bluuebunny/crossref_metadata_2025_split huggingface dataset:
1384-P: Trends in Prevalence, Awareness, and Treatment of Diabetes and Prediabetes among Young Adults in the U.S., 1988–2020
Authors: HUANG YUE , WANG HUI , ZHONG VICTOR W. 
Published: June 2023

Objective: To estimate trends in prevalence, awareness and treatment of diabetes and prediabetes among young adults in the US.
Methods: Adults aged 20-44 years except pregnant women were included from the National Health and Nutrition Examination Survey between 1988-1994 and 2017-2020. Primary outcomes were diabetes and prediabetes defined according to self-reported diagnosis, fasting plasma glucose, or hemoglobin A1c. Secondary outcomes were awareness and treatment of diabetes and awareness of prediabetes. The prevalence trends of outcomes were assessed, and grouping variables (e.g., age, sex, race/ethnicity) were selected for subgroup analysis.
Results: Among young adults included, the estimated prevalence of diabetes increased from 3.1% [95% CI, 2.5%-3.7%] in 1988-1994 to 4.9% [95% CI, 4.0%-5.8%] in 2017-2020 (P=0.002). The estimated prevalence of prediabetes rose from 21.8% [95% CI, 19.7%-23.9%] in 1988-1994 to 28.7% [95% CI, 24.6%-32.8%] in 2017-2020 (P=0.001). The estimated prevalence of diabetes awareness decreased from 70.8% [95% CI, 60.4%-81.2%] in 1988-1994 to 64.9% [95% CI, 59.0%-70.8%] in 2010-2020 with no significance (P=0.25), and the estimated prevalence of diabetes treatment plateaued (P=0.64). In 2011-2020, among young adults with prediabetes, only 8.8% [95% CI, 6.5%-11.2%] reported being aware of their condition. During the study period, young adults aged 20-29 years had significant decrease in the prevalence of diabetes awareness and diabetes treatment, significant increase in the prevalence of prediabetes, and the lowest prevalence of prediabetes awareness.
Conclusions: Among young US adults, the estimated prevalence of diabetes and prediabetes increased significantly from 1988 to 2020, and their awareness of diabetes and prediabetes was insufficient, especially among adults aged 20-29 years. Comprehensive actions are needed to address the continuously rising burden of glycemic control among young adults in the US.

Disclosure
Y.Huang: None. H.Wang: None. V.W.Zhong: None.

Funding
Shanghai Municipal Education Commission (QD2020027, GWV-10.1-XK15)
1389-P: Life’s Essential 8, Socioeconomic Status, and Incidence of Nonalcoholic Fatty Liver Disease
Authors: LI XIANG , XUE QIAOCHU , MA HAO , WANG XUAN , FENG HAN , HEIANZA YORIKO , QI LU 
Published: June 2023

Background: The American Heart Association (AHA) recently released a new cardiovascular health (CVH) metric, Life’s Essential 8 (LE8). Nonalcoholic fatty liver disease (NAFLD) shares many common risk factors with cardiovascular disease. We aim to analyze the relationship between LE8 and the risk of NAFLD; and assess the modification effects of socioeconomic status and genetic susceptibility.
Methods: We prospectively analyzed the association between LE8 and the risk of NAFLD among 141,504 participants from the UK Biobank. LE8 was defined by the AHA algorithm and categorized into low (0-49), moderate (50-79), and high (80-100) CVH.
Results: A higher LE8 score was associated with a significantly lower risk of NAFLD (p&lt;0.001). Compared to individuals with a low CVH, the HR (95% CI) was 0.40 (0.34, 0.47) for those with a moderate CVH, and 0.12 (0.09, 0.16) for those with a high CVH. Townsend deprivation index (TDI) and education level modified the association between LE8 and NAFLD (p-int&lt;0.001 for TDI and p-int=0.003 for education, Figure). The protective associations were more pronounced among those less deprived and those with higher education. Moreover, we observed a significant interaction between LE8 and genetic predisposition to NAFLD (p-int=0.023).
Conclusion: Adherence to a high LE8 is associated with a lower risk of NAFLD. Such relationships are modified socioeconomic status or lower genetic risk.

Disclosure
X. Li: None. Q. Xue: None. H. Ma: None. X. Wang: None. H. Feng: None. Y. Heianza: None. L. Qi: None.

Funding
National Heart, Lung, and Blood Institute (HL071981, HL034594, HL126024); National Institute of Diabetes and Digestive and Kidney Diseases (DK115679, DK091718, DK100383); Fogarty International Center (TW010790)
1390-P: Incidence and Predictors of Remission and Relapse of Type 2 Diabetes Mellitus (T2DM) in Japan—Analysis of Nationwide Patient Registry
Authors: FUJIHARA KAZUYA , MON KHIN LAY , MURAI KOSHIRO , MITSUMA YURIE , YAMAZAKI KATSUYA , MAEGAWA HIROSHI , TANAKA SHIRO , KODAMA SATORU , SONE HIROHITO 
Published: June 2023

To determine the incidence/one year relapse from remission and associated factors in patients with T2DM. A total of 48,320 Japanese patients with T2DM with HbA1c ≥6.5% and/or glucose-lowering drug prescription were identified from databases of specialists’ clinics from 1989 and followed until September 2022. Remission was diagnosed according HbA1c &lt;6.5% at least 3 months after cessation of glucose-lowering drug and relapse as failing to maintain remission for 1 year. Factors associated with remission/relapse were evaluated by logistic regression analysis. The overall incidence of remissions per 1,000 person-years was 10.5. Such values for those with HbA1c 6.5-6.9%, taking no glucose-lowering drugs at baseline, and a ≥10% BMI reduction in one year were 27.8, 21.7, 48.2, respectively (Fig.). Shorter duration, lower baseline HbA1c, higher BMI at baseline, higher BMI reduction at one year, and no glucose-lowering drugs at baseline were significantly associated with remission. Among 3,677 persons with remission, approximately two-thirds (2,490) relapsed within one year. Longer duration, lower BMI at baseline, and lower BMI reduction at one year were significantly associated with relapse. Results showed that the incidence of remission and predictors of relapse, especially baseline BMI were greatly different in East Asians compared to reports in Western populations.

Disclosure
K.Fujihara: None. L.Khin: None. K.Murai: None. Y.Mitsuma: None. K.Yamazaki: None. H.Maegawa: None. S.Tanaka: Research Support; Novo Nordisk. S.Kodama: None. H.Sone: Research Support; Novo Nordisk, Astellas Pharma Inc., Kyowa Kirin Co., Ltd., Taisho Pharmaceutical Holdings Co., Ltd., Ono Pharmaceutical Co., Ltd., Eisai Co., Ltd., Takeda Pharmaceutical Co., Ltd.

Funding
Japan Society for the Promotion of Science (21K11569)
1397-P: Characterization of Adults with Newly Diagnosed Type 2 Diabetes by Levels of Early Glycemic Control
Authors: BOARD CHRISTINE , ALEXEEFF STACEY , KARTER ANDREW J. , GRANT RICHARD W. , GOPALAN ANJALI 
Published: June 2023

Glycemic control for type 2 diabetes (T2D) in the US remains suboptimal, and the trajectory of improvement has plateaued over the past decade. The ability to use electronic health record (EHR) data available at the time of diagnosis to proactively risk-stratify newly diagnosed individuals could enable the targeting of more tailored, intensive initial care to high-risk individuals starting on day 1. As a first step we sought to explore the differences between patients by early sub-optimal glycemic control. Using data from a large healthcare system, we identified adults (21-74 years) diagnosed with T2D from 2010-2016. We use EHR-derived patient factors including clinical characteristics, sociodemographics, care utilization patterns, and health behaviors (assessed at T2D diagnosis). We defined suboptimal glycemic control using the time weighted HbA1c over the 5-years post diagnosis. We dichotomized people into those with a time weighted average HbA1c ≥ 8% vs. &lt;8%. We used chi-square tests and t-tests to compare patient factors by level of glycemic control. Among 49,213 individuals, 6,677 (13.7%) had suboptimal glycemic control. Those with suboptimal glycemic control were more likely to be younger (mean age 47.5 vs. 55.1, p&lt;0.001), male (60.3% vs. 50.9%, p&lt;0.001), and Latino (32.1% vs. 20.8%, p&lt;0.001), but less likely to have any prior HbA1c measurements (7.5% vs. 23.9%, p&lt;0.001), an influenza vaccine during the year prior to diagnosis (39.1% vs. 58.3%, p&lt;0.001), and to have a recent primary care provider (PCP) visit (88.3% vs. 95.2%, p&lt;0.001). There were clear demographic and care utilization differences between optimal vs. suboptimal glycemic control which suggests patient and provider engagement may be important for achieving glycemic control. In future work we seek to determine if models leveraging a set of EHR-derived patient variables can predict suboptimal glycemic control. Such risk stratification can support healthcare systems in tailoring the intensity of initial T2D care.

Disclosure
C.Board: None. S.Alexeeff: Research Support; NIH - National Institutes of Health. A.J.Karter: None. R.W.Grant: None. A.Gopalan: Research Support; American Diabetes Association, National Institute of Diabetes and Digestive and Kidney Diseases.

Funding
National Institutes of Health (1R21DK130018-01)
1400-P: Low Blood Oxygen Saturation Is Associated with Impaired Glucose Control in Diabetes
Authors: LUZI LIVIO , MACRÌ CONCETTA , FERRULLI ANNA , BERRA CESARE C. , ROMANO CRISTINA , MASSARINI STEFANO 
Published: June 2023

Low Blood Oxygen Saturation (BOS) is associated with increased overall morbidity / mortality and prevalence of diabetes is known to increase with altitude (lower 02 partial pressure). Individuals with complicated diabetes commonly have low blood oxygen saturation compared with nondiabetic patients. To unravel the link between low BOS and glucose metabolism, we investigated the correlation between BOS and glucose, BOS and HbA1c levels, BOS and VO2 consumption (Resting Energy Expenditure) in a cohort of adults with diabetes mellitus. The study included 1362 adults with diabetes (616 F, 746 M; 66.4 ± 14.2 years, range 18-85 years; BMI 27.6 ± 5.0 kg/m2, range 18-49.6 kg/m2; SpO2 97.2 ± 1.4%, range 88-100%; glucose 137.7 ± 45.0 mg/dl, range 50.0-323.0 mg/dl). A significant inverse correlation (Pearson) between the glucose (glucometer) and the BOS (pulsoximeter) (p&lt;0.0001*; r = -0.1530). An inverse correlation (Pearson correlation) between the HbA1c levels and the BOS (n=1295; 568 F, 727 M; 67.5 ± 13.1 years, range 18-85 years; BMI 27.8 ± 5.2 kg/m2, range 18-49.8 kg/m2; HbA1c 52.9 ± 13.0, range 25-152 mmol/mol; p&lt;0.0001*; r = -0.1351). In summary, we showed an inverse relationship between oxygen saturation and both glucose and glycosylated hemoglobin levels. Although the exact mechanisms behind lower blood oxygen saturation in diabetes are unknown, we speculate that a reduced pulmonary diffusion capacity as a consequence of pulmonary microvascular damage could play an important role. In conclusion, present preliminary data indicate the routine measurement of BOS along with glucose and glycosylated hemoglobin in the outpatient visit setting of diabetic patients as a biomarker of seriousness of disease.

Disclosure
L. Luzi: Speaker's Bureau; A. Menarini Diagnostics, Amgen Inc., Boehringer Ingelheim and Eli Lilly Alliance. Advisory Panel; Eli Lilly and Company. Speaker's Bureau; Eli Lilly and Company. Research Support; Gelesis. Advisory Panel; Medtronic. Speaker's Bureau; Novo Nordisk, Novartis. C. Macrì: None. A. Ferrulli: None. C.C. Berra: None. C. Romano: None. S. Massarini: None.

Funding
IRCCS MultiMedica (Ricerca Corrente)
1407-P: Trends in Health Behaviors among U.S. Adults with Diabetes—2007–2018
Authors: SHAH MEGHA K. , GANDRAKOTA NIKHILA , SIEGEL KAREN R. , ALI MOHAMMED K. 
Published: June 2023

Background: Understanding trends in health habits of people with diabetes can inform interventions to improve lifestyle management. Design: We used data from non-pregnant adults aged 18 and older with self-reported diabetes participating in cross-sectional National Health and Nutrition Examination Survey 2007-2010, 2011-2014, and 2015-2018. Self-reported lifestyle goals included: healthy eating (consumption of added sugar, fruits, vegetables, and whole grains), physical activity, weight management, sleep, alcohol consumption, and tobacco use.
Methods: For each period, proportions of adults with diabetes who met each recommended lifestyle goal were estimated overall and by sociodemographic characteristics.
Results: During 2007-2010, in adjusted analyses, 63.4% of adults with diabetes met added sugar recommendations, 68.8% did not smoke, 66.5% met alcohol consumption goals, 32.8% reported adequate sleep, 67.1% reported engaging in weight management, and 26.5% met physical activity goals. From 2007-2010 to 2015-2018, proportions of adults with diabetes meeting sleep (difference: +16.7; 95% CI: 10.6, 22.8) and physical activity (difference: +8.31; 95%CI: 3.8, 12.8) goals increased. Proportions meeting the added sugar goal (difference: -8.8; 95% CI -14.7,-2.9) decreased, while no significant changes in tobacco use, alcohol consumption, and weight management were seen. There were significant variations in added sugar consumption, physical activity, and weight management by older age, lower education level, and tighter glycemic control.
Discussion: There has been little improvement in health habits among most adults with diabetes, although adults aged 65 years and older or had lower educational attainment significantly increased sleep and physical activity.

Disclosure
M.K.Shah: None. N.Gandrakota: None. K.R.Siegel: None. M.K.Ali: Advisory Panel; Bayer Inc., Eli Lilly and Company, Research Support; Merck & Co., Inc.

Funding
National Institute on Minority Health and Health Disparities (5K23MD015088-03); Emory University School of Medicine; Doris Duke Charitable Foundation; COVID-19 Fund to Retain Clinical Scientists; National Institutes of Health (UL1TR002378)
1408-P: Use of Antihyperglycemic Medications among U.S. Patients with Limited English Proficiency
Authors: ALSHAARAWY OMAYMA , KOTTUTT JEPKOECH J. , BHANGU NIKITA , HOLMAN HARLAND , MUELLER FRANK 
Published: June 2023

Language-concordant care enhances self-management and adherence of patients. In agreement, limited English proficiency (LEP) is adversely associated with glycemic control and cardiovascular health of patients with diabetes mellites (DM). New antihyperglycemic medications with high effectiveness and cardiovascular benefit are now available in the market. The STEPS analysis identifies simplicity of administration as an important parameter for assessing medications, and communication barriers can complicate prescribing decisions for patients with LEP. This study examines the pharmacologic management of DM by LEP status. Data are for non-pregnant adults recruited for the National Health and Nutrition Examination Survey (NHANES, 2003-18). The sample included 4645 participants with self-reported physician-diagnosed probable type 2 DM (age of diagnosis ≥ 20 years; not solely using insulin). Most participants completed the NHANES interview in English (90%), whereas 7% completed the interview in Spanish and 3% requested an interpreter. Approximately 20% of English-speaking, 27% of LEP-Spanish, and 15% of LEP-interpreter participants did not use any antihyperglycemic medication in the past 30 days (Rao-Scott χ2 p = 0.003). The use of medications with hypoglycemia risk (insulin and/or secretagogues) did not differ by LEP status (52%, 52%, and 57%; p = 0.6). Similarly, there were no differences in the use of metformin (69%, 73%, and 64%; p = 0.3) or newer medications (GLP1 agonists, SGLT2 and DPP4 inhibitors) with weight loss or cardiovascular benefits (12%, 10%, and 11%; p = 0.7) between the 3 groups. Medications with cardiovascular risk (thiazolidinediones) were more commonly used among English-speaking (14%) than LEP-Spanish (7%) and LEP-interpreter participants (12%; p = 0.04). Pharmacologic management of DM did not significantly differ based on LEP status, suggesting that access to effective antihyperglycemic medications does not explain the observed disparities in DM control.

Disclosure
O.Alshaarawy: None. J.J.Kottutt: None. N.Bhangu: None. H.Holman: None. F.Mueller: None.

Funding
National Institutes of Health (AT009156)
141-OR: Discrepancy between Genetically-Predicted and Actual Body Mass Index Predicts Incident Diabetes Mellitus
Authors: RHEE TAE-MIN , LEE HYUNSUK , CHOI JAEWON , LEE JUNESEONG S. , HEON KWAK SOO , SOO PARK KYONG 
Published: June 2023

Background: Body mass index (BMI) is a key predictor of metabolic disorders including type 2 diabetes mellitus (T2D). Polygenic risk scores (PRS) derived from genome-wide association studies (GWAS) can predict BMI based on common variants, and genetically-predicted BMI (BMI-pred) could serve as a threshold for personal fat storage. We hypothesized that difference between BMI-pred and actual BMI (BMI-diff) could reflect severity of environmental factors affecting BMI and may predict incident T2D.
Methods: From the UK Biobank cohort, we selected participants of white British descent without a history of T2D (n=383,160). The PRS for BMI was calculated using polygenic prediction via Bayesian regression and continuous shrinkage priors (PRS-CS) with summary statistics from the Genetic Investigation of ANthropometric Traits consortium GWAS. According to the BMI-diff, the 10-year risk of T2D was assessed using multivariable Cox proportional-hazards model. Results were validated in an independent cohort from South Korea (n=8,840).
Results: Participants (mean age 56.8 ± 8.0, male 45.3%) were randomly divided into train (n=268,041) and test set (n=115,119) to establish BMI-pred using PRS-CS. In the test set, the BMI-pred could explain 7.1% of the variance of BMI and T2D occurred in 3,599 (3.1%) cases during 10-year follow-up. The risk of T2D increased linearly according to the decrease of BMI-diff. Participants in the higher quintiles of BMI-diff (more obese than genetically-predicted), had significantly higher risk of T2D than those in the lowest quintile (less obese than genetically-predicted) regardless of their own BMI: adjusted HR (aHR) of 1st quintile 1.61, 95% confidence interval (CI) 1.26-2.05, P &lt;0.001; aHR of 2nd quintile 1.48, 95% CI 1.21-1.81, P &lt;0.001. Results were consistent when validated in the South Korean cohort.
Conclusion: Deviation of actual BMI from BMI-pred which reflects severity of environmental factors is a significant predictor of incident T2D.

Disclosure
T.Rhee: None. H.Lee: None. J.Choi: None. J.S.Lee: None. S.Kwak: None. K.Park: None.
1417-P: High Prevalence of Compensated Advanced Chronic Liver Diseases among Patients with Type 2 Diabetes Mellitus (CDL 2301)—A Prospective Community-Based Study
Authors: QI XIAOLONG , HE RUILING , LIU CHUAN , SUN CHAO , TENG GAOJUN 
Published: June 2023

Objective: Considering that type 2 diabetes mellitus (T2DM) may be one of the strongest risk factors for promoting nonalcoholic steatosis to advanced fibrosis, we aimed to investigate the prevalence of steatosis and fibrosis, and identify risk factors associated with compensated advanced chronic liver diseases (cACLD) among Chinese adults with T2DM in the community.
Methods: This is a prospective large-scale study covering six cities in China. We enrolled T2DM patients registered in the community between June 2021 and November 2022, and collected baseline demographics and comorbidities. Furthermore, controlled attenuation parameter (CAP) and liver stiffness measurement (LSM) were measured by vibration-controlled transient elastography to assess hepatic steatosis and fibrosis.
Results: A total of 3,196 patients with T2DM in the community were included in the study. The prevalence of steatosis (CAP ≥248 dB/m) and cACLD (LSM ≥10 kPa) was 60% and 9%, respectively. Additionally, the prevalence of mild fibrosis (F1), moderate fibrosis (F2), severe fibrosis (F3) and cirrhosis (F4) was 12%, 7%, 7% and 3%, respectively. The distribution of mild (S1), moderate (S2), and severe (S3) steatosis was 14%, 8%, and 38%, respectively. Furthermore, 5% of patients with non-obesity (body mass index &lt;30 kg/m2) nonalcoholic fatty liver disease related cACLD (12/252) presented with clinically significant portal hypertension (LSM ≥25 kPa) according to the renewing Baveno VII consensus, indicating a high risk of hepatic decompensation. In the multivariate logistic regression model, age&gt;50 years, body mass index, and the presence of hypertension were independent predictors of cACLD among patients with T2DM in the community.
Conclusions: We found a considerable prevalence of steatosis and cACLD in community patients with T2DM. It is imperative to screen for these conditions to facilitate further intervention among T2DM patients.

Disclosure
X.Qi: None. R.He: None. C.Liu: None. C.Sun: None. G.Teng: None.
1419-P: Pandemic-Specific Associations of Maternal Exposure to Per- and Polyfluoroalkyl Substances and Glucose Metabolisms—A Cross-Sectional Analysis in Birth Cohort in Hong Kong
Authors: YANG AIMIN , TAM CLAUDIA H. , OZAKI RISA , LOWE WILLIAM L. , METZGER BOYD E. , TAM WING H. , WONG CHRIS K. , MA RONALD C. 
Published: June 2023

Introduction: Per- and polyfluoroalkyl substances (PFAS) have adverse cardiometabolic effects.
Methods: We conducted a cross-sectional analysis in 1601 mothers who had joined the Hyperglycaemia and Adverse Pregnancy Outcome (HAPO) study in Hong Kong in 2001-2006. All mothers underwent a 75g-oral-glucose-tolerance test at 24-32 weeks of gestation. We measured serum concentrations of six PFAS biomarkers using high-performance LC-MS-MS. We fitted linear-regression, weighted-quantile-sum (WQS) regression, and quantile-g-computation (qgcomp) models to estimate the associations of individual PFAS and their mixture with levels of HbA1c and plasma-glucose (PG). Subgroup analyses were performed based on the enrollment period by the severe-acute-respiratory-syndrome (SARS) epidemic in Hong Kong between March 2003 and May 2004.
Results: Maternal exposure to PFAS mixture was associated with increased HbA1c in both WQS (β=0.05, 95% CI: 0.02-0.07) and qgcomp models (β=0.04, 95% CI: 0.01-0.06). We did not observe significant associations of PFAS mixture with fasting PG, 1-h and 2-h PG in both models, except for 2-h PG in qgcmop model (β=0.074, 95% CI: 0.01-0.15). Pandemic-specific analyses showed a significant association of PFAS mixture with increased HbA1c in peri-SARS but not in pre-SARS and post-SARS epidemic period. Perfluorooctanoic-acid (PFOA) and perfluorooctane-sulfonic-acid (PFOS) were the main contributors to the overall positive effects on HbA1c. The level of PFOS was highest during the peri-SARS epidemic (median [IQR]: 24.7 [42.6-89.5] ng/mL) compared with pre-SARS (12.6 [20.0-49.8] ng/mL) and post-SARS (20.6 [27.8-46.4] ng/mL) epidemic.
Conclusions: Maternal exposure to PFAS mixture is associated with glucose metabolisms during pregnancy. Pandemic-specific associations call for further studies on its adverse health effects during the COVID-19 pandemic.

Disclosure
A.Yang: None. C.H.Tam: None. R.Ozaki: None. W.L.Lowe: None. B.E.Metzger: None. W.H.Tam: None. C.K.Wong: None. R.C.Ma: Advisory Panel; AstraZeneca, Merck & Co., Inc., Other Relationship; Bayer Inc., Boehringer-Ingelheim, Research Support; Tricida, Inc., Roche Diagnostics, Novo Nordisk.

Funding
Health and Medical Research Fund (13140761); Eunice Kennedy Shriver National Institute of Child Health and Human Development/National Institute of Diabetes and Digestive and Kidney Diseases (R01HD34242, R01HD34243); Research Grants Council of Hong Kong (473408, 471713)