الفهرس 
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Abstract
A
canthosis nigricans (AN) describes clinically a darkly pigmented thickening skin, which demonstrates epidermal/dermal hyperplasia with orthokeratotic hyperkeratosis and papillomatosis of stratum spinosum with basal layer hyperpigmentation, in the absence of actual acanthosis and melanocytosis in histology. It is a reactive cutaneous change closely associated with obesity/ insulin resistance/ hyperinsulinemia, endocrinopathy, or malignancy in particular gastrointestinal adenocarcinoma. The prevalence varies, and ethnicity seems an independent factor. Evidence shows that AN is a useful clinical marker to identify patients susceptible to insulin resistance, the metabolic syndrome, and type 2 diabetes (Karada˘g et al., 2017).
Obesity associated AN is the most frequent form of associated metabolic disorders, lesion severity being related with weight excess. Lesions are often slowly reversible after weight loss. It is more common in obese patients with insulin resistance (Panda et al., 2017).
Increased adipose tissue mass, especially in the visceral compartment, is characterized by altered metabolic and endocrine function leading to an increased secretion of pro-inflammatory adipokines. Chemerin is a recently described adipokine which has dual roles in adipose tissue metabolism and regulation of immune response. Chemerin serum concentrations are elevated in obese, insulin-resistant, and inflammatory states in vivo and suggested to be an obvious cause of insulin resistance in obesity. Chemerin is also suggested to be linked to obesity-induced insulin resistance in type 2 diabetes (Mona et al., 2012).
The aim of our work was assessment of serum concentrations of Chemerin level in obese patients with AN and the healthy control group, as well as evaluation of a possible correlation between chemerin concentrations and metabolic syndrome components.
Our study included 75 subjects, divided into three groups. The first group included 25 obese patients with AN, the second group included 25 obese patients without AN. In addition to the control group which included 25 healthy individuals. Each subject was assessed for blood pressure, body mass index and waist hip ratio. 3ml blood sample was taken from each subject. Lipid profile, serum glucose level, fasting serum insulin were measured. Chemerin concentration was assessed by quantitative ELISA.
There was a statistically highly significant difference found between control group when compared to group A and group B regarding BMI, WHR, SBP, DBP and insulin level while no statistically significant difference found between group A and group B regarding the previous parameters.
There was a statistically highly significant difference found between control group when compared to group A and group B regarding chemerin level.
There was a statistically highly significant difference found between control group when compared to group A and group B regarding cholesterol, TG, HDL and LDL.
There was a statistically highly significant difference found between control group when compared to group A and group B regarding hypertension (abnormal BP), abnormal WHR, High TG (> 150), high glucose, and metabolic syndrome while there was a non statistically significant difference found between control group when compared to group A and group B regarding Low HDL (<45).
This study showed that the neck was the most common site of acanthosis nigricans (AN) among the studied patients (80.0%), the axilla was the second most common site (68.0%) and the least common site was submammary (4.0%).
There was a statistically significant positive correlation found between serum chemerin and BMI, SBP, DBP, WHR, cholesterol, TG, LDL and also negative correlation with HDL in all patients group. Also there was a positive correlation between serum chemerin level with BMI and WHR in group A while no statistically significant correlation found between chemerin level and the other parameters in group B.
There was a non statistically significant between chemerin with sex, hypertension (abnormal BP), abnormal WHR, low HDL (<45) and high glucose while there was a highly statistically significant correlation between chemerin with high TG (> 150) and statistically significant correlation with MS.
In group A, there was a non statistically significant correlation found between chemerin with sex, neck, axilla, groin, hand, submammary, hypertension (abnormal BP), high TG (>150) and low HDL (<45) while there was a statistically significant correlation found between chemerin with abnormal WHR.
In group B, there was a non statistically significant correlation between chemerin with sex, hypertension (abnormal BP), abnormal WHR, high TG (> 150), high glucose and metabolic syndrome while there was a statistically significant correlation between chemerin level and Low HDL (<45).
These findings might provide evidence that chemerin concentrations can be used in as a marker in AN.