Abstract: Abstract Objective: To explore the significance of acanthosis nigricans (AN )combining non-alcoholic fatty liver disease (NAFLD) in early discovering metabolic disorders in obese children. Methods: According to the presence of AN and/or NAFLD, 132 obese children were divided into four groups: with AN and NAFLD were recruited as group A, with AN but without NAFLD as group B, with NAFLD but without AN as group C, had no AN and NAFLD as group D. Body mass index(BMI), waist circumference(WC), fasting plasma glucose(FPG), triglyceride(TG), high density lipoprotein-cholesterol(HDL), systolic blood pressure(SBP), diastolic blood pressure(DBP), fasting insulin (FINS), homeostasis model of insulin resistance (HOMA-IR) and the prevalence of MS were compared between the four groups. Results: ⑴BMI,WC,FINS,HOMA-IR in group A were significantly higher than in other groups ,HDL were significantly lower than group D, DBP was higher than group C and D, FPG and TG higher than group B and D （P＜0.05 or P＜0.01）⑵group B had higher DBP than group D, group C had higher FPG、TG than group D, WC、FINS、HOMA-IR in group B and group C were higher than group D(P＜0.01) ⑶The prevalence of MS in group A, group B, group C, group D were respectively 45.24％(19/42), 16.13％(5/31), 16.67％(5/30), 0％(0/29), group A had higher prevalence than the other groups(?2=22.539，P＜0.001). In the 132 obesity, 73( 55.3﹪) had AN, 72(54.5﹪) had NAFLD. Conclusion: obese children with AN and NAFLD had more serious metabolic disorder than the other obesity, we should pay more attention to those who have AN and NAFLD.

Key words: obesity, acanthosis nigricans, non-alcoholic fatty liver disease, metabolic syndrome X, children