bluuebunny/crossref_metadata_2025_split huggingface dataset:
1463-P: LEADER Eligibility and Preventable Cardiovascular Events in the U.S. Population: An Analysis of the National Health and Nutrition Examination Survey
Authors: WONG NATHAN D. , FAN WENJUN , TONG COREY A. 
Published: June 2019

Background: The LEADER trial showed in persons with type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD) or at high CVD risk the efficacy of liraglutide in reducing CVD events. We projected the impact of applying the LEADER trial results on reducing CVD events in U.S. adults with T2DM.
Methods: We identified U.S. adults eligible for LEADER from available inclusion criteria in the U.S. NHANES Survey. We estimated the number of primary (CVD death, myocardial infarction and stroke) and secondary CVD and microvascular events based on LEADER published event rates in the liraglutide and placebo groups, the difference being the number of preventable events.
Results: Among 29,629 adults aged &gt;18 years (representing 231.9 million [M]), 4,672 (27.3 M) were identified with T2DM; 1,299 (7.2M) had an HbA1c of &gt;7% and were aged &gt;50 years, of which 595 (3.3M) had CVD or chronic kidney disease and 205 (0.9M) were aged &gt;60 years with microalbuminuria or proteinuria for a total of 800 (4.2 M) who fit LEADER eligible criteria. Other criteria such as carotid or peripheral arterial disease or left ventricular hypertrophy were not available. From LEADER primary endpoint event rates of 13.0% and 14.9% over 3.8-year follow-up in the liraglutide and placebo groups, respectively, we estimated 551,420 and 632,012 events would occur, respectively, for a total of 80,592 (21,209/yr) preventable CVD events. Estimated preventable expanded composite outcomes were 101,800 (29,691/yr), myocardial infarctions 42,417 (12,725/yr), microvascular events 55,142 (12,725/yr), nephropathy occurrences 63,625 (19,967/yr), and all-cause 59,384 (16,967/yr) and CVD 55,142 (16,967/yr) deaths.
Conclusion: We show many CVD events (including myocardial infarctions, CVD and total deaths, as well as microvascular complications) in U.S. adults with DM could be prevented from liraglutide therapy highlighting the need for interventions with proven cardioprotective effects.

Disclosure
N.D. Wong: Advisory Panel; Self; Novartis Pharmaceuticals Corporation. Consultant; Self; Akcea Therapeutics, AstraZeneca. Research Support; Self; Amarin Corporation, Amgen Inc., Boehringer Ingelheim Pharmaceuticals, Inc., Novo Nordisk Inc. W. Fan: None. C.A. Tong: None.

Funding
Novo Nordisk
1486-P: Longitudinal Interrelationships of Adiposity-Associated Biomarkers in Women
Authors: BADEN MEGU , HU FRANK , HUANG TIANYI 
Published: June 2019

Background: Most prior studies on associations of adiposity-associated biomarkers are cross-sectional. Understanding their longitudinal interrelationships may provide mechanistic insights into biologic pathways that lead to cardiometabolic diseases.
Methods: We included 850 healthy women in the Nurses’ Health Study II (mean age: 45y) who provided two blood samples in 1996-1999 and 2010-2011 and measured plasma concentrations of adiponectin (ADPN), leptin, soluble leptin receptor, insulin, retinol binding protein-4, high-sensitivity C-reactive protein (hsCRP), and interleukin-6 (IL-6). All biomarkers were log2-transformed. Spearman partial correlations were used to examine cross-sectional biomarker associations at baseline and follow-up. Multivariable general linear models were used to evaluate associations of each biomarker change over 13 years with (1) concurrent changes in other biomarkers (change-change) and (2) baseline levels of other biomarkers (baseline-change).
Results: In cross-sectional analyses, most biomarkers were correlated after multivariable adjustment including BMI (p&lt;0.05) both at baseline and follow-up, with the strongest associations observed between leptin/insulin and hsCRP/IL-6. There were similar associations in the change-change analysis with multivariable adjustment including weight change. However, only two associations were consistently present in the baseline-change analysis after multivariable adjustment including baseline BMI. Every doubling in baseline hsCRP was associated with 3.1% leptin change (p=0.01), whereas every doubling in baseline ADPN was associated with -9.2% insulin change (p=0.01). Notably, baseline insulin was not associated with other biomarker changes.
Conclusions: While most adiposity-associated biomarkers were interrelated both cross-sectionally and longitudinally, our results suggest that baseline hsCRP and ADPN were strong predictors for long-term changes in leptin and insulin, respectively.

Disclosure
M. Baden: Other Relationship; Self; Manpei Suzuki Diabetes Foundation. F. Hu: None. T. Huang: None.

Funding
National Institutes of Health; Manpei Suzuki Diabetes Foundation
1490-P: Using Longitudinal Modeling to Find One-Hour Glucose Alternatives to Two-Hour Glucose for Prediction and Diagnosis of Glucose Tolerance
Authors: HA JOON , CHUNG STEPHANIE T. , SUMNER ANNE E. , BERGMAN MICHAEL , BOGARDUS CLIFTON , SHERMAN ARTHUR 
Published: June 2019

One-hour glucose (1h-PG) during an oral glucose tolerance test (OGTT) is an emerging biomarker for diagnosis and prediction of prediabetes (preDM) and type 2 diabetes (T2D). Our objectives were to: (1) use a longitudinal mathematical model to predict the pattern of glucose rise in 1h-PG and 2h-PG concentration with time and (2) test our predictions in a longitudinal cohort of 52 Pima Indians (baseline age, 26.5±5.8 years; BMI, 36.6±5.8 kg/m2) who were followed for 7.2±3.5 years. Model simulations suggested that the 1h-PG would pass the threshold of 155 mg/dl before the 2h-PG passed the threshold of 140 mg/dl for most individuals, and that the time difference could be as much as several years, depending on the balance of impairments in insulin resistance and early-phase insulin secretion. Using the longitudinal data set, we estimated the times of crossing the 1h-PG and 2h-PG thresholds by fitting a linear mixed effect model to trajectories of individual participants. Participants had a median of 6 (range 3-11) separate OGTTs, 1.7±0.8 years apart. For most participants (48/52), 1h-PG of 155 mg/dl was observed before 2h-PG reached 140 mg/dl (time difference, 1.9±2.0 years). Using the linear fits we also estimated that the average 1h-PG value would be 217 mg/dl (12.0 mmol/L) when 2h-PG reached 200 mg/dl (11.1 mmol/L). Overall, the times of crossing the 1h-PG threshold of 155 mg/dl and the 2h-PG threshold of 140 mg/dl were correlated, but 1h-PG crossed earlier, thus providing an earlier indication of future hyperglycemia. Additionally, since 1h-PG and 2h-PG rise together during the progression from preDM to T2DM, a 1h-PG of 217 mg/dl could be an alternative marker to the 2h-PG of 200 mg/dl for the diagnosis of T2D.

Disclosure
J. Ha: None. S.T. Chung: None. A.E. Sumner: None. M. Bergman: None. C. Bogardus: None. A. Sherman: None.
1500-P: Continuous Glucose Monitoring and Beta-Cell Function in Youth with Cystic Fibrosis
Authors: CHAN CHRISTINE L. , VIGERS TIM B. , PYLE LAURA , ZEITLER PHILIP , NADEAU KRISTEN J. 
Published: June 2019

Continuous glucose monitoring (CGM) is frequently used to assess glucose abnormalities in cystic fibrosis (CF) prior to frank diabetes, yet the biological significance of various CGM measures is unclear. Our aim is to identify CGM measures correlated with β-cell function decline in youth with CF. CGM and 2 hour oral glucose tolerance testing (OGTT) were collected in youth with CF and healthy controls (HC). Glucose and insulin were measured at baseline and 30 minutes on OGTT. Insulinogenic index [IGI=(insulin30-insulin0)/(Glucose30-Glucose0)] was used to estimate β-cell function. Eighty-one participants were included in the analysis [15 HC, 13 CF normal glucose tolerance (NGT), 41 CF abnormal glucose tolerance, and 12 CF related diabetes by OGTT]. There were no differences in age (13.6±3.5 years), sex, race, nor BMI z-score among groups. IGI was significantly lower in all CF groups, even CF NGT, compared to HC (p&lt;0.0001). Table 1 presents correlations between CGM measures and IGI. Youth with CF, despite NGT by OGTT, have impairments in insulin secretion. Greater peak glucose, %time &gt;140 mg/dl, and glucose variability (SD and MAGE), but not measures of average nor low glucose, on CGM correlate with declines in β-cell function. Further studies are needed to determine whether these CGM measures predict clinical decline in CF.

Disclosure
C.L. Chan: None. T.B. Vigers: None. L. Pyle: None. P. Zeitler: Consultant; Self; Boehringer Ingelheim Pharmaceuticals, Inc., Eli Lilly and Company, Janssen Research & Development, Merck & Co., Inc., Novo Nordisk Inc. K.J. Nadeau: None.

Funding
Cystic Fibrosis Foundation (CHAN16A0, CHAN16GE0); National Institutes of Health (DK094712-04)
1503-P: Seasonal Changes in the Achievement of Guideline Goals for HbA1c, Blood Pressure, and Cholesterol in Patients with Type 2 Diabetes Mellitus: A Nationwide Population-Based Study (ABC Study)
Authors: MATSUTANI DAISUKE , SAKAMOTO MASAYA , MINATO SOICHIRO , TSUJIMOTO YUKI , KAYAMA YOSUKE , UTSUNOMIYA KAZUNORI , NISHIKAWA MASAKO 
Published: June 2019

Aim: Precise monthly achievement rates for reaching guideline goals for HbA1c, blood pressure (BP), and cholesterol levels remain unknown. We evaluated achievement rates on a monthly basis in patients with type 2 diabetes mellitus (T2DM) and explored related factors.
Material and Methods: This retrospective study initially analyzed data on 104,601 patients with T2DM throughout Japan (38 medical clinics). Patients whose HbA1c, BP, and low-density lipoprotein (LDL)-cholesterol were measured ≥12 times during a 2-year period were included. We evaluated monthly achievement rates. Achieved goals were defined as HbA1c &lt;7%, BP &lt;130/80 mmHg, and LDL-cholesterol &lt;100 mg/dL. Achievement of all goals was expressed as the "all ABC achievement."
Results: A total of 4,678 patients were analyzed. The achievement rates of all ABC, HbA1c, BP, and LDL-cholesterol exhibited seasonal variations with the lowest rates in winter, with those for systolic BP (SBP) being particularly low (all ABC, summer 15.6%, winter 9.6%; HbA1c, 53.1%, 48.9%; SBP, 56.6%, 40.9%; LDL-cholesterol, 50.8%, 47.2%). In the multiple logistic regression analysis, in winter, BMI ≥25 kg/m2 (BMI 25-30 kg/m2, odds ratio 0.45 [0.29-0.70], p &lt; 0.001; BMI ≥30 kg/m2, 0.35 [0.22-0.57], p &lt; 0.001) and diabetes duration ≥10 years (0.53 [0.37-0.76], p &lt; 0.001) were independently related to lower achievement rates for HbA1c, and age ≥65 years (0.47 [95% CI 0.34-0.63], p &lt; 0.001) was independently related to decreased achievement rates for SBP. Insulin and sulfonylurea use were independently associated with the decreased all ABC achievement rates in both summer and winter.
Conclusion: This study showed that in patients with T2DM, the achievement rates for blood glucose, BP, and lipid goal levels varied seasonally. Seasonal variations in the all ABC achievement rate should be considered when managing T2DM in ordinary clinical practices.

Disclosure
D. Matsutani: None. M. Sakamoto: None. S. Minato: None. Y. Tsujimoto: None. Y. Kayama: None. K. Utsunomiya: None. M. Nishikawa: None.
1509-P: Development of Self-Assessable Diabetes Risk Score: A 10-Year Prospective Cohort Study
Authors: OH TAE JUNG , MOON JAE HOON , CHOI SUNGHEE , LIM SOO , CHO YOUNG MIN , PARK KYONG SOO , CHO NAM H. , CHUL JANG HAK 
Published: June 2019

Self-awareness of diabetes is the first step to prevent this non-curable disease. Therefore, it is important to develop diabetes risk scores which can be easily calculated by general people. We developed self-assessable diabetes risk score using the data of Korean Genome and Epidemiology Study (KoGES). A total of 8,740 subjects without diabetes at baseline were followed-up biannually over 10 years. We assessed the significantly different clinical and non-laboratory variables at baseline between subjects developed diabetes mellitus and those free from diabetes at 10-year follow-up. Each of variables generated a maximum score of 100 in each gender group. Next, the 10-year probability of incident diabetes in each score was calculated. During a median follow-up of 9.7 years, 22.7% of subjects progressed to diabetes. The self-assessable diabetes risk scores included age, living location, smoking history, hypertension, family history of diabetes and waist circumference. The developed risk score yielded acceptable discrimination for incident diabetes in both male (AUC 0.661) and female (AUC 0.691). If the subject had a score more than 50, the probability of 10-year incident diabetes would be 43.4% and 36.1% in male and female, respectively.
In conclusion, our newly developed self-assessable diabetes risk score is easily applicable to people without diabetes to predict their future risk of diabetes by themselves without laboratory tests. This model would be helpful to make a diabetes prevention program and to identify high risk subjects who should undergo laboratory tests more frequently. Further studies will be needed to validate the model and to test its feasibility in real clinical settings.

Disclosure
T. Oh: None. J. Moon: None. S. Choi: None. S. Lim: None. Y. Cho: Consultant; Self; Hanmi Pharm. Co., Ltd. Research Support; Self; AstraZeneca, Sanofi-Aventis. K. Park: None. N.H. Cho: None. H. Jang: None.

Funding
Korea Centers for Disease Control & Prevention
1521-P: An Efficacy Evaluation on Prediabetes Management Using a Machine Learning-Based Risk Stratification Approach
Authors: ZOU XIANTONG , ZHU ZHANXING , LUO YINGYING , LI YUFENG , ZHOU XIANGHAI , JI LINONG 
Published: June 2019

The progression of prediabetes towards diabetes was heterogeneous, suggesting a demand for individualized management. We aim to investigate whether stratifying participants with prediabetes according to their progression risk could affect the response to interventions. We developed a 1-year diabetes progression risk evaluating model with a panel of diabetes risk factors using a machine learning method (i.e., Bagging algorithm with 300 decision trees) in prediabetes participants in Pinggu Study (a prospective population-based survey in suburban Beijing, n=622). The model training phase was conducted on 2/3 randomly selected participants and the validation phase was conducted on other 1/3. This model successfully predicted the 1-year progression of prediabetes participants in Pinggu study (internal ROC AUC 1.000, external ROC AUC 0.883). In Beijing Prediabetes Reversion Program (BPRP, a multi-central RCT to evaluate the efficacy of lifestyle and/or pioglitazone on prediabetes reversion, n=1897), subjects were divided into tertiles as high, medium and low risk groups according to their progression probability predicted by the model. Pioglitazone plus intensive lifestyle significantly increased reversion and reduced diabetes progression only in high risk group. This study suggests personalized treatment on prediabetes according to their progression risk is necessary.

Disclosure
X. Zou: None. Z. Zhu: None. Y. Luo: None. Y. Li: None. X. Zhou: None. L. Ji: Advisory Panel; Self; AstraZeneca. Consultant; Self; AstraZeneca, Bayer AG, Boehringer Ingelheim International GmbH, Bristol-Myers Squibb Company, Eli Lilly and Company, Merck KGaA, Merck Sharp & Dohme Corp., Novartis AG, Novo Nordisk A/S, Roche Pharma, Sanofi, Takeda Pharmaceutical Company Limited. Research Support; Self; AstraZeneca, Bristol-Myers Squibb Company, Eli Lilly and Company, Merck Sharp & Dohme Corp., Novartis AG, Roche Pharma, Sanofi.

Funding
The Major Chronic Non-Communicable Disease Prevention and Control Research of China; Beijing Science and Technology Committee; National Natural Science Foundation of China
1525-P: Increasing Trend in Dyslipidaemia among the Urban and Rural Populations in Tamil Nadu, Southern India, the STRiDE-I Study
Authors: NANDITHA ARUN , RAGHAVAN ARUN , SUSAIRAJ PRISCILLA , SATHEESH KRISHNAMOORTHY , SIMON MARY , VINITHA RAMACHANDRAN , SNEHALATHA CHAMUKUTTAN , RAMACHANDRAN AMBADY 
Published: June 2019

Two cross-sectional epidemiological surveys were done in 2006 (Ramachandran A et al, Diabetes Care 2008) and 2016 (Nanditha A et al, Diabetes Care 2019, in press) in the same locations in men and women aged ≥ 20 years. We analyzed the increasing trend in dyslipidaemia among populations of varied levels of urbanization and socio-economic development in a 10 year period. Anthropometric measurements, clinical history, blood glucose and fasting serum lipid parameters were measured. The cut-off value suggested by the World Health Organization for Asian Indians for obesity was used. Prevalence of dyslipidaemia was calculated using the National Cholesterol Education Program criteria (NCEP Executive Summary, JAMA 2001). Prevalence of anthropometric and lipid abnormalities in 2006 and 2016 are shown in the Table. The total number screened were 7066 in 2006 and 9848 in 2016. Significant increases (p&lt;0.0001) in the prevalence of generalized obesity and abdominal obesity were observed in the urban and even among the rural populations. Total cholesterol, triglycerides, HDLc, LDLc, and non-HDLc showed significant increase in all three areas except for HDLc in the town. The increasing prevalence of diabetes, prediabetes and abdominal obesity, noted in the primary study, could have been the major determinant for the rising trend in dyslipidaemia in these populations.

Disclosure
A. Nanditha: None. A. Raghavan: None. P. Susairaj: None. K. Satheesh: None. M. Simon: None. R. Vinitha: None. C. Snehalatha: None. A. Ramachandran: None.
1542-P: Diabetes Care Goal Achievement over 1999-2016 Was Similar in Rural and Urban America
Authors: MERCADO CARLA , BULLARD KAI M. , ALI MOHAMMED K. , IMPERATORE GIUSEPPINA , SAYDAH SHARON , GREGG EDWARD 
Published: June 2019

Although it is hypothesized that rural American adults with diabetes (DM) have poorer control of ABCS risk factors [glycohemoglobin (A1c), Blood pressure (BP), Cholesterol, and Smoking], there are no empiric data comparing diabetes care in rural versus urban areas. We examined rural and urban differences in proportions of U.S. adults with DM achieving A1c &lt;8.0%, BP &lt;140/90 mmHg, non-HDL cholesterol &lt;160 mg/dL, and current non-smoker, separately and combined. We analyzed data from 5,534 participants aged ≥18 years with diagnosed DM in the NHANES during 1999-2016. About 20% of U.S. adults with diagnosed DM reside in rural areas. ABCS goal achievement changes from 1999-2004 to 2011-2016 varied by urban/rural areas (see Table). Current non-smoker prevalence increased only for rural areas by 17 percentage points. Non-HDL cholesterol goal achievement increased by 17 percentage points in both rural and urban areas. In urban areas, achievement in BP and all ABCS goals increased by 8 and 15 percentage points, respectively. Although no significant difference was noted in achieving A1c goal from 1999-2004 to 2011-2016 in rural or urban areas, between 2005-2010 to 2011-2016, there was a decrease in A1c goal achievement in rural setting by 11 percentage points. Achievement of ABCS goals has generally improved among U.S. adults with DM, with about 1/3 of U.S. adults with DM achieving all four ABCS goals, regardless of rural/urban status.

Disclosure
C. Mercado: None. K.M. Bullard: None. M.K. Ali: None. G. Imperatore: None. S. Saydah: None. E. Gregg: None.
1546-P: Acute Pancreatitis (AP) with Canagliflozin (CANA) vs. Other Antihyperglycemic Agents (AHAs): An Observational Study
Authors: YUAN ZHONG , DEFALCO FRANK , WANG LU , HESTER LAURA L. , SWERDEL JOEL N. , FREEDMAN AMY , RYAN PATRICK , SCHUEMIE MARTIJN , QIU ROSE , YEE JACQUELINE , MEININGER GARY , BERLIN JESSE A. , ROSENTHAL NORM 
Published: June 2019

Observational evidence suggests that patients with type 2 diabetes mellitus (T2DM) are at increased risk of AP. A small number of AP events were reported in clinical trials of the SGLT2 inhibitor CANA, with no imbalances noted between treatment groups. This observational study evaluated the risk of AP among new users of CANA vs. 6 classes of other AHAs. Three U.S. claims databases were analyzed based on a prespecified protocol approved by the European Medicines Agency. Propensity score adjustment controlled for imbalances in baseline covariates. Cox regression models were used to estimate the hazard ratio of AP with CANA vs. other AHAs using on-treatment and intent-to-treat (ITT) approaches. Sensitivity analyses assessed the robustness of study findings. Across the 3 databases, there were between 12,023 to 80,986 new users of CANA and the crude incidence rates of AP (events per 1000 person-years) were between 1.5 to 2.2 for CANA and 1.1 to 6.6 for other AHAs. AP risk in patients newly treated with CANA or other AHAs was generally similar (Table). Findings from the ITT approach and sensitivity analyses were qualitatively consistent with the on-treatment approach. In this large observational study, incidence rates of AP in patients with T2DM treated with CANA or other AHAs were generally similar, with no evidence to suggest that CANA is associated with an increased risk of AP compared with other AHAs.

Disclosure
Z. Yuan: Employee; Self; Janssen Research & Development. F. Defalco: Employee; Self; Janssen Research & Development. L. Wang: Employee; Self; Johnson & Johnson. L.L. Hester: Employee; Self; Janssen Research & Development. J.N. Swerdel: Employee; Self; Janssen Pharmaceuticals, Inc. A. Freedman: Employee; Self; Janssen Research & Development. P. Ryan: Employee; Self; Janssen Research & Development. M. Schuemie: Employee; Self; Janssen Research & Development. R. Qiu: Employee; Self; Janssen Research & Development. J. Yee: Employee; Self; Janssen Research & Development. G. Meininger: Employee; Self; Janssen Research & Development. J.A. Berlin: Employee; Self; Janssen Research & Development. Stock/Shareholder; Self; Janssen Research & Development. N. Rosenthal: Employee; Self; Janssen Research & Development.

Funding
Janssen Research & Development, LLC
1547-P: Early Intensive Glycemic Control Is Responsible for Long-Term Durable Glycemic Control and Lower Rate of Diabetic Complications in Newly Diagnosed Type 2 Diabetes Patients: A Six-Year Observational Study
Authors: KIM NAM HOON , KIM SIN GON , JANG HYE-MIN , KIM KYOUNG JIN , KIM HYE SUK 
Published: June 2019

Objective: To evaluate whether the early intensive glycemic control is responsible for development of diabetic complications as well as to determine early target HbA1c achievement affects long-term durable glycemic control.
Methods: Of 194 patients with newly diagnosed type 2 diabetes between Jan 2011 and Mar 2013 in the original cohort, 145 were followed-up for &gt; 6 years. Glycemic durability group was defined as the maintenance of optimal glycemic control (HbA1c &lt; 7.0%) without an intensification of glucose-lowering treatment regimens during first 2-year. Microvascular and macrovascular complications were assessed by multiple logistic regression analysis.
Results: During a median follow-up of 6.53 (range 5-9) years, 66 microvascular and 14 macrovascular events occurred. Risk of composite microvascular complications (OR; 4.55, 95% CI; 1.74-11.91) and composite macrovascular complications (OR; 5.57, 95% CI; 0.84-36.78) were higher in the non-durability group than in the durability group. In addition, early achievement to target HbA1c (&lt;3 months) was associated with maintenance of 6-year durable glycemic control (HR; 3.56. 95% CI; 1.14-11.16), and lower risk of microvascular complications (HR; 0.46, 95% CI; 0.26-0.82) compared to late achievement (&gt; 6 months).
Conclusion: This real-world database analysis showed that early intensive glycemic control was associated with a sustained effect on glycemic durability as well as significant reduction in the risk of microvascular complications.

Disclosure
N. Kim: None. S. Kim: None. H. Jang: None. K. Kim: None. H. Kim: None.