bluuebunny/crossref_metadata_2025_split huggingface dataset:
372-P: Type 2 Diabetes and Risk of Major Cardiovascular Events in Peripheral Artery Disease vs. Coronary Artery Disease Patients
Authors: SAELY CHRISTOPH H. , VONBANK ALEXANDER , LARCHER BARBARA , MADER ARTHUR , MAECHLER MAXIMILIAN , SPRENGER LUKAS , MUTSCHLECHNER BEATRIX , LEIHERER ANDREAS , MUENDLEIN AXEL , DREXEL HEINZ 
Published: June 2021

The prevalence of type 2 diabetes (T2DM) is higher in peripheral artery disease (PAD) than in coronary artery disease (CAD) patients, and PAD overall confers higher cardiovascular risk than CAD. How the incidence of major cardiovascular events compares between PAD and CAD patients when analyses are stratified by the presence of type 2 diabetes (T2DM) is unclear and is addressed in the present study. We prospectively recorded major cardiovascular events and death over 10.0±4.7 years in 923 patients with stable CAD, of whom 26.7% had T2DM and in 292 patients with PAD, of whom 42.1% had T2DM. Four groups were analyzed: CAD patients without diabetes (CAD/T2DM-; n=677), CAD patients with T2DM (CAD/T2DM+; n=246), PAD patients without diabetes (PAD/T2DM-; n=169) and PAD patients with T2DM (PAD/T2DM+; n=123). When compared to the incidence of MACE in CAD+/T2DM- patients (25.1%), it was significantly higher in CAD+/T2DM+ patients (35.4%; p&lt;0.001), in PAD+/T2DM- patients (30.2%; p=0.022) and in PAD+/T2DM+ patients (47.2%; p&lt;0.001). Patients with both PAD and T2DM in turn were at a higher risk than CAD+/T2DM+ or PAD+/T2DM- patients (p=0.001 and p&lt;0.001, respectively). The incidence of MACE did not differ significantly between PAD+/T2DM- and CAD+/T2DM+ patients (p=0.413). Compared to patients with CAD, Cox regression analyses after multivariate adjustment showed an adjusted hazard ratio of 1.46 [1.14-1.87], p=0.002 for the presence of PAD. Conversely, T2DM increased the risk of MACE after multivariate adjustment in CAD and PAD patients (adjusted HR 1.58 [1.27-1.98], p&lt;0.001).
In conclusion, our data show that T2DM and the presence of PAD are mutually independent predictors of MACE. Patients with both PAD and T2DM are at an exceedingly high risk of MACE.

Disclosure
C. H. Saely: None. H. Drexel: None. A. Vonbank: None. B. Larcher: None. A. Mader: None. M. Maechler: None. L. Sprenger: None. B. Mutschlechner: None. A. Leiherer: None. A. Muendlein: None.
374-P: Oleate Prevents Palmitate-Induced Abnormalities in Insulin Signaling in Human Cardiac Progenitor Cells
Authors: DORIA ROSSELLA , CACCIOPPOLI CRISTINA , SCHIPANI ROSSELLA , GENCHI VALENTINA ANNAMARIA , LEONARDINI ANNA , NATALICCHIO ANNALISA , PERRINI SEBASTIO , CIGNARELLI ANGELO , LAVIOLA LUIGI , GIORGINO FRANCESCO 
Published: June 2021

Myocardial ectopic lipid deposition has been associated with insulin resistance and cardiovascular risk. Palmitate, one of the most abundant saturated fatty acids, has been shown to impair insulin signaling in multiple cell types. Human cardiac progenitor cells (CPC) represent a compartment of multipotent stem cells essential for constant tissue repair and renewal in the adult heart. In this study, the ability of palmitate to impair insulin signaling, and the modulatory effects of oleate, a mono-unsaturated fatty acid, on palmitate-induced abnormalities were investigated in human CPC isolated from control subjects undergoing cardiac surgery. Human CPC express insulin receptor (IR), as assessed by quantitative RT-PCR and immunoblotting. Specifically, in human CPC both IR isoforms, A (IR-A) and B (IR-B), were identified, and IR-A was more expressed than IR-B. Exposure of human CPC to 100 nM insulin for 15 minutes resulted in increased Akt and p44/p42 MAPK phosphorylation (p&lt;0.05), evidenced by immunoblotting. Treatment of human CPC with 0.25 mM palmitate for 24 h impaired the ability of insulin, added for the last 15 minutes, to phosphorylate both Akt and p44/p42 MAPK (p&lt;0.05), without no effect on total Akt and p44/p42 MAPK protein levels. Interestingly, palmitate was able to increase both IR-A and IR-B mRNA levels (p&lt;0.05), and to reduce IR protein expression (p&lt;0.05). Co-incubation of palmitate with 0.1 mM oleate prevented the ability of palmitate to reduce insulin-induced Akt phosphorylation (p&lt;0.05), but did not rescue the impaired p44/p42 MAPK phosphorylation. In addition, co-treatment with oleate also prevented both palmitate-induced upregulation of IR-A and IR-B mRNA (p&lt;0.05), and downregulation of IR protein levels (p&lt;0.05).
In conclusion, oleate prevents some of the palmitate-induced impairments in insulin signaling in human CPC, thus contributing to cardiac protection from lipotoxicity-induced metabolic alterations.

Disclosure
R. Doria: None. F. Giorgino: Consultant; Self; AstraZeneca, Boehringer Ingelheim International GmbH, Lilly Diabetes, Novo Nordisk, Roche Diabetes Care, Sanofi, Research Support; Self; Lilly Diabetes, Roche Diabetes Care. C. Caccioppoli: None. R. Schipani: None. V. Genchi: None. A. Leonardini: None. A. Natalicchio: Speaker’s Bureau; Self; AstraZeneca, Boehringer Ingelheim International GmbH, Lilly Diabetes, Sanofi. S. Perrini: None. A. Cignarelli: None. L. Laviola: Advisory Panel; Self; A. Menarini Diagnostics, Abbott, AstraZeneca, Lilly Diabetes, Novo Nordisk Inc., Roche Diabetes Care, Sanofi-Aventis, Speaker’s Bureau; Self; Boehringer Ingelheim International GmbH, Medtronic.
377-P: Effect of Severe Hypoglycemia on Myocardial Cardiac Function in Type 1 Diabetes
Authors: FAHRMANN ELKE R. , ADKINS LAURA J. , LAMICHHANE RAJAN , DRISCOLL HENRY 
Published: June 2021

Objective: Associations between severe hypoglycemia (SH) and cardiovascular disease (CVD) have been reported in epidemiological studies. Mechanisms for the relationship between SH and CVD are not well understood. While associations of HbA1c and traditional CVD risk factors with myocardial function in subjects with type 1 diabetes in the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) study have been reported, it is unknown whether an association of SH with myocardial function exists.
Methods: We evaluated cardiac magnetic resonance (CMR) data of 1017 subjects. Associations of SH with CMR parameters using generalized linear models were examined. At time of CMR, subjects had been followed over ~ 22 years. SH was defined as SH requiring assistance of another party. A subset was defined as SH accompanied by coma and/or seizure (SHCS).
Results: At time of CMR, 660 subjects had a SH history (407 subjects with coma and/or seizures). Median age [interquartile range] was 50 [44, 54] years, 48% were females, and median diabetes duration was 26.6 [23.5, 31.4] years. SH was positively associated with end diastolic volume (EDV) by +4 ml, p&lt;0.01 and end systolic volume (ESV) by +2.7 ml, p&lt;0.01, left ventricular mass (LVM) by +2.8 mg, p&lt;0.05, and negatively correlated with ejection fraction by -0.8%, p&lt;0.05. Its SHCS subset was positively associated with EDV by +3.4 ml, p&lt;0.01, LVM by 2.6 mg, p&lt;0.05, stroke volume by +1.9 ml, p&lt;0.05, and cardiac output by +0.15 L/min, p&lt;0.05. Sensitivity analyses were consistent with results.
Conclusion: The effect of SH on cardiac function might be one of the mechanisms to explain the association between SH and CVD. It needs to be examined whether SH is associated with myocardial scars. Further studies are required to investigate whether the magnitude of SH effect on myocardial function increases with older age and leads to a clinically relevant CV event, especially in diabetic subjects with established coronary heart disease.

Disclosure
E. R. Fahrmann: None. L. J. Adkins: None. R. Lamichhane: None. H. Driscoll: None.
383-P: Comparative Study of Serum Testosterone Levels in Male T2DM and Nondiabetic Subjects as a Risk Marker for Atherosclerotic Coronary Artery Disease
Authors: DAS AMIT K. , BHAGAT ABHINAV , SINHA NEERAJ 
Published: June 2021

Background: Historically, higher levels of serum testosterone were presumed deleterious to the cardiovascular system. cardiovascular disease (CVD) risk factors prevalence were increased due to low testosterone levels.
Material and Methods: This was a prospective observational study, conducted among men with type 2 diabetes with documented CAD (n = 60) and controls healthy men (n = 50). Pearson correlation between sex hormones and CAD risk factors was done. The association between sex hormones and CAD risk factors among patients was analyzed by multiple logistic regression. The statistical significance was set at the 0.05 level.
Result: Mean age of diabetics was 44.5 ±7.9 years and non diabetics was 42.54 ± 5.63 years. 56% of Diabetics and 20 % non diabetics had lower levels of total testosterone. 68% of Diabetics and 26 % non diabetics had lower levels of free testosterone. Mean SHBG levels in Diabetics and non - diabetics was 8.6 ± 1.8 and 16 ± 3.2. Prevalence of Hypogonadism was 22% in Diabetics and 10% in Non diabetics. Among the cases, a significant positive correlation was found between total testosterone/FTI and waist circumference, W/H ratio, triglyceride levels, hs-CRP, and CIMT (P &lt; 0.01). In addition, a significant negative correlation was found between total testosterone and FTI with high-density lipoprotein-cholesterol levels (P &lt; 0.01). The multiple logistic regression analysis showed that total testosterone levels (P &lt; 0.01) and SHBG (P &lt; 0.01) are independently associated with the occurrence of atherosclerotic CAD in T2DM men.
Conclusion: We conclude that increased serum testosterone levels and low SHBG in T2DM men are associated with the development of atherosclerotic cardiovascular risk factors.

Disclosure
A. K. Das: None. A. Bhagat: None. N. Sinha: None.
396-P: Delayed Chronic Kidney Disease (CKD) Diagnosis in Type 2 Diabetes (T2D)
Authors: HARINDHANAVUDHI TASMA , FREESE REBECCA L. , CARAMORI LUIZA 
Published: June 2021

Background: CKD diagnosis is under recognized in T2D. We determined the interval between biochemical and clinically documented CKD diagnosis in a retrospective cohort of adults seen in the clinics of a large academic center between 1/1/11-7/31/20.
Methods: Biochemical CKD diagnosis was defined as 2 estimated glomerular filtration rate (eGFRcr) &lt;60 ml/min/1.73 m2 (CKD-EPI) and/or 2 out of 3 albumin-to-creatinine ratios (ACR, spot urine) &gt;30 mg/g, ≥3 months apart. KDIGO GFR and ACR categories were used. Clinical CKD diagnosis was defined by presence of any CKD code in the electronic health record.
Results: 139,369 unique patients with T2D (60±15 yrs; 47% female; 83% white) were seen during the study period. 62,201 (44.6%) and 53,352 (38.3%) had at least one GFR or ACR, respectively, and 53,141 (38.1%) had both lab measurements. 15,770 (25.3%) had CKD by eGFR criteria. The median interval between biochemical and clinical diagnosis was 1.9 yrs (range 0.003-17.9), longer among patients on CKD stage G3a (2.1 yrs, [0-18.0]) than on G3b (1.5 [0-16.2] yrs; P&lt;0.001) or G4 (1.2 [0-16.0] yrs; P&lt;0.001). 13,647 (15.6%) had CKD by ACR criteria. Out of the 24,368 patients who had albuminuria on a given sample, 7,866 (32.3%) reverted to normoalbuminuria and 2,152 (8.8%) died before repeating ACR. Median interval between biochemical (ACR criteria) and clinical CKD diagnosis was 1.3 [0-15.5] yrs for stage A2 and 1.1 [0-9.3] yrs for A3; P&lt;0.00001. Among patients who had both eGFR and ACR measurements, the median interval between biochemical (either by GFR or ACR) and clinical diagnosis was 1.7 [0.002-18.0] yrs.
Conclusions: Our study indicates low screening rates and delayed CKD diagnosis documentation in T2D. This was particularly marked at earlier disease stages, although significant documentation delay was also common among patients with more severe CKD. These findings suggest lack of physician awareness, which may lead to suboptimal care. Screening and documentation of CKD is of paramount importance to improve CKD care in T2D.

Disclosure
T. Harindhanavudhi: Stock/Shareholder; Self; Dexcom, Inc. R. L. Freese: None. L. Caramori: Consultant; Self; AstraZeneca, Bayer Healthcare Pharmaceuticals Inc., Boehringer Ingelheim Pharmaceuticals, Inc., Research Support; Self; Bayer Healthcare Pharmaceuticals Inc., Novartis Pharmaceuticals Corporation, Speaker’s Bureau; Self; Bayer AG.
4-OR: Racial/Ethnic Disparities in Diabetes Self-Care in Young Adults (YA) with Type 1 Diabetes (T1D)
Authors: SADIQ RABAIL , FAZZARI MELISSA , NAHVI SHADI , CUNNINGHAM CHINAZO , AGARWAL SHIVANI 
Published: June 2021

Background: Racial/ethnic disparities in diabetes self-care among YA with T1D may contribute to worse outcomes. We conducted a secondary data analysis of the Young Adult Racial Disparities in Type 1 Diabetes (YARDD) study to determine racial-ethnic differences in self-care and contributory factors.
Methods: The YARDD study recruited a diverse cohort of YA with T1D aged 18-28 years from six diabetes centers across the U.S. and collected cross-sectional information on sociodemographics, social determinants of health, clinical factors, psychosocial variables, and diabetes self-care. We performed multivariable linear regression to examine the association of race/ethnicity with a measure of diabetes self-care (Self-Care Inventory Revised (SCI-R)), and related factors.
Results: We included 299 YA with T1D: median age 20 years (IQR 19-22); 55% female (n=162); 33% each non-Hispanic White, non-Hispanic Black, and Hispanic. Compared with White YA, Black YA reported slightly lower SCI scores (B= -6.81/100, P=0.006), while Hispanic YA reported similar scores (B=-1.33/100, P=0.58). In multivariate analyses, race/ethnicity accounted for little variability in SCI score (adjusted R-squared=0.02), while age, sex and diabetes distress explained significant variability (adjusted R-squared=0.24). Diabetes distress scores on the Diabetes Distress Scale were slightly higher in Black YA than Hispanic or White YA (B= 0.38/6.0, P=0.01).
Discussion: In this large national study of YA with T1D, race/ethnicity was not independently associated with differences in diabetes self-care after accounting for demographic, social determinant, psychosocial, and clinical factors. However, diabetes distress was slightly higher among Black YA with T1D and had a strong association with diabetes self-care, providing a potential race-specific target for intervention.

Disclosure
R. Sadiq: None. M. Fazzari: None. S. Nahvi: Research Support; Self; Pfizer Inc. C. Cunningham: Employee; Spouse/Partner; GE Healthcare, Stock/Shareholder; Spouse/Partner; GE Healthcare. S. Agarwal: None.

Funding
National Institute of Diabetes and Digestive and Kidney Diseases (K23DK115869); National Center for Advancing Translational Science (UL1TR002556)
404-P: Advanced Liver Fibrosis Is Associated with an Increased Risk of Chronic Kidney Disease in Patients with Type 2 Diabetes and NAFLD
Authors: SEO DA HEA , CHO YONGIN , AHN SEONG HEE , SEO SEONG HA , HONG SEONGBIN , LEE YONG-HO , KIM SO HUN 
Published: June 2021

Objectives: Nonalcoholic fatty liver disease (NAFLD) is associated with chronic kidney disease (CKD). However, the causal relationship between NAFLD and the development of CKD is uncertain, particularly in patients with type 2 diabetes. We aimed to investigate the association between the presence and severity of NAFLD and incident CKD in patients with type 2 diabetes.
Research Design and Methods: In this longitudinal cohort study of patients with type 2 diabetes, 3,188 patients with preserved renal function were followed for the occurrence of incident CKD. NAFLD was defined as the presence of hepatic steatosis on ultrasonography without any other causes of chronic liver diseases. Advanced liver fibrosis of NAFLD was defined as NAFLD fibrosis score &gt;0.675. CKD was defined as estimated glomerular filtration rate (eGFR) &lt; 60 mL/min/1.73 m2.
Results: At baseline, 1,729 (54.2%) patients had NAFLD, of whom 94 (5.4%) had advanced liver fibrosis. During the follow-up of 8.3 ± 3.6 years, 472 (14.8%) patients developed incident CKD, 220 (15.1%) in the non-NAFLD group, 226 (12.8%) in the hepatic steatosis alone group and 26 (27.7%) in the advanced liver fibrosis group. There was no increased risk of incident CKD in the NAFLD group compared with the non-NAFLD group (p = 0.79). However, among patients with NAFLD, advanced liver fibrosis was associated with an increased risk of CKD (adjusted hazard ratio [HR] 1.78 (95% confidence interval [CI] 1.14-2.76), p=0.011).
Conclusions: Advanced liver fibrosis in NAFLD is independently associated with an increased risk of incident CKD in patients with type 2 diabetes.

Disclosure
D. Seo: None. Y. Cho: None. S. Ahn: None. S. Seo: None. S. Hong: None. Y. Lee: None. S. Kim: None.

Funding
National Research Foiundation (2017R1D-1A1B03034581)
414-P: Apparent Diffusion Coefficient on Diffusion-Weighted Magnetic Resonance Imaging Predicts the Progression of Renal Damage in Diabetic Nephropathy
Authors: KITSUNAI HIROYA , TAKIYAMA YUMI , NAKAGAWA NAOKI , HASEBE NAOYUKI , OKIZAKI ATSUTAKA , HANEDA MASAKAZU 
Published: June 2021

Renal damage in diabetic nephropathy (DN) is evaluated by biochemical tests such as urine albumin-to-creatinine ratio (UACR) and serum estimated glomerular filtration rate (eGFR). On the other hand, renal biopsy, which is rich in definitive information, is rarely performed because of its complexity and high invasion. To evaluate whether diffusion-weighted magnetic resonance imaging (DW-MRI) could be a noninvasive approach for distinguishing DN, we performed MRI scanning of the subjects with 6 b-values (b = 0, 50, 100, 350, 400, 700) and analyzed the parameters using the kidney imaging software (Hitachi, Ltd., Tokyo). A total of 40 subjects were enrolled, 25 of whom had type 2 diabetes with or without hypertension (T2D), 9 had nondiabetes but hypertension (HT), and 6 were healthy volunteers (Control). T2D showed lower values of apparent diffusion coefficient (ADC) 0-700 compared with HT (129.0 ± 2.12 x10-5mm2/s in T2D vs. 132.5 ± 1.43 ×10-5mm2/s in HT, p&lt;0.001). In addition, T2D with HT (n=15) had lower ADC0-700 compared with T2D without HT (n=10) (p &lt; 0.01). Interestingly, T2D with non-DN nor HT presented lower ADC0-700 compared with HT (p&lt;0.05). ADC0-700 in T2D were correlated with serum eGFR (r = 0.40, p &lt;0.05) and inversely correlated with serum creatinine (r = - 0.40, p &lt;0.05), cystatin C (r = - 0.54, p &lt;0.01) and UACR (r = - 0.57, p &lt;0.01). On the other hand, ADC0-700 in HT were not correlated with any of parameters of the renal function. Multivariate regression analysis with a stepwise forward method identified UACR as the only factor associated with the ADC0-700 values (β = - 0.68, p &lt;0.001). Accumulating evidences show that lower levels of ADC on DW-MRI indicate greater fibrosis in various organs. Therefore, cortical ADC0-700 could predict the progression of the renal damage such as tubulointerstitial fibrosis. DW-MRI might provide a convenient diagnostic tool in the evaluation of DN.

Disclosure
H. Kitsunai: None. Y. Takiyama: Other Relationship; Self; Gilead Sciences, Inc., Research Support; Self; Boehringer Ingelheim Pharmaceuticals, Inc., Mochida Pharmaceutical Co., Ltd., Roche Diabetes Care, Taisho Pharmaceutical Co., Ltd. N. Nakagawa: None. N. Hasebe: None. A. Okizaki: Research Support; Self; Fuji-Film Toyama Chemical Co., Ltd., Nihon Medhi-physics. M. Haneda: Advisory Panel; Self; Eli Lilly Japan K. K., Nippon Boehringer Ingelheim Co. Ltd., Novo Nordisk Inc.

Funding
Japan Society for the Promotion of Science (20K17420)
417-P: AGE Precursor Methylglyoxal Leads to Behavioral Pattern Changes Characteristics of Alzheimer’s Disease in Mice
Authors: LI WAI YIN , WU SZE LOK , LEE FIONA CHEUK YAN , YUE KEVIN 
Published: June 2021

Purpose of the Study: Diabetes mellitus (DM) is characterized by chronic hyperglycemia and diabetic complications. Exacerbated cortical neuronal degeneration were observed in Alzheimer’s disease (AD) patients with DM. DM is considered a risk factor of AD, as DM-induced activation of stress responses in central nervous system (CNS) such as oxidative stress and neuroinflammation may lead to various neurodegenerative disorders. Abnormal accumulation of methylglyoxal (MG), one of the most reactive advanced glycation end-product (AGE) precursors, is found in the serum of diabetic patients. As MG is reported to induce brain cells impairment, like neuronal cell death, in CNS, and increased levels of AGEs have also been observed in brains of AD patients, hence the effect of MG leading to subsequent symptoms of AD was investigated.
Methods: C57BL/6 mice were treated with MG solution (60mg/kg) or saline (100μl of 0.9% saline as sham control) by intraperitoneal injection for 9 weeks. The Morris water maze (MWM) was used to examine the spatial learning ability and cognition of mice. Footprint, escape latency and time spent in the target quadrant were measured and recorded.
Summary of the Results: Significantly longer escape latency was observed in the MG-treated mice than that of the control group starting from Day 3. The mean escape latency of the MG-treated group was 13.41sec. while that of the control group was 5.450sec. in Day 5. It was also demonstrated in the probe trial that there was a significant reduction of the percentage time spent in the target quadrant of the MG-treated mice (44.07 ± 2.720) than that of the control group (58.29 ± 4.324).
Conclusions: MG could induce AD symptoms causing spatial learning ability impairment and cognition decline in mice. MG may therefore play a role in the dysfunction of brain cells and dysregulation of CNS resulting in Alzheimer’s disease.

Disclosure
W. Li: None. S. Wu: None. F. Lee: None. K. Yue: None.
419-P: Correlation between 24-Hour Urinary Electrolyte and Urinary Albumin in Patients with Type 2 Diabetes
Authors: WANG YANRU , ZHANG MENGYU , LI HONG , QU SHEN 
Published: June 2021

Objective: To explore the characteristics of 24-hour urinary electrolyte excretion in patients with type 2 diabetes mellitus (T2DM), and its correlation with urinary albumin and early renal injury.
Methods: A total of 1475 T2DM and 265 nondiabetic patients (ND group) from 2018 to 2020 were enrolled. According to the urinary albumin excretion rate (UAER), T2DM patients were divided into normal albuminuria group (NA group): UAER &lt; 30mg/24h; Microalbuminuria group (MA group): UAER 30~300 mg/24 h; massive albuminuria group (PR group): UAER &gt; 300mg/24h. The characteristics of 24h urinary electrolyte excretion in different groups were observed and the correlation between 24h urinary electrolyte excretion and urinary albumin was analyzed.
Results: We found that 24h urinary potassium, sodium, chlorine, phosphorus and magnesium in all subgroups of T2DM were higher than those in ND group (P &lt; 0.001), 24h urinary calcium in ND group was higher than that in PR group (4.3±2.1 vs. 3.2±2.5, P &lt; 0.001), but lower than that in NA group (4.3±2.1 vs. 4.7±2.8, P &lt; 0.001). As urinary albumin increased, 24h urinary calcium of T2DM patients showed a decreasing trend while the other urinary electrolytes showed an increasing trend (P &lt; 0.001). Urinary albumin was positively correlated with 24h urinary potassium, sodium, chlorine, phosphorus, magnesium (r=0.133~0.169, P &lt; 0.001) and negatively correlated with 24h urinary calcium (r= -0.130, P &lt; 0.001). Multiple linear regression showed that 24h urinary potassium was an independent influencing factor of urinary albumin (β = 0.178, P &lt; 0.001).
Conclusion: There is a difference in 24h urinary electrolyte excretion between T2DM and nondiabetic patients. The urinary electrolyte excretion of T2DM patients varies with urinary albumin. 24h urinary electrolyte excretion changes before the appearance of albuminuria, which may be an indicator of early renal injury. High urinary potassium may serve as a parameter to predict early diabetic nephropathy.

Disclosure
Y. Wang: None. M. Zhang: None. H. Li: None. S. Qu: None.