Objective: To determine the association of Acanthosis nigricans, hyperinsulinemia, and hormonal levels in female subjects from the United Arab Emirates (UAE). Design: Prospective study. Setting: Tawam Teaching Hospital of Faculty of Medicine & Health Sciences. Subjects: Ninety-two females (age range 16-65 years) were recruited. Methods: Height, weight, and sitting blood pressure were recorded on 92 female subjects with A. nigricans. Fasting blood samples were obtained for measurement of uric acid, glucose, cholesterol, high-density lipoprotein- (HDL) cholesterol, and triglyceride levels. Serum levels of thyroid stimulating hormone (TSH), testosterone, luteinizing hormone (LH), follicle-stimulating hormone (FSH) and prolactin are obtained by radio-immunoassay. Results: Ninety-two females with A. nigricans were enrolled in the study. Of the 92 females, 36 subjects were considered to have diabetes mellitus (DM) and 56 euglycemic subjects. The analysis showed that in cases of family history of DM, HDL-cholesterol (mmol/l) and uric acid (mmol/l) levels were higher. Overall, DM subjects had significantly higher values for hormone levels of TSH, FSH, LH, progesterone, testosterone, cortisol, prolactin, (growth hormone) CH, and ferritin. Conclusion: Patients with A. nigricans have a high prevalence of DM and insulin resistance in UAE. Since A. nigricans is rather prevalent in the UAE, identifying this skin lesion can help detect those subjects with a higher risk of DM and hormonal disturbances. (C) 2000 International Federation of Gynecology and Obstetrics. All rights reserved.