bluuebunny/crossref_metadata_2025_split huggingface dataset:
2002-P: Waist-Hip Ratio: A Better Obesity Measure Index Represents Insulin Secretion among Obese Women with Different Glucose Metabolism Status
Authors: WU JING , WANG BIAN 
Published: June 2020

Objective: To investigate the association of simple obesity measures (BMI, WC and WHR) with insulin secretion in obese subjects with normal glucose metabolism (NGM), prediabetes, and T2DM.
Research Design and Methods: 848 obese patients were recruited and divided into three groups (428 NGM, 248 prediabetes, and 172 T2DM). BMI, WC, and WHR were obtained. Insulin secretion was described by three beta cell function indices (HOMA-β, ΔI30/ΔG30 and AUCI60-120). Pearson correlation analysis and multiple linear regression analysis were used. In addition, 284 subjects estimated their body fat by dual x-ray absorptiometry. The joint relationship between obesity measures, body fat and insulin secretion were studied.
Results: As glucose metabolism spectrum changed from NGM to prediabetes and to T2DM, the correlation between WHR and insulin secretion declined (from r=0.286**, r=0.081, r=0.2** to r=-0.012, r=-0.072, r=-0.074 and to r=-0.173*, r=-0.175*, r=-0.171*; *P &lt; 0.05, **P &lt; 0.01). In contrast, BMI and WC showed a consistent association with insulin secretion (r&gt;0). Similar relevant reversal was only found in female subjects. There were significant interactions of WHR and glucose status on insulin secretion in female subjects, in this adjusted model, WHR was associated with higher insulin secretion in NGM group (1.19±0.23**, 0.58±0.32, 0.82±0.26**) and lower in T2DM group (-0.77±0.34*, -1.78±0.47**, -1.36±0.39), not prediabetes (0.15±0.27, 0.08±0.38, 0.28±0.31). Adding HOMA-IR to the core model can increase the inverse associations. Elevated limb fat to trunk fat ratio had significantly lower insulin secretion levels, and the relationship between this fat ratio and WHR was considerably strong in female.
Conclusions: WHR and insulin secretion relationship is dependent on glucose status among obese women. As diabetes developed, higher WHR revealed lower insulin secretion, which may be attributed to more fat distributed in extremities.

Disclosure
J. Wu: None. B. Wang: None.
2006-P: Association between High Birth Weight and Later Higher BMI and Blood Pressure in 9-Year-Old Schoolchildren
Authors: HIRSCHLER VALERIA ,   CARIÑO STUDY GROUP, MOLINARI CLAUDIA , GARCIA CONCEPCION , LAPERTOSA SILIVA 
Published: June 2020

Background: Studies have suggested that high birth weight (BW) is associated with later higher BMI but its association with higher blood pressure (BP) should be further explored.
Objective: To determine the association between high BW with later higher BMI and BP in 9-year-old overweight/obese (OW/OB) schoolchildren.
Methods: Schoolchildren (n = 2567, 1157M) aged 8.7±2.1 years from 10 elementary schools in five states of Argentina were examined between April 2017 and September 2019. Mothers submitted children’s BW information. Body mass index (BMI) and BP were assessed by pediatricians.
Results: 1095 (42.7%) of the children were OW/OB. The prevalence of low (&lt;2500grams), and high BW (&gt;4000grams) was 6.6% (n=169) and 7.4% (n=190), respectively. There was a significant difference in mean BMI z-score in 9-year-old children between low BW, normal BW, and high BW (0.44, 0.73, and 1.05, respectively). OW/OB 9-year-old children with high BW had higher z-BMI (1.70 vs. 1.89, respectively) and higher systolic BP (97 vs. 100 mm Hg, respectively) than OW/OB 9-year-old children with normal or low BW. However, normal-weight 9-year-old children with high BW had similar BP than 9-year-old children with normal or low BW. Multiple linear regression analyses showed that systolic BP was significantly associated with age in 9-year-old normal-weight children (R2=0.07). However, systolic BP was positively associated with age and BW in 9-year-old-OW/OB children (R2=0.11). When systolic BP was replaced by diastolic BP similar results were obtained.
Conclusion: This study suggests that systolic BP was significantly associated with high BW in OW/OB 9-year-old children but not in 9-year-old normal-weight children. Children with high BW should be followed closely to prevent future cardiovascular disease.

Disclosure
V. Hirschler: None. C. Molinari: None. C. Garcia: None. S. Lapertosa: None.
2010-P: Adipocyte Clusterin Is a Link between Cardiometabolism and Alzheimer’s Disease
Authors: BRADLEY DAVID , LIU JOEY Z. , BLASZCZAK ALECIA M. , WRIGHT VALERIE P. , TARAWNEH RAWAN , LIU YUXI , RYU JAE CHEON , YOON SUNG OK , HSUEH WILLA 
Published: June 2020

Background: Obesity heightens the risk for both cardiometabolic complications and Alzheimer’s disease (AD). Although the reasons have yet to be fully elucidated, weight loss improves cognition. Given this link, factors overproduced by obese adipose tissue are ideal candidates for novel investigation into AD pathogenesis. We have recently shown that clusterin from the adipocyte is related to multiple factors of the metabolic syndrome (insulin resistance, dyslipidemia, NAFLD, and atherosclerosis). Clusterin is also involved in CNS lipid trafficking and has been proposed as an AD biomarker.
Rationale: Our goals were to characterize the effect of high-fat diet (HFD) feeding on CNS clusterin and neuronal insulin signaling in an AD mouse model (5XFAD); and furthermore, determine the relationship of adipocyte clusterin with neurocognition and insulin sensitivity in obese humans at baseline and following bariatric surgery.
Methods: We treated 5XFAD and WT mice with normal chow and HFD for 4 mo., measured CNS clusterin, and determined its effect on neuronal insulin signaling. We next measured subcutaneous adipocyte (SAd) clusterin expression, and performed neuropsychological evaluation and a hyperinsulinemic-euglycemic clamp procedure in obese human subjects (n=11) before and after sleeve gastrectomy.
Results: In the 5XFAD mice, HFD increases brain clusterin levels compared to WT, and in primary cortical neurons clusterin attenuates insulin signaling in a dose-dependent manner. In humans, SAd clusterin is related to hepatic insulin resistance, higher fasting glucose, and reduced working memory/attention. After sleeve gastrectomy SAd clusterin expression is reduced, with a significant inverse association between clusterin and working memory/attention and hepatic insulin sensitivity.
Conclusions: Our data suggests that SAd clusterin is a potential player in AD pathology, providing a critical link between excess adiposity, T2D, insulin resistance, and heightened AD risk.

Disclosure
D. Bradley: None. J.Z. Liu: None. A.M. Blaszczak: None. V.P. Wright: None. R. Tarawneh: None. Y. Liu: None. J. Ryu: None. S. Yoon: None. W. Hsueh: None.

Funding
American Diabetes Association (1-16-ICTS-049 to W.H.); National Institutes of Health (KL2TR001068, R01HL135622)
2011-P: Cognitive Function Improves after Vertical Sleeve Gastrectomy, and Cognitive Gains Are Associated with Reduced Inflammation
Authors: MOHEET AMIR , RUBIN NATHAN , EBERLY LYNN E. , IKRAMUDDIN SAYEED , LUCIANA MONICA 
Published: June 2020

Obesity (OB) is associated with cognitive impairments, though the mechanisms are not well understood. OB-related chronic systemic inflammation has been postulated to contribute to cognitive dysfunction. Inflammation improves after vertical sleeve gastrectomy (VSG) and could be a potential mechanism for cognitive improvement. We examined cognitive functions in morbidly obese adults without diabetes (n 10, mean age 35 ± 4 yrs, BMI 46±11, A1C 5.3±0.4) before and 6 months after VSG. Blood inflammatory markers including IL 6 and CRP were quantified at both assessments. Paired t-tests were used to index pre versus post VSG changes. Spearman correlations quantified associations between cognition and inflammatory markers. There were post VSG improvements in bilateral fine motor skills (Grooved Pegboard, dominant 73 ±21.2 vs. 61 ±8.0, p 0.003, non-dominant 81 ± 24 vs. 67±9 p 0.01), working memory (backward digit span 5.2 ±1.8 vs. 6.1±1.2, p 0.18; NIH Toolbox List Sort Working Memory 102 ± 14 vs. 108 ± 11, p 0.069), and Fluid Reasoning (NIH Toolbox 94 ± 18 vs. 102 ±17, p 0.048). Depression levels (Beck Inventory) significantly decreased; levels were sub-clinical prior to VSG. Functions that remained stable pre to post VSG included estimated nonverbal and verbal IQ (Matrix Reasoning and Picture Vocabulary Tasks), verbal learning (Rey Auditory Verbal Learning Test), basic attention (Digit span forward), and self-reported impulsivity. When pre-to-post VSG changes in cognitive performance was correlated with pre-to-post VSG changes in systemic inflammation (IL6 and CRP levels), decreased inflammation was associated with improvements in working memory and other fluid abilities (r’s from .4 to .8). These findings are novel and show that cognitive function improves after VSG in obese subjects without diabetes and inflammation may contribute to cognitive alterations in OB.

Disclosure
A. Moheet: None. N. Rubin: None. L.E. Eberly: None. S. Ikramuddin: Other Relationship; Self; Reshape Life Sciences (formerly EnteroMedics). M. Luciana: None.

Funding
National Institutes of Health (R21NS101140)
2012-P: Effective Online CME Improves Obesity Diagnosis and Management
Authors: LARKIN AMY , CAPPARELLI CATHERINE C. , LEPKOWSKI ELIZABETH , LE ANNE 
Published: June 2020

We sought to determine if online continuing medical education (CME) could improve the knowledge and competence of diabetologists/endocrinologists (D/Es) and primary care physicians (PCPs) related to diagnosis and management of obesity. The CME activity was a 30-minute online video panel discussion among 3 faculty. A repeated pairs pre-/post-assessment study design was used and chi-square test (P &lt;.05 is considered significant) assessed educational effect for each activity. Cramer’s V was used to calculate the effect size (0.06-0.15 is a noticeable effect, 0.16-0.26 considerable, and &gt;0.26 extensive). The activity launched August 29, 2019 and data were collected through October 3, 2019. In total, 110 D/Es and 507 PCPs completed all pre/post questions and were included in the study. • Overall, 16% of D/Es (P&lt;.01 V=.146) and 23% of PCPs (P&lt;.0001, V=.209) demonstrated improvement from pre to post. • 26% of D/Es (P&lt;.0001; V=.345) and 31% of PCPs (P&lt;.0001; V=.342) demonstrated improvement in diagnosing a patient with obesity. • 5% of D/Es (P=.60; V=.033) and 15% of PCPs (P&lt;.0001; V=.107) demonstrated improvement in diagnosing a patient with obesity. • 29% of D/Es and 38% of PCPs reported an increase in confidence in effectively managing obesity. Continued educational gaps: • 69% of D/Es and 62% of PCPs need additional education on diagnosis and staging of obesity. • 21% of D/Es and 49% of PCPs need additional education on strategies for managing obesity. This study demonstrates the success of an online CME activity with discussion among 3 experts in the field on improving knowledge and competence related to obesity diagnosis and management. Additionally, continued gaps were identified for future educational targets.

Disclosure
A. Larkin: None. C.C. Capparelli: None. E. Lepkowski: None. A. Le: None.

Funding
Novo Nordisk
2015-P: Endobarrier (EB) in Diabetes/Prediabetes with Obstructive Sleep Apnoea (OSA) Study: The Final Results
Authors: YADAGIRI MAHENDER , KINNEY FIONA Y. , ASHMAN NATALIE , ADAMS JESSICA , WYRES MELANIE C. , SHARRATT EMMA S. , GREENWOOD CHERYL , LANG MICHAEL H. , BLEASDALE JOHN , FOGDEN EDWARD , ANDERSON MARK , WALTON CHRISTOPHER , GREENSTONE MICHAEL A. , RYDER ROBERT E. 
Published: June 2020

Background/Aim: EB, a 60cm endoscopically implanted proximal intestinal liner is implanted for up to one year and then removed. We aimed to assess the extent to which patients with type 2 diabetes or prediabetes, obesity (BMI 30-45kg/m²) and moderate OSA requiring continuous positive airway pressure ventilation (CPAP) are able to discontinue CPAP following EB-related weight loss.
Method: We assessed Apnoea Hypopnoea Index (AHI), weight and HbA1c before and during EB treatment and following its removal in the 12 patients with moderate OSA requiring continuous positive airway pressure ventilation (CPAP) {75% female, 8/12 (66%) type 2 diabetes, 4/12 (34%) prediabetes, mean ± SD age 52.6±9.7 years, BMI 37.4±3.5 kg/m², median duration of OSA while on CPAP 9.0(7.0-15.0) months}.
Results: During the period of EB implantation, mean ± SD HbA1c fell by 1.26±0.7% from 7.9 ± 1.6 to 6.6 ± 0.9% (p=0.023), weight by 10.5±4.0 kg from 103.8± 14.1 to 93.3±13.7 kg (p&lt;0.001) and AHI by 9.1±5.0 events/hour from 18.9±3.8 to 9.7±3.0 events/hour(p&lt;0.001). Prior to EB, all patients had AHI in the National Institute for Health and Care Excellence (NICE) moderate OSA range (15-29.9 events/hour). During EB treatment the AHI of all 12 patients fell below 15 such that they no longer required CPAP according to NICE criteria. After EB removal, 10/12 (83%) patients attended follow up and at 12 months after removal, AHI remained below 15 in 5/10 (50%) patients but in the other 5 the AHI rose above 15 such that restarting CPAP was recommended. Two of these 5 patients, inspired by the desire to avoid CPAP, lost the regained weight and their AHI dropped below 15 again. Thus, 7/10 (70%) of patients were able to remain off CPAP 12 or more months after EB removal.
Conclusion: These results demonstrate major benefit of EB in moderate OSA, allowing patients to discontinue CPAP with maintenance of improvement at follow up in 70% and confirm previously demonstrated metabolic improvements in diabesity.

Disclosure
M. Yadagiri: None. F.Y. Kinney: None. N. Ashman: None. J. Adams: None. M.C. Wyres: None. E.S. Sharratt: None. C. Greenwood: None. M.H. Lang: None. J. Bleasdale: None. E. Fogden: None. M. Anderson: None. C. Walton: Speaker’s Bureau; Spouse/Partner; Celgene, LEO Pharma, Novartis Pharmaceuticals Corporation. M.A. Greenstone: None. R.E. Ryder: Consultant; Self; GI Dynamics Inc. Other Relationship; Self; Novo Nordisk A/S.
2024-P: A Qualitative Study in Obesity to Explore Clinically Meaningful Change on Patient-Reported Outcome (PRO) Measures
Authors: POON JIAT LING , MARSHALL CHRIS , JOHNSON CHLOE , PEGRAM HANNAH , HUNTER MAILE , KAN HONGJUN , AHMAD NADIA 
Published: June 2020

Background: Obesity is a chronic disease with significant impacts on health-related quality of life (HRQoL) specifically physical functioning (PF), which is increasingly assessed using PRO measures in clinical trials. A review of existing literature suggested that further qualitative research was required to establish patient-perceived clinically important change (CIC) thresholds for two PRO measures used in obesity studies: the acute 36-item Short Form Health Survey (SF-36v2) and Impact of Weight on Quality of Life-Lite-Clinical Trials Version (IWQOL-Lite-CT).
Objective: To explore the level of change on the SF-36v2 (acute) and IWQOL-Lite-CT that individuals living with obesity consider to be meaningful, noticeable and indicative of treatment success.
Methods: Semi-structured interviews were conducted in the U.S. with adults who have overweight or obesity (Body Mass Index [BMI] ≥ 27 kg/m2). Open-ended concept elicitation (CE) questions allowed participants to discuss the amount of body weight loss needed to have a noticeable improvement on PF. Cognitive tasks were later used during cognitive debriefing (CD) to explore what participants considered a CIC on each PRO measure.
Results: A total of 33 participants were interviewed (mean BMI: 37.6 kg/m2 [27.4 to 56.6 kg/m2] mean age: 45 years [19 to 81 years]). In CE, participants identified 5-10% weight loss as the threshold for having a noticeable improvement on PF and contextualized meaningful weight loss by using real-life examples (e.g., climbing stairs without becoming breathless). In CD, the majority of participants considered a 1-point change at the item level to be indicative of meaningful improvement on both PRO measures.
Conclusions: The combined CE and CD approach facilitated better understanding of meaningful change by participants, providing evidence that a 1-point change, the smallest detectable change on both the SF-36v2 (acute) and IWQOL-Lite-CT, is a CIC in people with overweight or obesity.

Disclosure
J. Poon: Employee; Self; Eli Lilly and Company. C. Marshall: Other Relationship; Self; Eli Lilly and Company. C. Johnson: Other Relationship; Self; Eli Lilly and Company. H. Pegram: Other Relationship; Self; Eli Lilly and Company. M. Hunter: Other Relationship; Self; DRG Abacus. H. Kan: Employee; Self; Eli Lilly and Company. N. Ahmad: Employee; Self; Eli Lilly and Company.
2031-P: Obesity and Insulin Resistance Alter the Biodistribution of Whole Body Insulin-Stimulated Glucose Disposal
Authors: KOH HAN-CHOW , VLIET STEPHAN VAN , LAFOREST RICHARD , GROPLER ROBERT , KLEIN SAMUEL , MITTENDORFER BETTINA 
Published: June 2020

Insulin-stimulated whole-body (WB) glucose disposal (GD) is thought to occur predominately in skeletal muscle (SM). Studies in animals suggest adipose tissue (AT) could also be an important site of GD, especially in people with obesity and insulin resistance. The interrelationship between adiposity, insulin sensitivity, and organ-specific insulin-stimulated GD is not known. We evaluated WB, SM, and AT insulin-stimulated GD by using the hyperinsulinemic-euglycemic clamp procedure together with [6,6-2H2]glucose infusion and 18F-deoxyglucose positron emission tomography in healthy lean people (n=13, age: 39±12 yrs, BMI: 23±2 kg/m2; body fat: 31±7%, mean±SD) and 27 people with obesity, who were then characterized as insulin sensitive (OIS, n=9, age: 48±10 yrs, body fat: 45±10%) or insulin resistant (OIR, n=9, age: 40±10 yrs, body fat: 48±4%) based on the top and bottom tertile values for WB insulin-stimulated GD. WB insulin-stimulated GD was 60% lower in the OIR (1,636±283 µmol/min) than both the OIS and Lean groups (P&lt;0.01), without a difference between the OIS and Lean groups (4,188±758 and 3,855±1115 µmol/min). Total GD in subcutaneous AT was lower in the OIR than the OIS group (392±134 vs. 663±224 µmol/min) and greater in the OIS than the Lean (305±97 µmol/min, P&lt;0.01) group. However, the contribution of AT to WB GD was greater in the OIR than the OIS and Lean groups (24±6%, 16±5%, and 9±4% of WB GD, P&lt;0.01). GD rate in four major muscle groups (erector spinae, obliques, hamstrings, quadriceps) was 75% lower in the OIR (median [IQR]: 29 [23-35] µmol/kg muscle/min) than the OIS and the Lean groups (P&lt;0.01), without a difference between the OIS and Lean groups (115 [89-139] and 102 [90-127] µmol/kg muscle/min). We conclude that: 1) a decrease in insulin-stimulated SM GD is responsible for the decrease in WB insulin-stimulated GD in the OIR group and 2) AT is a more important site of insulin-stimulated GD in people with obesity, particularly those with insulin resistance, than lean people.

Disclosure
H. Koh: None. S. van Vliet: None. R. Laforest: None. R. Gropler: None. S. Klein: Advisory Panel; Self; Danone Nutricia, Merck & Co., Inc. Research Support; Self; Johnson & Johnson, Pfizer Inc. Stock/Shareholder; Self; Aspire Bariatrics. B. Mittendorfer: None.

Funding
American Diabetes Association (1-18-ICTS-119 to B.M.); National Institutes of Health (DK115400, DK56341, DK020579, UL1TR000448)
2032-P: Adipose Tissue Inflammation after Weight Loss
Authors: ESPINOSA DE YCAZA ANA E. , SØNDERGAARD ESBEN , MORGAN-BATHKE MARIA , DELIVANIS DANAE A. , CARRANZA LEON BARBARA G. , LYTLE KELLI , JENSEN MICHAEL D. 
Published: June 2020

Background: Studies of changes in adipose tissue (AT) inflammation after weight loss have conflicting results. Our aim was to evaluate the changes in AT macrophages, senescence and AT insulin resistance after weight loss.
Methods: Twenty-five participants (18 women) with obesity underwent a lifestyle intervention weight loss program and abdominal-femoral AT biopsies. AT insulin resistance was estimated calculating the insulin concentration that suppresses lipolysis by 50% (IC50) during a hyperinsulinemic-euglycemic clamp. Immunohistochemistry was used to estimate total adipose tissue macrophage (ATM) content (CD68+), pro-inflammatory ATM (CD14+), anti-inflammatory ATM (CD206+). Senescent cells in AT were identified by senescence associated β-galactosidase staining. All parameters were assessed before and after weight loss.
Results: Median BMI was 34 kg/m2 (IQR, 32-35). A median percent weight loss of 10.2% (IQR, 6.5-12.1) resulted in a mean IC50 reduction of -6.2 ± 13 µIU/mL, p=0.03. There was no significant change in ATM content in the abdominal or femoral fat depots after weight loss, except for an increase in CD68 ATMs (mean change 4.5 ± 7.1 ATM/100 adipocytes, P=0.02) in the femoral depot. The proportion of senescent pre-adipocytes in abdominal and femoral depots remained unchanged after weight loss. In the abdominal depot, there was no relationship between IC 50 and CD68 or CD206 ATMs after weight loss, R2= 0.11, P=0.15 and R2= 0.08, P =0.22, for CD68 and CD206 ATMs respectively. There was a weak negative relationship between CD14 ATMs and IC 50 (R2=0.2, P =0.04). In the femoral depot, there was a weak negative relationship between IC 50 and CD68 ATMs (R2=0.23, P=0.04), and no relationship between IC 50 and CD14 ATMs (R2= 0.2, P=0.06) or CD206 ATMs after weight loss (R2= 0.06, P=0.33).
Conclusion: Moderate weight loss is not associated with reduction in ATM content or senescent pre-adipocytes, despite an improvement in AT insulin resistance. Our results suggest that recruitment of some populations of ATMs increases after weight loss.

Disclosure
A.E. Espinosa De Ycaza: None. E. Søndergaard: None. M. Morgan-Bathke: None. D.A. Delivanis: None. B.G. Carranza Leon: None. K. Lytle: None. M.D. Jensen: None.