IMC Journal of Medical Science https://www.imcjms.com/ Ibrahim Medical College Journal of Medical Science <![CDATA[Clinical outcome of metformin treatment in patients of acanthosis nigricans with insulin resistance]]> Tahmina AkterMd. Reza Bin ZaidZeenat Farzana RahmanM Abu Sayeed https://www.imcjms.com/registration/journal_full_text/91 2016-09-26 09:36:36 Original Article IMC J Med Sci 2016; 10(1): 18-23 0.05 Knee (n=30 ) Control (n=6) 16.66 83.34   Drug (n=24 ) 37.50 62.50 >0.05 Knuckle (n=27 ) Control (n=7) 00.00 100.00   Drug (n=20 ) 25.00 75.00 >0.05     Table-3: Improvement of AN in different sites following metformin treatment as determined by quantitative scale of measuring AN   This study demonstrates that metformin therapy for AN with IR has a significant beneficial effect and is also safe and well tolerated. Improvement was assessed by reduction of score as measured by the quantitative scaling method scale [18] and vice versa. The study also reveals that metformin has different clinical effects on AN in different anatomic location. It seems that its effect is more pronounced in AN affecting axilla and neck. It could be due to the presence of more insulin-like growth factor 1 receptors in these specific sites. But further specific study is needed to elucidate its mechanism in these sites. Correcting hyperinsulinemia was presumably accomplished by metformin and led to improvement or resolution of AN. Oral metformin hydrochloride is a first choice drug in the treatment of AN associated to obesity and IR [1]. Metformin does not induce hypoglycemia but prevents hyperglycemia. In IR, hyperinsulinemia precedes type 2 diabetes mellitus sometimes by many years. AN develops during this non-diabetic hyperinsulinemic period. Thus, recognition of AN identifies those at increased risk of developing type 2 diabetes mellitus, dyslipidemia and hypertension. Therefore, recognition of AN offers an opportunity for both preventive measures and focused intervention. The present study had some limitations. The sample size was small and the long-term effects of metformin on the outcome of AN could not be assessed. The diagnostic and scoring criteria used in the study was based solely on direct visual examination. No histopathological scoring or grading technique of AN was available. Study was precisely directed to AN associated with biochemical evidence of IR and AN due to other causes was not included. This research was funded by Aristopharma Ltd. We express our acknowledgement to Dr. Shahidul Alam Khan, PhD, Chief Research Officer and Head, Dept. of Endocrinology and Immunology, BIRDEM, for overall guidance and support for performing laboratory works; Dr. Md. Zahid Hasan, Associate Prof. Dept of Physiology and Molecular Biology, BIRDEM, for his valuable opinion regarding the laboratory methods. 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