bluuebunny/crossref_metadata_2025_split huggingface dataset:
120-OR: Muscle Lipid Turnover Predicts Aerobic Training Effects on Body Composition
Authors: CHOW LISA S. , BANTLE ANNE , ALVEAR ALISON C. , MASHEK DOUGLAS G. , JENSEN MICHAEL D. 
Published: June 2023

Aerobic exercise utilizes muscle lipid. We hypothesize that high pre-training muscle lipid turnover, suggesting high muscle lipid utilization, predicts the effects of aerobic training. Obese, insulin-resistant subjects [mean(SD), BMI:37.7 kg/m2(6.2), VO2max 25 ml/kg/min (6.3)] underwent a 16 week of supervised, weight-stable, aerobic training (n=16). Body composition (DXA), fitness level (VO2max) and insulin sensitivity (hyperinsulinemic-euglycemic clamp) were performed at baseline and end-training. Two muscle biopsies (Bx) were acquired during a pulse-chase experiment using [U-13C]palmitate and [9-2H]palmitate infusions (6 h each), overlapping by 1 hour. Bx#1 captured muscle lipid incorporation and was performed during the infusion overlap [last hour of 6 h [U-13C]palmitate infusion, 1 hour after starting [9-2H]palmitate. Bx#2 captured muscle lipid breakdown and was performed at study conclusion [last hour of [9-2H]palmitate infusion, 6 hours after stopping [U-13C]palmitate]. As expected, aerobic training increased VO2max, fat-free mass, insulin sensitivity and hepatic insulin sensitivity while decreasing fat mass and visceral fat (Table 1). Baseline measures, especially muscle palmitate incorporation and breakdown, best predicted training effects on body composition. Muscle lipid turnover, along with other baseline measures, predicts aerobic training effects on body composition.

Disclosure
L.S.Chow: Research Support; Dexcom, Inc. A.Bantle: None. A.C.Alvear: None. D.G.Mashek: None. M.D.Jensen: Other Relationship; Novo Nordisk, Elsevier.

Funding
National Institutes of Health (R01DK098203)
1294-P: Prevalence of Islet Autoantibodies in Adults from the General Population
Authors: PAULEY MEGHAN E. , GENO RASMUSSEN CRISTY , DONG FRAN , SIMMONS KIMBER M. , REWERS MARIAN 
Published: June 2023

Objective: Over half of cases of type 1 diabetes are diagnosed in adults, yet the prevalence of islet autoantibodies (IA) in general population adults is unknown.
Methods: The Autoimmunity Screening for Kids (ASK) Study screened 1,087 adults (age 41±7 years, 78% female, 63% non-Hispanic white, 10% first-degree relatives) and 29,441 youth (age 1-17 years, 52%, 36%, and 5%, respectively) for IA to GAD, IA-2, insulin, and ZnT8 using electrochemiluminescence (ECL) or radiobinding assays (RBA).
Results: In adults, 3.9% screened positive; 0.6% were positive for multiple IA, 1.7% were positive for a single high-affinity IA, and 1.6% were positive for a single low-affinity IA. GADA was most prevalent, found in 2.7%. Unexpectedly, the prevalence of IA in adults and youth screened by ASK was not statistically different (Figure).
Conclusion: IA positivity is similar in youth and adults in the general population. Expanded access to type 1 diabetes screening and monitoring will aid in determining if early detection is similarly beneficial in adults as seen in youth, such as reducing rates of diabetic ketoacidosis at diagnosis of clinical type 1 diabetes.

Disclosure
M.Pauley: None. C.Geno rasmussen: None. F.Dong: None. K.M.Simmons: Advisory Panel; Provention Bio, Inc., Consultant; Dexcom, Inc., Provention Bio, Inc., Research Support; Novartis. M.Rewers: Research Support; Provention Bio, Juvenile Diabetes Research Foundation (JDRF), Hemsley Charitable Trust, Dexcom, Inc., Janssen Research & Development, LLC.

Funding
National Institute of Diabetes and Digestive and Kidney Diseases (T325T32DK063687); JDRF (2-SRA-2022-1270-S-B)
1319-P: Vascular Multimorbidity in Danish Persons with Type 2 Diabetes Is Decreasing, Contributing to Mortality Decline
Authors: CARSTENSEN BENDIX , CLEMMENSEN KIM K.B. , KOSJERINA VANJA , PERSSON FREDERIK 
Published: June 2023

Background: Multimorbidity in persons with type 2 diabetes (T2D) has not been studied in population wide settings. We used a Danish nation-wide diabetes register to assess trends in incidence and prevalence of vascular multimorbidity.
Methods: All Danish persons with T2D since 1996 were followed from diagnosis to death or 2020-12-31. Follow-up was classified by the number of vascular morbidities from: atrial fibrillation, heart failure, myocardial infarction, ischemic stroke, hemorragic stroke, transient cerebral ischemia, amputation, retinopathy and nephropathy. Persons could enter with any number of vascular morbidities. We analyzed mortality rates and rates of each additional morbidity, using age, calendar time and number of attained morbidities as predictors. Prevalence of morbidities at diagnosis and at calendar times was modeled by binomial regression.
Results: 505,124 persons entered the study. Occurrence of first morbidity increased mortality by a factor 2. Further morbidities increased mortality by a factor of 1.5. Mortality decreased 4%/year regardless of morbidity status. Incidence of additional morbidities increased only for the first 2 acquired morbidities by factors 1.8 and 1.2 and decreased by 3%/year regardless of morbidity status. The prevalence of morbidities at date of T2D increased until 2015. The prevalence of 1+ morbidity in all persons with T2D increased till 2008 and remained stable at 40% for men and 25% for women at age 65, and for 2+ at 10 and 5%.
Conclusion: The decrease in morbidity and mortality rates is an indication of successful treatment of Danish persons with diabetes with respect to adverse vascular outcomes. This could be the result of earlier diagnosis of T2D; including persons earlier in the course of T2D would result in a “healthier” population. The increase in prevalence of morbidities at T2D diagnosis and the constant prevalence over time among all T2D persons may be an indication that management of morbidities is improving.

Disclosure
B.Carstensen: Stock/Shareholder; Novo Nordisk. K.K.B.Clemmensen: Employee; Novo Nordisk A/S, Stock/Shareholder; Novo Nordisk A/S. V.Kosjerina: Research Support; Sanofi-Aventis Deutschland GmbH. F.Persson: Advisory Panel; AstraZeneca, Bayer Consumer Care AG, Boehringer-Ingelheim, Novo Nordisk A/S, Consultant; AstraZeneca, Boehringer-Ingelheim, Novo Nordisk A/S, Research Support; Boehringer-Ingelheim, Novo Nordisk A/S, Speaker's Bureau; AstraZeneca, Bayer Consumer Care AG, Boehringer-Ingelheim, Novo Nordisk A/S, Sanofi.
1358-P: Disparities in Acute and Chronic Complications of Diabetes in Rural U.S.
Authors: STEIGER KYLE , HERRIN JEPH , SWARNA KAVYA , MCCOY ROZALINA G. 
Published: June 2023

Rural Americans are more likely than urban Americans to be diagnosed with diabetes, to have poorly controlled diabetes, and to die from diabetes-related complications; however, there is little published data about the rates of acute and chronic diabetes complications in rural as compared to urban areas. We examined the rates of acute and chronic diabetes complications across the spectrum of rurality among U.S. adults with diabetes using OptumLabs Data Warehouse, a de-identified dataset of commercially insured and Medicare Advantage beneficiaries: remote (population &lt;2,500; N=75,077), town (population 2,500-50,000; N=409,152), and city (population &gt;50,000; N=2,417,334). As compared to cities, small towns had greater incidence of severe hyperglycemia (HR=1.1; 95% CI: 1.06, 1.14), severe hypoglycemia (HR= 1.15; 95% CI: 1.12, 1.18), end-stage kidney disease (HR=1.06; 95% CI: 1.04, 1.08), heart failure (HR=1.08; 95% CI: 1.07, 1.1), myocardial infarction (HR=1.14; 95% CI: 1.12, 1.16), osteomyelitis (HR=1.06; 95% CI: 1.04, 1.08), and revascularization (HR=1.06; 1.05, 1.08). Compared to cities, remote areas had higher incidence of myocardial infarction (HR=1.09; 95% CI: 1.05, 1.13), osteomyelitis (HR=1.09; 95% CI: 1.04, 1.14), and revascularization (HR=1.05; 95% CI: 1.03, 1.07). Urban areas had lower incidence of stroke: (Remote: HR=0.93; 95% CI: 0.89, 0.96); (Town: HR=0.98; 95% CI: 0.96, 0.99). There were no significant differences between the groups in the development of atrial fibrillation, Charcot joint, retinopathy, or lower extremity ulcer. Overall, rural areas had greater incidence of diabetes complications (remote areas in 3 out of 12 complications and towns in 7 out of 12 complications); however, cities had decreased incidence of stroke. An important limitation of this study is that it measures treatment/diagnosis rates, necessitating health care utilization. We therefore likely underestimate the rate of complications in rural areas, where gaps in access to health care is widely recognized.

Disclosure
K.Steiger: None. J.Herrin: Consultant; Johnson & Johnson Medical Devices Companies. K.Swarna: None. R.G.Mccoy: Consultant; Emmi.

Funding
National Institute of Diabetes and Digestive and Kidney Diseases (K23DK114497)
1371-P: Factors Influencing the Development of Polycystic Ovary Syndrome in Premenopausal Women with Type 1 Diabetes
Authors: BAYONA ANE , NATTERO-CHÁVEZ LÍA , ESTHER DE LA CALLE DE LA VILLA MARÍA , DURÁN ELENA F. , DORADO AVENDAÑO BEATRIZ , LUQUE-RAMÍREZ MANUEL , ESCOBAR-MORREALE HÉCTOR F. 
Published: June 2023

Objective: Polycystic ovary syndrome (PCOS) is common in women with type 1 diabetes (T1D). Reported prevalence rates vary according to diagnostic criteria used for PCOS. However, not all women with T1D develop hyperandrogenic traits and factors that influence the occurrence of PCOS have not been well stablished yet. We aim to assess the factors associated to the occurrence of PCOS in premenopausal women with T1D.
Methods: Cross-sectional study. For this analysis, we included 110 patients with T1D, 24 diagnosed with PCOS by ESHRE/ASRM-Rotterdam criteria (prevalence: 22%, 95%CI: 15-30%). Women aged 18 to 45 years were consecutively recruited from a Diabetes Clinic at a tertiary hospital in Madrid, Spain. All participants were under intensive insulin treatment, had been diagnosed with T1D at least 1 year ago, and had a gynecological age of at least 2 years. A comparison between both groups T1D-PCOS and T1D-without PCOS was performed. We used Stata software v23 (StataCorp LLC) for statistical analysis.
Results: Mean age was 30.3 ± 8.7 yrs and mean HbA1c was 7.31 ± 1.4%. Three-quarters (75%) of these patients were on multiple insulin doses. Women with T1D and PCOS were younger than those without PCOS (26.3 ± 7.4 in DM1-PCOS vs 31.2 ± 8.7, P &lt; 0.05). Total daily insulin dose (TDI) was higher in T1D-PCOS group compared to T1D-without PCOS (0.71 ± 0.35 vs 0.58 ± 0.19, P = 0.025). There was a trend towards a more common premenarcheal diagnosis of T1D in T1D-PCOS (62.5% vs 46.5%, P = 0.116). Age (OR: 0.93, P = 0.016) and TDI (OR: 7.84; P = 0.043) were significant predictors of PCOS in the univariate logistic regression analysis. After introducing these variables in a multivariate regression analysis, only age was retained as a significant predictor factor of PCOS in women with T1D (OR: 0.93; P = 0.040).
Conclusions: In this study, premenopausal women with T1D and PCOS were younger, used higher daily insulin doses and tend to have a more common premenarcheal diagnosis of T1D as compared to T1D women without PCOS.

Disclosure
A.Bayona: None. L.Nattero-chávez: None. M.De la calle de la villa: None. E.F.Durán: None. B.Dorado avendaño: None. M.Luque-ramírez: None. H.F.Escobar-morreale: None.
138-OR: Characterization and Prediction of Genetic Risk of T1D in Individuals without HLA-DR3 or HLA-DR4
Authors: MCGRAIL CAROLYN , GAULTON KYLE J. 
Published: June 2023

The Major Histocompatibility (MHC) class II haplotypes HLA-DR3 and HLA-DR4 confer substantial genetic risk for type 1 diabetes (T1D), where 90% of individuals with T1D carry at least one copy of DR3 and/or DR4. We sought to understand whether the remaining 10% of T1D individuals without DR3 or DR4 haplotypes (non-DR3/DR4) have differences in genetic risk and whether current risk scores are effective for these individuals. We tested for T1D association using 12,716 non-DR3/DR4 samples from five European ancestry cohorts using genotypes imputed into the Michigan HLA and TOPMed v2 reference panels and identified independent signals using stepwise conditional analyses. There were 21 signals with significant effects on T1D, including 13 at the MHC locus and 8 genome-wide, of which 5 were novel. Across all T1D signals, 14 lead variants exhibited significant heterogeneity in effects on T1D in the non-DR3/DR4 subset compared to the full T1D population, including HLA-B*39 and the PTPN22 locus. Nearly 50% of non-DR3/DR4 T1D would be misclassified by a current T1D genetic risk score (T1D GRS1), which is weighted heavily by DR3/DR4 tag variants. We developed a new GRS using the 21 independent signals and determined whether this GRS could better discriminate T1D in individuals with non-DR3/DR4 haplotypes. The non-DR3/DR4 T1D GRS effectively differentiated T1D case and control samples (AUC=0.87) including in samples not in the initial discovery set (AUC=0.86), and improved prediction compared to GRS1 (AUC=0.52 using all controls, AUC=0.79 using only non-DR3/DR4 controls). These findings reveal a subset of T1D cases with heterogeneity in genetic risk and which are not as well represented by current risk scores, and argue that risk scores developed within heterogeneous subsets may enable even more accurate prediction of T1D.

Disclosure
C.Mcgrail: None. K.J.Gaulton: Consultant; Genentech, Inc., Stock/Shareholder; Neurocrine Biosciences, Inc., Vertex Pharmaceuticals Incorporated.

Funding
National Institutes of Health (DK120429, DK122607)
1394-P: Risk for Newly Diagnosed Type 2 Diabetes Mellitus after SARS-CoV-2 Infection among Korean Adults—A Nationwide Matched Cohort Study
Authors: HAN CHOI JONG , SONG KEE-HO 
Published: June 2023

Background: There is growing evidence that coronavirus disease 2019 (COVID-19) can cause various extrapulmonary sequelae, including diabetes. However, it is unclear whether these effects persist even after 30 days from the date of diagnosis. We investigated the incidence of newly diagnosed type 2 diabetes mellitus (T2DM) during the post-acute phase of COVID-19.
Methods: This cohort study used data from the Health Insurance Review and Assessment Service, a representative national healthcare database in Korea. We initially established a cohort of 348,180 people among those diagnosed with COVID-19 without a history of any diabetes between January 2020, and September 2021. Among people with neither a history of any diabetes nor a diagnosis of COVID-19, the control group consisted of sex- and age-matched people with the cohort. We assessed the hazard ratio (HR) of newly diagnosed T2DM in patients with COVID-19 compared to the control adjusted for age, sex, and presence of hypertension and dyslipidemia.
Results: In the post-acute phase of COVID-19, patients with COVID-19 had an increased risk of newly diagnosed T2DM than those without COVID-19 (adjusted HR 1.30, 95% CI 1.27-1.33). The adjusted HRs of non-hospitalized, hospitalized, and intensive care unit-admitted patients were 1.14 (95% CI 1.08-1.19), 1.34 (95% CI 1.30-1.38), and 1.78 (95% CI 1.59-1.99), respectively.
Conclusion: COVID-19 may increase the risk of developing T2DM beyond the acute period. The higher the severity of COVID-19 in the acute phase, the higher the risk of newly diagnosed T2DM. Therefore, T2DM should be included as a component for managing long COVID.

Disclosure
J.Choi: None. K.Song: None.
1410-P: Impacts of COVID-19 on Underserved Communities with Diabetes
Authors: MAIZEL JENNIFER , HALLER MICHAEL J. , MAAHS DAVID M. , ADDALA ANANTA , LAL RAYHAN , FILIPP STEPHANIE L. , GURKA MATTHEW J. , WESTEN SARAH C. , DIXON BRITTNEY , FIGG LAUREN , HECHAVARRIA MELANIE , MALDEN KEILECIA G. , WALKER ASHBY F. 
Published: June 2023

People with diabetes have higher COVID-19 morbidity and mortality. These risks are amplified for racial minorities and people living in rural areas or with low income, who are more likely to experience severe COVID-19 illness, vaccine hesitancy, and unemployment. A survey of adults with type 1, type 2, and other forms of diabetes (n=450, µ age= 52.7 years) receiving care at 41 federally qualified and community health centers in FL and CA examined COVID-19 illness, prevention, and financial and healthcare impacts. Surveys were completed from fall 2021 to summer 2022; all outcomes were self-reported. Descriptive statistics were computed for key outcomes (n, %). Logistic regression assessed independent associations of COVID-19 vaccine receipt. Between-group comparisons were evaluated via Chi-Squared, Fisher’s Exact, and Cochran-Mantel-Haenszel tests. Overall, 29.7% of participants contracted COVID-19; of those, 45.3% sought medical care or were hospitalized. Most (81.3%) received at least 1 COVID-19 vaccine; of those, 97.5% were fully vaccinated. Hispanics had the highest vaccination rate while Non-Hispanic Blacks (NHB) had the lowest (91.1%, 73.9%, p=.0281). Hispanics had 4.63x greater odds of vaccination than Non-Hispanic Whites (NHW) [95% CI=(1.81, 11.89)]. A majority “always” or “very often” wore masks (53.2%). Participants reported income loss (64.9%), more frequently in FL (76.1%, CA: 52.2%, p&lt;.001). NHB had the highest rate of severe income loss (26.4%, p=.0124). Loss of health insurance was greater among NHB (13.3%) than other races (&lt;8%, p=.0422) and in FL (9.7%, CA: 4.5%, p=.039). Participants reported healthcare access changes (62%) and higher diabetes medication costs (41%). These findings demonstrate underserved communities with diabetes suffered significant health and financial challenges from COVID-19, which were especially disparate for NHB and FL residents. Further research, interventions, and policy changes are needed to promote health equity for underserved communities with diabetes.

Disclosure
J.Maizel: None. L.Figg: None. M.Hechavarria: None. K.G.Malden: None. A.F.Walker: None. M.J.Haller: Board Member; SAB Biotherapeutics, Inc., Consultant; Sanofi, MannKind Corporation. D.M.Maahs: Advisory Panel; Medtronic, LifeScan Diabetes Institute, MannKind Corporation, Consultant; Abbott, Research Support; Dexcom, Inc. A.Addala: None. R.Lal: Advisory Panel; Provention Bio, Inc., Consultant; Abbott Diabetes, Biolinq, Capillary Biomedical, Inc., Deep Valley Labs, Gluroo, Tidepool, PhysioLogic Devices, Morgan Stanley. S.L.Filipp: None. M.J.Gurka: None. S.C.Westen: None. B.Dixon: None.

Funding
The Leona M. and Harry B. Helmsley Charitable Trust (G-2005-03934)
1425-P: C-Peptide and Islet Autoantibodies at Diagnosis Predict Long-Term ß-Cell Function and Insulin Dependence in Pediatric Diabetes
Authors: TOSUR MUSTAFA , HUANG XIAOFAN C. , DEEN SAIMA , UYSAL SERIFE , ASTUDILLO MARCELA , HAGOPIAN WILLIAM , ORAM RICHARD A. , JAHOOR FAROOK , REDONDO MARIA J. , BALASUBRAMANYAM ASHOK 
Published: June 2023

We asked if assessment of islet autoimmunity and β cell function in children at diabetes diagnosis is useful for prognosis, using the “Aβ” system, [“A” representing autoimmunity (A+ = ≥1 autoantibody; A- = no antibodies), “β” representing β cell function (β+ = random serum C-peptide ≥0.6 ng/mL; β- = C-peptide &lt;0.6 ng/mL)]. We followed β cell function longitudinally with 2h post-prandial urinary C-peptide-creatinine ratio (UCPCR) at 3-12 wk (V1) and 6-12 m (V2). We compared clinical characteristics, glycemia and β cell function at baseline and clinical outcomes at V2 between the groups. The cohort (n=74) was 50% female, 76% White, 22% non-Hispanic Black, 2% Other, 47% Hispanic. Median age (25p-75p) was 12.6 (8.5-14.6) years, median BMI 70.7 (16.7-96.1) %ile. Phenotypic frequencies were A+β- (36.5%), A-β+ (29.7%), A+β+ (31.1%) and A-β- (2.7%). Baseline serum C-peptide correlated with UCPCR at V1 (r=0.37, p=0.03). Adjusting for age, sex, race/ethnicity, and BMI, UCPCR at V2 was higher in A-β+ than A+β- (β=1.18, 95% CI:0.31-2.07, p=0.009). Fully 36% of A-β+ but none of A+β+ and A+β- were insulin-independent at V2 (p&lt;0.001). The remaining results are shown in Table 1. The A-β+ phenotype at diagnosis predicts sustained β cell function and potential insulin-independence after 6-12 months. Random serum C-peptide at diagnosis correlates with 2h post-prandial UCPCR at 3-12 weeks.

Disclosure
M.Tosur: Advisory Panel; Provention Bio, Inc. A.Balasubramanyam: None. X.C.Huang: None. S.Deen: None. S.Uysal: None. M.Astudillo: None. W.Hagopian: Research Support; Janssen Research & Development, LLC, Provention Bio, Inc., Randox R & D. R.A.Oram: Consultant; Janssen Research & Development, LLC, Research Support; Randox R & D. F.Jahoor: None. M.J.Redondo: None.

Funding
Texas Children's Hospital (to M.T.); Rutherford Fund (to A.B.); National Institutes of Health (K23DK129821 to M.T.)
1431-P: Exocrine Pancreatic Insufficiency Is Both a Risk Factor for and Comorbidity of Diabetes Mellitus
Authors: ROMO KARINA G. , SHU SHARON , NOOR ABDULLAH A. , WEST WILLIAM A. , BHAMRE SNEHA , UWAIFO GABRIEL I. 
Published: June 2023

Introduction: Exocrine Pancreatic Insufficiency (EPI) is an uncommon but important disease of the exocrine pancreas. Its relationship to endocrine pancreas function and diabetes (DM) remains poorly characterized. To better understand this relationship, a retrospective chart review was performed in a large statewide multispecialty practice.
Methods: A retrospective review of the entire 1.3 million patient-practice of Ochsner Health system in Louisiana was performed to cover the period of January 2017 to January 2020. All cases of documented EPI and patients on pancreatic enzyme replacement therapy (PERT) were identified and underwent individual chart review to identify etiologic factors and cardiometabolic, demographic, vital sign data, and clinical course information.
Results: 677 EPI patients were identified with DM being the most prevalent etiologic risk factor (44.6% T2DM, 9.6% T1DM and 11.5% secondary DM). EPI patients without DM had a 10.9% prevalence of pre-DM, and 127 new DM cases developed over the observation period among EPI patients initially without DM with an 18.7% incidence rate. EPI patients, compared to the general DM population, were significantly younger with more diverse DM etiology. They also had greater LFT and serum lipase elevations. EPI patients had lower BMIs; 25.6 ± 7.5 vs 32.8 ± 46.9 kg/m2 with greater alcohol use. EPI patients also had better glycemic control (HBAC 6.83 ± 2.1 vs 7.2 ± 1.9) and triglycerides (125.7 ± 104.7 vs 140.6 ± 118.9) though other lipids were similar. Discussion and
Conclusions: EPI, though uncommon, is both an important risk factor for onset of DM and comorbidity of diabetes. DM patients with EPI have distinctive etiologic, metabolic, and anthropometric features from DM patients in the general population. Further study of EPI patients to better understand predictors of onset of EPI in DM patients and DM onset in non-DM EPI patients are needed to guide evidence based screening. This would in turn enable early EPI recognition and management.

Disclosure
K.G.Romo: None. S.Shu: None. A.A.Noor: None. W.A.West: None. S.Bhamre: None. G.I.Uwaifo: None.