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

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dc.contributor.author Teelucksingh, Surujpal
dc.contributor.author Jaimungal, Sarada
dc.contributor.author Pinto Pereira, Lexley
dc.contributor.author Seemungal, Terence
dc.contributor.author Nayak, Shivananda
dc.date.accessioned 2012-06-07T11:14:34Z
dc.date.available 2012-06-07T11:14:34Z
dc.date.issued 2012-03-30
dc.identifier http://dx.doi.org/10.1186/1475-2840-11-31
dc.identifier.citation Cardiovascular Diabetology. 2012 Mar 30;11(1):31
dc.identifier.uri http://hdl.handle.net/2139/12898
dc.description.abstract Abstract Background The metabolic syndrome is associated with increased risk for both diabetes and coronary artery disease, which insulin resistance alone does not satisfactorily explain. We propose an additional and complementary underlying mechanism of glucocorticoid resistance. Results 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). Findings 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. Conclusion 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.
dc.title 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
dc.type Journal Article
dc.date.updated 2012-06-07T11:14:35Z
dc.description.version Peer Reviewed
dc.language.rfc3066 en
dc.rights.holder Surujpal Teelucksingh et al.; licensee BioMed Central Ltd.


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