bluuebunny/crossref_metadata_2025_split huggingface dataset:
1292-P: Serum Thrombospondin-2 Level as a Novel Liver Fibrosis Biomarker That Changes with Liver Stiffness Improvement in Patients with Type 2 Diabetes
Authors: MAK JIMMY H.C. , YI CAROL FONG HO , WONG YING , TAN KATHRYN C. , LING KAREN LAM SIU , LEE CHI-HO 
Published: June 2023

Introduction: High baseline circulating thrombospondin-2 (TSP2) level was recently found to associate with both the development and progression of liver fibrosis in patients with co-existing nonalcoholic fatty liver disease (NAFLD) and type 2 diabetes. Here, we investigated whether circulating TSP2 levels changed with improvement in liver fibrosis.
Methods: Serum TSP2 levels were measured in all participants of the DISTINCTION study (NCT 03959501), a randomized 1:1 open-label intervention study, at baseline and after treatment with either 10mg dapagliflozin (N=30) or 100mg sitagliptin daily (N=30) for 24 weeks. Liver stiffness (LS) and controlled attenuation parameter (CAP) were measured using vibration-controlled transient elastography for evaluation of hepatic fibrosis and steatosis, respectively.
Results: Among these 60 participants with similar clinical characteristics at baseline (mean HbA1c 8.9%, CAP 289 dB/m and LS 5.9 kPa), despite similar HbA1c lowering, treatment with dapagliflozin, but not sitagliptin, led to significant improvements in body weight (BW) (p=0.012), CAP (p=0.015) and LS (p=0.011) after 24 weeks. Serum TSP2 level significantly decreased from 3.07 to 2.90 ng/mL (p=0.012), whereas no significant change in TSP2 was observed with sitagliptin. In Pearson correlation analysis, change in serum TSP2 levels positively correlated with change in LS in the dapagliflozin group (r=0.388, p=0.034), but not with changes in BW, CAP or HbA1c after dapagliflozin treatment.
Conclusion: Serum TSP2 level decreased with LS after dapagliflozin treatment, and was independent of improvements in BW, glycemic control and liver steatosis, further supporting the potential of serum TSP2 level as a novel liver fibrosis biomarker in type 2 diabetes.

Disclosure
J.H.C. Mak: None. H. Fong: None. Y. Wong: None. K.C. Tan: None. S. Lam: None. C. Lee: None.
1293-P: Diagnosing GDM in the Indian Population with Country-Specific Glucose Cut-Off Values
Authors: JHA SUDHIR C. , KUMAR NAWEEN 
Published: June 2023

Introduction: In India, about 5 million pregnancies are affected with gestational diabetes mellitus (GDM), which triggers unfavourable pregnancy outcomes. Infants that experience intrauterine hyperglycemia are more likely to develop obesity and diabetes. Insulin resistance is associated with the Indian phenotype's propensity to accumulate excessive central fat. This study aimed to ascertain how different plasma glucose concentrations affected the ability of participants in an Indian birth cohort to predict unfavourable outcomes for both mothers and babies.
Methods: We looked at a prospective cohort of pregnant women in public hospitals in Bihar, India. Pregnant women between 24 and 36 weeks underwent a 2-hour 75g oral glucose tolerance test. Following delivery, we measured the skinfold thickness of infants at the biceps, triceps, and subscapular regions of the body. For predicting the risk of SSFT new-borns and caesarean deliveries with the FBS and PPBS, 240 reliable Poisson models were built. FBS≥87 up to 92 mg/dL and PPBS≥134 up to 153 mg/dL with a one-unit increase were tested with sum of skinfold thickness (SSST) and C section delivery.
Results: We discovered that 46.91% of the mothers underwent caesarean sections, and 10.65% of the new-borns had SSFT. Results show that after correcting for age, parity, socioeconomic status, height, and maternal obesity, FBS87 mg/dL and PPBS of 134 mg/dl were linked with risk of higher SSST in new-borns and caesarean delivery.
Conclusion: In India, pregnant women are more likely to experience negative birth outcomes due to lower glucose cut-off readings than in other international classification systems. These results provide information for revising the cutoff points in light of the contextual conditions in LMIC nations.

Disclosure
S.C.Jha: None. N.Kumar: None.
1295-P: The Association between Risk of Gout Flares and Monosodium-Urate Burden Assessed Using Musculoskeletal Ultrasound in Patients with Gout
Authors: YANG SHAOLING , LIN XIAOJING , GAO YINING , LIANG NAN , HAN YALI , SUN HANG , QU SHEN , CHEN HAIBING 
Published: June 2023

Objective: We aimed to investigate the association between the risk of gout flares and ultrasound (US)-detected monosodium urate (MSU) burden using two different US score.
Methods: Patients with gout were consecutively recruited to undergo musculoskeletal ultrasound examinations of their knees, ankles, and feet. The Outcome Measure in Rheumatology (OMERACT) and musculoskeletal ultrasound features-based (MSUS) score were used to quantify the MSU burden of gout. Odds ratios for the risk of frequent gout attacks were calculated.
Results: We enrolled 1253 patients with gout (median age, 46 years; gout duration, 5 years; males, 95.9%) and a median of 3 flares over the past year. Of these, 275 (21.9%) patients had frequent (≥7) gout attacks. The OMERACT and MSUS median scores were 6 and 9, respectively. For each 5-point OMERACT and MSUS score increase, the risk of frequent gout attack increased 1.13-fold and 1.27-fold, respectively. The area under the curve (AUC) for the OMERACT and MSUS score was 0.654 (95% confidence interval [CI] 0.617-0.691) and 0.699 (95% CI: 0.663-0.735), respectively, (AUC difference 0.046, P-value for AUC difference, 0.013).
Conclusions: The OMERACT and MSUS score were significantly associated with the risk of frequent gout attacks. The MSUS score outperformed the OMERACT in terms of frequent gout attack discrimination.

Disclosure
S.Yang: None. X.Lin: None. Y.Gao: None. N.Liang: None. Y.Han: None. H.Sun: None. S.Qu: None. H.Chen: None.

Funding
Key Technologies Research and Development Program of China (2019YFA0904500); National Natural Science Foundation of China (81870606, 82170904); Three-Year Action Plan (2022-2024) to Promote Clinical Skills and Innovation in Municipal Hospitals of Shanghai
1296-P: Comparison of Fingerstick and Venous Plasma Glucose in the Ugandan Diabetes in Low-Resource Populations Study
Authors: NIWAHA ANXIOUS J. , SUMNER ANNE E. , NKABURA HUBERT , MUKASA ROGERS J. , MUBIRU NATHAN , BALUNGI PRISCILLA A. , SEKITOLEKO ISAAC , MPAIRWE BERNARD 
Published: June 2023

As Africa is experiencing the most rapid rise in the world of type 2 diabetes (T2D), identifying feasible, accurate ways to measure glucose is imperative. While venous glucose (ven-glucose) is recommended, cost and lack of access to pre-analytical processing often rules out this option. Fingerstick measurement of capillary glucose (fs-glucose) is a potential alternative. But data on the correlation between fs-glucose and ven-glucose are scant. Hence OGTT were performed in 512 Ugandans (Male: 46% (234/512), age: 43±17y (mean±SD) enrolled in the Diabetes in Low Resource Populations Study with fs-glucose (Contour Plus Glucometer) and ven-glucose (Glucokinase Method, Roche Cobas 6000) obtained at 0h and 2h. To determine correlation, bias and levels of agreement, Pearson’s correlations and Bland Altman analyses were performed. T2D, preT2D and normal glucose tolerance occurred in 2% (9/512), 18% (92/512) and 80% (411/512), resp. At 0h, fs-glucose and ven-glucose were modestly correlated (r= 0.56) (Fig) with a modest bias for lower glucose by fs-glucose 0.28 mmol/L (95% CI: 0.23, -0.34). At 2h, glucose, fs-glucose and ven-glucose were highly correlated (r=0.92) (Fig) with modest bias for higher glucose by fs-glucose 0.60 mmol/L (95% CI: 0.53, 0.66) mmol/L. Overall, fs-glucose may be an alternative to ven-glucose in Africans where the prevalence of undetected T2D is high and resources are limited.

Disclosure
A.J.Niwaha: None. A.E.Sumner: None. H.Nkabura: None. R.J.Mukasa: None. N.Mubiru: None. P.A.Balungi: None. I.Sekitoleko: None. B.Mpairwe: None.
1299-P: Predictors of Glucagon-Like Peptide-1 Responses following OGTT in Treatment-Naïve Type 2 Diabetes Mellitus among Three Ethnic Groups in Malaysia
Authors: CHIN CHONG SHIAU , SUKOR NORLELA , ROBERT SARAH A. , FONG NG KIM , KAMARUDDIN NOR A. 
Published: June 2023

Introduction: Predictors of glucagon-like peptide-1 (GLP-1) responses following OGTT in treatment-naïve type 2 diabetes mellitus (T2DM) have not been fully elucidated. In this respect, we aim to investigate the various predictors of GLP-1 responses following OGTT in treatment-naïve T2DM.
Aim: To assess the clinical and biochemical predictors of GLP-1 responses following OGTT in treatment-naïve T2DM among three ethnic groups in Malaysia.
Methods : Thirty-one treatment-naive T2DM subjects underwent a 75-g OGTT. Total GLP-1 concentrations were measured at 0, 30 and 120 min. By using area under the curve (AUC) for GLP-1 (AUCGLP-1) as an index of GLP-1 secretory response, predictors of GLP-1 responses following OGTT were assessed using multiple linear regression analysis.
Results: Majority of the treatment-naïve T2DM patients were newly-diagnosed (n=28, 96.6%). The GLP-1 levels at 0, 30- and 120-min were 25.59 ± 10.87 pmol/L, 46.86 ± 18.36 pmol/L and 27.02 ± 13.37 pmol/L respectively. There was a positive correlation between increasing age and AUCGLP-1 (Β = 8.55, p&lt;0.001). Male had higher GLP-1 response to OGTT than female (Β = -303.04, p&lt;0.001). The Indian ethnicity exhibited higher GLP-1 secretion than the Malays (Β = 244.17, p&lt;0.001). Fasting insulin was positively correlated with AUCGLP-1 (Β = 8.73, p=0.001). AUCGLP-1 was positively correlated with increased systolic blood pressure (Β = 3.65, p=0.03), total cholesterol (Β = 174.32, p=0.004) and LDL-cholesterol (Β = 202.35, p=0.002).
Conclusions: Older age, male and Indian ethnicity were independent predictors of GLP-1 responses following OGTT in treatment-naïve T2DM. The positive correlation between risk factors associated with insulin resistance and GLP-1 suggested that these risk factors are responsible for driving GLP-1 secretion.

Disclosure
S.Chong: None. N.Sukor: None. S.A.Robert: None. K.Ng: None. N.A.Kamaruddin: Advisory Panel; Zuellig Pharma Holdings Pte. Ltd., Other Relationship; American Association of Clinical Endocrinologists, Speaker's Bureau; AstraZeneca, Boehringer-Ingelheim, Eli Lilly and Company, Merck Sharp & Dohme Corp., Novo Nordisk.

Funding
National University of Malaysia (GUP-2017-066); Malaysian Endocrine & Metabolic Society (L12-MEMS6)
1300-P: Glucagon-Like Peptide-1 Levels Mirror Insulin Resistant States in Treatment-Naïve Type 2 Diabetes Mellitus
Authors: CHIN CHONG SHIAU , SUKOR NORLELA , ROBERT SARAH A. , FONG NG KIM , KAMARUDDIN NOR A. 
Published: June 2023

Introduction: In some Asian populations incretin system has been shown to be preserved in type 2 diabetes mellitus (T2DM). The association between fasting and post-OGTT glucagon-like peptide-1 (GLP-1) levels and insulin resistance in treatment-naïve T2DM population has not been clearly defined.
Aim: To assess the insulin resistant states (IRS) by means of insulin resistance index (HOMA-IR) and relate this to the fasting and post-OGTT GLP-1 responses in treatment-naïve T2DM.
Methods : Thirty-one treatment-naive T2DM subject underwent a 75-g OGTT. Fasting plasma glucose and insulin levels were obtained for HOMA-IR analyses along with plasma total GLP-1 concentrations measured at 0, 30 and 120 min.
Results: Majority of the treatment-naïve T2DM patients were newly-diagnosed (n=28, 96.6%). The GLP-1 levels at 0, 30- and 120-min were 25.59 ± 10.87 pmol/L, 46.86 ± 18.36 pmol/L and 27.02 ± 13.37 pmol/L respectively. Fasting GLP-1, incremental GLP-1 at 30 min (∆GLP-130min) and ∆GLP-1120min were positively correlated with HOMA-IR (r=0.654, p&lt;0.001; r=0.421, p=0.018; r=0.574, p=0.001 respectively).
Conclusions: The novel finding of this study is that fasting and post-OGTT GLP-1 levels increased proportionately to IRS. This suggests an adaptive compensatory GLP-1 responses to overcome the worsening insulin resistance in treatment-naïve newly-diagnosed T2DM patients.

Disclosure
S.Chong: None. N.Sukor: None. S.A.Robert: None. K.Ng: None. N.A.Kamaruddin: Advisory Panel; Zuellig Pharma Holdings Pte. Ltd., Other Relationship; American Association of Clinical Endocrinologists, Speaker's Bureau; AstraZeneca, Boehringer-Ingelheim, Eli Lilly and Company, Merck Sharp & Dohme Corp., Novo Nordisk.

Funding
National University of Malaysia (GUP-2017-066); Malaysian Endocrine & Metabolic Society (L12-MEMS6)
1301-P: Glucagon Stimulation Test—Is It Time for an Easy Interpretation Proposal?
Authors: RIZZI ALESSANDRO , TARTAGLIONE LINDA , GUGLIANDOLO SHAWN , DI STASIO ENRICO , BARBERIO ANNARITA , PITOCCO DARIO 
Published: June 2023

Background and Aims. Guidelines suggest the use of c-peptide in case of ambiguous diabetes. Glucagon stimulation test (GST), with the intravenous administration of glucagon 1 mg, is a 10-minutes test and it is suitable in clinical practice. It can describe residual beta-cell function although an easy way to identify from this test the type of diabetes or need for insulin in the short term is not available. The aims of this pilot study were to describe c-peptide response during GST and to identify classes of subjects corresponding to different types of diabetes or need of insulin.
Methods: We retrospectively recorded c-peptide levels of adults with ambiguous diabetes who underwent to GST. We divided subjects in 4 classes according to basal c-peptide (BCP) and to mean stimulated c-peptide increase (SCPi): class 1 (BCP &lt;0.5 and SCPi &lt;0.7 mmol/L from basal levels); class 2 (BCP &lt;0.5 mmol/L and SCPi ≥0.7 mmol/L), class 3 (BCP ≥0.5 mmol/L and SCPi &lt;0.7 mmol/L); class 4 (BCP ≥0.5 mmol/L and SCPi ≥0.7 mmol/L). Data about antibody positivity for anti-GAD and I.C.A. (Ab+) and need for insulin within two months were recorded.
Results: We enrolled 61 subjects, age 48.4 (14.6) years [mean (standard deviation)]. 7 subjects (11%) were included in class 1. Mean basal c-peptide was 0.3 mmol/L. 5 subjects (71%) were Ab+ and all required insulin. None of the participants were included in class 2. 18 subjects (29.5%) were included in class 3. Mean basal c-peptide was 1.0 mmo/L. 11 (61%) of class 3 subjects were Ab+ and required insulin within 2 months. 36 subjects (59.5%) were included in class 4. Mean basal c-peptide was 1.8 mmol/L. 5 (13%) of them required insulin therapy within 2 months and 4 (11%) were Ab+. Class 1 and 3 presented with lower BMI than class 4 (p&lt;0.001).
Conclusions: In those preliminary data subjects in class 1 are more likely type 1 diabetes, while subjects in class 3 are more likely T1DM or LADA requiring insulin in the short term. Those preliminary data suggest an easy interpretation for GST to include it more frequently in clinical practice.

Disclosure
A.Rizzi: None. L.Tartaglione: None. S.Gugliandolo: None. E.Di stasio: None. A.Barberio: None. D.Pitocco: None.
1302-P: Predicting Insulin Time-Course Profiles for Early Prediabetes Interception Using a Mechanistic Mathematical Model
Authors: HOR CHENG KOH , CHAN JAMES C.Y. 
Published: June 2023

Early detection of prediabetes using blood glucose remains difficult as individuals often present with slight elevations or even normoglycaemia. However, their insulin profiles usually show marked elevations, suggesting that insulin is a more sensitive biomarker for prediabetes. We developed a mechanistic whole-body model that can predict an individual’s insulin time-course and insulin sensitivity from a given glucose time-course. The model describes the absorption, distribution, metabolism and excretion of glucose and the relevant hormones, while various homeostatic processes such as insulin secretion were dynamically represented by sub-models. Matched glucose and insulin data were obtained from 7 oral glucose tolerance test studies. Model predictions of insulin time-course using glucose data as inputs were compared with observed data for validation (Fig 1). Both population and individual simulation results indicated robust prediction of insulin profiles and demonstrate that it is possible to utilize glucose data (easy to obtain) to predict insulin data (difficult to obtain) for prediabetes screening.

Disclosure
K.Hor cheng: None. J.C.Y.Chan: None.
1305-P: The Effect of Limited Pregnancy Weight Gain on Fetal Growth during Dietary Therapy in Gestational Diabetes Mellitus–Affected Women
Authors: KUMAR NAWEEN , JHA SUDHIR C. 
Published: June 2023

Aims: We aimed to evaluate how diet-related maternal weight gain (GWG) affected foetal growth in gestational diabetes (GDM)-complicated pregnancies.
Methods: This study involved 182 women who were sequentially diagnosed with GDM before 34 weeks of pregnancy and gave birth to live singletons at our hospital. To gauge compliance with an energy-limited “diabetic diet,” the women were divided into three groups based on their restricted (53%), appropriate (16%), and excessive (31%) weekly GWG. If necessary, insulin therapy was started in accordance with regional clinical recommendations.
Results: At the time of the diagnosis of GDM at 276 ± 51 weeks, the three groups' glucose tolerance, HbA1c, weekly GWG before dietary treatment, and SD score for foetal abdominal circumference were comparable. The women were monitored for 100 ± 51 weeks, during which time 54% of them got further insulin medication, and the average GWG during dietary therapy varied amongst the three groups, weighing 0 kg, 3 kg, and 5 kg. Increased HbA1c between the time of GDM diagnosis and late pregnancy was associated with excessive weekly GWG during dietary treatment, reflecting poor dietary adherence, and newborns had a birthweight-SD score of 0.59 ± 1.6.
Conclusions: In women with GDM, restricted GWG during nutritional therapy was linked to improved foetal growth. Clinical determinants of infant birthweight-SD score that are possibly modifiable include GWG during nutritional therapy and late-pregnancy HbA1c.

Disclosure
N.Kumar: None. S.C.Jha: None.
1306-P: Body-Worn Motion Sensors Detect Gait Deficits in People with Impaired Fasting Glucose Who Have Normal 400-Meter Walk Time
Authors: SHAH VRUTANGKUMAR V. , CARLSON-KUHTA PATRICIA , SOWALSKY KRISTEN , MANCINI MARTINA , HORAK FAY B. 
Published: June 2023

Background: Gait is increasingly recognized as a marker of general health status. Abnormal gait characteristics have been observed in people with diabetes, but it is unclear if subtle changes in specific gait characteristics can be found in people with impaired fasting glucose (IFG), who are not yet classified as diabetic (prediabetic).
Aim: The aim of this study was to investigate if digital gait measures discriminate people with IFG from healthy control subjects (HC) who have a normal 400-meter walk time.
Methods: One-hundred and eight people with IFG (mean age: 71.20 years) and 63 healthy control participants (mean age: 70.40 years) wore 6 inertial sensors (Opals by APDM, a Clario Company) while performing a 400-meter fast walk test. In total, 56 measures were derived from the 400-meter walk test, including time to complete the test. Analysis of Covariance (ANCOVA) was used to investigate the differences between the prediabetic and healthy control groups while adjusting for body mass index (BMI) as a covariate.
Results: After controlling for BMI as a covariate, 9 out of 55 gait measures were significantly different (p&lt;10-4) between IFG and HC groups. Step duration, cadence, and turn velocity were the most discriminative measures. In contrast, there was no significant difference between groups for stopwatch timed for 400-meter walk test.
Conclusion: Specific gait measures using body-worn sensors could be abnormal in people with IFG, even when stop watch time for the 400-meter walk test is normal. Thus, digital gait measures show promise to be used as endpoints for clinical trials in people with prediabetes.

Disclosure
V.V.Shah: Employee; APDM Wearable Technologies, A Clario Company. P.Carlson-kuhta: None. K.Sowalsky: Employee; Clario. M.Mancini: Consultant; Clario. F.B.Horak: Employee; APDM Precision Motion, division of Clario.

Funding
National Institutes of Health (5IK2CX000729-05)
1307-P: To What Extent Are the Risks in Prediabetes Explained by Progression to Diabetes?
Authors: ROONEY MARY R. , ECHOUFFO TCHEUGUI JUSTIN , LUTSEY PAMELA , FANG MICHAEL , HU JIAQI , GRAMS MORGAN , CORESH JOSEF , SELVIN ELIZABETH 
Published: June 2023

Introduction: Prediabetes is associated with elevated risks of microvascular and macrovascular complications but it is unknown to what extent progression from prediabetes to diabetes explains these associations.
Methods: In 11536 participants from the Atherosclerosis Risk in Communities (ARIC) Study (aged 46-70, ~55% women, ~20% Black) without diabetes at baseline (1990-2), we used Cox regression to characterize associations of prediabetes (A1C 5.7-6.4%) with incident atherosclerotic cardiovascular disease (ASCVD), heart failure (HF), non-traumatic amputation, and all-cause mortality before and after accounting for time-varying diabetes. We calculated the excess risk in prediabetes explained by progression to diabetes.
Results: Of the ~20% of adults with prediabetes at baseline, ~40% progressed to diabetes (median time to diabetes, ~15 years). Over ~25 years of follow-up, there were 2195 ASCVD and 2307 HF events, 100 amputations, and 5556 deaths. Prediabetes was associated with modestly elevated risks of all outcomes (Figure). Incident diabetes accounted for 15% of CVD risk, 19% of HF risk, 24% of amputation risk, and 29% of mortality risk in persons with baseline prediabetes.
Conclusion: Progression to diabetes explained an important fraction of the risks of clinical outcomes associated with prediabetes. Prediabetes contributes to risk of clinical outcomes even when persons do not progress to overt diabetes.

Disclosure
M.R.Rooney: None. J.Echouffo tcheugui: None. P.Lutsey: None. M.Fang: None. J.Hu: None. M.Grams: None. J.Coresh: Consultant; Healthy.io Ltd, SomaLogic. E.Selvin: None.