The Relation of Perianal Acrochordons are with Insulin Resistance

Abstract

Objectives: Acrochordons are common benign tumors of the skin. Perianal acrochordons are frequently observed in the examination of the anal region. Abnormal lipid and glucose metabolism are suggested to play a role in the development of acrochordons. The association of perianal acrochordons with insulin resistance is unknown. The aim of this study was to investigate the relationship between perianal skin tags and insulin resistance. Materials and Methods: A total of 21 patients with perianal acrochordons and 21 age, gender and body mass index (BMI) matched controls were prospectively enrolled in the study. Serum glucose, total cholesterol, low‐density lipoprotein (LDL) cholesterol, high‐density lipoprotein (HDL) cholesterol and triglyceride (TG) were measured. Insulin resistance was evaluated by homoeostasis model assessment of insulin resistance (HOMA‐IR) method. HOMA‐IR levels above 2.5 were considered as insulin resistance. Results: There were no statistically significant differences between patients with perianal acrochordons and controls in terms of the glucose, total cholesterol, HDL cholesterol, LDL cholesterol and TG. Mean HOMA‐IR was significantly higher in the patient group of perianal acrochordon (P=0.007). The proportion of patients with insulin resistance was significantly higher in patients with perianal acrochordons than controls (p=0.022). Conclusion: Although acrochordons are closely related to insulin resistance, there are no studies evaluating perianal acrochordons in the literature. The results of this study showed that perianal acrochordons tags are associated with insulin resistance.

Keywords

• Anal examination,acrochordon,insulin resistance

Perianal Akrokordonların İnsülin Direnci ile İlişkisi

Abstract

Amaç: Akrokordonlar derinin sık rastlanılan benign tümörleridir. Anal bölgenin muayenesinde perianal akrokordonlar sıklıkla görülmektedir. Anormal lipid ve glukoz metabolizmasının akrokordon gelişiminde rol oynayabileceğini öne sürülmektedir. Perianal akrokordonların insülin direnci ile ilişkisi bilinmemektedir. Bu çalışmanın amacı perianal akrokordon ve insülin direnci arasındaki ilişkiyi araştırmaktır. Materyal ve Metot: Çalışmaya perianal akrokordon saptanan 21 olgu ve yaş, cinsiyet ve vücut kitle indeksi (VKİ) benzer 21 kontrolü dahil edildi. Olguların serum açlık glukoz, total kolesterol, düşük‐ dansiteli lipoprotein (LDL) kolesterol, yüksek‐dansiteli lipoprotein (HDL) kolesterol ve trigliserid (TG) düzeyleri ölçüldü.  İnsülin direnci, homeostasis model insülin rezistans ölçüm modeli (HOMA‐IR) metodu ile hesaplandı. HOMA‐IR düzeyi 2,5 üzerinde olması insülin direnci olarak kabul edildi.    Bulgular: Perianal akrokordon saptananlar ve kontrolleri arasında total kolesterol, HDL kolesterol, LDL kolesterol ve TG düzeyleri açısından istatiksel olarak anlamlı farklılık saptanmadı. Perianal akrokordon hasta grubunda ortalama HOMA‐IR anlamlı yüksek bulundu (p=0,007). İnsülin direnci olan hastaların oranı, perianal akrokordonlu hastalarda kontrollere göre anlamlı olarak daha yüksekti (p=0,022). Sonuç: Akrokordonların insülin direnci ile yakın ilişkili olduğu belirtilmesine karşın literatürde anal akrokordonların değerlendirildiği çalışma bulunmamaktadır. Çalışma perianal akrokordonların insülin direnci ile ilişkisini göstermektedir.  

Keywords

• Anal muayene,akrokordon,insulin direnci

References

1. 1. Pariser RJ. Benign neoplasms of the skin. Med Clin North Am 1998;82:1285-307.
2. 2. Spanos CP. Anal skin tags: removal made simple. Colorectal Dis. 2012;14(10):e747-8.
3. 3. Uzuncakmak TK, Akdeniz N, Karadag AS. Cutaneous manifestations of obesity and themetabolic syndrome. Clin Dermatol 2018;36:81-8.
4. 4. Touraine A. A new hereditary chain; cutaneous fibromas, diabetes, obesity. Ann Dermatol Syphiligr (Paris) 1951;78:409-16.
5. 5. García Hidalgo L. Dermatological complications of obesity. Am J Clin Dermatol 2002;3:497-506.
6. 6. Wali V, Wali VV. Assessment of Various Biochemical Parameters and BMI in Patients with Skin Tags. J Clin Diagn Res 2016;10:9-11.
7. 7. Rasi A, Soltani-Arabshahi R, Shahbazi N. Skin tag as a cutaneous marker for impaired carbohydrate metabolism: a case-control study. Int J Dermatol 2007;46:1155-9.
8. 8. Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 1985;28:412-9.

9. 9. Grundy SM, Grundy SM, Cleeman JI et al. American Heart Association; National Heart, Lung, and Blood Institute Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation 2005;112:2735-52.
10. 10. Abbasi F, Pourghasem G, Rezaei M. Giant skin tag. J Surg Pak 2011;16:183–4.
11. 11. Banik R, Lubach D. Skin tags: localization and frequencies according to sex and age. Dermatologica 1987;174:180-3.
12. 12. Bonheur JL, Braunstein J, Korelitz BI, Panagopoulos G. Anal skin tags in inflammatory bowel disease: new observations and a clinical review. Inflamm Bowel Dis 2008;14:1236-9.
13. 13. Jusuf NK, Putra IB, Kartayana J. The Correlation between Body Mass Index with the Occurrence of Skin Tag. Open Access Maced J Med Sci 2017;5:271-4.
14. 14. Erdoğan BS, Aktan S, Rota S, Ergin S, Evliyaoğlu D. Cilt etiketleri ve aterosklerotik risk faktörleri. J Dermatol 2005;32:371-5.
15. 15. Rasi A, Faghihi A, Rahmanzadeh Y, Hassannejad H. A comparison study of lipid profile levels between skin tags affected people and normal population in Tehran, Iran. Adv Biomed Res 2014;3:109.
16. 16. Eshghi G, Alirezaei P, Ghalavand H, Khezrian L. Comparison of Serum Lipid Levels in Skin Tag Affected Patients with Healthy Individuals. Avicenna J Clin Med 2016;23:34-9 .
17. 17. Shah R, Jindal A, Patel N. Acrochordons as a cutaneous sign of metabolic syndrome: a case-control study. Ann Med Health Sci Res 2014;4:202-5.
18. 18. Abdou AG, Maraee AH, Antar AG, Fareed S. Role of mast cells in skin tag development: an immunohistochemical study.Anal Quant Cytopathol Histpathol 2014;36:222-30.
19. 19. Bakry OA, Samaka RM, Shoeib MA, Maher A. Immunolocalization of androgen receptor and estrogen receptors in skin tags. Ultrastruct Pathol 2014;38:344-57.
20. 20. Tamega Ade A, Aranha AM, Guiotoku MM, Miot LD, Miot HA. Association between skin tags and insulin resistance. An Bras Dermatol 2010;85:25-31.
21. 21. Cordain L, Eades MR, Eades MD. Hyperinsulinemic diseases of civilization: more than just Syndrome X. Comp Biochem Physiol A Mol Integr Physiol 2003;136:95–112.
22. 22. Harbutluoğlu MK, Karaman G, Şendur N et al. Molluskum pendulum ile karbonhidrat metabolizması bozukluğu arasındaki ilişkinin araştırılması. Türkderm-Deri Hastalıkları ve Frengi Arşivi 2011,45:188-92.