bluuebunny/crossref_metadata_2025_split huggingface dataset:
1967-P: Retinoic Acid Signaling Suppresses Adipogenic Differentiation of Fibro/Adipogenic Progenitors and Benefits Skeletal Muscle Regeneration Impaired Due to Obesity
Authors: ZHAO LIANG , ZHU MEI-JUN , DU MIN 
Published: June 2020

Impaired regeneration of skeletal muscle in obese individuals is accompanied with fatty degeneration. Retinoic acid (RA) supplementation promotes myogenesis but inhibits white adipogenesis. The objective of this study was to examine the effects of RA on the restoration of skeletal muscle after injury under obese condition and its effects on the physiological functions of fibro/adipogenic progenitors (FAPs) which coordinate regeneration process. ROSA26-RARαDN mice were crossed with Pdgfra-cre/ER mice; in these cross-bred mice (RARαDN), tamoxifen induces RA signaling blockage specific in PDGFRα+ FAPs. Following injury, RA enhanced muscle regeneration, which was abolished due to the blockage of RA signaling in FAPs, accompanied with ectopic adipocyte accumulation, showing the mediatory roles of RA receptor signaling. Consistently, in diet-induced obese mice, muscle regeneration was inhibited but adipogenesis was enhanced; RA effectively reduced adipogenesis in the regenerated skeletal muscle of obese mice, but such beneficial effect disappeared in HFD mice with RA signaling blockage in FAPs.
In summary, our studies showed that RA signaling controls the adipogenic differentiation of FAPs and RA treatment effectively inhibits adipogenesis during skeletal muscle regeneration and promotes muscle repair of obese mice.

Disclosure
L. Zhao: None. M. Zhu: None. M. Du: None.

Funding
National Institutes of Health (R01HD067449)
197-OR: Six Months Experience on Hybrid Closed-Loop System in Children and Adolescents Previously Treated with Multiple Daily Injections
Authors: PETROVSKI GORAN , CAMPBELL JUDITH , ALKHALAF FAWZIYA , UMER FAREEDA , HUSSAIN KHALID 
Published: June 2020

Aim: Evaluation of six months experience on MiniMed 670G Hybrid Closed Loop (HCL) system in patients with type 1 diabetes (T1D), previously treated with Multiple Daily Injections (MDI).
Methods: This is a 6-months prospective observational study of patients (7 to 18 years) with T1D on MDI, starting the MiniMed 670G system, using a 10-day initiation protocol: 2-days, HCL system assessment; 5-days, HCL system training (2-hours sessions in 5 consecutive days); 3-days, Manual Mode use of HCL system and 6 months, Auto Mode use of the HCL system.
Results: MiniMed 670G was initiated in 47 patients (age 12.2±3.2 years). All patients used the system for six months period. Auto Mode usage was 87.2% at the first month and 89.6% at the 6-months of Auto Mode initiation. The mean HbA1c decreased from 8.4±1.5% (68±16.4 mmol/mol) at baseline, 6.7±0.8% (50±8.7 mmol/mol) at 3-months (p=0.021), to 6.9±0.7% (52±7.7 mmol/mol) at 6-months of MiniMed 670G initiation (p=0.024). Time in Range (70-180mg/dL) significantly increased over the time (Figure 1). No severe hypoglycemia nor DKA were found.
Conclusion: Children and adolescents with T1D can successfully initiate the HCL system, achieve and maintain better glycemic control than previous MDI regimen. Low attrition rate and the sustainability of the results are likely due to patients’ selection, structured educational program and HCL system by itself.

Disclosure
G. Petrovski: None. J. Campbell: None. F. AlKhalaf: None. F. Umer: None. K. Hussain: None.
1975-P: Effects of Bariatric Surgery on the Incidence of Heart Failure and Atrial Fibrillation in Patients with Type 2 Diabetes and Obesity: A Nationwide, Matched, Observational Cohort Study
Authors: HÖSKULDSDOTTIR GUDRUN , SATTAR NAVEED , MIFTARAJ MERVETE , NASLUND INGMAR , OTTOSSON JOHAN R. , FRANZÉN STEFAN , SVENSSON ANN-MARIE , ELIASSON BJORN 
Published: June 2020

Aims: Obesity and diabetes are both risk factors for atrial fibrillation (AF) and heart failure (HF). Our aim was to study the effects of bariatric surgery on incidence of HF and AF in patients with type 2 diabetes (T2D) and obesity.
Methods: In this register-based nationwide cohort study we compared individuals with T2D and obesity that underwent Roux-en-Y gastric bypass surgery (GBP) between 2007 and 2013 with individuals with T2D that did not undergo surgery. Propensity score matching was performed on the basis of sex, age, BMI and calendar time. Data were gathered from the Swedish National Diabetes Register and Scandinavian Obesity Surgery Registry as well as other national databases for our main outcomes of hospitalization for HF and/or AF.
Results: We identified 5321 individuals with T2D that had undergone GBP and 5321 matched controls. Follow up was up to 9 years. Our results show a 44% lower risk for AF (HF 0.56, 0.42-0.75, p &lt; 0.001), 71% for HF (HR 0.29, 0.21-041, p &lt;0.001) and 75% lower risk for simultaneous diagnosis of AF and HF (HR 0.25, 0.13-0.29, p &lt; 0.001) in the surgical group.
Conclusion: Our study suggests that bariatric surgery may substantially lower risk for HF and AF in patients with T2DM that undergo GBP as compared to patients who do not. These data reiterate importance of excess weight on such outcomes.

Disclosure
G. Höskuldsdottir: None. N. Sattar: Advisory Panel; Self; Amgen, AstraZeneca, Boehringer Ingelheim International GmbH, Eli Lilly and Company, Novo Nordisk A/S, Pfizer Inc., Sanofi. Research Support; Self; Boehringer Ingelheim Pharmaceuticals, Inc. M. Miftaraj: None. I. Naslund: Consultant; Self; Baricol Bariatrics AB, Sweden, Ethicon,Johnson&Johnson A/S, Denmark. Other Relationship; Self; AstraZeneca. J.R. Ottosson: Advisory Panel; Self; Johnson & Johnson Medical Devices Companies. S. Franzén: None. A. Svensson: None. B. Eliasson: Consultant; Self; Amgen, AstraZeneca, Boehringer Ingelheim International GmbH, Eli Lilly and Company, Merck Sharp & Dohme Corp., Mundipharma International, Novo Nordisk A/S, Sanofi.
198-OR: Individual Response of Automated Glycemic Control with the iLet Bionic Pancreas in the Insulin-Only vs. Bihormonal Configuration with the Stable Glucagon Analog Dasiglucagon
Authors: SHERWOOD JORDAN , BALLIRO COURTNEY A. , JAFRI RABAB Z. , CASTELLANOS LUZ E. , HILLARD MALLORY , SELAGAMSETTY RAJENDRANATH , GREAUX EVELYN , ZHENG HUI , EL-KHATIB FIRAS , DAMIANO EDWARD , RUSSELL STEVEN J. 
Published: June 2020

In an outpatient, home-use, random-order, controlled trial we compared automated glycemic control with the iLet bionic pancreas in the insulin-only (IOBP) vs. the bihormonal (BHBP) configurations for one week each in adult subjects (n=10) with type 1 diabetes. Subjects used their typical insulin analog (lispro or aspart) during both arms of the study. During the BHBP period the iLet delivered micro-doses of dasiglucagon, a glucagon analog stable in aqueous solution (Zealand Pharma). The insulin control algorithm was identical in both configurations, was initiated solely based on each subjects’ body mass without any information regarding patients’ baseline insulin needs, and used a glucose target of 110 mg/dl. The mean CGM glucose was lower in the BHBP arm vs. the IOBP arm (139±11 vs. 149±13 mg/dl, p=0.004) while the % of time with CGMG &lt;54 mg/dl was nominally reduced (0.2%, IQR 0-0.4 vs. 0.6%, IQR 0.2-1.1%, p=0.11). We used an autoregressive time series model to determine statistical significance for differences between arms for each individual subject. Eight subjects had a significantly lower mean CGMG during the BHBP arm (p&lt;0.05, mean improvement 12±7 mg/dl), while in the remaining two subjects there was no significant difference (nominal absolute difference 2±1 mg/dl). Eight of the ten subjects had a nominal reduction of the % of time &lt;54 mg/dL in the BHBP arm (mean nominal difference -0.5%, range -0.1 to -1.0%), none of which were statistically significant. Here we demonstrated significant benefit of adding dasiglucagon in eight of ten subjects, allowing them to achieve a lower mean glucose without increased rates of hypoglycemia, in a trial comparing the BHBP and IOBP configurations of the iLet.

Disclosure
J. Sherwood: None. C.A. Balliro: None. R.Z. Jafri: None. L.E. Castellanos: None. M. Hillard: None. R. Selagamsetty: Employee; Self; Beta Bionics, Inc. Stock/Shareholder; Self; Beta Bionics, Inc. E. Greaux: None. H. Zheng: None. F. El-Khatib: Other Relationship; Self; Beta Bionics, Inc. E. Damiano: Board Member; Self; Beta Bionics, Inc. Employee; Self; Beta Bionics, Inc. Stock/Shareholder; Self; Beta Bionics, Inc. Stock/Shareholder; Spouse/Partner; Beta Bionics, Inc. S.J. Russell: Consultant; Self; Beta Bionics, Inc., ConvaTec Inc., Novo Nordisk A/S, Senseonics. Research Support; Self; Beta Bionics, Inc., Novo Nordisk A/S, Zealand Pharma A/S. Stock/Shareholder; Self; Companion Medical. Other Relationship; Self; Ascensia Diabetes Care, Roche Diabetes Care.

Funding
Beta Bionics, Inc.
1982-P: Laparoscopic Sleeve Gastrectomy as Bridge to Kidney Transplantation: Pilot Study in Subjects with Renal Failure and Obesity
Authors: HRÁDKOVÁ VIKTORIE , KASALICKY MOJMIR , RAJNOCHOVA-BLOUDICKOVA SILVIE , LANKOVA IVANA , KRATOCHVILOVA HELENA , MRAZ MILOS , DVORAKOVA KATERINA , SLABA SARKA , MENDL JIRI , VIKLICKY ONDREJ , FRONEK JIRI , HALUZIK MARTIN 
Published: June 2020

Obesity and associated metabolic complications are established risk factors for the development and progression of chronic kidney disease; however, BMI (body mass index)&gt;35 kg/m2 is a contraindication for kidney transplantation. The aim of our study was to reduce excess body weight via laparoscopic sleeve gastrectomy (LSG) in obese patients with end-stage renal disease (ESRD) in order for them to become eligible for the transplantation program.
Subjects with ESRD undergoing hemodialysis or peritoneal dialysis and BMI&gt;35kg/m2 without serious comorbidities were included into the study. Anthropometric and biochemical parameters were measured before and 1, 3 and 6 months after LSG.
In the thus far enrolled 7 subjects (6 females, aged 47.6 ± 9.6 years) LSG resulted in improved body weight (118.0 ± 17.6 vs. 107.5 ± 14.5 vs. 105.5 ± 14.4 vs. 99.5 ± 10.7 kg for baseline vs. 1 vs. 3 vs. 6 months, p&lt;0.001) and BMI (42.5 ± 3.8 vs. 38.6 ± 3.2 vs. 37.4 ± 2.8 vs. 37.0 ± 3.1 kg/m2 for baseline vs. 1 vs. 3 vs. 6 months, p&lt;0.001) with 3 subjects achieving target BMI&lt;35 kg/m2 1-6 months after LSG enabling their inclusion in the kidney transplantation waiting list. Weight loss was accompanied by significant decrease of systolic (160.0 ± 25.0 vs. 128.7 ± 31.2 mmHg, p=0.042) and diastolic (99.0 ± 13.6 vs. 75.5 ± 12.0 mmHg, p=0.022) blood pressure with antihypertensive medication being reduced in 2 subjects. The only subjects with diabetes mellitus (type 1) showed improvement in fasting glucose (15.8 vs. 9.3 mmol/l) and HbA1c (84 vs. 68 mmol/mol) and a 25% reduction of prandial insulin dose 1 month after LSG. No peri- or postoperative complications have been observed to date.
To conclude, our pilot data suggest LSG to be an efficient and safe method to achieve the necessary weight reduction enabling renal transplantation in subjects with renal failure and higher degrees of obesity.

Disclosure
V. Hrádková: None. M. Kasalicky: None. S. Rajnochova-Bloudickova: None. I. Lankova: None. H. Kratochvilova: None. M. Mraz: None. K. Dvorakova: None. S. Slaba: None. J. Mendl: None. O. Viklicky: None. J. Fronek: None. M. Haluzik: Advisory Panel; Self; Lilly Diabetes, Sanofi. Consultant; Self; Ethicon US, LLC. Speaker’s Bureau; Self; AstraZeneca, Mundipharma International, Novartis AG, Novo Nordisk A/S.

Funding
Institute for Clinical and Experimental Medicine (00023001)
1983-P: Dihomo-Gamma-Linolenic Acid and Estimated Delta-5-Desaturase Activity Are Associated with Obesity and Metabolic Components in Type 2 Diabetic Patients
Authors: SAITO MANABU , HIGA MARIKO , SUZUKI TAKAYUKI , MICHISHITA MOE , HIJIKATA MAI , YAMASHITA KAORU , IKEHARA KAYOKO , ICHIJO TAKAMASA 
Published: June 2020

Polyunsaturated fatty acid (PUFA) is an essential class of dietary fatty acids, because of the lack of endogenous enzymes for desaturation in humans. Previous research on n-3 PUFA has demonstrated several health benefits and antiatherogenic actions, but n-6 PUFA have not received much research attention. We investigated whether serum fatty acid composition, especially n-6 PUFAs and desaturase activity, is associated with obesity in type 2 diabetic patients. Subjects were 80 type 2 diabetic patients (age: 60.3±13.9 years) who had no EPA agent intake. They were divided into two groups: obese group (n=52) with a BMI more than 25 kg/m2 and non-obese group (n=28) with a BMI less than 25 kg/m2. Fatty acid levels in serum were measured using gas chromatography. The desaturase activity for n-6 PUFAs was calculated as the arachidonic acid/dihomo-gamma-linolenic acid (DGLA) ratio for Δ5 desaturase (D5D). The obese group revealed a higher saturated fatty acid (SFA) and DGLA levels than those in the non-obese group. No significant difference was observed in the serum n-3 PUFA levels between the two groups. The D5D index of the obese group was significantly lower than that of the non-obese group. Serum DGLA levels showed significant positive correlations with waist circumference, BMI, triglyceride, and hepatic AST and ALT levels. Moreover, SFA showed a significant positive correlation with BMI. The levels of D5D index showed a significant negative correlation with BMI. Increase in serum DGLA levels was related to the number of metabolic factors. These results suggest that type 2 diabetic patients with obesity had changes in their blood fatty acid profile, especially increased DGLA levels. The high levels of blood DGLA indicate downregulation of n-6 metabolism, probably caused by the decreased activity of D5D. The fat quality in the diet and changes in desaturase activity might contribute to the development of obesity.

Disclosure
M. Saito: None. M. Higa: None. T. Suzuki: None. M. Michishita: None. M. Hijikata: None. K. Yamashita: None. K. Ikehara: None. T. Ichijo: None.
199-LB: Diabetes, Macrophage Dysfunction, and Mesh Complications
Authors: LIANG RUI , LOPA SAMIA 
Published: June 2020

Objective: Diabetic women who receive polypropylene meshes in the surgical repair of stress urinary incontinence and/or pelvic organ prolapse have a ~5-fold increased risk in developing mesh complications, mainly mesh exposure and pain. Macrophage plays important roles in inflammation and mesh-tissue integration. This study aims to establish an association between diabetes and macrophage dysfunction at the mesh implantation site.
Methods: Diabetic (n=20) vs. nondiabetic (n=28) mesh-tissue complexes excised from women with mesh complications were assessed for macrophage phenotype transition, efferocytosis and immune mediator production with TUNEL apoptotic cell labeling, immunofluorescence, NanoString and Luminex multiplex assays. Significance of all statistical tests was set at 0.05 level.
Results: Demographic parameters were not different except that BMI was higher in diabetic women (p=0.04). In diabetic vs. nondiabetic specimens, the ratio of pro-healing M2 to pro-inflammatory M1 was 50% lower; the ratio of apoptotic cells/CD68+ macrophages was 50% higher; normal correlations of molecules involved in cell apoptosis (BCL10 and TRAF3) and CD68 were disrupted (Figure); and levels of chemokines CCL11, CCL13, CXCL10 were significantly increased (all p&lt;0.05).
Conclusion: Diabetes was associated with macrophage dysfunction at the mesh implantation site, which may contribute to short-term and long-term mesh complications.

Disclosure
R. Liang: None. S. Lopa: None.

Funding
Pennsylvania Department of Health
1990-P: The Improvement of Liver Function Correlates Positively with Decreasing FABP1 Level in Chinese Patients with Obesity after Laparoscopic Sleeve Gastrectomy: A 12-Month Follow-Up Study
Authors: MA HUIHUI , HUI YOU , QU SHEN 
Published: June 2020

Objective: Various studies have documented the liver fatty acid-binding protein (FABP1) were closely related to liver function. However, the interrelation between the liver function and FABP1 in Chinese patients with obesity after laparoscopic sleeve gastrectomy (LSG) is unclear. Therefore, we aimed to interpret the correlation between FABP1 level and progression of liver function in obese patients, during a 12-month follow-up.
Methods: This study included 131 individuals: 54 had normal weight (BMI:21.63±1.52kg/m2),77 had obesity (BMI:39.67±6.14kg/m2). The subjects were divided into three tertiles (Q1, Q2, and Q3) according to FABP1 levels: Q1, &lt;16.35ng/ml; Q2, 16.35∼34.30ng/ml; Q3, &gt;=34.30ng/ml. FABP1 levels were measured using ELISA.
Results: Serum FABP1 levels were significantly higher in patients with obesity (29.71±22.35 ng/ml, P&lt; 0.001) than normal weight individuals (13.70±9.48 ng/ml). FABP1 level was decreased at 6 and 12 months after LSG (15.00±10.27ng/mL, P&lt;0.001, and 12.74±7.64 ng/mL, P&lt;0.001).At baseline, compared to the bottom tertile (Q1), middle (Q2) and upper (Q3) tertile of FABP1 were related to higher liver enzyme level. Besides, after LSG, liver enzymes declined rapidly in Q2 and Q3 than Q1. Correlation analysis found that the decrease in FABP1 level was positively correlated with the decrease in ALT, AST, and γ-GT at 6 and 12 months after LSG. After adjusting for age, sex, ΔTC, ΔTG, ΔHDL, ΔLDL, ΔFBG, ΔFINS, ΔFCP, ΔFFA, and ΔUA, linear regression analysis revealed the decreased FABP1 levels was only positively correlated with the alterations of ALT (R2=0.769, P=0.001) and AST (R2=0.836, P&lt;0.001) at 12 months after LSG.
Conclusion: Our results suggested obesity was strongly associated with up-regulated serum FABP1 level. In addition, the improvement of liver function was positively correlated with changes in FABP1 at 12 months in Chinese patients with obesity after LSG.

Disclosure
H. Ma: None. Y. Hui: None. S. Qu: None.

Funding
National Natural Science Foundation of China (81700752, 81970677)
1994-P: Task-Oriented Connectivity Analysis of Disease-Dependent Effects of Diet
Authors: WATT CHARLES , STANLEY THEODORA K. , LACADIE CHERYL , LAM KATHERINE W.Y. , SAVOYE MARY , SINHA RAJITA , CONSTABLE TODD , SEO DONGJU , HWANG JANICE J. , BELFORT-DEAGUIAR RENATA 
Published: June 2020

Previous results have demonstrated that short-term dieting attenuates neuronal inhibitory control on appetite measured with blood-oxygen-level-dependent (BOLD) responses to a food cue task. Because recent studies have suggested that functional connectivity measured during the task is strongly predictive of disease states, we sought to investigate the effect of weight loss on brain functional connectivity during the picture viewing task. Sixteen healthy obese (10F/6M, age 44.4±8 years, BMI 32.7±2) and 9 type 2 diabetes (T2DM) obese subjects (5F/4M, age 48±9, BMI 33.9±2) underwent functional MRI (fMRI) before and after an 8-week low-calorie diet. Brain connectivity (BOLD) was recorded while subjects viewed preselected images (high-calorie food, low-calorie food, and non-food). Participants lost 2.9±2.8 kg (p&lt;0.05) weight after the diet. Using intrinsic connectivity distribution (ICD) analysis, there was a significant diet effect (p&lt; 0.01) in the inferior pons, hypothalamus, and inferior medial hippocampus across all subjects. Diet by group interaction in ICD (p &lt;0.001) was observed in the inferior anterior amygdala, inferior medial hippocampus, and hypothalamus, brain regions involved in the modulation of emotion and glucose metabolism. These results highlight the adaptive nature of neuronal control on diet and provide novel evidence for a variable nature of inhibitory neuronal adaptions in metabolic diseases.

Disclosure
C. Watt: None. T.K. Stanley: None. C. Lacadie: None. K.W.Y. Lam: None. M. Savoye: None. R. Sinha: None. T. Constable: None. D. Seo: None. J.J. Hwang: Research Support; Self; General Electric. R. Belfort-DeAguiar: Research Support; Self; Silver Palate Kitches.

Funding
National Institute of Diabetes and Digestive and Kidney Diseases (P30DK045735, K23 DK098286-02, R01DK020495); National Institutes of Health (UL1TR001863)
20-OR: Psychological Impact and Need for Psychological Care and Support: What Do People with Diabetes and Caregivers Say? Results of a Scientific Survey of 9,869 People with Diabetes and Caregivers in Denmark
Authors: SKOVLUND SOREN E. , NIELSEN KASPER A. , EJSKJAER NIELS 
Published: June 2020

Aim: To characterize the need for and access to psychological care and self-care support for People With Diabetes (PWD) and Caregivers (CG) in Denmark.
Methods: The national diabetes survey (Life with Diabetes 2019) was designed by the Danish Diabetes Association, Steno Diabetes Center North, and Aalborg University with PWD and CG to benchmark Impact/daily life, Access to care, technology and services and understand key wishes and priorities. The study used pre-validated, national PRO diabetes and purpose-built Likert items/scales, as well as open-ended items for mixed-methods research. E-mail invites were sent to 38.820 members of the Danish Diabetes Association. Statistics were done with (STATA/SPSS 26) and coding and thematic analysis with (NVIVO12).
Results: 9.108 PWD and 761 CG completed the survey: 71% had T2 and 26% T1 diabetes. 51% were women. All Danish regions were represented: Capital (n=2.753), South (n=2365), Central (n=2.126), Zealand (n=1.490) and North (n=1.082). Age/gender was similar to the general population. Impact: 19% of PWD felt distress (diabetes taking up “too much of daily life”). Access: 18% of PWD (24% women vs. 12% men) needed a referral for a psychologist, but had not been offered one. 36% of PWD/21% of CG did not get the support they needed to deal with diabetes related emotions. Wishes: 19% reported a major need for system wide improvement in psychosocial support and analyses of 1.100 free text responses identified detailed problem/improvement areas, notably within: 1) access to new technology, 2) quality of care in primary practice 3) Whole-person care beyond medicine (exercise, diet, mental health).
Conclusions: This is the largest nationwide Danish survey to date to quantify as well as qualitatively characterize a major need for better access to psychological and other non-medical diabetes care in Denmark.

Disclosure
S.E. Skovlund: None. K.A. Nielsen: None. N. Ejskjaer: None.

Funding
Danish Diabetes Association