Epidemiology

AN is most often associated with obesity and insulin resistance.[2][7] It is the most common dermatological manifestation of obesity.[16] As rates of obesity rise globally, so does the incidence of AN.[7][17] AN is very common in dark-skinned populations throughout the world, but is rare in white people.[18] AN is found in 21% to 74% of selected adult populations and 17% of urban youth in the US.[19][20][7] The prevalence of AN varies from 7% to 74%, depending on the type of AN and on patient factors; including age, race, and presence of obesity and associated endocrinopathy.[17] A study of 1133 patients in southwest US found a prevalence ratio for type 2 diabetes in patients with AN of 1.97.[19] Children with AN are up to 4.2 times as likely to have hyperinsulinaemia as those without.[21] In one study of 618 urban youths, AN was found in 62% of subjects with a BMI >98th percentile and was more common in ethnic minorities, with 23% of Hispanic, 19% of black, and 4% of white people affected.[7] Malignant AN is rare, although the exact incidence is unknown. It is reportedly present in 2 out of 12,000 patients with cancer.[22] There have been over 1000 reported cases in the world literature.[23] It is reported most often in adults over the age of 40 years and has no sex or racial predilection.[9]

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