bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Relationships between Serum Levels of Adipokines, Body Fat Distribution, and Subcutaneous Microvasculature in Type 2 Diabetic Subjects
Authors: KLIMONTOV VADIM , BULUMBAEVA DINARA , BGATOVA NATALIYA P. , TASKAEVA IULIIA , FAZULLINA OLGA , ORLOV NIKOLAI , KORBUT ANTON I. , SAVCHENKO SERGEY , KONENKOV VLADIMIR 
Published: June 2018

The aim of the study: to determine the relationships between serum levels of adipokines, body fat distribution, density and ultrastructure of blood and lymphatic microvessels in subcutaneous adipose tissue (AT) in type 2 diabetic subjects. We observed 125 patients with type 2 diabetes, including 82 subjects with obesity, and 30 lean nondiabetic individuals matched by sex and age. The concentrations of leptin, resistin, visfatin, adipsin, and adiponectin in the fasting serum were determined by Multiplex analysis. The fat mass and AT distribution was assessed by DEXA. The samples of subcutaneous abdominal AT were obtained with the knife biopsy in 25 patients and in 15 healthy subjects. Immunohistochemistry for biomarkers CD-34, podoplanin (D2-40) and LYVE-1 was applied to identify the blood and lymphatic microvessels. The volume density, numeral density and ultrastructure of blood and lymphatic microvessels were assessed. Patients with diabetes, as compared to control, had significantly higher levels of leptin (p=0.004), resistin (p&lt;0.0001), adipsin (p&lt;0.0001) and visfatin (p=0.0003). The concentrations of leptin and adipsin were associated with total, truncal, android and gynoid fat mass. The levels of resistin and adiponectin demonstrated relationships with gynoid fat mass only. In obese diabetic subjects an increase in the volume and numeral density of podoplanin-expressing lymphatic vessels was observed. The swelling of cytoplasm, mitochondria, rough endoplasmic reticulum and reduced content of micropinocytic vesicles was revealed in lymphatic capillaries. The levels of leptin and adipsin, but not resistin and visfatin levels, correlated negatively with the numeral density of microvessels in subcutaneous AT (r=-0.53 and r=-0.32 respectively).
In conclusion, the levels of circulating adipokines in patients with type 2 diabetes are related in varying degrees with body fat distribution and AT microvessel density.

Disclosure
V. Klimontov: None. D. Bulumbaeva: None. N.P. Bgatova: None. I. Taskaeva: None. O. Fazullina: None. N. Orlov: None. A.I. Korbut: None. S. Savchenko: None. V. Konenkov: None.
Overnight Insulin Delivery and Glucose in Children Using the MiniMed™ 670G System
Authors: ROY ANIRBAN , GROSMAN BENYAMIN , PARIKH NEHA , WU DI , LEE SCOTT W. , KAUFMAN FRANCINE R. 
Published: June 2018

The Medtronic MiniMed™ 670G hybrid closed-loop system was designed to automatically adjust basal insulin delivery every 5 minutes based on sensor glucose (SG) values. Its safety and effectiveness have been recently investigated in a multi-center pivotal trial conducted in 1T1D children aged 7-13 years.
During the 2 week run-in phase, participants used the system in Manual Mode. This was followed by a 3-month at-home study phase in which the Auto Mode feature was enabled. The SG data and the amount of insulin delivered were analyzed during the overnight period (11:00 p.m.-7:00 a.m.).
Figure-1 (top panel) shows overnight SG tracings from the run-in phase and study phase, and that the median [IQR] reduced significantly from run-in (142 [71]mg/dL) to study phase (126 [34]mg/dL), by 7:00 a.m. This was mainly achieved by the system transferring variability from SG to insulin infusion rate (bottom panel). During the nighttime period, the system suspended insulin for an average 1.3 hours and delivered insulin at the maximum allowable limit for an average 3.6 hours. The remainder of the time, it delivered insulin between 1-99% of the maximum allowable limit.
These data suggest that greater variability of basal insulin delivery, such as that achieved with MiniMed™ 670G system automation, compared to fixed pre-set basal rates, improves nighttime glucose control in children.

Disclosure
A. Roy: Employee; Self; Medtronic MiniMed, Inc. B. Grosman: Employee; Self; Medtronic. N. Parikh: Employee; Self; Medtronic. D. Wu: None. S.W. Lee: Employee; Self; Medtronic. F.R. Kaufman: Employee; Self; Medtronic.
Thyroid Function Improved after Laparoscopic Sleeve Gastrectomy in Severe Obesity and Related to Inflammatory Changes
Authors: ZHU CUILING , MEI FANGYUN , GAO JINGYANG , WANG XINGCHUN , LI LIANG , LU LIESHENG , ZHOU DONGLEI , QU SHEN 
Published: June 2018

Objective: Obesity, a state of chronic low grade inflammation, has been reported to be associated with significant alterations of thyroid function. The purpose of this study is to evaluate the effect of laparoscopic sleeve gastrectomy (LSG) on thyroid function and its relation with inflammatory changes in severely obese patients.
Methods: We performed a retrospective observational study of 128 severely obese patients (61.7% female; age 31.8 ± 10.0 years, BMI 39.4 ± 5.8 kg/m2) submitted to LSG. Patients were subdivided in two groups: euthyroid group and subclinical hypothyroidism (SCH) group. TSH, FT4, anthropometric data, and inflammatory markers were collected pre- and 1, 3, 6, and 12 months post-LSG.
Results: The mean percent weight loss at 12 months was 37.2% ± 11.8%. The mean BMI decreased from 39.4 ± 5.8 kg/m2 to 27.1 ± 3.9 kg/m2. Patients with SCH (37.5% of patients) and higher TSH showed higher BMI, HOMA-IR, interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) than those in euthyroid group (all P &lt; 0.05). After surgery, TSH levels significantly decreased at 1, 3, 6, and 12 months regardless of thyroid function, which presented more apparent in SCH group. Additionally, we observed marked reduction of IL-6, IL-8, TNF-α, and CRP levels in SCH group, as well as IL-8, TNF-α, and CRP in euthyroid group from baseline by 12 months postoperatively. Moreover, decreased TSH levels correlated significantly with decreased BMI, HOMA-IR, IL-6, and TNF-α at 12 months after LSG.
Conclusion: SCH in severely obesity subjects appears to be associated with excess weight, insulin resistance, and elevated inflammatory markers. LSG promotes a decrease of TSH that is significantly greater in patients with SCH, and associated with alleviation of inflammatory status in addition to substantial weight loss and improved insulin resistance after surgery.

Disclosure
C. Zhu: None. F. Mei: None. J. Gao: None. X. Wang: None. L. Li: None. L. Lu: None. D. Zhou: None. S. Qu: None.
Alteration of Bone Mineral Density Differs between Genders in Obese Subjects after Laparoscopic Sleeve Gastrectomy—Bone Morphogenetic Protein 4 May Count
Authors: WANG XINGCHUN , LI LIANG , ZHU CUILING , GAO JINGYANG , QU SHEN 
Published: June 2018

Laparoscopic sleeve gastrectomy (LSG) has been proven successfully in weight reduction but with potential loss of bone mass. Previous studies indicate that bone morphogenetic protein 4 (BMP4) plays an important role both in bone formation and glucose-lipid metabolism. This study aimed to investigate the alteration of bone mineral density (BMD), bone metabolic parameters and serum BMP4 levels in Chinese obese subjects after LSG. Seventy-one obese patients (34 males, age 31.70±9.61 years and 37 females, age 32.80±11.45 years) were enrolled. BMD (at right hip, femoral neck and lumbar spine 1-4 (L1-L4) by dual-energy X-ray absorptiometry), bone metabolic markers and routine anthropometric/laboratory biochemical parameters at baseline, 3, 6 and 12 months after LSG (abbreviated as 3M/6M/12M Post-LSG) were recorded. Serum BMP4 levels were measured by enzyme-link immunosorbent assay. In females, BMD was significantly decreased at right hip at 3M/6M/12M Post-LSG, femoral neck at 6M/12M Post-LSG and L1-L4 at 6M Post-LSG (all P&lt;0.05). In males, BMD was not significantly changed (all P&gt;0.05). Intriguingly, serum BMP4 levels were reduced slightly at 3M Post-LSG (P=0.463), and significantly at 6M Post-LSG (from 75.51±16.54pg/ml to 65.40±10.51pg/ml, P=0.048) in females, while unchanged in males (all P&gt;0.05). In all subjects, free calcium but not total calcium was increased at 12M Post-LSG (P=0.028). Vitamin D and 25(OH)VD were increased in males at 12M Post-LSG (all P&lt;0.05). Osteocalcin was increased in males at 3M/6M/12M Post-LSG and in females at 3M/6M Post-LSG (all P&lt;0.05). Type I collagen was increased in males at 3M/6M Post-LSG and in females at 3M/6M/12M Post-LSG (all P&lt;0.05).
In conclusion, the change of BMD differs between genders after LSG, significantly decreased in females while unchanged in males. Moreover, the decreased BMP4 levels may partly account for the diminished BMD in Chinese female obese subjects after LSG.

Disclosure
X. Wang: None. L. Li: None. C. Zhu: None. J. Gao: None. S. Qu: None.
Collaborative Intensive Lifestyle Weight (Wt) Loss Intervention in Underserved Predominantly African-American (AA) Patients in Chicago
Authors: POKU CAROLINE , TAHSIN BETTINA , FOGELFELD LEON 
Published: June 2018

Minorities are disproportionately affected by obesity. Intensive lifestyle interventions (ILI) have been shown to result in a moderate amount of clinically significant weight loss (5% BW), less so in minorities. Few ILI are culturally adapted for minorities. A collaborative multidisciplinary team implemented a culturally-tailored ILI using current guidelines in a predominantly AA obese population in a primary care setting. Program consisted of individual and group sessions led by MD, RD, PT, and psychologist meeting for 6 months. After the initial ILI, a 6 month maintenance period of monthly meetings with an intensification every 3rd month of 3 visits/month aimed to prevent weight regain. Program goals were to attain a 5% weight loss in 6 months and prevent weight regain after the intensive phase. 40 English-speaking patients enrolled: median age 52.0 years (41.5, 60.0), 77.5% female, 72% AA, 15% Hispanic with median weight 279.9 lbs (236.0, 324.1) and median BMI 44.7 kg/m2 (37.7, 50.1). 60% completed the program with 25% of those achieving at least 5% weightt loss in 6 months. Results correlated with attendance (Figure). Of the 25% attaining the initial 5% weight loss, 60% showed continued weight loss in maintenance, notably after intensification periods. In this study, attendance and maintenance intensification appeared to be key to continued loss success.

Disclosure
C. Poku: None. B. Tahsin: None. L. Fogelfeld: None.
Improved Insulin Sensitivity and Irisin after a Dietary Weight-Lowering Program in Obese, Otherwise Healthy Subjects
Authors: PENESOVA ADELA , RADIKOVA ZOFIA , BAJER BORIS , VLCEK MIROSLAV 
Published: June 2018

Recent studies suggest that serum irisin might be a predictor of insulin resistance in obese subjects. The aim of the study was to analyze the effect of life style intervention on insulin sensitivity, irisin, and visfatin concentrations.
Methods: A group of 43 obese patients (13M/30F; 43.0 ±12.4 years; BMI 31.2 ± 6.3 kg/m2) participated in a weight loss interventional program (NCT02325804) following an 8-week program consisting of hypocaloric diet (-30% energy intake) and physical activity 150 minutes/week. Insulin sensitivity was evaluated according to the homeostasis model assessment of insulin resistance (HOMA-IR) and insulin sensitivity indices according Matsuda and Cederholm were calculated (ISIMat and ISICed). Plasma ALT, AST, irisin, visfatin, and physical fitness were measured.
Results: The average reduction of body weight was 6.8±4.9 kg (0-15 kg; p=0.0006), accompanied with significant reduction of body fat mass (p=0.03), and waist circumference (p=0.02). Insulin sensitivity improved (IR HOMA 2.71±3.90 vs. 1.24 ±0.83; p=0.01; ISIMat 6.64±4.38 vs. 8.93±5.36 p ≤ 0.001; ISICed 59.1±21.4 vs. 64.7±22.2 p=0.03). Total and LDL cholesterol, as well as triglycerides decreased (p=0.02, p=0.02, p=0.resp.), Physical fitness significantly improved after intervention (as measured by VO2 max: 25.1±5.9 vs. 28.0±6.0 ml.kg-1.min-1, p ≤ 0.001). Plasma irisin significantly decreased after intervention (233 ± 66 vs. 167 ± 88 ng/mL; P ≤ 0.001), while visfatin levels did not changed.
Conclusion: Eight weeks of diet and physical activity intervention program in obese otherwise healthy subjects leaded to improvement of insulin sensitivity, as well as physical fitness and lowering of plasma irirsin levels. Irisin strongly reflects body fat mass, suggesting that the irisin circulating levels are conditioned by adiposity level.

Disclosure
A. Penesova: None. Z. Radikova: None. B. Bajer: None. M. Vlcek: None.
Role of Free Fatty Acids in the Alteration of Cardiovascular Autonomic Activity and Its Postprandial Changes in Obese Patients with Glucose Intolerance
Authors: REZKI AMEL , FYSEKIDIS MARINOS , SABRINA CHIHEB , BANU ISABELA , COSSON EMMANUEL , VALENSI PAUL 
Published: June 2018

Rationale: Depressed cardiac vagal activity and elevated sympathetic activity have been reported in prediabetic obese patients. In healthy individuals, insulin was shown to acutely induce such changes, and free fatty acids (FFA) to enhance sympathetic activity. This study aimed to examine the relations between glycemia, insulinemia and plasma FFA with cardio-vascular autonomic activity in obese patients with glucose intolerance.
Patients and Methods: We included 24 obese patients (BMI 36.6±5.0 kg/m²) with glucose intolerance, normal blood pressure, and no cardio-vascular events. Cardiac vagal (HFnu-HR) and sympathetic (LFnu-HR) activity, and sympatho-vagal balance (LF/HF-HR) were measured by spectral analysis of heart rate variations during 6 minutes of controlled breathing rate (12 cycles/minute) (Task Force Monitor®). These measurements were performed at fasting and after a standardised breakfast including 75g of carbohydrates. The changes (∆) between fasting and 2 hours after breakfast were calculated.
Results: At fasting, age correlated positively with LFnu-HR (p=0.02) and negatively with HFnu-HR (p=0.02). There was no significant correlation between autonomic indexes and glycemia and insulinemia. At fasting, FFA correlated positively with LFnu-HR and LF/HF-HR and negatively with HFnu-HR (p&lt;0.04 and &lt;0.02, respectively); and positively with nitrotyrosine (p=0.02). The correlations of FFA with spectral indexes were not altered after age adjustment, but were no more significant after adjustment for nitrotyrosine. Post-prandially, ∆FFA correlated positively with ∆LFnu-HR and ∆LF/HFnu-HR and negatively with ∆HFnu-HR (p&lt;0.04 to &lt;0.02).
Conclusion: In prediabetic obese patients, FFA (lipotoxicity) play an important role both at fasting and post-prandially in sympathetic activation and vagal depression, probably by increasing oxidative stress. These effects could increase the arrhythmogenic risk.

Disclosure
A. Rezki: None. M. Fysekidis: None. C. Sabrina: None. I. Banu: None. E. Cosson: Consultant; Self; Lilly France. Board Member; Self; Novartis France. Consultant; Self; Roche Diagnostics France. Board Member; Self; Ascensia Diabetes Care. Consultant; Self; Bezins France. Board Member; Self; MSD France. P. Valensi: None.
Effects of Deep Transcranial Magnetic Stimulation (dTMS) on Anti-inflammatory Gut Bacterial Species in Obesity
Authors: FERRULLI ANNA , TOSCANO MARCO , ADAMO MICHELA , TERRUZZI ILEANA , DRAGO LORENZO , LUZI LIVIO 
Published: June 2018

Growing evidence highlights the crucial role of gut microbiota in affecting different aspects of obesity. Potential mechanisms for microbial control over eating behavior include microbiota influence on reward and satiety pathways, neurotransmitters release, and hypothalamic-pituitary-adrenal (HPA) axis modulation. A methodology proved to be effective in modulating orexigenic/anorexigenic pathways and food-reward system in obesity is the dTMS. Considering its assets, we hypothesized a potential role of dTMS in inducing weight loss in obesity also via microbiota composition modulation. Twenty-two obese subjects (5 M, 17 F; 44.6±2.5 years; BMI 37.5±1.1 kg/m2) were allocated into 3 groups receiving 15 sessions (3 per week for 5 weeks) of high frequency (18 Hz, HF), low frequency (1 Hz, LF) dTMS, or sham stimulation. Fecal samples were collected at baseline and after 5 weeks of treatment. Total bacterial DNA was extracted from fecal samples using the QIAamp DNA Stool Mini Kit (Qiagen, Italy) and analyzed by a metagenomics approach (Ion Personal Genome Machine). After 5 weeks, a weight loss in HF (-3.4±1.0%; p&lt;0.05) was found, associated with a decrease in norepinephrine (-61.5±15.2%; p&lt;0.01). Furthermore, an increase of Faecalibacterium (+153.3% vs. baseline, p&lt;0.05) and Alistipes (+153.4% vs. baseline, p&lt;0.05) genera, and a significant decrease of Lactobacillus (-77.1% vs. baseline, p&lt;0.05) were found in HF. A significant inverse correlation between Phascolarctobacterium variation and BMI reduction (R:-0.728; p&lt;0.05) was found in HF; norepinephrine change significantly correlated with Eubacterium (R:0.857; p&lt;0.05), Parasutterella (R:0.786; p&lt;0.05), and Streptococcus (R:-0.937; p&lt;0.01) variations.
In conclusion, the weight loss, induced by HF dTMS, improves sympathetic activity and gut microbiota composition in obese subjects, mainly promoting bacterial species with anti-inflammatory properties, that are typical of healthy subjects intestinal flora.

Disclosure
A. Ferrulli: None. M. Toscano: None. M. Adamo: None. I. Terruzzi: None. L. Drago: None. L. Luzi: Speaker's Bureau; Self; A. Menarini Diagnostics, AstraZeneca, Eli Lilly and Company. Research Support; Self; Gelesis. Consultant; Self; McKinsey & Company. Speaker's Bureau; Self; Menarini Group, Merck Sharp & Dohme Corp.. Research Support; Self; Novartis AG. Speaker's Bureau; Self; Novo Nordisk A/S. Research Support; Self; Sunstar Foundation. Speaker's Bureau; Self; Smith & Nephew.
Beneficial Effects of RYGB on ß-Cell Function and Hepatic and Peripheral Insulin Sensitivity Are Maintained Seven Years after Surgery in Both Diabetic and Nondiabetic Subjects
Authors: CAMASTRA STEFANIA , ASTIARRAGA BRENNO D. , BARBIERI CHIARA , GAGGINI MELANIA , PALUMBO MARIA , BERTA ROSSANA , CIOCIARO DEMETRIO , ANSELMINO MARCO , MARI ANDREA , FERRANNINI ELE , GASTALDELLI AMALIA 
Published: June 2018

Gastric bypass surgery (RYGB) leads to improvement or remission of type 2 diabetes (T2D). Long-term studies indicate that the remission rate is higher 2 than 10 years post-surgery; whether the positive effects of surgery on ß-cell function (ß-GS) and glucose metabolism are maintained long term after surgery has not been determined. We studied 21 patients (12 T2D and 9 nondiabetic (ND)) before (B), 1 (1y) and 7 years (7ys) after RYGB with the use of a mixed meal test (MTT) in combination with glucose tracers to measure postmeal glucose fluxes and a euglycemic insulin clamp for insulin sensitivity (M). ß-GS (insulin secretion and dose response curve) was assessed by mathematical modelling. Weight loss 1y after RYGB was 30% and 35% of initial weight for ND and T2D respectively, and 24% and 30% at 7ys. T2D was resolved 1y post surgery in T2D and this outcome was maintained at 7ys (HbA1c 58±4 vs. 35±1 vs. 41±2 mmol/mol; B, 1y and 7ys). M value improved at 1y in proportion to the weight lost (5.0±0.8 to 7.2±0.7 in ND, and 4.3±0.8 to 7.5±0.7 mg. kgffm-1. min-1 in T2D, p&lt;0.01 for both), and was maintained at 7ys (7.0±0.8 in ND and 6.9±0.9 mg.kgffm-1. min-1 in T2D, p=ns vs. 1y). Plasma glucose profiles were similar in ND and T2D at 1y and 7ys. After RYGB, most of the oral glucose appeared in the circulation in the first 90 min after meal ingestion in both groups and the dynamic of the oral glucose Ra was unchanged at 7ys. Suppression of endogenous glucose production (EGP) was improved in both groups during the first 90 min at 7ys compared to 1y; in T2D, mean EGP was significantly decreased. In T2D, the improvement in ß-GS seen at 1y (34±6 to 67±11 pmol.min-1.m-2.mM-1, p=0.001) was maintained at 7ys (80±21) at a similar level as in ND (138±18 vs. 87± 9 vs. 82±11, B, 1- and 7ys).
Conclusion: In both ND and T2D, RYGB induces marked improvements in glucose tolerance, insulin sensitivity (both muscle and hepatic) and ß-cell function that are maintained 7 years after surgery.

Disclosure
S. Camastra: None. B.D. Astiarraga: None. C. Barbieri: None. M. Gaggini: None. M. Palumbo: None. R. Berta: None. D. Ciociaro: None. M. Anselmino: None. A. Mari: None. E. Ferrannini: None. A. Gastaldelli: Advisory Panel; Self; Gilead Sciences, Inc.. Other Relationship; Self; European Foundation for the Study of Diabetes. Consultant; Self; INVENTIVA SA.
Impact of the Intragastric Balloon Associated with Diet on the Treatment of Diabetic Patients with Overweight or Grade I Obesity and Its influence on the Production of Enterohormones
Authors: REIMAO SILVIA M. , DA SILVA MARIA ELIZABETH R. , NUNES GABRIEL C. , MESTIERI LUIZ HENRIQUE M. , SANTOS ROSA F. , DE MOURA EDUARDO G. 
Published: June 2018

Introduction: Obesity is one of the most important public health problems facing the world today. Intragastric balloon (BIB) is a short term, reversible, minimally invasive method for weight loss. Furthermore, it helps changing eating habits and behavior. It promotes gastric distension, resulting in decreased intake of food, delays gastric emptying and enhances the feeling of satiety. The objective of this study was to evaluate the effects of BIB in patients with type 2 diabetes mellitus (T2DM) and overweight or with grade I obesity, by analyzing the weight loss, body composition, glucose and lipid metabolism, production of enterohormones and quality of life.
Methods: Clinical trial including 40 patients with T2DM and BMI 27-34.9 kg/m2, which underwent placement of BIB, kept for 6 months, and follow-up for another 6 months after withdrawn. A standardized meal test diet was carried out at 0 and 6 months. Glucose, insulin, triglycerides, GLP-1 active and total PYY were measured at times 0, 30, 60, 120 and 180 minutes.
Results: The total weight decreased by 15.6 ± 7.23 kg after 6 months of use of BIB, which corresponds to loss of 17.1% of the total weight. After 6 months of follow-up, mean weight loss was maintained at 13.89 kg (15.2%). There was a significant reduction in body fat mass and area of the glucose curve, insulin and triglycerides (p ranged from &lt;0.001 to 0.003). Of the 24 patients (60%) patients with hypertension at baseline, only 3 (7.5%) remained hypertensive after using the BIB. Serum levels of active GLP-1 and total PYY decreased with BIB. The quality of life improved in all domains analyzed (p &lt; 0.001 to 0.041): physical functioning, physical function, pain, general health, vitality, social functioning, emotional aspects and mental health.
Conclusion: BIB is effective for weight loss and control of DM2 with quality of life improvement. There is no positive correlation with the production of enterohormones.

Disclosure
S.M. Reimao: None. M.R. da Silva: None. G.C. Nunes: None. L.M. Mestieri: None. R.F. Santos: None. E.G. de Moura: None.