bluuebunny/crossref_metadata_2025_split huggingface dataset:
MON-596 Effects of Angiotensin Type 1 Receptor Blockers (ARBs) on the Expression and Secretion of Adiponectin and Leptin in Human White Adipocytes
Authors: Hattori Naoki , Matsuda Takeshi , Chihara Kazuhisa , Nakatsuji Shunya , Nishida Natsuka , Shimatsu Akira 
Published: May 2020

Abstract
[Introduction]
Adiponectin and leptin are adipokines that are mainly produced in adipocytes and exert various functions. Adiponectin decreases atherosclerosis, oxidative stress, angiogenesis, inflammation, and apoptosis, whereas leptin works oppositely. Angiotensin type-1 receptor (AT1R) blockers (ARBs) are widely used as antihypertensive drugs. Some ARBs are known to activate peroxisome proliferator-activated receptor (PPAR) γ, which is a key regulator of fatty acid metabolism. It is reported that adiponectin secretion increases by pioglitazone, a full agonist of PPARγ, and some ARBs via PPAR γ activation. However, the effects of ARBs on leptin secretion are controversial. The present study aimed to examine the effects of ARBs on the expression and secretion of adiponectin and leptin in human white adipocytes.
[Materials and Methods]
Human white preadipocytes (Promo Cell) were differentiated into mature adipocytes in the medium containing insulin, dexamethasone, thyroxin and isobutylmethylxanthine. Pioglitazone and ARBs including telmisartan, irbesartan, azilsartan, candesartan, losartan, olmesartan and valsartan (1µM) were administered in the culture medium on day 4 and 8. The medium was collected on day 12 and the concentrations of adiponectin and leptin were measured by enzyme immunoassay. Real time PCR was performed to quantitate the mRNA expression of adiponectin and leptin in adipocytes. The experiments were performed in quadruplicate.
[Results]
Pioglitazone significantly increased adiponectin secretion (386.7 ± 133.7 vs. 7.3 ± 1.9 ng/ml in control) from human adipocytes. Among ARBs, adiponectin secretion significantly increased by telmisartan (136.7 ± 16.3 ng/ml) and irbesartan (69.7 ± 23.1 ng/ml), while the other 5 ARBs did not have any influence on adiponectin secretion. Real-time PCR also showed that mRNA expression increased 5.1-fold, 3.8-fold and 1.5-fold by pioglitazone, telmisartan and irbesartan, respectively. Leptin secretion significantly decreased by pioglitazone (27.7 ± 5.0 vs. 82.5 ± 3.8 ng/ml in control). Among ARBs, only telmisartan (38.7 ± 4.2 ng/ml) decreased leptin secretion. Real-time PCR also showed that mRNA expression decreased to be 0.5-fold and 0.7-fold by pioglitazone and telmisartan, respectively. GW9662, a selective antagonist of PPARγ, potently blocked pioglitazone-induced changes of adiponectin and leptin expression and secretion. On the other hand, GW9662 did not reverse telmisartan and irbesartan induced changes.
[Conclusion]
The changes in adiponectin and leptin secretion by pioglitazone are via PPARγ activation, while those by telmisartan and irbesartan may occur in PPARγ-independent manner.
SAT-024 Investigating Racial and Ethnic Comorbidity Patterns of Polycystic Ovary Syndrome
Authors: Actkins Ky’Era , Edwards Digna Velez , Aldrich Melinda , Davis Lea 
Published: May 2020

Abstract
Polycystic ovary syndrome (PCOS) is a highly heterogenous reproductive endocrine disorder that affects up to 15% of women and is one of the leading causes of infertility. However, its genetic etiology remains poorly understood. Additionally, PCOS patients have a greater risk of having metabolic disorders, such as insulin resistance and cardiovascular diseases, but it is estimated that up to 75% of women remain undiagnosed. Delayed treatment and care can exacerbate comorbid conditions and be detrimental to high risk populations like African American and Hispanic women. We aim to characterize genetic and environmental variables contributing to PCOS and understand its shared etiological features with metabolic disorders. To do this, we developed two algorithms to identify diverse PCOS patients using medical records. The broad algorithm used a combination of PCOS-related billing codes (Code Based) and identified a large dataset (N = 8,340) who exhibited diverse PCOS symptoms, while the strict algorithm required PCOS keywords in addition to billing codes (Regex Based). The strict algorithm identified a smaller cohort of patients (N = 4,593) who exhibited more classically diagnoseable PCOS characteristics according to Rotterdam and NIH criteria. Using both datasets, we tested PCOS case status against 1,853 phenotypes in the medical database using a logistic regression model and identified comorbidity patterns for women of European and African descent. We observed that European descent women consistently had more distinct phenotypes associated with PCOS case status than African American women. Next, we examined the interacting effects of self-reported race on PCOS case status and found four significant phenotypes (p &lt; 6.25e-4) in our Regex Based algorithm. African American women with PCOS had greater odds of being diagnosed with “Early onset of delivery” (p = 1.3e-4, OR = 1.86), “Hereditary hemolytic anemias” (p =1.8e-4, OR = 0.65), and “Other hereditary hemolytic anemias” (p = 3.7e-04, OR = 0.90). Meanwhile, European descent women had greater odds of being diagnosed with “Hypertensive chronic kidney disease” (p = 1.7e-04, OR = 0.68). Results show that European and African American women have unique metabolic comorbidity patterns and it may also indicate that clinical PCOS diagnostic standards vary between these groups with possible disparity-causing effects.
SAT-122 Expression of Cell Synthesis and Dna Repair Markers in Meningioma Recurrence or Regrowth
Authors: Leães Rech Carolina Garcia Soares , Silva Camila Batista de Oliveira , Ongaratti Barbara , Trott Geraldine , Minuzzi Ricardo Kunde , Ferreira Nelson Pires , Oliveira Miriam da Costa , Pereira-Lima Júlia Fernanda Semmelmann 
Published: May 2020

Abstract
Meningiomas correspond to 37% of intracranial tumors and are considered the second most common neoplasm of the central nervous system in adults. Most of them are benign with slow growth pattern, common from the fifth decade, more frequent in women and with high recurrence rates. In tumors, there is a reduction in the efficiency of DNA error repair, allowing the proliferation of tumor cells. In this work, we evaluated the protein expression of markers involved in cell synthesis (cyclin D1) and repair of DNA errors (MUTYH, XPF, and XPG) in meningiomas. To date, this is the first study to use the immunohistochemical technique in the evaluation of these repair proteins, relating them to clinical data, tumor variables and recurrence-regrowth free survival. 85 samples were included in the study, patients with a mean age of 52 + 13.3 years, 68% female, in proportion 2:1. Most cases were classified as grade I (79%), meningothelial subtype (38%) and transitional (25%). Regarding surgery, 59% of the patients underwent total resection. Regarding location, the most common was the peripheral (62.2%). Most tumors (64%) were larger than 3cm, with a mean of 3.6±2cm. The median recurrence-regrowth free survival was 67 months (95% CI:57.8-76.6). According to the Kaplan-Meier curve, the recurrence-regrowth free survival rate was 94.4% at 1 year, 76.6% at 2 years and 64.7% at 3 years and 49.4% at 5 years. Grades II and III were prognostic factors for tumor recurrence-regrowth (p&lt;0.05). Cyclin D1 was positive in 92%, 77% in grade I and 23% in grades II and III. A statistically significant relationship was found between cyclin D1 and tumor grade (p = 0.001), with higher expression in grade II and III. Repair proteins were expressed in most meningiomas. MUTYH (63.5%), 43.5% in grades I and 20% in grades II and III, with a significant relationship between grades II and III and, expression 10-50% (p=0.02). Significant association was observed with MUTYH (p=0.001) and XPF (p=0.019). XPF and XPG were associated with grades II and III (p=0.002 and p&lt;0.001) and XPF with size &gt;3cm (p=0.03). There was a positive correlation between XPF and XPG (p= 0.02) and between MUTYH and XPF (p=0.003). XP proteins were related to recurrence-regrowth (p=0.04), but not with recurrence-regrowth free survival. Our results demonstrate the activation of repair pathways and increased cell synthesis in grades II and III in meningiomas. Cellular synthesis and DNA repair markers are important tools to broaden knowledge about the biological behavior of meningiomas.
SAT-375 A 59 Year Old Female with Isolated Vitamin B6 Deficiency and Muscle Spasms
Authors: Zhou Joseph , Effiong Utibe 
Published: May 2020

Abstract
Introduction
Vitamins are essential micronutrients required by biological organisms in small quantities for maintaining basic cellular metabolism. Vitamin B6 is an important co-factor for many biochemical reactions in cellular metabolism related to the synthesis and catabolism of amino acids, fatty acids, neurotransmitters, and organelle-specific compounds, as well as in detoxifying reactive oxygen species within the cell. (1) Due to the role of Vitamin B6 in intracellular metabolism and synthesis of neurotransmitters, deficiency of the vitamin results in impaired transcellular signaling between neurons, and classically presents with muscular convulsions, hyperirritability, and peripheral neuropathy. (2)
Case Presentation
History
We present a case of a 59-year old female with Type 2 diabetes who complained of muscle spasms. She experienced muscle spasms in her feet which have spread proximally to involve her legs. She also admitted to experiencing intermittent spasms in her left arm. The spasms occurred intermittently throughout the day and persist throughout the night, making it difficult for her to fall asleep. She had taken cyclobenzaprine twice daily and tried leg stretches, however her spasms persist. She had also tried baclofen in the past without significant alleviation of her symptoms.
Evaluation
An extensive investigation was conducted including tests for water-soluble vitamins. Her plasma pyridoxal 5-phosphate was 3 mcg/L (reference range 5-50 mcg/L), confirming vitamin B6 deficiency. She was also tested for Vitamins B1, B3, B12 and folate. None of the respective tests indicated deficiencies. Other test results were within normal limits.
Treatment
The patient received standard-dose intramuscular vitamin B6 injections for three weeks followed by oral supplements for 3 months. She was also given cyclobenzaprine (10 mg tablet) three times a day for muscle spasms in her legs. Although she had reported cyclobenzaprine did not significantly alleviate her spasms per se, it produces a sedative effect which improves her tolerance to the spasms and helps her to fall asleep at night.
Conclusion
This case illustrates the rare instance of isolated vitamin B6 deficiency with normal serum levels of other water-soluble vitamins, manifesting as myoclonic spasm involving the legs and arms in the absence of objective polyneuropathy.
References
i1 Parra, Marcelina, Seth Stahl, and Hanjo Hellmann. “Vitamin B6 and its role in cell metabolism and physiology.” Cells 7.7 (2018): 84.
i2 Brown, Mary J., and Kevin Beier. “Vitamin B6 Deficiency (Pyridoxine).” StatPearls [Internet]. StatPearls Publishing, 2018.
MON-210 Role of Female Gender and Subcutaneous Fat in the Positive Association of Obesity with Idiopathic Hyperaldosteronism
Authors: Sawayama Nagisa , Hatano Yu , Ebihara Ken , Ebihara Chihiro , Takahashi Manabu , Nagashima Shuichi , Kurashina Tomoyuki , Okada Kenta , Ishibashi Shun 
Published: May 2020

Abstract
Context: Primary aldosteronism (PA) is the most frequent cause of secondary hypertension. The relationship between PA and various metabolic disorders including obesity, diabetes mellitus and dyslipidemia has been reported. On the other hand, PA consists of two main subtypes: unilateral aldosterone-producing adenoma (APA) and the bilateral idiopathic hyperaldosteronism (IHA), which have different etiologies. Recently, it was reported that the prevalence of obesity was higher in patients with IHA than those with APA, suggesting that there is a link between obesity and the etiology of IHA (Ohno Y et al. J Clin Endocrinol Metab 2018). Furthermore, it has also been reported that female patients with PA are more likely to have IHA than male patients.
Objective: Our objective was to clarify the pathological role of female gender in the positive association of obesity with IHA. Because of the difference of body fat distribution between men and women, we also investigate the contribution of visceral and subcutaneous fats in the pathogenesis of IHA.
Design: This retrospective observational study comprised 117 PA patients (IHA: n = 73, APA: n = 44) diagnosed by adrenal venous sampling between January 2006 and July 2019 at Jichi Medical University Hospital. We compared prevalence of obesity and metabolic parameters including visceral and subcutaneous fat areas measured by computed tomography between patients with IHA and APA by gender. We also compared visceral and subcutaneous fat areas between patients with IHA and APA by the presence of obesity, BMI ≥25 kg/m2 (the diagnosis criteria by Japan Society for the Study of Obesity).
Results: In consistent with previous reports, BMI was significantly higher in patients with IHA than those with APA. However, in male patients, no difference of BMI between IHA and APA was observed. By contrast, in female patients, not only BMI but also both visceral and subcutaneous fat areas were significantly higher in IHA than in APA. Next, we investigated the contribution of visceral and subcutaneous fats in the positive association of obesity with IHA in female patients. Subcutaneous fat area but not visceral fat area was significantly higher in female obese patients with IHA. By contrast, visceral fat area but not subcutaneous fat area was significantly higher in female non-obese patients with IHA.
Conclusions: These results suggest that obesity, especially subcutaneous fat accumulation, contributes to the pathogenesis of IHA in female patients.
SUN-287 A Case of Ectopic Neurohypophysis
Authors: folawewo kehinde Matilda , Hodge MaKenzie , Osman Nada , Zenebe Anteneh Woldetensay , Ganta Vijaya A , Odonkor Wolali Akua-Sabia , Nunlee-Bland Gail Louise , Nunlee-Bland Gail Louise 
Published: May 2020

Abstract
Pituitary stalk interruption syndrome (PSIS) is a congenital disorder of the pituitary gland. Symptoms at presentation may vary widely as this disease presents along a spectrum which includes; ectopic posterior pituitary, interrupted pituitary stalk or aplasia and hypoplasia of the pituitary gland. It is a heterogeneous disorder in terms of radiologic and clinical presentation. It can present clinically as an isolated pituitary hormone deficiency (most common being growth hormone deficiency) or as multihormonal deficiencies.
CASE PRESENTATION
Patient is a 34-year-old woman with history of primary amenorrhea who was evaluated by a gynecologist and was prescribed oral contraceptive pills which lead to her having a menstrual bleed for the first time in her life. She denied any difficulty with smell. She had undergone normal psychomotor milestones and highest level of education was high school. She had normal puberty with normal pubic and axillary hair growth, normal breast development but no menarche. Of note, patient has a short stature, height is 4 feet and 11 inches, and her biological parents are of normal adult height
On evaluation, patient had normal am cortisol, prolactin and thyroid function tests. IGF-1 was significantly low for her age, FSH and LH were inappropriately low for her low estradiol level suggesting hypogonadotropic hypogonadism.
Patient subsequently had an MRI of the pituitary and DXA scan. MRI findings were suggestive of ectopic neurohypophysis. DXA scan showed significant reduction in bone mineral density for age.
Patient is currently being treated with hormonal replacement which is the main modality of treatment for ectopic neurohyphysis. She will need long term follow up as disease progression to pan-hypopituitarism is common.
CONCLUSION
PSIS is a rare syndrome with different phenotypic presentation depending on when the diagnosis is made; therefore, adequate follow up is indicated as the disease can progress from a single hormonal deficiency to pan-hypopituitarism.
SUN-682 Type Two Diabetes Patient in Remission After Twelve Years of Diagnosis
Authors: Shaghouli Amna Ali , Aranky Rola 
Published: May 2020

Abstract
Introduction
Type 2 diabetes (T2D) has been defined as a lifelong condition which is inevitably progressive.1 The idea that beta cell function certainly declines with time in diabetic people who have developed T2D has been definitively disproven.2 It has been recognised that the processes that cause T2D can be reversed and T2D remission can be achieved.2
Many studies show that, by changing life style dramatically, controlling diabetes can improve significantly and a significant proportion of patients can also reduce or come off their glucose-lowering therapies.3 This has been formally proven in DIRECT, with clear evidence of gradual continuing improvement in beta cell functional capacity over at least 12 months.4 Remission was linked to weight loss, as two third of those who lost more than 10kg were in remission after two years.4
Methods
A case study was done on a 66 years old male, who is diabetic for the last 12 years, with other comorbidities: hypertension and hypercholesterolemia.
He presented with Hemoglobin A1C (HbA1c) of 7.4% with BMI of 37.7 kg/m2 on four oral hypoglycaemic agents and basal insulin of 20 units per day.
His treatment was changed by adding Glucagon-like peptide-1 receptor agonists (GLP-1 RA) for better glycemic control and weight reduction in a setting of a multidisciplinary team approach, including endocrinologist, diabetes educator, dietitian and physical trainer.
Results
Over the last one year and two months, patient was able to stop all his diabetes medication including GLP-1 RA. Over three years follow ups patient achieved weight reduction of 17.3% with HbA1c of 6.5% and additional other metabolic factor benefits.
Conclusion
Even with 12 years of diabetes, reversibility of T2D can still be achieved with weight reduction of over 15%. We will wait for another 10 months to reconfirm our data for two years remission.
References
1. Steven S, Taylor R. Restoring normoglycaemia by use of a very low calorie diet in long-and short-duration Type 2 diabetes. Diabetic Medicine. 2015 Sep;32(9):1149-55.
2. Nagi D, Hambling C, Taylor R. Remission of type 2 diabetes: a position statement from the Association of British Clinical Diabetologists (ABCD) and the Primary Care Diabetes Society (PCDS). British Journal of Diabetes. 2019 Jun 27;19(1):73-6.
3. Wing RR, Blair E, Marcus M, Epstein LH, Harvey J. Year-long weight loss treatment for obese patients with type II diabetes: does including an intermittent very-low-calorie diet improve outcome?. The American journal of medicine. 1994 Oct 1;97(4):354-62.
4. Taylor R, Al-Mrabeh A, Zhyzhneuskaya S, Peters C, Barnes AC, Aribisala BS, Hollingsworth KG, Mathers JC, Sattar N, Lean ME. Remission of human type 2 diabetes requires decrease in liver and pancreas fat content but is dependent upon capacity for β cell recovery. Cell metabolism. 2018 Oct 2;28(4):547-56.
SAT-388 Dry Cough as Only Sign of a Parathyroid Adenoma Producer of PTH
Authors: Selman-Geara Antonio , Benitez-Camporro Antonio , Defillo-Guerrero Guillermo , Ibrahim Ammar , Redondo, Cytopathologist Yasmin , Rodriguez L , Selman-Fermin Antoine , Selman-Fermin Anyel I 
Published: May 2020

Abstract
BACKGROUND: The parathyroid adenoma producing an excess of PTH is characterized by hypercalcemia, asthenia, physical weakness and renal lithiasis. This clinical case is presented only with a dry (non-productive) cough sign of long duration.CASE: 51-year-old female born in Padre Las Casas, D.R. presenting with chief complain of dry cough for about four years. Clinical findings: (03/13/2019) Height 62”, Weight 142 lbs, Temperature 36.2 Celsius, BP 90/60 mmHg, RR 16 rpm, HR 60 bpm, on her neck no adenopathies or thyroid changes. Occasional coughing. A sonographic evaluation of the neck (04/09/2019) reveals a solid, heterogeneous nodular image of 0.7 cm x 0.5 cm in the left lobe of the Thyroid (Fig. 1) which by FNAB (04/10/2019) showed a benign adenomatoid node with cystic changes (Bethesda II) (Fig. 2). TEST: (03/20/2019) anti-TG 0.10 IU/mL (NV -115), anti-TPO 9.00 IU/mL (NV -34), TG 9.41 (NV -78 ng/mL), TSH 0.34 μIU/mL (VN 0.27-4.20), free T3 2.05 pg/mL (NV 2.04-4.40), total T3 0.74 ng/mL (NV 0.83-2.00), total T4 8.46 μg/dL (NV 5.1-14.1), free T4 1.61 ng/dL (NV 0.93-1.71) Calcium 10.4 mg/dL (NV 8.1-10.4), Phosphorus 2.6 mg/dL (NV 2.5-4.5), PTH-Intact 157 pg/mL (NV 14.5-87.1) Thyroid-Parathyroid scintigraphy (Sestamibi-Technetium 99mTc04: 15 mCi) (04/23/2019) shows lower left Parathyroid Adenoma (Fig. 3). She undergoes surgery (05/23/2019) removing the left thyroid lobe and left inferior parathyroid gland whose pathology shows chronic nodular colloid goiter, with areas of hemorrhage. Parathyroid adenoma of main cells (Fig. 4-5). Post-surgical TEST (06/24/2019) PTH-intact 69.0 pg/mL (NV 14.5-87.1), Calcium 8.6 mg/dL (NV 8.1-10.4), Phosphorus 2.7 mg/dL (NV 2.5-4.5), anti-TG 10.0 IU/mL (NV &lt;115), anti-TPO 9.00 IU/mL (NV &lt;34), TG 8.92 ng/mL (NV &lt;78), total T3 0.68 ng/mL (NV 0.83-2.00), free T3 1.95 pg/mL (NV 2.04-4.40), total T4 6.40 μg/dL (NV 5.1-14.1), free T4 1.02 ng/dL (NV 0.93-1.71). Post-surgical clinical evaluation (06/21/2019) Weight 142 lbs, Temperature 36.5 Celsius, BP 110/70 mmHg, RR 16 rpm, HR 60 bpm. Patient has not shown signs of coughing. Last TESTS (10/20/2019) Calcium 9.40 mg/dL, Phosphorus 3.10 mg/dL, PTH-intact 24.40 pg/mL, TG 11.90 ng/mL, total T4 6.80 μg/dL, free T4 1.23 ng/dL, total T3 0.88 ng/mL, free T3 2.66 pg/mL, anti-TPO 11.14 IU/mL, anti-TG 10 IU/mL. CONCLUSIONS: Lower left (benign) parathyroid adenoma whose clinical manifestations are not common. Dry (non-productive) cough is not known as a manifestation of elevated PTH-intact. Calcium and Phosphorus levels in normal values. In addition, histological alterations of the left thyroid lobe of benign character with few manifestations of hormonal alterations and normal antibodies. It is of crucial clinical importance to observe and document more cases with similar presentation in order to identify the possible causes of cough with an elevated PTH manifestation.