This cross-sectional study was conducted among low-income middle-school students (N = 426) in rural northern California to compare rates of overweight, elevated blood pressure and acanthosis nigricans (AN) between Hmong and white students. Associations among rates of overweight, elevated blood pressure, AN, and scores for adherence to recommended dietary guidelines were also examined. Fifty-two percent (52%) of white students were overweight/obese compared to 38% of Hmong students. Higher fruit consumption was associated with a lower BMI among white, but not Hmong students. Whereas 7% of white students were classified as pre-hypertensive/hypertensive, the rate for Hmong students was 17%. Additionally, at 13 versus 2%, six-fold more Hmong students had an elevated blood pressure with a normal BMI compared to white students, respectively. Ethnicity was also an independent predictive factor for AN. Hmong students appear to be at higher risk for both hypertension and AN than white students irrespective of BMI.

Acanthosis nigricans (AN) is a dermatologic condition of the flexor surfaces of the body consisting of papular hypertrophy, hyperpigmentation, and rugae. AN is commonly associated with malignancy when in adults but is primarily associated with endocrinologic disorders and obesity when found in adolescents. A special search for occult malignancy is not warranted in adolescents with AN unless no associated benign condition is found. Careful follow-up is recommended, however, since AN may be the first indication of a serious systemic disease.