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Research Letter
July 2013

Posterolateral Neck Texture (Insulin Neck): Early Sign of Insulin Resistance

Author Affiliations
  • 1Stoecker & Associates, Rolla, Missouri
  • 2Division of Endocrinology, Diabetes and Metabolism, Department of Internal Medicine, University of Missouri School of Medicine, Columbia
  • 3Department of Dermatology, University of Missouri School of Medicine, Columbia
  • 4student at Missouri University of Science and Technology, Rolla
JAMA Dermatol. 2013;149(7):875-877. doi:10.1001/jamadermatol.2013.4054

Acanthosis nigricans (AN) is so closely linked with insulin resistance (IR) that it has been called a clinical surrogate for laboratory-determined hyperinsulinemia.1 The presence of AN can therefore indicate patients with IR, allowing implementation of interventions that may prevent progression to type 2 diabetes mellitus.2 We report 30 patients who presented with elevated body mass index (BMI, calculated as weight in kilograms divided by height in meters squared) to correlate IR with different AN physical findings.

The homeostasis model assessment of insulin resistance (HOMA-IR) is widely used as an index of IR based on serum fasting glucose and insulin values: HOMA-IR = [glucose (mg/dL) × insulin (μIU/mL)]/405. Esteghamati et al3 determined that IR is present in nondiabetic individuals if HOMA-IR is greater than 1.775.