Acanthosis nigricans and acrochordons as clinical markers of metabolic disturbance during pregnancy: a prospective cohort study

Background: This study investigated the prevalence of acanthosis nigricans and acrochordons as potential markers of diabetes or insulin resistance in diabetic and non-diabetic pregnant women, and examined their potential association with pregnancy complications. Methods: This prospective cohort study was conducted at a tertiary university medical center and included 62 pregnant women with diabetes during pregnancy and 58 non-diabetic controls. Maternal demographics, obstetrical history, and neonatal outcomes were collected. The presence of acanthosis nigricans and acrochordons was assessed at multiple body sites. Multivariable logistic regression analysis was performed to identify obstetrical complications and perinatal outcomes that are independently associated with acrochordons. Results: Acanthosis nigricans was more prevalent among women with diabetes, particularly in the axilla (59.7% vs. 32.8%, p = 0.004), under the breast (46.8% vs. 19%, p = 0.002) and in the lower abdomen (35.5% vs. 25.5%, p = 0.021). Similarly, acrochordons were significantly more common in diabetic patients, with a higher prevalence at various sites (p < 0.001). In multivariable regression analysis, diabetes during pregnancy and maternal age were independently associated with a high prevalence of acrochordons. Conclusion: Pregnant women with gestational diabetes showed a significantly higher prevalence of acanthosis nigricans and acrochordons compared to those without. This association suggests that acanthosis nigricans and acrochordons may be potential indicators of underlying insulin resistance during pregnancy.