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Objective: To evaluate the effect of laparoscopic sleeve gastrectomy (LSG) on the psychological and quality of life of young obese patients with acanthosis nigricans (AN) and explore the mechanism. Methods: Clinical data of 52 young AN patients who underwent LSG surgery at Shanghai Tenth People's Hospital from January 2020 to December 2022 were retrospectively collected, and 50 healthy individuals were selected as the control group (CON). The Beck self-rating depression scale ⁃Ⅱ was used to evaluate the psychological status, and the Chinese version of SF-36 was used to evaluate the quality of life of the subjects. The anthropometries parameters, glucose metabolic indicators, lipid metabolism indicators, and C-reactive protein (CRP) levels of AN patients were evaluated and calculated before and 12 months after surgery, and compared before and after surgery. Correlation analysis was performed between depression and related metabolic indicators. Results: The scores of each dimension of quality of life assessment in the AN group before surgery were significantly lower than those in the CON group (P < 0.05), and the incidence of depression (63.5%) was significantly higher than that in the CON group (P < 0.001), with a significantly higher severity of depression than the CON group (P < 0.001). The levels of fasting insulin, insulin resistance, blood lipids and CRP of the AN group before surgery were significantly higher than those of the CON group (P < 0.05). Twelve months after surgery, as the weight of AN patients decreased, blood lipids and CRP levels significantly decreased, and their hyperinsulinemia and insulin resistance significantly improved. Meanwhile, the mental health score in the SF-36 scale of AN patients significantly increased, and the depression score and severity also significantly improved. Depression scores in patients were positively correlated with body mass index, insulin resistance, and CRP. Conclusion: Depression in AN patients is closely related to increased insulin resistance and inflammatory factors. LSG effectively improves depression and quality of life in AN patients by reducing weight, improving insulin resistance, and inflammation. [ABSTRACT FROM AUTHOR]

Objective: To explore the genotype and clinical phenotype of congenital generalized lipodystrophy type 1(CGL1), and to improve awareness of the disease. Methods: A patient with severe acanthosis nigricans was diagnosed as having CGL1, and the clinical information and results of laboratory and gene tests were analyzed. Five Chinese cases with CGL1 in the database were literaturally reviewed. Results: The patient was a girl(10 years and 11 months), who had significantly acanthosis nigricans and body subcutaneous fat loss. The examination of the girl showed hyperinsulinemia, impaired glucose tolerance, advanced bone age, low adiponectin and polycystic ovary. The compound heterozygous mutations were identified, which was c.646A>T:p.K216*(PVS1_Strong+ PM2+PM3 ( inherited from her father) and c.406G>A:p.G136R(PM3_Strong+PM1+PM2+PP3 (inherited from her mother) in AGPAT2 gene. The mutation of two gene loci could be pathogenic, which had not been reported in CNKI database. All 5 Chinese cases in CNKI database were reported before (including 2 males and 3 females, and age was between 66 days and 26 years old) showed the absence of adipose tissue, in which two patients presented severe acanthosis nigricans. Conclusions: The CGL1 is rare in Chinese population, and it should be considered as the patients present the acanthosis nigricans and absence of adipose tissue, and its diagnosis depends gene detection.

Objective: To study the relationship between serum uric acid (UA), cystatin C (CysC), galectin 3 (Gal-3), serine protease inhibitor B1 (Serpin B1) and blood glucose and carotid atherosclerosis (CAS) in patients with type 2 diabetes mellitus (T2DM). Methods: 110 patients with T2DM who were treated in the Department of Endocrinology of Qingdao Hospital of Traditional Chinese Medicine from April 2020 to April 2022 selected, and they were divided into 36 cases in CAS group and 74 cases in non CAS group according to the presence or absence of CAS. The levels of serum UA, CysC, Gal-3 and Serpin B1 were detected and compared between the two groups. Pearson/Spearman correlation coefficient was used to analyze the correlation between the levels of serum UA, CysC, Gal3, Serpin B1 and blood glucose indexes in patients with T2DM. The basic data of patients were collected, and the influencing factors of CAS in patients with T2DM were analyzed by multivariate Logistic regression. The levels of serum UA, CysC, Gal-3 and Serpin B1 in CAS group were significantly higher than those in non CAS group (P<0.05). The average age of CAS group was higher than that of non CAS group, and the proportion of patients with smoking history, fasting blood glucose, glycosylated hemoglobin (HbA1c), insulin resistance index (HOMA-IR) and low density lipoprotein cholesterol (LDL-C) were higher than those in non CAS group (P<0.05). Correlation analysis showed that the levels of serum UA, CysC, Gal-3 and Serpin B1 in patients with T2DM were positively correlated with HbA1c and HOMA-IR (P<0.05). Multivariate Logistic regression analysis showed that older age, higher levels of HbA1c, HOMA-IR, serum UA, CysC, Gal3 and Serpin B1 were the risk factors of CAS in patients with T2DM (P<0.05). Elevated levels of serum UA, CysC, Gal3 and Serpin B1 are closely associated with blood glucose level of patients with T2DM, and it is also the influencing factor of CAS in patients with T2DM. [ABSTRACT FROM AUTHOR]

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To investigate the relationship between serum vitamin D, ferritin, and sICAM-1 levels in obese patients, who has polycystic ovary syndrome and insulin resistance, glucose and lipid metabolism indexes sex. From August 2018 to November 2021, 65 PCOS patients diagnosed and treated in the department of gynecology in our hospital were selected as the research objects, and they were divided into polycystic ovary syndrome obesity group (n=30, body mass index 28 kg/m² ) and multiple Cystic ovarian syndrome non-obese group (n=35, body mass index <28 kg/m ² ). Detect and calculate the two groups of vitamin D, ferritin, sICAM-1, insulin resistance, glucose and lipid metabolism indicators and conduct correlation analysis. There were no difference in serum T4, TSH and PRL between the two groups (P>0.05). The serum luteinizing hormone in the obese group The levels of LH, FSH and T were higher than those in the non-obese group (P<0.05). The levels of serum ferritin and sICAM-1 in the obese group were higher than those in the non-obese group, and the serum vitamin D levels were lower than those in the non-obese group ( P<0.05). Insulin resistance index (HOMA-IR), insulin level (FINS), TG, TC and LDL-C in obese group were higher than those in non-obese group, while high density lipoprotein cholesterol (HDL-C) was lower than those in non-obese group (P<0.05). In obese patients with polycystic ovary syndrome, Pearson analysis showed that serum vitamin D, ferritin, sicAM-1 were correlated with insulin resistance and glucolipid metabolism (P<0.05). The polycystic ovary syndrome obese patients and non-obese patients Serum vitamin D, ferritin, sICAM-1, insulin resistance, glucose and lipid metabolism index levels are different, and serum vitamin D, ferritin, sICAM-1 levels are correlated with insulin resistance and glucose and lipid metabolism indexes. [ABSTRACT FROM AUTHOR]

Hyperandrogenism-insulin resistance-acanthosis nigricans (HAIR-AN) syndrome is a special and rare subtype of polycystic ovarian syndrome. It can lead to hyperandrogenism (HA), insulin resistance (IR), and acanthosis nigricans (AN) accompanied by acne, hirutism, irregular menstruation, and other androgen excess symptoms. A case of pediatric HAIR-AN syndrome with severe AN was admitted to the Department of Endocrinology, China-Japan Friendship Hospital. The patient's clinical manifestations, laboratory data, imaging features, and gene sequencing were analyzed, and the patient was diagnosed with pediatric HAIR-AN syndrome. Obesity, IR, hyperglycemia, menstrual disorder, and AN were significantly improved after treating with metformin and liraglutide. HAIR-AN syndrome occurs in various forms. When the patient appears unexplained acanthosis nigricans and menstrual disorders, the disease should be considered possible. Early diagnosis and symptomatic supportive treatment can improve the quality of life.

Objective: To investigate the correlation of the total testosterone (TT) level with insulin secretion and resistance in patients with acanthosis nigricans (AN) and non-acanthosis nigricans (NAN)., Methods: This study was conducted in a total of 639 overweight patients (body mass index ≥24 kg/m 2 ), including 137 female AN patients, 277 female NAN patients, 129 male AN patients, and 146 male NAN patients. Each group was further divided into 4 subgroups according to the quartile of TT level for comparison of insulin secretion and insulin resistance parameters., Results: Both female and male patients with AN showed obvious hyperinsulinemia with increased area under the curve for insulin (AUC-INS) ( P < 0.05), increased homeostatic model assessment of insulin resistance (HOMA-IR) index ( P < 0.05) and decreased whole-body insulin sensitivity index (WBISI) ( P < 0.01) as compared with those in NAN groups, but these parameters did not show significant variations with the change of TT levels. In female patients with NAN, insulin secretion level increased progressively as the TT level increased; the AUC-INS increased ( P < 0.01) and WBISI decreased significantly ( P < 0.05) when the TT levels increased to Q4. In male patients with NAN, insulin secretion level increased progressively as the TT levels decreased, and the AUC-INS increased ( P < 0.05) and the WBISI decreased significantly ( P < 0.05) when the TT levels decreased to Q1., Conclusions: The TT level has a significant effect on insulin resistance and insulin secretion, but its effect varies between genders and is more significant in NAN patients than in AN patients.

Objective: To explore the serum levels of leptin, adiponectin and sex hormone and their relationship in benign acanthosis nigricans of males., Methods: A total of 15 males patients with benign acanthosis nigricans were recruited from January 2010 to December 2013. The serum concentrations of leptin, adiponectin and sex hormone were measured with radioimmunoassay and enzyme-linked immunoabsorbant assay (ELISA) respectively., Results: As compared with normal control, the values of body mass, body mass index and %Fat were much higher in benign acanthosis nigricans of males ((88 ± 6) vs (62 ± 5) kg, (31.7 ± 2.1) vs (22.2 ± 2.7) kg/m(2), 33.3% ± 2.6% vs 29.0% ± 5.8%, all P < 0.05) , leptin was much higher ((8.0 ± 1.1) vs (4.5 ± 1.5) µg/L, P < 0.01) , adiponectin was much lower ((27.7 ± 4.8) vs (38.6 ± 5.8) µg/L, P < 0.01) , estradiol and testosterone were much higher ((112 ± 28) vs (38 ± 7) pmol/L, (7.3 ± 1.9) vs (3.9 ± 2.0) nmol/L, both P < 0.01), luteinizing hormone was much lower ((128 ± 11) vs (155 ± 24) U/L, P < 0.01) . And prolactin and follicle stimulating hormone were not significantly different between two groups (both P > 0.05)., Conclusions: Benign acanthosis nigricans is associated with abnormal levels of lepin, adiponectin and sex hormone. And there may be some relationship between the abnormal levels of lepin and sex hormone in benign acanthosis nigricans.