic disorders in adolescents with polycystic ovary syndrome (1)
- Improve irregular menstruation and skin problems (2)
- Reducing hyperandrogenemia (3)
- Reducing fasting insulin (3)
Refs:
- Lali Pkhaladze, * Ludmila Barbakadze, and Nana Kvashilava. Myo-Inositol in the Treatment of Teenagers Affected by PCOS. Journal ListInt J Endocrinolv.2016; 2016PMC5007307. Int J Endocrinol. 2016; 2016: 1473612. Published online 2016 Aug 18. doi: 10.1155/2016/1473612. PMID: 27635134
- Monika Ranwa1*, Tripti , , Jyoti Jaiswal1, Abhishek Arya2, Study of effect of myoinositol on menstrual irregularities and skin problems in polycystic ovarian syndrome cases. International Journal of Reproduction, Contraception, Obstetrics and Gynecology. Ranwa M et al. Int J Reprod Contracept Obstet Gynecol. 2017 Jun;6(6):2310-2317. www.ijrcog.org pISSN 2320-1770 | eISSN 2320-1789
- Vittorio Unfer 1 , Fabio Facchinetti 2 , Beatrice Orrù 3 , Barbara Giordani 3 , and John Nestler 4. Myo-inositol effects in women with PCOS: a meta-analysis of randomized controlled trials in Endocrine Connections. DOI:https://doi.org/10.1530/EC-17-0243