bluuebunny/crossref_metadata_2025_split huggingface dataset:
509-P: The Nuclear Receptor Nr5a1 Promotes Adipogenesis as a Novel Transcriptional Regulator of PPARgamma
Authors: CHENG YANGLEI , GUO YAN , LI YANBING 
Published: June 2024

Introduction & Objective: The nuclear receptor subfamily 5 group A member 1 (Nr5a1) recognized as a transcription factor in adrenal and gonadal organs is also found to regulate lipid metabolism in the islets. However, its involvement in the development of white adipose tissue (WAT) in which peroxisome proliferator activated receptor gamma (PPARgamma) plays a key role remains to be elucidated. Herein, we aim to study the roles and effects of Nr5a1 in adipogenesis.
Methods: Human and mice subcutaneous and visceral adipose tissue were harvested and primary adipose-derived preadipocytes were isolated and cultured in vitro. The expression of Nr5a1 in WAT and preadipocytes was validated by qPCR, western blot and immunofluorescence. RNA-seq and qPCR were conducted to discern downstream target genes. Oil-red O staining detected the lipid accumulation and western blot tested the expression of key factors in adipogenesis. The transcriptional regulation of Nr5a1 on the target gene was tested by CUT&tag and qPCR and luciferase reporter assays.
Results: Nr5a1 levels were elevated in WAT of ob/ob and db/db and diet-induced-obese mice compared to their lean controls. In primary preadipocytes of human and mice, Nr5a1 expressed at a low-level while was dramatically upregulated during adipogenesis both in mRNA and protein level. GO analysis showed that overexpression of Nr5a1 in preadipocytes upregulated adipogenesis marker genes and lipid biosynthetic process. And it was demonstrated that adipogenesis was suppressed by knockdown of Nr5a1 while overexpression of Nr5a1 promoted it. In the process of adipogenesis, Nr5a1 promoted the transcription of PPARgamma by binding to its promoter.
Conclusion: Nr5a1 promotes adipogenesis in WAT by upregulating the transcription of PPARgamma. Our findings highlight the roles of Nr5a1 in the adipocyte differentiation and lipid metabolism in WAT, positioning it as a potential target for obesity treatment.

Disclosure
Y. Cheng: None. Y. Guo: None. Y. Li: Consultant; Sanofi, Novo Nordisk, AstraZeneca.
510-P: Remnant Cholesterol and Triglyceride-Rich Lipoproteins Are Associated with Insulin Resistance and Subclinical Inflammation in Youth and Young Adults
Authors: CHOWDHURY ARUBA , GLAROS SOPHIA B. , SAMPSON MAUREEN , DAVIS FAITH , DIXON SYDNEY A. , KRENEK ANDREA , MALANDRINO NOEMI , MABUNDO LILIAN , LIGHTBOURNE MARISSA , BROWN REBECCA , MAGGE SHEELA N. , CHUNG STEPHANIE T. 
Published: June 2024

Introduction: Remnant cholesterol (Rem-C) and triglyceride-rich lipoproteins (Rem-TRLp) increase risk for atherogenesis in adults but the concentrations and relationship with insulin resistance (IR) and subclinical inflammation in youth and young adults (YYA) is unclear.
Methods: We measured fasting lipoprotein particle size and number, GlycA (composite marker of inflammation), and lipoprotein insulin resistance index (LPIR) using NMR LipoProfile® in a pooled cohort analysis of 379 YYA: 64 healthy lean (HL), 163 healthy with BMI≥85th percentile (OWOB), 104 youth-type 2 diabetes (YT2D), and 48 lipodystrophy (LD). Rem-TRLp was calculated as small + very small TRLp and Rem-C as totalC — HDLC — LDLC). Regression models compared groups and determined relationships with LPIR and GlycA, adjusting for age, sex, and race/ethnicity.
Results: YYA were aged 17.1±4.3y (mean±SD), 62% female, 66% Black, BMI 31.7 ± 9.2 kg/m2. LPIR and GlycA were higher in LD and Y-T2D vs. OWOB and HL (Table). TRLp, Rem-C, and Rem-TRLp were highest in LD. Y-T2D had higher TRLp and Rem-TRLp vs. HL. Rem-C was related to LPIR and GlycA (both adjR2=0.5, P&lt;0.01) and Rem-TRLP (both adjR2=0.2, P&lt;0.01).
Conclusion: In YYA, Rem-C and Rem-TRLp associate with severe IR and inflammation. Their contribution to atherogenesis in high risk YYA with Y-T2D and LD requires further study.

Disclosure
A. Chowdhury: None. S.B. Glaros: None. M. Sampson: None. F. Davis: None. S.A. Dixon: None. A. Krenek: None. N. Malandrino: None. L. Mabundo: None. M. Lightbourne: None. R. Brown: Research Support; Regeneron Pharmaceuticals Inc., Pfizer Inc., Amryt Pharma Plc. S.N. Magge: None. S.T. Chung: None.

Funding
Intramural Research Program of the National Institute of Diabetes & Digestive & Kidney Diseases
523-P: Proteomic Predictors of Diabetic Foot Ulcer Healing Time
Authors: SINGH AHLUWALIA TARUNVEER , JAIN SIDDHI , PETKOVIC MARIJA , RAGUZ JANA A. , KAUR GURJEET , JERSIE-CHRISTENSEN ROSA R. , KIRKETERP-MØLLER KLAUS , ANDERSEN JONAS H. , PEDERSEN ANDERS G. , VEVES ARISTIDIS , RASMUSSEN ANNE , DALGAARD LOUISE T. , ROSSING PETER 
Published: June 2024

Background and Aims: Longer diabetic foot ulcer (DFU) healing time is associated with a 10 to 20 times higher risk of foot amputations in people with diabetes than in nondiabetic subjects, however no biomarkers for DFU healing exist. We investigated foot ulcer swap proteins associated with DFU healing time.
Material and Methods: Untargeted proteomics profiling of DFU surface swaps was conducted on 112 diabetic individuals at the Steno Diabetes Center Copenhagen outpatient clinic with follow-up of 6 months. Proteomics was performed using Liquid Chromatography Mass Spectrometry workflow with quantification (MaxQuant), and annotation (Perseus). Two data preprocessing workflows (WFs) were compared, WF1: Missing values were either imputed from normal distribution after filtering 30% non-missing data, and WF2: Compositionality-based Bayesian multiplicative replacement was applied. Longitudinal analysis was conducted using cox proportional hazards regression adjusting for covariates (age, gender, BMI, diabetes type and duration, HbA1c, and triglyceride levels) with false detection rate (FDR) applied, with significance PFDR&lt;0.1 in R Studio. A lower hazards ratio (HR) indicated longer healing time.
Results: Study participants had a mean (± SD) age 50.7(11.9), and diabetes duration 26.9(14.6) years, HbA1c 64.8(15.3) mmol/mol, BMI 29.9(5.5) kg/m2, TBI 0.48 (0.22), 83.9% had neuropathy and 62.5% had type 2 diabetes. Of 256 (WF1) and 1092 (WF2) unique proteins remaining post preprocessing, 6 and 46 proteins remained significantly associated (PFDR&lt;0.1) with ulcer healing time. Top proteins included S100A8 (HR: 0.81), and Myeloblastin (HR: 0.74) associating with longer healing and IL16 and MMP1 (HR:1.28) with faster healing. Both WFs were highly correlated (R=0.7).
Conclusions: We identify tissue proteomic signatures for DFU wound healing time particularly proteins indicating increased inflammation and granulocyte infiltration in DFU wound bed and poor healing.

Disclosure
T. Ahluwalia: None. S. Jain: None. M. Petkovic: None. J.A. Raguz: None. G. Kaur: None. R.R. Jersie-Christensen: None. K. Kirketerp-Møller: None. J.H. Andersen: None. A.G. Pedersen: None. A. Veves: None. A. Rasmussen: None. L.T. Dalgaard: None. P. Rossing: Other Relationship; AstraZeneca, Bayer Inc., Boehringer-Ingelheim, Gilead Sciences, Inc., Novo Nordisk, Eli Lilly and Company, Novartis AG, Abbott Diagnostics.

Funding
Novo Nordisk Foundation (NNF 23OC0084081)
525-P: Use of a Remote Thermovisual Monitoring System in High-Risk Patients—A Pilot Study
Authors: ABBOTT CAROLINE , FRANKLYN KERRYN , STUART DAVID , KIRWAN ELLEN , FLYNN SINEAD , MCINTOSH CAROLINE D. , BOULTON ANDREW J. 
Published: June 2024

Introduction: Diabetic foot ulcer (DFU) recurrence rates are high, at 40% in 12 months. We investigated patient adherence to, and effects of, a remote thermovisual monitoring system (Bluedrop Medical) in high-risk diabetic patients. We hypothesized that at-home thermovisual monitoring is easy, used consistently by patients, and may assist podiatry care
Methods: In this single arm, open-label, 12-week pilot study in 2 countries, 27 patients with a DFU history were recruited to remote monitoring alongside routine podiatry care. Users were asked to stand on the investigational device (in the form of a home weight scale) for 30s per day at home. Plantar thermal and visual data were captured and transmitted to a cloud-based server for daily review. Scans with abnormalities were reported to patients’ healthcare provider (HCP) who determined best course of intervention. Primary endpoint was mean patient adherence across the study. Likert scales assessed a) HCP reported utility of data to perform remote assessment, b) patient reported device usability
Results: Sixteen patients completed 12 study weeks, 11 were withdrawn early (new DFU (7), technical issues) after 59.2 ± 22.3 days. 1,547 daily scans were taken during 1,940 active study days. Mean patient adherence to daily device use was 80% (±19) and 91% had high adherence (≥3 scans/wk). From 73 reported scans: in 62% of cases HCPs did remote interventions (25%) or continued to monitor (37%); in 39% of cases HCPs scheduled in-person care. HCPs strongly agreed/agreed that they could use these data to remotely assess patients’ foot health (96% reports) and help identify issues earlier than standard care (82% reports). HCPs found temperature data useful in 12% of reports vs. 90% for visual data. All patients agreed they were satisfied with the device and found it easy to use
Conclusions: Remote monitoring of vulnerable patients was achieved with good adherence, clinical utility and patient satisfaction. Future studies are warranted to assess the impact on DFU prevention

Disclosure
C. Abbott: Research Support; Bluedrop Medical. K. Franklyn: Research Support; Bluedrop Medical. D. Stuart: Research Support; Bluedrop Medical. E. Kirwan: Research Support; Bluedrop Medical. S. Flynn: Research Support; Bluedrop Medical. C.D. McIntosh: None. A.J. Boulton: None.
526-P: Risk Factor for Prolonged Hospital Stay in Patient with Diabetes-Related Foot Infection Admitted to a Specialized Unit—A Retrospective Cohort Study
Authors: LOPEZ-HUAMANRAYME EDDY , PASQUEL FRANCISCO J. , CAYCHO ANGELICA , ROQUE-QUICO KEVIN R. , CORDOVA-HUANCAS CLAUDIA C. , ALFEREZ CONDORI JHANIRA B. , FLORES FIDEL , TAMAYO CARLOS W. 
Published: June 2024

Introduction: Diabetes-related foot infections (DFI) demand high costs for health systems due prolonged hospital stay (PHS). We evaluated factors associated with PHS in patients hospitalized with DFI.
Methods: We conducted a retrospective cohort study of patient&gt;18 years hospitalized in a Peruvian hospital, during 2020 and 2021. Characteristic of patients and wounds were collected, such as the wound treatment (conservative care, minor/major amputation, and surgical debridement) and we evaluated its association with PHS, &gt;10 days, using Poisson regression, to calculate adjusted relative risks (aRR) with their 95% confidence interval.
Results: Data from 228 patients were analyzed, 76.3% were men, the mean age was 66 years, 56.6% had previous atherosclerotic cardiovascular disease (ASCVD). The median wound length was 3.5 cm, 59.5% pf patients had peripheral arterial disease, 50.5% received conservative wound care, and 49.6% had a prolonged hospital stay. Prolonged hospital stay was associated to wound length &gt; 5 cm (aRR=1.63, 95%CI: 1.17 to 2.26), major amputation/surgical debridement (aRR=2.04, 95%CI: 1.4 to 2.97), minor amputation (aRR=1.79, 95%CI: 1.22 to 2.63), and previous ASCVD (aRR=1.4, 95%CI: 0.8 to 1.84).
Conclusion: About half of the patients had a PHS, which was associated with longer wound length, type of wound treatment, and history of ASCVD.

Disclosure
E. Lopez-Huamanrayme: None. F.J. Pasquel: Research Support; Tandem Diabetes Care, Inc., Insulet Corporation, Dexcom, Inc., Ideal Medical Technologies, Novo Nordisk. Consultant; Dexcom, Inc., Medscape. A. Caycho: None. K.R. Roque-Quico: None. C.C. Cordova-Huancas: None. J.B. Alferez Condori: None. F. Flores: None. C.W. Tamayo: None.

Funding
Oficina de Docencia e Investigación, Hospital Nacional Alberto Sabogal Sologuren
530-P: Self- and Family-Management Experiences of Barriers and Facilitators in the People Living with Diabetic Foot Ulcers and Comorbidity—A Qualitative Study
Authors: SHI SHUPENG 
Published: June 2024

Objective: Diabetic foot ulcers are the leading cause of lower extremity amputations and require foot care for healing and prevention of recurrence, especially in family care settings. Patients’ high prevalence of co-morbidity is directly to risks of adverse outcomes including poor functional status and low quality of life, which needs self- and family management (SFM) beyond foot care for better prognosis. This qualitative study aimed to identify factors that impact patients and their families to manage patients’ health and meet health-related goals after discharge.
Methods: Semi-structured in-depth interviews were conducted with 15 patients and 6 informal caregivers based in China. Patients were eligible if they had completed primary diabetic foot treatment and had at least one other chronic condition. The SFM framework was used to inform the interview outline and data analysis.
Results: Twenty-six themes were mapped onto the 5 domains of SFM as barriers and facilitators. These themes include (1) health status: high symptom burden and impaired cognitive function were prominent barriers, as well as (2) personal/lifestyle: emotional factors including fear and lack of knowledge. “Maintaining whole body” in the Chinese culture motivated patients and their families to perform SFM. (3) resources: financial and equipment constraints also hindered SFM. (4) environment: social network shaped attitude and involvement in SFM. (5) health care system: service access and relationship with health providers also shaped SFM’s effect.
Conclusion: Elucidating the impact factors identified in this study allows for a more systematic selection of strategies that may improve the design of effective interventions for diabetic foot patients with co-morbidity. Adding symptom management and dementia-friendly interventions to the current foot care program may improve accessibility and quality of care.

Disclosure
S. Shi: None.

Funding
Guangdong Provincial Fundamental and Applied Fundamental Research Regional Joint Fund-Key Project (2020B1515120076)
531-P: Role of Social and Family Status in Long-Term Follow-up of Patients with Diabetic Foot
Authors: GOROBEIKO MAKSYM , DINETS ANDRII , MARCHENKO OLGA , PRYSTUPIUK MAKSYM 
Published: June 2024

Patients and Methods: 396 patients were identified from 3 diabetic foot (DF) clinics with follow-up for 1 year (2019-2022). Patients constituted study groups according to their social status: living in family (Group 1, n=154), periodical care (Group 2, n=132), living alone (Group 3, n=110). We estimated quantity of patients with ulcers at time of primary visit, after 6 and 12 months.
Results: 202 (51%) patients were females, 194 (49%) males. Mean age was 59.2±2.7 years. Mean HbA1c was 8.7±1.7%. 56 (14%) patients had HbA1c &lt; 7.0%, whereas 179 (45%) patients had HbA1c &gt; 8.2%. We provided a “fear management strategy” to patients and relatives. However, emotional reaction of single patient was weak and sceptic. Reaction of patients’ relatives was productive with multiple questions. From Group2 on 2nd visit 28 relatives out of 35 came for the first time. At follow-up of 1 year, we detected decreasing of DF ulcers in Group1 from 16% to 10%. In Group2 increasing of ulcers frequency was increased up to 12% (13 patients with new ulcers, of which 11 patients admitted DF clinic alone). In Group3 was increasing ulcers frequency from 20% to 28.5%. 7 patients underwent amputations (5 low-amputations, 2 high-amputation): one patients in Group 1, 6 patients in Group3. Patients who were accompanied by relatives support at time of visit to DFclinic had decreasing of ulcers frequency (baseline-6 months-1 year) 17.4-36.2-18.8%, as compared to patients not-accompanied with relatives for 8-34-31%, respectively. After beginning of Russian aggression against Ukraine 2 DFclinic were closed, but 49 patients were still under the follow-up.
Conclusions: Living in family even under partial care is associated with better benefit for patients. Visit relatives together with patient to DF clinic scientifically improves effect of treatment. Alone patients have higher level of amputation and complications. War is associated with significant and negative impact on DF medical centers and quantity of patients who can possibility to admit clinic.

Disclosure
M. Gorobeiko: None. A. Dinets: None. O. Marchenko: None. M. Prystupiuk: None.
548-P: Multidisciplinary Team Education Has an Effect on Prevention of Renal Function Decline in Subjects with Diabetes and Macroalbuminuria
Authors: HITOMI MAMIKO , MORIYA TATSUMI , MIYATSUKA TAKESHI , HIKI NAOKI 
Published: June 2024

It had been well known that the multidisciplinary team approach (MTA) contributes to remission of microalbuminuria in persons with type 2 diabetes, whereas it remains unclear as to whether MTA improves macroalbuminuria, a risk factor of progressive kidney failure. To investigate the effect of MTA on progression of diabetic kidney diseases (DKD) in the subjects with diabetes and macroalbuminuria, 24 subjects were managed by MTA (n=11), or by dietitian approach alone (DA, n=13) during January 2012 and December 2022. The team, which consists of physicians, nurses, and dietitians, provided support and education for DKD subjects: [1] pathophysiology and stages of DKD, [2] medications, [3] daily measurements of blood pressure, blood glucose, and body weight, [4] how to check edema, and [5] medical diet therapy based on estimated protein and salt intake from 24-hour urine collection. There was no significant difference between MTA and DA in types of diabetes, gender, age, frequencies of interventions, and the initial eGFR. HbA1c levels in MTA group (7.5±1.5) was significantly lower than those in DA group (9.7±2.8 %)(p=0.021). During the intervention period, there was a numerical decrease in albuminuria levels in MTA group (906.7 to 349.6 mg/gCr, p=0.511), whereas a numerical increase in DA group (785.1 to 1841.5 (p=0.064). Five subjects were initiated hemodialysis in the DA group, but not in MTA group. DKD stage was improved (A3 to A2) in four MTA subjects during the intervention period. The annual rate of eGFR decline during 4-year observation was significantly better in MTA group than in DA group (-2.78±4.42 vs, -8.18±6.9 mL/min/1.73m2/y, p=0.031). Thus, MTA is likely to prevent deterioration of DKD, compared with DA alone, in DKD subjects with macroalbuminuria. Further studies would be needed to uncover the effects of MTA in the prevention of other diabetic complications.

Disclosure
M. Hitomi: None. T. Moriya: None. T. Miyatsuka: None. N. Hiki: None.
553-P: Digital Storytelling Intervention for Type 2 Diabetes Self-Management among Hispanic Adults—A Randomized Clinical Trial
Authors: WIELAND MARK , VICKERY KATHERINE , GONZALEZ CRYSTAL R. , GOODSON MIRIAM L.P. , NJERU JANE W. , FORD BECKY , O'BYRNE THOMAS J. , SIA IRENE G. 
Published: June 2024

Background: Digital storytelling interventions are narrative-based videos elicited through a community-based participatory research (CBPR) approach to surface the voices of participants overcoming obstacles to healthful behaviors that perpetuate health inequities. A digital storytelling intervention for type 2 diabetes (T2D) self-management was developed by a CBPR partnership. Assessment in primary care settings demonstrated feasibility and acceptability of the intervention. This study assessed the intervention impact on glycemic control among Hispanic patients with poorly controlled T2D.
Methods: A randomized controlled trial was conducted at two primary care networks in Minnesota and Arizona among Hispanic adults with poorly controlled T2D (hemoglobin A1c≥8%). Patients were randomly assigned to receive the intervention by viewing the video at the clinical facility plus access to the intervention on a software application or to no intervention. Both groups received usual diabetes care. The 12-minute intervention included an introduction, four stories with transitions, and a closing educational message re-enforcing diabetes self-management goals. The primary outcome was the mean change from baseline of hemoglobin A1c at 3 months. Secondary outcomes included blood pressure, LDL cholesterol, body mass index, and self-reported diabetes self-management behaviors.
Results: There was a small improvement in hemoglobin A1c in the intervention group compared with the control group after adjusting for baseline A1c, age, sex, education, and income (9% to 8.3% in the intervention group compared with 9.4% to 8.8% in the control group, p=0.04). There were no statistically significant changes in secondary outcomes.
Conclusion: A digital storytelling intervention developed with and for Hispanic adults with T2D was highly acceptable and feasibly implemented within primary care settings and resulted in a modest improvement of glycemic control.

Disclosure
M. Wieland: None. K. Vickery: Research Support; National Institute of Diabetes and Digestive and Kidney Diseases. Other Relationship; National Institutes of Health, UnitedHealth Group. C.R. Gonzalez: None. M.L.P. Goodson: None. J.W. Njeru: None. B. Ford: None. T.J. O'Byrne: None. I.G. Sia: None.

Funding
National Institutes of Health (DK113999)
557-P: User Engagement and Usage Patterns in a Mobile Application for Adults with Type 2 Diabetes
Authors: BERLOT ASHLEY , WILSON SCOTT M. , KIM VIVIAN , JARIWALA SUNIT 
Published: June 2024

Introduction & Objective: Mobile applications (apps) are effective tools for improving patients’ self-management of chronic health conditions. However, there is a scarcity of published data on how patient-level characteristics are linked to app usage patterns, which could provide insight into factors influencing app engagement and health outcomes. Our study aimed to evaluate the app-usage patterns and participant characteristics of users of the DiabetesXcel mobile app, a diabetes-focused educational mobile app that has been previously shown to improve diabetes-related quality of life and clinical outcomes.
Methods: DiabetesXcel was implemented in the Bronx, NY among adult participants with Type 2 Diabetes. Logistic regression was used to determine the association of baseline characteristics with user logins and app questions answered (AQA) at 6 months. Logins and AQA were dichotomized above and below the mean.
Results: Participants (N=46) were, on average, 47 + 9 years-old, mostly women (71.7%), with half identifying as Black or African American (50.0%) and having public insurance of Medicaid or Medicare (50.0%). The average number of logins was 11 &lt;u&gt;+&lt;/u&gt; 24 and AQA was 34 &lt;u&gt;&lt;u&gt;+&lt;/u&gt; &lt;/u&gt;40. There were trends of older participants having greater odds of answering more than the mean AQA (OR=1.09 [95% CI 0.99, 1.21], p=0.07) months. Those of non-Black/African American race or ethnicity trended towards lower odds of answering more than the mean AQA (OR=0.14 [95% CI 0.02, 1.30], p=0.08) compared to those who were Black/African American, as did those with non-private insurance (OR=0.14 [95% CI 0.02, 1.30], p=0.08) than those with private insurance.
Conclusion: Our study showed trends towards older participants engaging with the app more, while those identifying as non-Black/African American and with non-private insurance engaged with the app less. Additional studies are needed to further understand this relationship, and potentially tailoring the application to these groups may improve application usage.

Disclosure
A. Berlot: None. S.M. Wilson: None. V. Kim: None. S. Jariwala: None.