bluuebunny/crossref_metadata_2025_split huggingface dataset:
1346-P: Investigation of Changes in Urinary Titin N-terminal Fragment during Hospitalization for Glycemic Control
Authors: YOSHIDA SUMIKO 
Published: June 2023

Background: Urinary titin N-terminal fragment concentration (urinary titin) has been reported to be negatively correlated with muscle mass, grip strength, and knee joint extension strength, and is considered a biomarker that reflects sarcopenia, muscle damage, and the catabolic state of muscle. Sarcopenia and skeletal muscle dysfunction occur in the person with diabetes, but it is unclear how urinary titin changes with improved blood glucose control.
Methods: One hundred and five Japanese patients with diabetes (85 type 2 and 20 type 1) who were hospitalized for glycemic control for approximately 2 weeks were included. Patients who were hospitalized with acute complications of diabetes or who had infections were excluded. Urinary titin was measured in all patients at admission and discharge, and skeletal muscle mass index (SMI) was measured in 49 patients.
Results: Patients were 55 males and 50 females. Median age was 62.0 years, BMI was 25.5, and HbA1c was 9.2%. There was no correlation between urinary titin at admission and age, BMI, SMI, and HbA1c, but it tended to be higher in men (p=0.08). Urinary titin was 2.31±5.40 nmol/gCr at admission and 1.30±1.48 nmol/gCr at discharge, showing a significant decrease (p=0.049). Body weight loss of -1.8% was observed during hospitalization, and SMI decreased by -1.4% from admission. There was no correlation between changes in urinary titin during hospitalization and age, BMI, HbA1c, and changes in body weight and SMI during hospitalization.
Conclusion: Urinary titin significantly decreased in patients with diabetes who were hospitalized for glycemic control for approximately 2 weeks, and no correlation was observed with changes in SMI. The short-term changes in urinary titin suggested that skeletal muscle dysfunction was improved by improvement of blood glucose control. However, in this study, the quality of skeletal muscle such as muscle strength could not be evaluated, and additional examination is necessary.

Disclosure
S.Yoshida: None.
1377-P: The Contribution of Binge Eating to the Glycometabolic Risk Factors Is Mediated by Nutritional Status and Body Composition in People with Overweight and Obesity
Authors: LEONE ALESSANDRO , DE AMICIS RAMONA , FOPPIANI ANDREA , BERTOLI SIMONA , MENICHETTI FRANCESCA , BATTEZZATI ALBERTO 
Published: June 2023

Binge eating (BE) has been associated with an increased risk of obesity and diabetes. However, it is unclear whether the relationship between BE and glycometabolic risk factors is direct or mediated by other factors, such as lifestyle, nutritional status, and body composition. To clarify this issue, we conducted a cross-sectional study of 4799 subjects free of diabetes (68% women, mean age: 47±13 years) with overweight (53.8%) and obesity (46.2%) recruited at ICANS, University of Milan. All subjects underwent a clinical examination. Anthropometric measurements (weight, height and body fat estimation by body skinfold), visceral and subcutaneous abdominal adipose tissue thicknesses measured by ultrasound, and fasting blood parameters (glucose, insulin and HOMA) were measured. Lifestyle was assessed, with particular regard to smoking, physical activity, and adherence to the Mediterranean diet (MEDAS questionnaire). BE was assessed using the Binge Eating Scale (BES) questionnaire (range score: 0-46). People with a BES score ≥18 were categorized as having BE. Overall, 18.4% of subjects presented BE, with higher prevalence in women (22.8%) than in men (9.1%, p&lt;0.001) and in people with obesity (22.4%) than overweight (15.0%, p&lt;0.001). In the linear regression model adjusted for sex and age, BES was significantly associated with glucose (β=0.05, 95%CI: 0.01, 0.08; p&lt;0.013), insulin (β=0.10, 95%CI: 0.07, 0.13; p&lt;0.001) and HOMA (β=0.03, 95%CI: 0.02, 0.04; p&lt;0.001). The significant association between BES and glycometabolic risk factors remained after inclusion of lifestyle factors (smoking, physical activity and adherence to the Mediterranean diet). However, after inclusion of BMI, total and abdominal fat, the significance was lost. Our data do not support the hypothesis of a direct contribution of BE to the glycometabolic risk. The contribution of BE seems to be mediated by nutritional status and body composition.

Disclosure
A.Leone: None. R.De amicis: None. A.Foppiani: None. S.Bertoli: None. F.Menichetti: None. A.Battezzati: None.

Funding
Italian National Recovery and Resilience Plan Mission 4 Component 2 Investment 1.3 - Call for Proposals (341) of 15 March 2022 of Italian Ministry of University and Research funded by the European Union - NextGenerationEU (PE00000003) Concession Decree (1550) of 11 October 2022 adopted by the Italian Ministry of University and Research (CUP D93C22000890001)
1395-P: The Impact of Type 2 Diabetes on the Outcomes of Solid Organ Transplants in the U.S.
Authors: STEPANOVA MARIA , KUMAR AMEETA , BRANDT PAMELA , GUNDURAO NAGASHREE , CUSI KENNETH , YOUNOSSI ZOBAIR 
Published: June 2023

Background and Aim: Type 2 Diabetes (T2D) is a major driver of chronic diseases across the globe. The aim of this study was to assess the impact of T2D on the outcomes of solid organ transplantations.
Method: We used Scientific Registry of Transplant Recipients (SRTR) 2006-2021 to collect data for all patients ≥18 years who received a lung, heart, liver, or kidney single organ transplant in the U.S.
Results: We included 442,100 solid organ transplant recipients: 31,503 lung, 38,004 heart, 86,153 liver, 286,440 kidney transplants. The prevalence of pre-transplant T2D was 15% in lung (increased from 12% in 2006 to 15% in 2021), 26% in heart (22% in 2006 to 28% in 2021), 26% in liver (23% in 2008 to 28% in 2019), and 30% in kidney (26% in 2006 to 34% in 2021). In all organs, post-transplant mortality was significantly higher among transplant recipients with vs. without T2D [lung transplant: 14.2% vs. 13.1% (1 year), 46.4% vs. 42.6% (5 years), p&lt;0.05; heart transplant: 11.2% vs. 9.1% (1 year), 24.4% vs. 20.6% (5 years), all p&lt;0.0001; liver transplant: 10.3% vs. 8.4% (1 year), 25.4% vs. 21.1% (5 years), all p&lt;0.0001; kidney transplant: 5.3% vs. 2.5% (1 year), 20.8% vs. 10.1% (5 years), all p&lt;0.0001]. Independent association of pre-transplant T2D with higher post-transplant mortality was significant after adjustment for clinico-demographic confounders (calendar year, age, sex, race, education, insurance, functional status, obesity, history of cancer, listing diagnosis, donor-related parameters): adjusted hazard ratio (aHR) for T2D in lung transplant recipients =1.08 (1.03-1.13), in heart transplant aHR = 1.26 (1.20-1.32), in liver transplant recipients aHR = 1.26 (1.22-1.30), and in kidney transplant recipients aHR = 1.65 (1.62-1.68) (all p&lt;0.01).
Conclusions: The prevalence of T2D is rapidly increasing in solid organ transplant candidates. In all solid organ transplants, pre-transplant T2D is independently associated with an increased risk of post-transplant mortality, the most profoundly in kidney transplants.

Disclosure
M.Stepanova: None. A.Kumar: None. P.Brandt: None. N.Gundurao: None. K.Cusi: Consultant; Poxel SA, Altimmune, Arrowhead Pharmaceuticals, Inc., AstraZeneca, 89bio, Inc., Bristol-Myers Squibb Company, Lilly, Madrigal Pharmaceuticals, Inc., Merck & Co., Inc., Medscape, Myovant, Novo Nordisk, ProSciento, Quest Diagnostics, Sagimet, Sonic Incytes, Terns, Research Support; Echosens, Inventiva, LabCorp, Zydus. Z.Younossi: Consultant; AbbVie Inc., BMS, Gilead Sciences, Inc., Novo Nordisk, Merck & Co., Inc., Quest Diagnostics, Siemens, Intercept Pharmaceuticals, Inc., Viking Therapeutics.
14-LB: Abdominal Obesity Indices Predict Incident Renal Events in a 10-Year Cohort with Type 2 Diabetes Mellitus
Authors: MA CHIFA , YUAN MINGXIA 
Published: June 2023

Background: Obesity, especially abdominal obesity, has been associated with diabetes. However, few studies focused on the association between obesity indices and diabetic nephropathy, let alone the longitudinal studies. Waist circumference (WC), visceral adiposity index (VAI), Chinese visceral adiposity index (CVAI) and lipid accumulation product (LAP) are described as abdominal obesity indices. The present study aimed to explore the associations between these indices and incident renal events in a 10-year cohort with type 2 diabetes mellitus (T2DM).
Methods: A total of 2709 participants with T2DM from the Beijing Community Diabetes Study were included. Prespecified renal outcomes included incident or worsening nephropathy (progression to macroalbuminuria, doubling of the serum creatinine, initiation of renal-replacement therapy, or renal death) and incident albuminuria. Multivariable Cox regression were applied to analyze the associations between these indices and renal events.
Results: Multivariable analyses indicated that each 1-SD increase in WC, VAI, CVAI and LAP was associated with a higher risk of renal events, with adjusted hazard ratios (HRs) being 1.236 [95% CI (confidence interval): 1.079-1.417], 1.135 (1.026-1.257), 1.295 (1.132-1.483), and 1.144 (1.036-1.263), respectively. Moreover, participants in the highest quartile of abdominal obesity indices were at higher risk of renal events compared to those in the lowest quartile (all P for trend&lt;0.05). However, only CVAI was always significantly positively associated with incident renal events in all subgroups, including gender (male vs. female), age (&lt; 60 years vs. ≥60 years) and ACEI (angiotensin-converting enzyme inhibitor) or ARB (angiotensin II receptor blocker) treatment (no vs. yes).
Conclusion: Abdominal obesity indices could predict renal events in a 10-year cohort with T2DM, and CVAI may be more universal to predict renal events than WC, VAI and LAP in certain population.

Disclosure
C. Ma: None. M. Yuan: None.

Funding
Capital's Funds for Health Improvement and Research (2022-1-1101, 2016-1-2057)
1409-P: Association between Population Level Social Risk Factors and Prevalence of Diabetes
Authors: EGEDE LEONARD E. , WALKER REBEKAH J. , LINDE SEBASTIAN 
Published: June 2023

Background: The goal of this study was to evaluate the independent effect of population social risk on the crude prevalence of diabetes.
Methods: We combined census tract level data including diabetes prevalence from the CDC PLACES 2019 database and social risk factor data from the Opportunity Insights database. A multiple linear regression model was run with diabetes prevalence as the outcome and incarceration, poverty, housing, education, employment, job environment, economic mobility, and healthcare access as independent correlates, adjusting for US population in 2020 and state fixed effects.
Results: The final analytic sample consisted of 11,457 census tracts within 157 counties in 38 states. Mean prevalence of diabetes was 11.8% +/- 4.9%. All indicator variables were significantly associated with crude prevalence of diabetes and explained 89.2% of the variance in diabetes prevalence at the national level. In the fully adjusted model, with every standard deviation (SD) increase in proportion with an annual check-up, crude prevalence increased by 0.7 SD. For every SD increase in proportion uninsured, crude prevalence increased by 0.5 SD. For every SD increase in income below the poverty line, crude prevalence increased by 0.1 SD. For every SD increase in average rent for a two-bedroom apartment, crude prevalence decreased by 0.1 SD. For every SD increase in proportion of residents with a college degree, crude prevalence decreased by 0.1 SD. For every SD increase in proportion incarcerated, crude prevalence increased by 0.05 SD. In addition, in the fully adjusted model, the crude prevalence of diabetes varied significantly across states.
Conclusions: Population level social risk factors were significantly associated with changes in prevalence of diabetes at the national level. The strongest drivers of this relationship were healthcare access, insurance, income, housing, education, and incarceration.

Disclosure
L.E.Egede: None. R.J.Walker: None. S.Linde: None.

Funding
National Institutes of Health (R01DK118038, R01DK120861, R01MD013826)
1437-P: Treatment Pattern and Glycemic Control of Adults with T2DM in Northern China
Authors: CHEN LIMING , ZHANG QIUMEI , FAN YAQING , LIU XIXI , ZHANG MINLU , WU GUANGYU , WU MENG , HUANG QIONG , HAN YANFANG , KANG LEI , LI MING 
Published: June 2023

Aim: To better understand the current treatment pattern and glycemic control status in Chinese adults with T2DM.
Methods: A retrospective study was conducted among adult T2DM patients using electronic medical records from 2015 to 2019 in Tianjin, a metropolis in Northern China.
Results: From 2015 to 2019, a total of 312,203 patients from 75 hospitals were included, with mean age of 61.9 years old and BMI 26.1 kg/m2. HbA1c decreased from 8.2% to 7.9% with the percentages of HbA1c &lt;7% increased from 28.1% to 33.7% (P&lt;0.001). A growing proportion treated with basal insulin and GLP-1RA ± basal insulin was seen while the proportion of premixed insulin decreased (P&lt;0.001). 44.0% of the subjects were treated with OAD only and the most frequently used OADs were α-glucosidase inhibitor (55.7%) and metformin (47.0%). The percentages of cardiovascular risk factors and macrovascular events including hypertension, dyslipidemia, obesity, cardiovascular disease and stroke were increased each year (P&lt;0.001). During 2015-2019, 27.7% and 40.3% of the population had FPG&lt;7 mmol/L and PPG&lt;10 mmol/L, respectively, while 46.1% of them had both FPG ≥ 7 and PPG ≥10 mmol/L.
Conclusion: From 2015 to 2019, an increasing proportion of T2DM population achieved HbA1c target, reflecting the potential optimized treatment concept and regimen. Meanwhile, there is still room to improve the holistic management of T2DM in China for a better patient outcome.

Disclosure
L.Chen: None. L.Kang: Employee; Sanofi China. M.Li: None. Q.Zhang: None. Y.Fan: None. X.Liu: None. M.Zhang: Employee; Sanofi China. G.Wu: Employee; Sanofi China. M.Wu: Employee; Sanofi China. Q.Huang: Employee; Sanofi China. Y.Han: Employee; Sanofi China.

Funding
Sanofi
1443-P: Population-Based Survey Showing No Increased Incidence of Type 1 Diabetes in Association with COVID-19 Vaccination in China
Authors: LIU CHANG , XIN ZHONG , YANG JIN-KUI 
Published: June 2023

Introduction: Several reports showed that COVID-19 vaccine may cause type 1 diabetes (T1D), especially fulminant T1D (FT1D). This study investigates the incidence of T1D during 2007-2021 in a general population of China, where &gt;90% of people have received a full COVID-19 vaccination (3 injections) in 2021.
Methods: A population-based registry of T1D was performed by the Beijing Municipal Health Commission Information Center.
Results: In this population included 14.14 million registered residents, we identified 7,697 people with newly diagnosed T1D from 2007 to 2021, including 4,094 men and 3,603 women. T1D incidence [95% CI] (/100,000 persons) increased from 2.77 [2.49, 3.08] in 2007 to 3.84 [3.53, 4.18] in 2021. From 2007 to 2019 the T1D incidence increased with an annual percentage change (APC) of 3.13% (p&lt;0.05). However, the T1D incidence was stable from 2019 to 2021 (the APC was -11.5% (p&gt;0.05)), indicating that T1D incidence did not increase when people were vaccinated in Jan-Dec 2021. Meanwhile, the T1D with diabetic ketosis/ketoacidosis as the initial presentation incidence increased from 2007 to 2019, and it was stable from 2019 to 2021 (P&gt;0.05) (Figure 1). The incidence of FT1D did not increase from 2015 to 2021 (APC:8.9%, P=0.53).
Conclusion: Our study indicates that COVID-19 vaccination did not increase T1D onset, at least not on a large scale.

Disclosure
C.Liu: None. Z.Xin: None. J.Yang: None.

Funding
National Natural Science Foundation of China (81930019)
147-LB: Visits in Pediatric vs. Adult Clinics for Young Adults (YA) with T1D—Prepandemic and Pandemic Care
Authors: SHAPIRA AMIT , TINSLEY LIANE J. , TOSCHI ELENA , LAFFEL LORI M. 
Published: June 2023

Aim: YA with T1D have high risk of rising A1c and loss to follow up. To understand factors associated with visit frequency, we compared characteristics of YA with T1D seen in pediatric vs adult diabetes clinics in the pre- and pandemic periods.
Methods: EMR data included YA, aged 18-30 yrs, with T1D in pediatric and adult clinics during the pre- and pandemic (4/1/19 to 3/15/20 and 3/30/20 to 3/15/21, respectively), for both inperson and telehealth visits.
Results: There were 1,762 YA (54% male), aged 24.0±3.6 yrs, with T1D duration 13.4±6.3 yrs and A1c 8.2±1.6%; 61% were pump treated; 64% used CGM. Pre-pandemic, almost all visits were inperson while most pandemic visits were virtual. During the pandemic, proportion of virtual visits was greater in pediatric vs adult care (99% vs 90%, p&lt;.001). Overall, pre-pandemic visit frequency was 3.5±3.4, reduced to 3.1±4.1 (p&lt;.0001) during pandemic. Pre-pandemic visit frequency was higher in those with higher A1c (r =.18, p&lt;.001) in pediatric and adult care. During pandemic, YA visit frequency was preserved across A1c groups only for those in pediatric care (Figure 1). Pandemic visit frequency was lower in adult care regardless of sex, pump, CGM or A1c.
Conclusion: Maintaining visit frequency may mitigate glycemic deterioration in YA with T1D. Pediatric care likely maintained visit frequency through use of telehealth, highlighting need for hybrid care to optimize outcomes.

Disclosure
A. Shapira: None. L. J. Tinsley: None. E. Toschi: Advisory Panel; Eli Lilly and Company. L. M. Laffel: Advisory Panel; Medtronic, Lilly Diabetes, Novo Nordisk, Vertex Pharmaceuticals Incorporated, Roche Diagnostics, Provention Bio, Inc., Consultant; Dexcom, Inc., Janssen Pharmaceuticals, Inc., Medscape.

Funding
Thomas J. Beatson, Jr. Foundation
148-OR: CGM Time Below Range Predicts Epinephrine Response to Hypoglycemia in Patients with Type 1 Diabetes
Authors: THOMAS ROBERT L. , GREGORY JUSTIN M. , GIOVANNETTI ERIN R. , BOEDER SCHAFER C. , PETTUS JEREMY 
Published: June 2023

Identifying T1D patients with impaired awareness of hypoglycemia (IAH) is essential, as these patients are at ~10-fold risk of severe hypoglycemia. Defining IAH has relied on questionnaires such as Clarke score that are rarely used in clinical practice. Additional tools are needed to stratify hypoglycemia risk in patients with T1D. Here we show that CGM metrics correlate with physiologic response to hypoglycemia. We measured serum epinephrine levels in 22 subjects with T1D (ages 28-52, A1c 6.1-7.2, median Clarke score 3) during a hyperinsulinemic-hypoglycemic clamp. Baseline CGM data was collected for 2 weeks prior to clamp. These data show a novel, inverse relationship between CGM time below range (TBR, &lt;70 mg/dL) and epinephrine response (EpiR, pg/mL/min) FIGURE. CGM TBR (ρ = -0.562, p = 0.006), Clarke score (ρ = -0.592, p = 0.03), and older age (ρ = -0.500, p = 0.015) were inversely associated with EpiR. Higher average glucose was associated with increased EpiR while time in range, coefficient of variation, BMI, and duration of T1D showed no significant association with EpiR. Our study suggests that CGM TBR predicts counterregulatory dysfunction in T1D. CGM TBR demonstrated a robust, inverse correlation with EpiR similar to the validated Clarke survey. CGM is now the gold standard for glycemic monitoring in T1D, and the percentage TBR may help identify patients at highest risk for severe hypoglycemia outcomes.

Disclosure
R.L.Thomas: None. J.M.Gregory: Advisory Panel; Eli Lilly and Company, vTv Therapeutics, Other Relationship; Medtronic. E.R.Giovannetti: None. S.C.Boeder: Consultant; Cecelia Health, Research Support; Dexcom, Inc., REMD Biotherapeutics, Eli Lilly and Company. J.Pettus: Advisory Panel; Sanofi, Novo Nordisk, Lilly, MannKind Corporation, Consultant; Carmot Therapeutics, Inc., Diasome.

Funding
JDRF (2-SRA-2018-606-M-B, 5-ECR-2020-950-A-N); National Institute of Diabetes and Digestive and Kidney Diseases (K23DK123392)
1485-P: The Involvement of ANGPTL4 in Periodontitis and the Influence of High Glucose
Authors: KONDO SHUN , KOJIMA KENTO , NAKAMURA NOBUHISA , MIYABE MEGUMI , KIKUCHI TAKESHI , OHNO TASUKU , SAWADA NORITAKA , MINATO TOMOMI , SAIKI TOMOKAZU , ITO MIZUHO , SASAJIMA SACHIKO , MATSUBARA TATSUAKI , MITANI AKIO , NARUSE KEIKO 
Published: June 2023

Periodontitis is a chronic inflammatory disease in which periodontal tissue is destroyed by bacterial infection. Periodontal disease is considered a comorbidity of diabetes due to its high prevalence and severity. However, the molecular mechanisms how diabetes aggravates periodontitis are still unclear. In this study, we investigated the involvement of Angiopoietin-like proteins (ANGPTLs) in periodontitis and the impacts of high glucose. Experimental periodontitis was induced in 6-week-old male Sprague-Dawley rats by placing a nylon suture around the neck of the maxillary second molar. Induction of periodontitis significantly increased the expression of ANGPTL4 in the gingiva. To clarify the involvement of ANGPTL4 in periodontitis, the human gingival fibroblasts (hGFs) were stimulated with LPS of Porphyromonas gingivalis (Pg-LPS), the bacterium most frequently isolated from inflamed sites of adult periodontitis. Pg-LPS significantly increased the gene and protein expression of ANGPTL4 in hGFs but not the gene expression of other ANGPTLs or ANGPTL receptors. Recombinant human ANGPTL4 significantly increased matrix metalloproteinase 13 (MMP13) gene expression in hGFs. We also confirmed that MMP13 expression was increased in the gingiva during experimental periodontitis. Pg-LPS induced MMP13 gene expression in hGFs. Next, we investigated the impacts of high glucose in Pg-LPS-stimulated hGFs. The expression of ANGPTL4 by Pg-LPS was significantly increased in high glucose condition compared with that in normal glucose condition. These results suggest the pivotal role of ANGPTL4 in periodontitis, especially under the high glucose condition.

Disclosure
S.Kondo: None. M.Ito: None. S.Sasajima: None. T.Matsubara: None. A.Mitani: None. K.Naruse: None. K.Kojima: None. N.Nakamura: None. M.Miyabe: None. T.Kikuchi: None. T.Ohno: None. N.Sawada: None. T.Minato: None. T.Saiki: None.