OBJECTIVE: To compare the clinical and biochemical parameters of Indian adolescent girls with PCOS with and without acanthosis nigricans (AN).  

Materials and Methods: Total 59 adolescent girls (14-19 years) with PCOS (Rotterdam 2003 criteria) were selected for study after considering inclusion and exclsion criteria. Clinical parameters studied are body mass index (BMI), abdominal circumference (AC), west hip ratio (WHR), blood pressure (BP), hirsutism (modified Ferriman- Galway score; mFG≥6), presence of acne and AN. Transabdominal ultrasonography done to record PCO. Biochemical tests included-Serum total testosterone (TT) level, sex hormone binding globulin (SHBG), post prandial pasma insulin (PPI) and post prandial plasma glucose (PPG) (2 hours after 75gm glucose intake). PP insulin (≥150 mcu / ml) and PP glucose ≥ 140 mg / dl were considered as indicatives of insulin resistance (IR) and glucose intolerance respectively. The subjects were divided into two groups based on the presence or absence of AN. Group A Without AN - 19 cases; Group B With AN - 40 cases.

RESULTS: Significant differences between the two groups were noted in BMI (p=0.0001), AC (p=0.0001), WHR (0.0001), SBP (p=0.03), DBP (p= 0.01), TT (p= 0.002), but no significant difference in the prevalence rates of abnormal glucose tolerance PPG (p=0.92) and IR (p=0.09). Logistic regression modeling with AN (response variable of interest) and BMI, AC, WHR, SBP, DBP, testosterone level, PP insulin and PP glucose levels (as predictors) yields BMI, testosterone, SHBG, PP sugar, PP insulin, as the statistically main determinants. The model signifies positive impacts of BMI, testosterone level, and negative influence of PP sugar, PP insulin level with AN. The overall model is statistically significant with a p value of < 0.000 and is also indicative of a strong relation between BMI and AN.

Conclusion: Presence of AN in adolescent girls with PCOS is a clinical marker of obesity and is not just an indicator of underlying IR or glucose intolerance. Follow up studies will detect how many of them ultimately develop IR or diabetes in future.

Key words: Acanthosis nigricans, Polycystic ovary syndrome, Adolescent girls.

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