%0 Journal Article
%T Does insulin resistance co-exist with glucocorticoid resistance in the metabolic syndrome? Studies comparing skin sensitivity to glucocorticoids in individuals with and without acanthosis nigricans
%A Surujpal Teelucksingh
%A Sarada Jaimungal
%A Lexley Pinto Pereira
%A Terence Seemungal
%A Shivananda Nayak
%J Cardiovascular Diabetology
%D 2012
%I BioMed Central
%R 10.1186/1475-2840-11-31
%X Using acanthosis nigricans (AN) and skin vasoconstrictor (SVC) response to topically applied beclomethasone dipropionate as markers of insulin and glucocorticoid resistance, respectively, we compared anthropometric, biochemical, pro-inflammatory markers and the SVC response in subjects with AN in two studies: STUDY 1 was used to compare subjects with AN (Grade 4, n = 32), with those without AN (n = 68) while STUDY 2 compared these responses among a cross-section of diabetic patients (n = 109) with varying grades of AN (grade 0, n = 30; grade 1, n = 24; grade 2, n = 18; grade 3, n = 25; grade 4, n = 12).In both studies there was an inverse relationship between AN Grade 4 and the SVC response, (P < 0.001). In STUDY 1, AN Grade 4 was associated with age, waist circumference, BMI, fasting blood glucose, plasma lipids and hs-CRP (P < 0.05). SVC was an independent predictor of CRP and those with combined AN and a negative SVC response, CRP levels were highest. In Study 2 when the SVC response in subjects with type 2 diabetes mellitus with varying degrees of AN was studied, it showed that for any degree of AN, the SVC response is more likely to be negative and was independent of gender and ethnicity.An absent SVC response represents a new biomarker for the metabolic syndrome and the exaggerated inflammatory response, which characterizes the metabolic syndrome, may be an outcome of deficient glucocorticoid action in vascular tissue.Cardiovascular disease, the leading cause of death in developed countries for many decades, is gaining fresh momentum from the pandemic of obesity which is an emergent major public health problem in developing countries globally [1]. The long recognized association between cardiovascular disease and obesity [2] became clearer in 1988 when Reaven [3] consolidated the concept proposing that insulin resistance with compensatory hyperinsulinemia was a fundamental pathogenetic mechanism. Type 2 diabetes mellitus (T2DM), hypertension, dyslipidemia and
%K Insulin resistance
%K Glucocorticoid resistance
%K Acanthosis nigricans
%K Skin vasoconstrictor test
%U http://www.cardiab.com/content/11/1/31