bluuebunny/crossref_metadata_2025_split huggingface dataset:
2209-PUB: Type 2 Diabetes and Different Manifestations of Preexisting Cardiovascular Disease as Predictors of Specific Cardiovascular Events
Authors: SAELY CHRISTOPH H. , VONBANK ALEXANDER , HEINZLE CHRISTINE , ZANOLIN-PURIN DANIELA , LARCHER BARBARA , MADER ARTHUR , STERNBAUER SIMON , SCHINDEWOLF MARC , BAUMGARTNER IRIS , LEIHERER ANDREAS , MUENDLEIN AXEL , DREXEL HEINZ 
Published: June 2019

Coronary artery disease (CAD) and peripheral artery disease (PAD) confer an increased risk of cardiovascular events that is particularly high when type 2 diabetes (T2DM) is present in addition to cardiovascular disease (CVD). Here, we aimed at investigating the impact of T2DM and of the manifestation of pre-existing cardiovascular disease (PAD vs. CAD) as predictors of specific cardiovascular events. We prospectively recorded cardiovascular events over 10 years in 1777 patients with established CVD, including 1312 patients with CAD, of whom 29.3% had T2DM and 465 patients with PAD, of whom 43.9% had T2DM. T2DM after multivariate adjustment significantly predicted cardiovascular mortality (n=102; HR 1.77 [1.33-2.36]; p&lt;0.001), myocardial infarction (n=74; HR 1.50 [1.10-2.04]; p=0.010), ischemic stroke (n=54; HR 1.69 [1.16-2.46]; p=0.007), and revascularization of non-coronary arteries (n=134; HR 1.66 [1.29-2.13]; p&lt;0.001) independently from the manifestation of CVD. The presence of PAD versus that of CAD after adjustment for conventional cardiovascular risk factors including T2DM predicted myocardial infarction (HR 2.33 [1.61-3.37]; p&lt;0.001) and revascularization of non-coronary arteries (HR 7.48 [5.51-10.16]; p&lt;0.001). Neither T2DM nor the presence of PAD vs. that of CAD was significantly associated with percutaneous coronary interventions (n=246) or coronary artery bypass graftings (n=94) in our cohort. We conclude that both T2DM and the manifestation of pre-existing CVD predict cardiovascular events in patients with established CVD.

Disclosure
C.H. Saely: None. A. Vonbank: None. C. Heinzle: None. D. Zanolin-Purin: None. B. Larcher: None. A. Mader: None. S. Sternbauer: None. M. Schindewolf: None. I. Baumgartner: None. A. Leiherer: None. A. Muendlein: None. H. Drexel: None.
2215-PUB: Serum Levels of the Advanced Glycation End Product (AGE) Pentosidine Do Not Correlate with the Extent of Coronary Artery Disease Assessed by SYNTAX Score
Authors: BASMAN CRAIG , AVTANSKI DIMITER , ZISKOVICH KARINA , JONAS REBECCA , FISHMAN SARAH , SONMEZ HALIS , RASHID UMAR , KODRA ARBER , STOFFELS GUILLAUME , LESSER MARTIN , SINGH VARINDER , PORETSKY LEONID 
Published: June 2019

Advanced glycation end-products (AGEs) are endogenously produced or exogenously derived glycated proteins and lipoproteins. The accumulation of AGEs may have a variety of adverse effects since they cause oxidative stress and thus may act as contributing factors to the development of disease states such as, for example, complications of diabetes mellitus. The aim of this study was to investigate whether the levels of three AGEs (pentosidine, N(6)-carboxymethyllysine [CML], and methylglyoxal [MGO]) and the soluble form of the AGE receptor (sRAGE) may be used as markers for the presence and extent of coronary artery disease (CAD). We recruited 363 consecutive patients with suspected CAD who presented for cardiac catheterization at Lenox Hill Hospital in New York City (54% of patients were male, 48% of the patients had diabetes). At the time of this abstract submission 169 patients had circulating pentosidine levels measured (74 of these patients had diabetes). We examined relations between pentosidine levels, HbA1c, LDL, and the extend of CAD (measured by SYNTAX score). Serum pentosidine levels did not significantly correlate with any of other parameters. There was, however, a positive correlation between HbA1c levels and the SYNTAX score (Spearman correlation coefficients of 0.26, ρ = 0.0001 for the entire group; 0.18, ρ = 0.01 for patients without diabetes; and 0.29, ρ= 0.0001 for patients with diabetes).
In conclusion, our preliminary results demonstrate that in patients with suspected CAD undergoing cardiac catheterization, SYNTAX score does not correlate with pentosidine levels but correlates positively with HbA1c. The data on all three AGEs and sRAGE in the entire cohort of 363 patients will be presented at the meeting.

Disclosure
C. Basman: None. D. Avtanski: None. K. Ziskovich: None. R. Jonas: None. S. Fishman: None. H. Sonmez: None. U. Rashid: None. A. Kodra: None. G. Stoffels: None. M. Lesser: None. V. Singh: None. L. Poretsky: None.

Funding
The Gerald J. and Dorothy R. Friedman New York Foundation for Medical Research
2216-PUB: More Precise Assessment of Flow-Mediated Dilation (FMD) by Measuring at Maximum Dilatory Peak Time (MDP) in Subjects With and Without Type 2 Diabetes (T2D)
Authors: HERBRAND THERESA , COESTER HANS VEIT , DEVRIES J. HANS , HEISS CHRISTIAN , HEISE TIM , KELM MALTE , SANSONE ROBERTO 
Published: June 2019

FMD is widely used to quantify endothelial function. FMD is calculated from the artery’s baseline diameter and peak diameter during reactive hyperemia. To this day, many published FMD results are based on values assessed at predefined time points, e.g., 60 s after start of hyperemia, rather than at the time of MDP. This may limit the accuracy and reproducibility of FMD. We hypothesized that FMD values at MDP would be higher and more reproducible than at predefined times, resulting in a lower number of subjects needed to show significance for a given difference in FMD. FMD was measured in subjects with and without T2D by ultrasound (12 MHz transducer; GE Logiq P7, GE Healthcare, Germany). In a subset of subjects, FMD was measured again after 30 days. All measurements were performed by certified physicians and evaluated by three certified FMD analysts using Brachial Analyzer 5 (MIA LLC, U.S.). FMD values at 60 s and 90 s after start of hyperemia were compared to FMD at MDP using ANOVA. In this study, 100 healthy middle-aged subjects and 52 subjects with T2D (mean ± SD age 56 ± 5.4 years, T2D HbA1c 7.2 ± 0.7%) underwent FMD. FMD was measured again in 25 healthy subjects after 30 days. Overall, FMD was lower at predefined time points compared to MDP (least square mean difference (95% CI)) 60 s vs. MDP 1.12% ( 1.56; -0.68); p&lt;0.0001 and 90 s vs. MDP 1.82% ( 2.27; 1.37); p&lt;0.0001). The intra-subject variability was lowest for MDP compared to 60 s and 90 s (15% vs. 36% vs. 51%). Assuming 80% power and alpha at 0.05, the MDP requires 15 people to detect a 1% difference in FMD versus 26 and 31 subjects if determined at 60 s and 90 s. This study demonstrated significantly higher FMD values and superior reproducibility of the individually determined maximum dilatory peak compared to peaks at predefined time points. This roughly halves the number of study participants needed to detect a 1% difference in FMD.

Disclosure
T. Herbrand: None. H. Coester: None. J. DeVries: Advisory Panel; Self; Novo Nordisk A/S. Employee; Self; Profil Institute for Metabolic Research. Research Support; Self; Medtronic. Speaker's Bureau; Self; Novo Nordisk A/S. C. Heiss: None. T. Heise: Advisory Panel; Self; Mylan. Research Support; Self; ADOCIA, Boehringer Ingelheim International GmbH, Dance Biopharm Holdings Inc., Eli Lilly and Company, Gan & Lee Pharmaceuticals, Johnson & Johnson, MedImmune, Mylan, Nordic Bioscience, Novo Nordisk A/S, Pfizer Inc., Poxel, Saniona, Sanofi, Wockhardt, Zealand Pharma A/S. Speaker's Bureau; Self; Eli Lilly and Company, Novo Nordisk A/S. M. Kelm: None. R. Sansone: None.
2227-PUB: Relationship between Depression and Cardiovascular Outcomes in T2DM Patients: A Propensity Score-Matched Analysis of ACCORD Trial
Authors: CHEN YUNZHI , ZHUANG DIAODONG , LIANG HUA , CHEN XIJIE , XU XIAO 
Published: June 2019

Background: Despite the fact that depression increases risk for cardiovascular disease (CVD), there has met a controversy that evidences linking well depression management to CVD outcomes improvement have yet to be established. In this study, we aim to explore relationship between depression and CVD outcomes among T2DM patients in intensive and standard glycemic therapy cohort.
Method: The ACCORD database was divided into intensive glycemic therapy cohort and standard cohort. And we applied logistic regression model to assess the association between depression and CVD outcomes (primary outcome and secondary outcomes), using the propensity score method to adjust for age, gender, BMI, waist, CVD history, race, live alone, education, SBP, DBP, TRIG, CPK, alcohol, VLDL, heart failure and smoke in each cohort.
Result: 2272 patients were included in the standard glycemic therapy cohort and 2192 in the intensive cohort finally. Propensity score adjusted logistic models showed that there was no significant difference in CVD outcomes between depressed and non-depressed patients in the standard glycemic therapy cohort. While in the intensive glycemic therapy cohort, the risk of congestive heart failure was significantly higher in patients with depression than in the non-depressed group (p=0.019, OR: 1.608, 95% CI: 1.082-2.39). Besides, depressed patients seemed to more likely to develop non-fatal myocardial infarction (P=0.058, OR: 1.417, 95% CI: 0.989-2.032).
Conclusion: On equal terms, T2DM patients with depression have a greater risk of congestive heart failure in patients receiving intensive glycemic therapy, while a larger prospective randomized controlled trial focusing on this endpoint is needed to verify our result.

Disclosure
Y. Chen: None. D. Zhuang: None. H. Liang: None. X. Chen: None. X. Xu: None.
2233-PUB: Clinical Features and Biomarkers of Nonalbuminuric and Albuminuric Patterns of Chronic Kidney Disease in Subjects with Type 2 Diabetes
Authors: KORBUT ANTON I. , KLIMONTOV VADIM 
Published: June 2019

The Aim: to define the phenotypes of non-albuminuric and albuminuric chronic kidney disease (NA-CKD and A-CKD) in subjects with type 2 diabetes (T2D).
Methods: One hundred and eighty four T2D patients were included in the study. Patients with urinary albumin to creatinine ratio (UACR) &lt;3 mg/mmol and estimated glomerular filtration rate (eGFR) &lt;60 ml/min×1.73 m2 were classified as NA-CKD group (n=111). Individuals with persistent UACR &gt;3 mg/mmol and eGFR &lt;60 ml/min×1.73 m2 were considered as A-CKD patients (n=73). Urinary nephrin and podocin, as podocyte injury markers, and whey acidic protein four-disulfide core domain protein 2 (WFDC-2), which is considered as a marker of tubulointerstitial involvement, were assessed by ELISA and compared to control (20 nondiabetic subjects).
Results: The NA-CKD pattern was associated with female sex (p=0.04), reduced HbA1c levels (p=0.04) and diuretic use (p=0.001). Patients with A-CKD, as compared to NA-CKD one, demonstrated lower body weight (p=0.02), waist-to-hip ratio (p=0.009), HDL-cholesterol (p=0.01), and lymphocyte count (p=0.002). Age, diabetes duration, the prevalence of diabetic retinopathy, coronary artery disease, myocardial infarction, chronic heart failure and stroke did not differ between the groups. The nephrin and podocin concentrations, adjusted to urinary creatinine, were increased significantly in subjects with A-CKD only (p=0.002 and 0.04 respectively). The excretion of WFDC-2 was elevated in both NA-CKD and A-CKD groups (p=0.01 and p=0.0003 respectively).
Conclusion: In T2D subjects, female gender, acceptable glycemic control and treatment with diuretics are associated with NA-CKD, whereas abdominal obesity, poor glycemic control, and elevated urinary excretion of podocyte markers are the features of A-CKD. Urinary WFDC-2 excretion is increased in both CKD phenotypes.

Disclosure
A.I. Korbut: None. V. Klimontov: Advisory Panel; Self; Sanofi. Speaker's Bureau; Self; AstraZeneca, Boehringer Ingelheim International GmbH, Sanofi.
2237-PUB: Validation of the Simple Diagnostic Criteria in Japan
Authors: HIMENO TATSUHITO , SHIBATA YUKA , SHIMODA HIROMI , KONDO MASAKI , TSUNEKAWA SHIN , KATO YOSHIRO , NAKAMURA JIRO , KAMIYA HIDEKI 
Published: June 2019

Introduction: The simple diagnostic criteria (SDC) proposed by Diabetic Neuropathy Study Group in Japan has been widely accepted in our country. However, the diagnostic ability has not yet been fully validated. In the present study, we examined the usefulness of SDC in diagnosis of diabetic polyneuropathy (DPN).
Methods: We evaluated admitted 114 diabetic subjects who were diagnosed as DPN employing three independent decision rules consisting SDC: physical signs and symptoms (PHY), nerve conduction study (NCS), or coefficient of variation of RR interval (CVR-R) on electrocardiogram (CVRR).
#1. PHY rule: satisfied any two or more of following three items: the presence of symptoms considered to be due to DPN, the decrease or disappearance of bilateral Achilles tendon reflexes, and decreased vibration in the bilateral medial malleoli.
#2. NCS rule: one or more nerve conduction abnormalities in two or more nerves out of 12 peripheral nerves.
#3. CVRR rule: less than 2% of CVR-R.
The diagnostic accuracy was evaluated using the NCS rule as the reference standard.
Result:
1. Ninety-six subjects (84.2%) diagnosed as DPN. The proportions of DPN were 37.7% for PHY, 74.6% for NCS, and 43.9% for CVRR.
2. The diagnostic accuracy of PHY and/or CVRR.
Discussion: Diagnosis by NCS showed the highest prevalence. The sensitivity of PHY was improved by a combination with CVRR. DPN can be identified effectively utilizing SDC.

Disclosure
T. Himeno: None. Y. Shibata: None. H. Shimoda: None. M. Kondo: None. S. Tsunekawa: None. Y. Kato: Speaker's Bureau; Self; Merck & Co., Inc. J. Nakamura: Research Support; Self; Astellas Pharma Inc., Boehringer Ingelheim Pharmaceuticals, Inc., Daiichi Sankyo Company, Limited, Eli Lilly and Company, Japan Tobacco Inc., Kissei Pharmaceutical Co., Ltd., Merck Sharp & Dohme Corp., Novartis Pharmaceuticals Corporation, Novo Nordisk Inc., Ono Pharmaceutical Co., Ltd., Sanofi K.K., Sumitomo Dainippon Pharma Co., Ltd., Taisho Pharmaceutical Co., Ltd., Takeda Pharmaceutical Company Limited. Speaker's Bureau; Self; Astellas Pharma Inc., AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Daiichi Sankyo Company, Limited, Eli Lilly and Company, Kowa Pharmaceu. Co. Ltd., Merck Sharp & Dohme Corp., Mitsubishi Tanabe Pharma Corporation, Novartis Pharmaceuticals Corporation, Novo Nordisk Inc., Ono Pharmaceutical Co., Ltd., Sanofi K.K., Takeda Pharmaceutical Company Limited, Terumo Medical Corporation. H. Kamiya: Speaker's Bureau; Self; Astellas Pharma Inc., Eli Lilly Japan K.K., MSD K.K., Novartis Pharma K.K., Novo Nordisk Oharma Ltd., Ono Pharmaceutical Co., Ltd., Sanofi K.K.
2247-PUB: Comparative Analysis of the Thickness of Inner Retinal Layers among African Immigrants Based on Their Status of Glucose Tolerance
Authors: HWANG CHRISTOPHER K. , AGRON ELVIRA , SUMNER ANNE E. , BRIKER SARA M. , ADUWO JESSICA Y. , DUBOSE CHRISTOPHER , CHEW EMILY 
Published: June 2019

Inner retinal neurodegeneration was found, independent of the severity of retinopathy in persons with diabetes (DM). However, it is unknown whether the inner retinal neurodegeneration is evident in people with prediabetes (preDM) or asymptomatic people with newly diagnosed DM. In this cross-sectional study, we prospectively enrolled African immigrants who self-identified as being healthy with no prior history of diabetes. Each participant was tested for diabetes with an OGTT and underwent a comprehensive eye exam with spectral-domain optical coherence tomography and stereoscopic fundus photographs. The thickness of parafoveal (PA) retinal nerve fiber layer (RNFL), perifoveal (PE) RNFL, PA ganglion cell + inner plexiform layers (G+I), and PE G+I were measured using an automated segmentation software. A total of 211 African immigrants enrolled in the study. After excluding participants with a history or signs of glaucoma and other conditions that could affect retinal structural integrity, there were 21 DM participants (76% male, age 46 (28-61y) (mean (range))), 72 preDM participants (61.1% male, age 42.4 (23-65)), and 91 normal glucose tolerant (NGT) participants (58% male, age 36 (20-62y)). From the 91 NGT control subgroup, 52 age-sex-matched participants were selected for comparative analyses (64% male, age 43 (32-62y)). Among participants in the 3 subgroups (DM, preDM, NGT), there was no significant difference in the mean thickness of PA RNFL (24.7 (2.4) (mean (SD)), 24.9 (2.1), 24.6 (2.8), respectively, P=0.863), PE RNFL (35.9 (3.8), 36.7 (4.1), 35.4 (3.2), P=0.794), PA G+I (88.8 (5.6), 90.6 (10.3), 89.7 (7.2), P=0.415), or PE G+I (65.0 (5.0), 67.2 (5.6), 67.4 (4.2), P=0.194). With this limited sample size, we were unable to find in fircan an association of neurodegeneration in persons with PDM and NDM. Future studies with larger sample size may provide further supporting evidence for such an association.

Disclosure
C.K. Hwang: None. E. Agron: None. A.E. Sumner: None. S.M. Briker: None. J.Y. Aduwo: None. C. DuBose: None. E. Chew: None.
2254-PUB: Durability and Effectiveness of Split-Thickness Skin Grafting of the Plantar Foot
Authors: WALTERS ELLIOT , PANDYA MIRA , RAJPAL NEHA , ABBOUD MICHEL M. , ATTINGER CHRISTOPHER , KIM PAUL J. 
Published: June 2019

Background: Split-thickness skin grafting (STSG) is an effective coverage method for chronic foot ulcers. Many of these ulcers develop on the plantar aspect of the foot. Split-thickness skin grafting may be a high-risk operation in such a high wear area. However, outcomes data is lacking for patients receiving STSG to the plantar aspect of the foot, especially in terms of recurrence. The purpose of this study is to retrospectively compare outcomes of STSG to plantar and non-plantar chronic ulcers.
Methods: Medical records for all patients receiving STSG from 2014-2016 at our institution were reviewed under IRB approval. Major outcome measures included time to healing and time to ulcer recurrence.
Results: There were 158 patients with 182 STSGs identified. Fifty-two STSGs were located on the plantar surface of the foot and 130 STSGs on a non-plantar surface. Percent take at 30 days was not significant between the two groups (56% plantar vs. 60% non-plantar, p=0.199). However, plantar surface STSGs were significantly less likely to be healed at 60, 90, and 365 days (p&lt;0.05). STSGs on the plantar surface were 3.7 times more likely to experience a grafting complication (OR 3.7, 95% CI 1.82-7.50). After 12 months of follow-up there was no significant difference in ulcer recurrence (17% plantar vs. 10% non-plantar, p=0.172).
Conclusions: Split-thickness skin grafting to the plantar surface of the foot is more likely to experience complications and take longer to heal than on non-plantar surfaces but the durability of the graft approximates that of non-plantar surface grafts. This suggests that STSG to the plantar surface of the foot may require more upfront investment from the patient and the surgeon but remains a viable wound coverage option.

Disclosure
E. Walters: None. M. Pandya: None. N. Rajpal: None. M.M. Abboud: None. C. Attinger: Consultant; Self; Acelity, Integra LifeSciences. P.J. Kim: Consultant; Self; Acelity, Integra LifeSciences.
2261-PUB: Update on U.S. Federal Government Programs for Diabetes
Authors: POWELL CLYDETTE 
Published: June 2019

The U.S. Congress passed Public Law 115-80 in November 2017 requiring the Department of Health and Human Services (HHS) to establish a National Clinical Care Commission. The purpose of this Commission is to evaluate and make recommendations to the U.S. Secretary of Health and to the U.S. Congress regarding improvements to the coordination and leveraging of programs within HHS and other federal agencies (e.g., Veterans Administration) that relate to diabetes and its complications. The Commission was launched in October 2018 and now is reviewing the large scope of federal efforts that support clinicians in providing integrated, high-quality care to individuals with diabetes and its complications. These efforts include identifying current activities and gaps in coordination of federal education and awareness around prevention; treatment; use of new and existing technologies; methods for outreach and dissemination of education and awareness materials; and whether there are opportunities for consolidation of inappropriately overlapping or duplicative federal programs related to diabetes and its complications. This session will provide an overview of the current work of the National Clinical Care Commission with examples from some federal agencies, such as the Centers for Medicare and Medicaid Services, the Agency for Health Care Research and Quality, and the Veterans Administration.

Disclosure
C. Powell: None.
2267-PUB: Skeletal Muscle mRNA Transcriptional Signature of Response to Exercise of Patients in Different Stages of Glucose Tolerance
Authors: SZCZERBINSKI LUKASZ , NIEMIRA MAGDALENA , SZCZERBINSKI KAROL , PUCHTA URSZULA , CITKO ANNA , SIEWIEC ELWIRA , ZAPOLSKA JOANNA , TAYLOR MARK , LARSEN STEEN , GORSKA MARIA , KRETOWSKI ADAM 
Published: June 2019

Physical activity is an effective method to prevent and treat type 2 diabetes (T2D); however, the mechanisms of its beneficial effects have not been precisely elucidated. Skeletal muscle is a major contributor to overall glucose homeostasis in the body and is responsible for the efficacy of exercise intervention in the prevention and treatment of T2D. Currently, there is a lack of studies investigating the transcriptional signature of exercise training on skeletal muscles of patients with different stages of glucose tolerance.
Thus, the aim of this study was to identify the mRNA signature of skeletal muscle adaptation to three-month exercise intervention in patients with different dysregulations of glucose metabolism.
For this project we included 35 sedentary males, aged 24-65 years old, with BMI 26-33 kg/m2, divided into three groups: 15 normoglycemics, 12 prediabetics and 8 subjects with type 2 diabetes, treated with metformin only. RNA samples were obtained from biopsied Vastus lateralis muscles, before and after a 3-month supervised exercise intervention that occurred thrice weekly and consisted of mixed aerobic (60-70% of individual’s VO2max) and strength (60-70% of the repetition maximum for each exercise) activities. Selected groups of patients did not differ in age, BMI, number of performed trainings or diet during the intervention. mRNA sequencing was performed on an Illumina HiSeq 4000.
We found highly significant differential mRNA expression in normoglycemics vs. T2D and prediabetic subjects, mostly related to mitochondrial processes, including the oxidative phosphorylation and thermogenesis pathways. Furthermore, we found that exercise intervention mostly affected these pathways, suggesting that a major defect of skeletal muscle in type 2 diabetes development is related to mitochondrial function and can be diminished by exercise.

Disclosure
L. Szczerbinski: None. M. Niemira: None. K. Szczerbinski: None. U. Puchta: None. A. Citko: None. E. Siewiec: None. J. Zapolska: None. M. Taylor: None. S. Larsen: None. M. Gorska: None. A. Kretowski: None.

Funding
Polish Diabetes Association; Polish Ministry of Science and Higher Education