bluuebunny/crossref_metadata_2025_split huggingface dataset:
Alpha-1 Antitrypsin Therapy in Recent-Onset Type 1 Diabetes
Authors: LEBENTHAL YAEL , BRENER AVIVIT , HERSHKOVITZ ELI , SHEHADEH NAIM , SHALITIN SHLOMIT , GAI-CASTRO SHARON , STEIN MICHAL , TOV NAVEH , RACHMIEL MARIANNA 
Published: June 2018

Previous phase I studies demonstrated that alpha-1 antitrypsin (AAT) was safe and well tolerated in type 1 diabetes (T1D) patients. This multicenter, randomized, placebo-controlled phase II trial was designed to test whether AAT could preserve C-peptide secretion in new-onset T1D patients aged 8-25 years. Seventy patients (37 males; mean age 13.1 ± 4.1 years) were randomized (1:1:1) to treatment with 22 IV infusions − 60 mg/kg AAT, 120 mg/kg AAT or placebo administered over 1 year. The primary end point of the study was the change in C-peptide area under the curve (AUC) from a 2-h mixed-meal tolerance test (MMTT) after 1 year. Secondary endpoints were HbA1c and safety parameters. Post-hoc sub-group analysis by age was performed. At 1 year, the decrease in C-peptide AUC was not different in AAT vs. placebo groups (P = 0.66 and 0.96, for 60 and 120 mg/kg AAT). Within 12-18 years subgroup (n=35), C-peptide AUC in placebo-treated and 60 mg/kg AAT-treated patients decreased significantly from baseline (-0.34 and -0.55 pmol/mL, respectively, P &lt; 0.01) while no significant decrease was observed in the 120 mg/kg AAT-treated patients (-0.18 pmol/mL, P = 0.20). At 1 year, mean HbA1c levels were higher in placebo-treated patients and 60 mg/kg AAT-treated patients vs. 120 mg/kg AAT-treated patients (8.24 ± 1.42% and 7.85% ± 1.67% vs. 6.66% ± 1.01%, respectively, P = 0.for 120 mg/kg AAT vs. placebo); a lower percentage of patients attained HbA1c ≤ 7% in the placebo and 60 mg/kg AAT groups compared to 120 mg/kg AAT (25% and 28.6% vs. 70%, P = 0.07). The infusions were well tolerated with a similar safety profile in the AAT and placebo groups. Two patients in the 60 mg/kg treatment group had allergic reactions after 4 and 17 infusions. Although AAT intervention shows promise with a favorable safety profile, the efficacy of AAT in T1D patients is inconclusive. Further studies should be undertaken with appropriate patient stratification pre-randomization and implementation of biomarkers to determine whether AAT has a beneficial effect on beta cell preservation.

Disclosure
Y. Lebenthal: Speaker's Bureau; Self; Novo Nordisk Inc.. Consultant; Self; Kamada. A. Brener: None. E. Hershkovitz: None. N. Shehadeh: None. S. Shalitin: None. S. Gai-Castro: Employee; Self; Kamada. M. Stein: Employee; Self; Kamada. N. Tov: Employee; Self; Kamada. M. Rachmiel: Advisory Panel; Self; Novo Nordisk Inc.. Other Relationship; Self; Medtronic MiniMed, Inc.. Research Support; Self; Kamada.
The Awareness of Preconception Counseling in Childbearing Age Women with Type 1 Diabetes Mellitus in China
Authors: ZHOU YONGWEN , YAN JINHUA , LUO SIHUI , ZHENG XUEYING , LING PING , WU ZEKAI , LV JING , QIU LILING , YANG DAIZHI , WENG JIANPING 
Published: June 2018

Objectives: To assess the awareness of preconception counseling in childbearing age women with T1DM (type 1 diabetes mellitus) in China.
Methods: Women with T1DM in childbearing age were enrolled from 11 hospitals in Beijing, Jinan, Nanjing, Shanghai, Chengdu, Changsha and Guangzhou from May 2015 to August 2017. Demographic data, clinical characteristics and information on preconception counseling were collected. Redcap was used to establish the database and SPSS 20.0 was adopted to analyze data.
Results: A total of 178 T1DM women with age 30.43±4.34 years and duration of T1DM 20.52±7.62 years were enrolled. Patients were pregnant (≤13 weeks, n=89; 13-28 weeks, n=30; ≥28 weeks, n=12) or planning pregnancy (n=47). There were 85.9% of patients realizing pregnancy was permitted when HbA1c&lt; 7.0% while 2.2% worrying T1DM women cannot be pregnant due to genetic susceptibility or potential injury. Most patients had the awareness to perform thyroid function test (92.0%), blood/urine ketone test (94.2%), diabetic retinopathy (90.8%) and nephropathy screening (95.4%) before pregnancy. Patients considered it was necessary to tighten glycemic control(100.0%) and postprandial glucose monitoring should be included (90.1%). Most patients(93.6%) admitted intake of multivitamin and folic acid was essential and 96.0% of them knew weight control and exercise for at least 30 mins per day,while only 78.5% thought preparing for a delivery in advance of the third trimester was necessary. Among 131 pregnant women, 65.6% received preconception counseling; patients with preconception counseling had better glycemic control before pregnancy compared with those without counseling (HbA1c 6.73±0.93% vs. 7.55±1.38%, P=0.028; severe hypoglycemic 25.6% vs. 61.9%, P&lt;0.001).
Conclusion: The awareness of preconception counseling had been improved but was still not sufficient. Effective preconception counseling was associated with better glycemic control before pregnancy in pregnant women with T1DM.

Disclosure
Y. Zhou: None. J. Yan: None. S. Luo: None. X. Zheng: None. P. Ling: None. Z. Wu: None. J. Lv: None. L. Qiu: None. D. Yang: None. J. Weng: None.
Country-Wide Capacity Building Model in Gestational Diabetes Management for Primary Care Physicians in India
Authors: CHANDWANI HARESH , KUMAR PUSHKAR 
Published: June 2018

Background: Pregnancies complicated by GDM have fourfold increased risk of perinatal mortality and has a long-term health impact, with more than 50% of women with GDM going on to develop type 2 diabetes within 5-10 years of delivery. In India an estimated 4 million women have GDM.
Aims: The aim of this abstract is to highlight the components of a PAN India training model specifically designed to enhance the knowledge, skills, and core competencies of Primary Care Physicians (PCPs) in the management of GDM.
Methodology: Addressing the issue of dearth of trained professionals in specialised area like gestational diabetes by building the capacity of primary care physicians is an important strategy towards improving GDM management. A four modular course was developed jointly by Public Health Foundation of India and Dr.Mohan’s Diabetes Education Academy to train primary care physicians with strong course curriculum, vetted and approved by the eminent panel of national experts constituting of eminent endocrinologists and gynaecologists.
Result: Certificate Course in Gestational Diabetes Mellitus (CCGDM) has trained 3200 participants and covered 26 states, 3 Union Territories, 257 districts and 437 cities in the last 4 cycles. This model has been adopted by four state governments for training their medical officers. Out of the trained participants, 52% were post- graduates and 39% belonged to Government sector. The robust monitoring mechanism and precise certification method led to 90% pass percentage and 92% of trained physicians claimed that it helped them in better diagnosis, timely referral and management of GDM patients with significant knowledge improvement.
Conclusion: Focusing on GDM by training PCPs is a low-cost intervention both to improve maternal and child health as well as to prevent future diabetes. CCGDM is a well- defined progressive training model to build capacity among doctors in GDM Management and has the potential to be adopted by low income countries.

Disclosure
H. Chandwani: None. P. Kumar: None.
DXA-Determined Visceral Adipose Tissue Is Associated with Cardiometabolic Risk Factors Even in Healthy Young Adults from the Nutritionists’ Health Study—NutriHS
Authors: VALENTE ANGÉLICA M.M. , ALMEIDA-PITITTO BIANCA , FERRARO ALEXANDRE A. , FOLCHETTI LUCIANA , SILVA ISIS T. , FERREIRA SANDRA R.G. 
Published: June 2018

Background: Association of excessive visceral adipose tissue(VAT) with cardiometabolic risk in middle-aged adults has been recognized. VAT determined by dual-x-ray absorptiometry(DXA) is an accurate measurement but its usefulness for early detection of cardiovascular risk at a younger age is less investigated. The NutriHS has examined several cardiometabolic markers in undergraduates and graduates from Nutrition courses in Brazil.
Aim: To evaluate whether DXA-VAT is associated with cardiometabolic markers in young adults with a normal cardiovascular risk profile.
Methods: In this cross-sectional analysis, 177 NutriHS participants(90% women, 70% Caucasians) underwent clinical examination, body composition(iDXALunarGE®) and blood sampling. Associations of DXA-VAT(exposure) with blood pressure(BP), waist and neck circumferences(WC and NC), BMI, triglycerides(TG), HDL-c, non-HDL-c, uric acid, fasting glucose, insulin, HOMA-IR and inflammatory biomarkers(outcomes) were tested by multiple linear regression, adjusted according to the directed acyclic graphs.
Results: Mean values of age, BMI and FG were 25.8±8.0years, 23.5±4.3kg/m2 and 83±9mg/dL, respectively. DXA-VATs were 693.6±640.3g for men and 235.7±322.6g for women. In regression models, DXA-VAT was directly associated with NC(r2 0.62, p&lt;0.001), non-HDL-c(r2 0.21, p=0.022), TG(r2 0.39, p&lt;0.001), uric acid(r2 0.34, p&lt;0.001), E-selectin(r2 0.11; p=0.004), leptin(r2 0.10, p=0.006), insulin(r2 0.26; p=0.029) and HOMA-IR(r2 0.27; p=0.024), and inversely with HDL-c(r2 0.22, p=0.039) after adjustments, but not with BP, FG, interleukins and TNF-a.
Conclusion: Such associations of DXA-VAT with traditional and novel risk markers suggest that this method may be useful to identify those at an increased risk even in a selected sample of low-risk healthy individuals. Our follow-up is necessary to confirm the hypothesis raised in this study.

Disclosure
A.M.M. Valente: None. B. Almeida-Pititto: None. A.A. Ferraro: None. L. Folchetti: None. I.T. Silva: None. S.R.G. Ferreira: None.
Trends in High-Density Lipoprotein Cholesterol (HDL-C) among Hispanic vs. Non-Hispanic Adults with Normal Glycohemoglobin in the U.S., 2009–2014
Authors: CALDERON MORENO ROSSANA M. , FERNANDEZ MIGUEL MALDONADO , VASUNILASHORN SARINNAPHA 
Published: June 2018

HDL-C, an independent cardiovascular risk factor, is often impacted by biological and environmental factors. Previous studies have observed lower HDL-C levels in Hispanics, with insulin resistance as a strong predictor; however, it is unclear how HDL-C changes over time. Using data from the U.S. National Health and Nutrition Survey (NHANES) 2009-2014, we evaluated trends in HDL-C levels among 2,190 Hispanic and 7,429 non-Hispanic adults with glycohemoglobin levels &lt;5.7%, stratified by age and gender. Baseline characteristics using survey methods are reported in Table 1. In terms of trends in HDL-C levels among the 3 NHANES waves, older non-Hispanic women had significantly higher levels in 2013-2014 vs. 2009-2010 (β 5.23, p&lt;0.01), adjusted for BMI and smoking status. Also, Hispanics had significantly lower HDL-C levels, specially men (age 20-59: β 2.16 p=0.009, ≥60: β 5.p=0.046), but only borderline in Hispanic women (β 2.03, p=0.07). Sex-specific low HDL-C prevalence was not significantly different by race, although suggested in Hispanic women ≥60 y/o (OR 2.04, p=0.07). These data indicate that Hispanics have overall lower absolute HDL-C levels, a trend that did not improve across NHANES waves. Although stronger in men, our findings highlight the importance of age and gender on HDL-C among Hispanics and the need for further research as reports vary across studies.
Table 1. Baseline Demographic Characteristics NHANES 2009-2014Hispanic Men (n=1,010; 49.54%)Hispanic Women (n=1,180; 50.46%)Hispanics, Total (n=2,190; N=20,016,409.4)Non-Hispanic Men (n=3,567; 47.94%)Non-Hispanic Women (n= 3,862; 52.06%)Non-Hispanics, Total (n= 7,429; N= 124,187,151)HDL-C mg/dl (mean ±SE)All Adults46.97±0.5355.5±0.4751.27±0.3949.32±0.3560.89±0.455.35±0.31HDL-C mg/dL(mean±SE)20-59 y/o46.85±0.5655.27±0.4851.07±0.4048.35±0.3460.19±0.4354.43±0.32HDL-C mg/dL(mean±SE) ≥60 y/o48.93±1.3658.56±1.3654.31±0.8854.18±0.9863.88±0.7959.55±0.75Low HDL-C n(%) All Adults(men &lt;40 mg/dL, women &lt;50 mg/dL)287 (27.72)424 (36.74)711 (32.27)880 (25.74)1,074 (25.26)1,954 (25.49)Low HDL-C n(%) 20-59 y/o248 (27.78)372 (37.24)620 (32.52)741 (27.34)898 (26.41)1,639 (26.86)Low HDL-C n(%) ≥60 y/o39 (26.6952 (29.82)91 (28.44)139 (17.73)176 (20.38)315 (19.19)Age yrs (mean ± SE)36.12±0.4036.89±0.4336.5±0.3343.26±0.4044.22±0.4043.8±0.42

Disclosure
R.M. Calderon Moreno: None. M. Maldonado Fernandez: None. S. Vasunilashorn: None.
Differences between Point-of-Care Blood Glucose Analyzers in Identifying Prediabetes
Authors: SZABLOWSKI CARRIE J. , MERCER KARMEN R. , MANALANG MILBEN , SUSCHA EMILY , MOSKOWITZ KEITH , ANDERSON JAMES H. , MECHLEY AMY 
Published: June 2018

Background: According to the ADA, 84 million Americans have prediabetes and are at risk for developing diabetes. Ninety percent of those Americans don’t know they have it and are at a higher risk of serious health complications such as heart disease, stroke, kidney disease, and blindness. Early identification of prediabetes facilitated by corporate health and wellness screening companies is an important aspect of diabetes prevention.
Method: Approximately 25,000 blood glucose results were obtained between 2015 and 2016 from four corporate wellness sites using both the Alere Cholestech LDX® and the PTS Diagnostics CardioChek® Plus. The glucose results were compared to the CDC’s 2017 National Diabetes Statistics Report and the percent of nondiabetic, prediabetic, and diabetic populations were tabulated using clinical decision limits of &lt; 100, 100-125, and ≥ 126 mg/dL, respectively. Fisher’s exact test was used to evaluate statistical differences between the U.S. population relative to the LDX or CardioChek Plus blood glucose results.
Results: Based on the CDC report, 12% of the U.S. population (&gt; 18 years) is diabetic. The remaining population was calculated at 34% prediabetic and 54% nondiabetic. The LDX results under-reported the prediabetic population at 20% and over-reported the nondiabetic population at 73% (p=0.015). CardioChek Plus results were more aligned with U.S. population statistics at 32% prediabetic and 59% nondiabetic (p=0.645). Unlike prediabetes, there were no statistical differences in classifying diabetes with the LDX or CardioChek Plus.
Conclusion: Both point-of-care analyzers were helpful in screening for prediabetes. The CardioChek Plus more accurately categorized prediabetes relative to U.S. population statistics. The PTS Diagnostics CardioChek Plus offers reliable results to help recognize prediabetes and prevent its progression to diabetes.

Disclosure
C.J. Szablowski: Employee; Self; PTS Diagnostics. K.R. Mercer: None. M. Manalang: Other Relationship; Self; Provant Health Solutions. E. Suscha: Employee; Self; PTS Diagnostics. K. Moskowitz: Employee; Self; PTS Diagnostics. Stock/Shareholder; Self; PTS Diagnostics. J.H. Anderson: Employee; Self; PTS Diagnostics. Board Member; Self; GENEREX Biotechnology. A. Mechley: Consultant; Self; PTS Diagnostics.
The Establishment of a Registry of Elderly Patients with Diabetes and an Investigation of the Inhibitory Factor of Cognitive Dysfunction
Authors: OKAMOTO MISATO , ITOH JUN , SONODA NORIYUKI , MAEDA YASUTAKA , FUJII MASAKAZU , OGAWA YOSHIHIRO 
Published: June 2018

Objectives: Diabetes and dementia has been considered to have pathological relevance. Early diagnosis and treatment for Mild Cognitive Impairment (MCI) are important to stop it from advancing to dementia. We investigated the rate of MCI or dementia, correlation between cognitive dysfunction (CD) and background factor in diabetes patients, a valuable marker for diagnosis and effective diabetes treatment for prevention of CD.
Approach and Results: We identified 161 patients aged ≥60 years, outpatient treatment at Kyushu University hospital from 2016/7 ∼ 2017/11. The Japanese versions of Montreal Cognitive Assessment (MoCA-J) and Mini-Mental State Examination (MMSE) were performed as screening. The patients who showed MMSE≤27 or MoCA-J≤25 had head MRI/SPECT, visited dementia specialist and were diagnosed with the disease type. The CD, screening results, diabetic clinical findings, contents of treatment and relative factors were analyzed by univariate or multivariate analysis. The subjects of investigation were aged 72.6±7.4 years, female 74/161 (46%), BMI 23.3±3.4, HbA1c 7.1±0.8%, duration14.4±10.6 years, insulin therapy 49/161(30.8%).
Screening Results: MMSE{MCI22(13.7%), dementia1(0.6%)}/{ MoCA-J: MCI 44 (27.3%), dementia 6 (3.7%)}. 22 patients visited a dementia specialist, and diagnosed with Alzheimer’s dementia 2, MCI 15 and normal 5. The sensitivity of MCI in MMSE, MoCA-J were 46.7% and 93.3%, respectively. Exercise therapy showed significant inhibition of CD in correlation between MoCA-J and diabetes treatment. BMI, insulin history, sulfonylurea history, solitary life, CK, ASO were chosen by stepwise regression, which objective variable was MoCA-J. Age and BMI were significant objective variable by age correction.
Conclusions: MMSE and MoCA-J showed significant correlation with treatment background of diabetes patients. MoCA-J is especially thought to be an eminent screening method for MCI in diabetes patients.

Disclosure
M. Okamoto: None. J. Itoh: None. N. Sonoda: None. Y. Maeda: None. M. Fujii: None. Y. Ogawa: Research Support; Self; AstraZeneca. Advisory Panel; Self; Gilead Sciences, Inc.. Research Support; Self; Japan Agency for Medical Research and Development, Japan Society for the Promotion of Science, Mitsubishi Tanabe Pharma Corporation, Mochida Pharmaceutical Co., Ltd., Sumitomo Dainippon Pharma Co., Ltd..
Clinical Characteristics and Early Treatment Patterns of Newly Diagnosed Cystic Fibrosis–Related Diabetes in Two Tertiary Centers
Authors: MCCORRY ERIN , BASHEER HIBA , LASCANO JORGE E. , YOON JOHN , LEEY JULIO A. 
Published: June 2018

The 2010 ADA/CFRD guidelines have recommended insulin for CFRD. However, these recommendations are often not followed in clinical practice. We performed a chart review of newly diagnosed CFRD patients at University of California Davis (UCD) and University of Florida (UF) for years 2011-2015.
Six new CFRD patients were diagnosed at UCD and 19 at UF. A BMI over 25 was more common in UCD than at UF (50% vs. 11%), whereas a BMI below 20 was more common at UF (0% vs. 21%). The prevalent method of diagnosis was A1c at UCD (100%) and OGTT at UF (63%). One year after diagnosis, insulin was prescribed in 31% of UF patients and none at UCD. A weight loss &gt;3% was observed in 21% of patients in the preceding year at UF but none at UCD. The only patient started on insulin at UCD did so 14 months after the diagnosis whereas the median time was 4.5 months at UF. Of note, the OGTT screening rate was lower at UCD. Because OGTT detects CFRD earlier than A1c, patients diagnosed via OGTT would have experienced less weight loss, not more. While it remains unclear what accounts for the higher BMI at UCD, better nutritional status could have delayed the decision to initiate insulin.
In conclusion, newly diagnosed CFRD patients have divergent characteristics at different centers. Further studies assessing social and dietary differences can serve to evaluate center-to-center variations.
CharacteristicsUC Davis (n=6)U Florida (n=19)OGTT screening rate in 201619%43%Mean age of CFRD at onset in years (SD)31 (7.9)28.8 (7.6)Females66%47.3%BMI 20-25 Kg/m250%68%BMI below 20 Kg/m2None21%CFRD diagnosis vi OGTT50%63%

Disclosure
E. McCorry: None. H. Basheer: None. J.E. Lascano: None. J. Yoon: None. J.A. Leey: None.
The Risk Measure of Hypertension and Diabetes by National Health Insurance Data
Authors: CHUN KI HONG 
Published: June 2018

Introduction: Korea’s health insurance is a social insurance that the government is the insurer and the whole nation. All of the national medical benefits are claimed,reviewed and paid for. PURPOSE The study purpose is to investigate the relative risk(RR) of stroke, myocardial infarction and chronic renal failure due to hypertension and diabetes, and the population attributable risk(PAR) by using health claim data for all Koreans in Korea.
Method: The research data are the claims for medical insurance fees from 1999 to 2006.We calculated the RR of stroke, myocardial infarction,and chronic renal failure in 2004 and 20respectively,among those who had been diagnosed with hypertension or diabetes even once in eight years from 1999 to 2006, compared with those in other populations.If a person who did not claim a medical fee for the disease for five years from 1999 to 2003 had a medical fee claim for that year,the person was defined as the treatment incidence.PAR of hypertension or diabetes for these complications was calculated using RR and treatment prevalence.
Result: In 2005, the treatment prevalence rate of hypertension over 30 years old was 23.1% and the diabetes was 10.5%.The National Health and Nutrition Survey, which is a nationwide survey,has 27.9% hypertension and 8.1% diabetes.The RR of stroke was 11.0,the RR of myocardial infarction was 13.6, and the RR of chronic renal failure was 30.3.The PAR of hypertension or diabetes to stroke was 73.0% over 30 years old. Myocardial infarction was 77.3% and chronic renal failure was 88.8%. In other words, 73% of patients with stroke, 77.3% of patients with myocardial infarction,and 88.8% of patients with chronic renal failure could not have developed if hypertension and diabetes is completely managed.
Discussion: Although it is different from the official cohort data because it is measurement using the health insurance fee claim data,it is meaningful to be able to generally see the disease prevalence and the occurrence status for the whole nation.

Disclosure
K. Chun: None.
Novel Associations of Adipokines and Atherosclerotic Markers with Rising Levels of Insulin Resistance in a Mexican-American Border Population
Authors: GUTIERREZ ABSALON D. , FLORES CARLOS A. , LEE MINJAE , LAING SUSAN , ASGARISABET PARISA , RESMAN MASHA , NAIK SAPNA , LEE MIRYOUNG , MCCORMICK JOSEPH B. , FISHER-HOCH SUSAN P. 
Published: June 2018

Background: Epidemiological studies suggest that increased levels of leptin and resistin, and decreased levels of adiponectin are associated with worsening insulin resistance (IR) and atherosclerosis. However, it is unclear if these findings apply to Mexican-Americans, as few have been studied. We examined the relationship of these adipokines and carotid intima media thickness (cIMT) to IR and atherosclerosis in a Mexican-American population.
Methods: A retrospective cross-sectional analysis of the Cameron County Hispanic Cohort (CCHC) was performed. Adult participants were stratified into three groups of IR: no-diabetes, prediabetes, and diabetes mellitus (DM). We examined differences in levels of adipokines and cIMT across groups. We constructed multivariable linear and logistic regression models to account for confounding factors. There were 819 subjects (43%, 35%, and 22% for no-diabetes, prediabetes, and DM, respectively) for the study of adipokines and 249 subjects for the study of cIMT (34%, 50%, and 16% for no-diabetes, prediabetes, and DM, respectively).
Results: After controlling for gender, hypertension, age, and BMI, adiponectin levels lowered significantly across increasing levels of IR (p=0.002) and resistin levels did not change significantly across groups (p=0.10). Compared to no-diabetes, leptin levels surprisingly decreased significantly in DM (p=0.013). cIMT levels heightened across increasing levels of IR (p=0.01).
Conclusion: In a Mexican-American population, participants with DM unexpectedly displayed lower levels of leptin compared to no diabetes. Surprisingly, there was also no change in resistin across IR groups. In DM, adiponectin levels decreased and cIMT measurements increased. These findings support the need for more research to understand the relationship of leptin deficiency to DM in this population.

Disclosure
A.D. Gutierrez: Speaker's Bureau; Self; AstraZeneca, Med Learning Group. C.A. Flores: None. M. Lee: None. S. Laing: None. P. Asgarisabet: None. M. Resman: None. S. Naik: None. M. Lee: None. J.B. McCormick: None. S.P. Fisher-Hoch: None.