Prevalence of obesity, acanthosis nigricans and hyperinsulinemia in an adolescent clinic.

A descriptive chart analyses was conducted of 100 consecutive patients at an adolescent medicine clinic at West Virginia University School of Medicine between April and May 2002 to determine the prevalence of overweight and obesity, acanthosis nigricans and hyperinsulinemia. Height, weight, body mass index (BMI), blood pressure, and screening for acanthosis nigricans (AN) were recorded. For patients with AN, fasting lipid, glucose, and insulin levels were also recorded. A total of 37% (37/100) of adolescents were found to be significantly overweight or obese, with BMIs greater than the 85th percentile for gender and age, 28% (28/100) had a BMI greater than the 95th percentile for gender and age, and 17% (17/100) were observed to have AN. In this cohort, 94% (16/17) had a BMI greater than the 95th percentile. Patients with AN were found to have higher mean BMI (39.7 vs. 29.7), systolic (132 vs. 122), and diastolic (73 vs. 65) blood pressures that the patients who were obese and did not have AN. In addition, 16 of the 17 adolescents with AN were found to have elevated fasting insulin levels (mean 33.6). A fasting insulin level was not obtained on a 12-year-old girl with AN already receiving treatment with rosiglitazone (Avandia) for type 2 diabetes mellitus. The prevalence of overweight and obesity in patients at the adolescent clinic is over twice the national average. The prevalence of acanthosis nigricans in this mostly non-minority population is over three times the highest previously reported rate for Caucasians.