Endocrine Abstracts

JOINT2874

Background: Acanthosis nigricans (AN) is a common skin manifestation associated with insulin resistance in overweight and obese individuals. Although previous studies have suggested a relationship between insulin resistance and AN development, the association between different surrogate insulin resistance indices and AN remains unclear. This study aimed to investigate the differential associations of three commonly used insulin resistance indices (HOMA-IR, TYG-BMI, and METS-IR) with AN occurrence in overweight and obese individuals.

Methods: This cross-sectional study included 1, 077 patients (age ≥ 18 years, BMI ≥24 kg/m²) from the Department of Endocrinology, Shanghai Tenth People’s Hospital, between May 2010 and October 2021. Participants were stratified into two groups: AN (n = 446) and non-AN (n = 631). Insulin resistance indices were calculated and associations with AN were assessed using multivariate logistic regression, adjusting for potential confounders, including sex, age, waist circumference, family history of obesity, blood pressure, hormonal levels, liver enzymes, and uric acid. Predictive performance was assessed using receiver operating characteristic (ROC) curves.

Results: Patients with AN exhibited significantly higher insulin resistance indices compared to those without AN (HOMA-IR: 7. 11 ± 3. 37 vs. 5. 37 ± 3. 09; TYG-BMI: 319. 54 ± 43. 13 vs. 293. 85 ± 49. 00; METS-IR: 57. 74 ± 9. 20 vs. 52. 19 ± 9. 33, P < 0. 05). Multivariable-adjusted models demonstrated significant positive associations between each index and AN occurrence, with an adjusted odds ratio (OR) of 1. 10 (95% CI: 1. 02 - 1. 18) for HOMA-IR, 1. 13 (95% CI: 1. 04 - 1. 21) for TYG-BMI/10 and 2. 09 (95% CI: 1. 44 - 3. 04) for METS-IR. Quartile analysis demonstrated a striking dose-response relationship, showing a progressive increase in the risk of AN across insulin resistance index quartiles, with METS-IR showing the most pronounced association (Q4 vs. Q1: Or = 5. 19, 95% CI: [2. 18 - 12. 36], P for trend < 0. 001). ROC analysis confirmed the superior predictive performance of METS-IR (AUC = 0. 670) compared with HOMA-IR and TYG-BMI.

Conclusion: Although HOMA-IR and TYG-BMI were significantly associated with AN occurrence, METS-IR demonstrated the strongest predictive ability for AN risk in overweight and obese individuals.