bluuebunny/crossref_metadata_2025_split huggingface dataset:
1096-P: The LDL-C/apoB Ratio Predicts Future Cardiovascular Events in Cardiovascular Disease Patients with Nonalcoholic Fatty Liver Disease as Well as in Those without Nonalcoholic Fatty Liver Disease
Authors: MAECHLER MAXIMILIAN , SPRENGER LUKAS , MADER ARTHUR , LARCHER BARBARA , VONBANK ALEXANDER , LEIHERER ANDREAS , MUENDLEIN AXEL , DREXEL HEINZ , SAELY CHRISTOPH H. 
Published: May 2022

A low LDL-C / apoB ratio reflects small LDL particle size and is associated with insulin resistance. Nonalcoholic fatty liver disease (NALFD) is an important feature of the insulin resistance syndrome and confers an increased cardiovascular risk. The impact of the LDL-C / apoB ratio on the risk of cardiovascular events in patients with NAFLD is unclear and is addressed in the present study. We enrolled a large high risk cohohort of 1515 patients with established cardiovascular disease (1272 patients with angiographically proven stable CAD and 243 patients with sonographically proven peripheral artery disease) . NAFLD was diagnosed using the validated fatty liver index. Prospectively, cardiovascular events were recorded over a mean follow-up period of 7.6±4.9 years. At baseline, the LDL-C / apoB ratio was significantly lower in patients with NAFLD (n=709) than in subjects who did not have NAFLD (1.34±0.29 vs. 1.39±0.26 mg/dl; p=0.001) . During follow-up, 755 patients suffered cardiovascular events. The event rate was higher in patients with than in those without NAFLD (53.6 vs. 47.6%; p=0.020) . The LDL-C/ApoB ratio significantly predicted cardiovascular events in the total study cohort, with a standardized adjusted hazard ratio (HR) of 0.86 [0.80-0.94]; p&lt;0.0 and both in patients with NAFLD (HR 0.87 [0.78-0.97]; p=0.013) and in subjects who did not have NAFLD (HR 0.87 [0.77-0.97]; p=0.013, respectively) . We conclude that in subjects with established cardiovascular disease the LDL-C / apoB ratio predicts cardiovascular events both among patients with NAFLD and in those who do not have NAFLD.

Disclosure
M.Maechler: None. L.Sprenger: None. A.Mader: None. B.Larcher: None. A.Vonbank: None. A.Leiherer: None. A.Muendlein: None. H.Drexel: None. C.H.Saely: None.
1097-P: Value of Blood Pressure Measurement Earlier vs. Later in Life to Predict Cardiovascular Mortality
Authors: LEIHERER ANDREAS , ULMER HANNO , MUENDLEIN AXEL , SAELY CHRISTOPH H. , FRAUNBERGER PETER , MADER ARTHUR , SPRENGER LUKAS , MAECHLER MAXIMILIAN , VONBANK ALEXANDER , LARCHER BARBARA , BROZEK WOLFGANG , NAGEL GABRIELE , ZITT EMANUEL , CONCIN HANS , DREXEL HEINZ 
Published: May 2022

We here aimed at comparing the value of systolic blood pressure (BP) earlier versus later in life to predict cardiovascular mortality. In a cardiovascular observation study (OS) we prospectively recorded fatal cardiovascular events over up to years in 1282 patients of whom 570 had the Metabolic Syndrome (MetS) at baseline. These patients had participated in a health survey (HS) 15 years prior to the OS baseline. BP was measured both at the HS and at the baseline of the OS. We found that the increase in cardiovascular mortality matched the increase of BP in the HS in a linear way but this is not the case for BP assessed at the OS (figure) . A cox regression analysis revealed that each millimeter of mercury (mm Hg) increased the risk for cardiovascular death by 2% (HR = 1.02 [1.01-1.03], p&lt;0.001) . Applying a stratification for the presence of MetS, we found that in both groups BP was a significant predictor of cardiovascular mortality (HRMetS = 1.02 [1.01-1.02], p&lt;0.0 and HRnoMetS = 1.02 [1.01-1.03], p&lt;0.001) . In contrast, BP as measured at the baseline of the OS was not significantly associated with cardiovascular death during follow-up neither in the total population nor in any subgroup (HR = 1.00 [0.99-1.01], p=0.652; HRMetS = 1.00 [0.99-1.01], p=0.468 and HRnoMetS = 1.00 [0.99-1.01], p=4.66) . We thus conclude that BP assessed earlier in life is a better predictor of cardiovascular mortality than BP assessed later in life.

Disclosure
A.Leiherer: None. B.Larcher: None. W.Brozek: None. G.Nagel: None. E.Zitt: None. H.Concin: None. H.Drexel: None. H.Ulmer: None. A.Muendlein: None. C.H.Saely: None. P.Fraunberger: None. A.Mader: None. L.Sprenger: None. M.Maechler: None. A.Vonbank: None.
1099-P: Truncal Fat–to–Leg Fat Ratio and Carotid Plaque Score in Patients with Type 2 Diabetes
Authors: SHIN JANG YEL 
Published: May 2022

High truncal fat is known to be a risk factor for cardiovascular disease (CVD) , but high leg fat has a protective effect on CVD. We investigated the association between truncal fat-to-leg fat ratio (TLR) and carotid plaque score PS) in patients with type 2 diabetes (T2D) . A total of 1966 participants aged over 30 years and having T2D were recruited. Truncal fat, leg fat, and appendicular muscle mass (ASM) were measured using dual-energy X-ray absorptiometry and Carotid intima-media thickness (CIMT) and PS were assessed using high-resolution B-mode ultrasonography. High PS was defined as PS ≥ 3. The prevalence of plaque and high PS were 72.0% and 40.0%, respectively. Patients with high PS were more likely to be old, male, and hypertensive and had higher systplic blood pressure (SBP) , diabetic duration (DD) , serum creatinine (Cr) , and TLR, but lower values of diastolic BP, truncal and leg fat, HDL, and estimated glomerular filtration rate (eGFR) than those without high PS. Participants in the highest TLR tertile group were older and more hypertensive and had higher DD, SBP, waist circumference (WC) , body mass index (BMI) , HOMA-IR, glycated A1c (HbA1c) , triglycerides (TG) , serum Cr, CIMT, and PS, but lower ASM/BMI, HDL, and eGFR than those in the lowest TLR tertile group. The prevalence of high PS progressively increased with increasing TLR tertiles (Lowest vs. Middle vs. Highest = 33.4 vs. 41.0 vs. 45.7%, respectively, p &lt; 0.001) . After adjusting age and sex, the odd ratios (ORs) and 95% confidence intervals (CIs) for high PS were 1.39 (1.- 1.79, p = 0.01) in the middle and 1.65 (1.28 - 2.11, p = &lt; 0.001) in the highest tertile groups. After further adjusting for hypertesnsion, WC, BMI, SBP, DD, HbA1c, HOMA-IR, HDL cholesterol, TG, and eGFR, the ORs and 95% CIs in the middle and highest tertile groups remained significant.
In conclusion, higher TLR was independently associated with carotid PS in patients with T2D. Therefore, we suggest that high TLR may be a risk factor for early atherosclerosis in patients with T2D.

Disclosure
J.Shin: n/a.
1100-P: Endothelial Protein Expression and Its Association with Type 1 Diabetes
Authors: WISE HALEY K. , KESHAWARZ AMENA , MOREAU KERRIE , SNELL-BERGEON JANET K. 
Published: May 2022

Introduction: People with type 1 diabetes (T1D) have an increased risk of developing cardiovascular disease. Endothelial cell dysfunction is thought to be a factor in this increased risk but underlying cellular mechanisms related to vasodilation, inflammation and oxidative stress are unknown.
Methods: Participants with T1D (n= 25) and non-T1D (n=20) were categorized into groups of high (≥80) or low (&lt;15 AU) coronary artery calcium (CAC) , measured by computed tomography. Protein expression was assessed for endothelial Nitric Oxide Synthase [eNOS], estrogen receptors (ER) α and ER-β (women only) , nuclear factor [NF]κβ and nicotinamide adenine dinucleotide phosphate [NADPH] using quantitative immunofluorescence in peripheral venous endothelial cells harvested by endovascular biopsy. SphygmoCor Pulse Wave Velocity (PWV) measured arterial stiffness. Linear regression was used to test associations of high vs. low CAC and T1D with proteins of interest. All models included age, sex, CAC and diabetes.
Results: As shown in table 1, eNOS and NADPH were lower and NFκβ and Nitrotyrosine [NT] were higher in T1D compared to non-T1D participants with low CAC. Among T1D, PWV was higher in those with high vs. low CAC. Among non-T1D participants, eNOS was lower and NT and ER-α were lower in those with high vs. low CAC.
Conclusions: T1D is associated with adverse endothelial proteins that may contribute to endothelial dysfunction and vascular disease.

Disclosure
H.K.Wise: None. A.Keshawarz: None. K.Moreau: None. J.K.Snell-bergeon: Stock/Shareholder; GlaxoSmithKline plc.
1109-P: Performance of 2021 U.S. Preventative Services Task Force Screening Criteria for Prediabetes and Diabetes
Authors: O'BRIEN MATTHEW J. , ZHANG YAN , BAILEY STACY , KHAN SADIYA , ACKERMANN RONALD T. , ALI MOHAMMED K. , BENOIT STEPHEN R. , IMPERATORE GIUSEPPINA , HOLLIDAY CHRISTOPHER S. , BULLARD KAI M. 
Published: May 2022

In 2021, the US Preventive Services Task Force (USPSTF) expanded the recommended age range for prediabetes and diabetes screening among those with overweight/obesity to 35-70 years. Using 2017 to pre-pandemic March 2020 National Health and Nutrition Examination Survey data, we applied these screening criteria to assess their performance in a nationally representative sample. We included 3243 non-pregnant adults aged ≥18 years without diagnosed diabetes. Screening eligibility was determined based on participants' age and measured body mass index (BMI) [≥23kg/m2 for non-Hispanic (NH) Asian adults and ≥25kg/m2 for other ethnic groups]. Dysglycemia was defined based on A1c ≥5.7% or fasting plasma glucose ≥100mg/dL. We compared participant characteristics by USPSTF eligibility. We also assessed performance [sensitivity, specificity, positive predictive value (PPV) , and negative predictive value (NPV) ] of the screening criteria for detecting dysglycemia overall and by ethnicity. During 2017-2020, 44.4% of US adults aged 35-70 years were eligible for screening, representing 95.9 million US adults. Relative to adults who were ineligible, those who were eligible had a higher burden of diabetes risk factors, as well as greater proportions of some racial ethnic groups, higher proportion of those with less than a high school education, and more likely to be living in poverty. The performance characteristics of the USPSTF screening criteria were: sensitivity 59.4% (95% CI: 56.4-62.4) ; specificity 68.6% (65.1-71.9) ; PPV 62.4% (59.2-65.6) ; and NPV 65.8% (61.9-69.5) . The sensitivity by ethnicity was as follows: NH White adults 59.1% (55.4-62.7) ; NH Black adults 63.6% (57.8-68.9) ; Hispanic adults 62.0% (55.0-68.5) ; and NH Asian adults 57.3% (46.6-67.3) . Screening based on the 2021 USPSTF criteria will detect approximately 60% of US adults with dysglycemia, which was similar across ethnic groups.

Disclosure
M.J.O'brien: None. K.M.Bullard: None. Y.Zhang: n/a. S.Bailey: Consultant; Lundbeck, Luto, Pfizer Inc., Sanofi, Research Support; Eli Lilly and Company, Gordon and Betty Moore Foundation, Lundbeck, Merck & Co., Inc., Pfizer Inc., Retirement Research Foundation for Aging. S.Khan: None. R.T.Ackermann: Consultant; UnitedHealth Group. M.K.Ali: Advisory Panel; Bayer AG, Research Support; Merck & Co., Inc. S.R.Benoit: None. G.Imperatore: None. C.S.Holliday: None.
1116-P: Enrollment of Racial/Ethnic Minorities in the Rare and Atypical Diabetes Network (RADIANT)
Authors: TOSUR MUSTAFA , GANDOLFO LAURA , BALASUBRAMANYAM ASHOK , NAYLOR ROCHELLE N. , POLLIN TONI I. , RASOULI NEDA , BUSE JOHN B. , REDONDO MARIA J. ,   RADIANT STUDY GROUP
Published: May 2022

RADIANT is an NIH study of people with uncharacterized forms of atypical diabetes mellitus (DM) in the US. RADIANT participants consent online and progress through three sequential stages of study procedures, as eligible. DM in underrepresented minorities (URM) is rapidly increasing in incidence and has worse outcomes than DM in non-Hispanic whites. RADIANT pre-set targets proportionate to ethnic/racial distribution in the US to enroll individuals from a wide racial/ethnic spectrum. We aimed to study the URM participation in RADIANT across study stages. Enrollment rate for URM was significantly below pre-set targets at consent and across most stages (Table 1) . Referral sources significantly differed by races (p=0.003) but not ethnicities (p=0.16) . Most African-Americans (54%) were referred by RADIANT investigators but flyers, news, social media and family or friend were the major sources of referral for whites (30%) . Some of the initiatives to increase URM in RADIANT include engaging with clinics serving URM, working with local clinics/hospitals, electronic medical record screening approaches, increased focus on DM types more frequent in URM, providing culturally competent study coordination and targeted advertisement. In sum, enrollment rate of URM in RADIANT is suboptimal. Investigating barriers and facilitators for minority recruitment in RADIANT, with implications for other studies, is warranted.

Disclosure
M. Tosur: Advisory Panel; Provention Bio, Inc. A. Balasubramanyam: None. R.N. Naylor: None. T.I. Pollin: Research Support; Regeneron Genetics Center, Regeneron Pharmaceuticals Inc. N. Rasouli: Advisory Panel; Eli Lilly and Company, Novo Nordisk, Sanofi. Research Support; Allergan, Eli Lilly and Company, Novo Nordisk. J.B. Buse: Consultant; Alkahest, Anji, AstraZeneca, Boehringer Ingelheim International GmbH, Cirius Therapeutics, Inc., Eli Lilly and Company, Fortress biotech, GentiBio, Glycadia, Glyscend, Janssen Pharmaceuticals, Inc., Mellitus Health, Moderna, Inc., Pendulum Therapeutics, Praetego, LLC, Stability Health, Valo, Zealand Pharma A/S. Research Support; AstraZeneca, Dexcom, Inc., Eli Lilly and Company, Novo Nordisk, vTv Therapeutics. Stock/Shareholder; Glyscend, Mellitus Health, Pendulum Therapeutics, PhaseBio Pharmaceuticals, Inc., Praetego, LLC, Stability Health. Other Relationship; Adocia, AstraZeneca, Eli Lilly and Company, Intarcia Therapeutics, Inc., MannKind Corporation, Novo Nordisk, Sanofi, Senseonics, vTv Therapeutics. M.J. Redondo: Advisory Panel; Provention Bio, Inc.

Funding
National Institutes of Health (U54, DK118638-01)
1131-P: Progression to Diabetes Despite a Baseline Fasting Plasma Glucose = 80mg/dL: A Population-Based Case-Control Study
Authors: MOHAN SNEHA , VELLA ADRIAN , EGAN AOIFE M. 
Published: May 2022

While elevations in baseline fasting plasma glucose (FPG) are associated with risk of type 2 diabetes mellitus (DM) , some individuals with lower FPG will also develop DM. The aim of this study was to identify factors associated with DM in people with a baseline FPG of ≤ 80mg/dL. Using the population-based Rochester Epidemiology Project medical records linkage system, we identified subjects with ≥ 2 FPG tests from 2005-17, and a baseline FPG of ≤ 80mg/dL. Subjects who developed DM (FPG &gt; 125mg/dL) were assigned an event date as the date of the 1st diagnostic value. Those who did not develop DM were censored at their last FPG. The median duration of follow-up was 7 years. The entire cohort consisted of 2315 subjects, of whom 130 (5.6%) developed DM. Using a nested case-control design we compared all 130 who progressed to diabetes (cases) to 491 randomly selected controls. Among the cases, 121 (93%) developed type 2 DM, 4 (3%) had type 1 DM, and 5 (4%) reverted to normal FPG on repeat. Cases were older, more commonly male, and had a higher BMI (see table) . Cases were more likely to have experienced a critical health event such as a malignancy diagnosis or exposure to high dose glucocorticoids. On extended follow up, 15% of cases were deceased.
In summary, progression to DM in individuals with a low-normal FPG at baseline typically occurs in the context of significant medical comorbidity and portends a poor prognosis.

Disclosure
S.Mohan: None. A.Vella: Advisory Panel; Crinetics Pharmaceuticals, Inc., Rezolute, Inc., vTv Therapeutics, Zealand Pharma A/S, Other Relationship; Novo Nordisk. A.M.Egan: None.
1133-P: High Prediabetes Risk and Associated Risk Factors in Indian Population Based on Online Prediabetes Risk Test
Authors: VERMA RITIKA , SAHAY RAKESH , BANTWAL GANAPATHI , KALRA SANJAY , AGNIHOTRI AKSHATA D. , TIWASKAR MANGESH H. , ADE SURESH F. , JUNEJA ARCHANA M. , LAKHANI OM J. , SINGAL ARBINDER K. 
Published: May 2022

Background: In India, a significant number of people are still diagnosed with diabetes at a later stage or after the complications have started. The unawareness about the disease and financial burden associated with the diagnostic testing remains a challenge. The study was aimed at the digital administration of a prediabetes risk test questionnaire to understand the people who are at high risk and more prone to developing prediabetes and eventually diabetes.
Methods: A prediabetes risk questionnaire was developed based on the American Diabetes association risk score test. The test was completed by 1722 participants across India. The test was based on risk factors like age, gender, race, BMI, family history of diabetes, history of high blood pressure, and physical activity status. The scoring was done for three groups including high risk (score &gt;5) , medium risk (score 3-5) , and low risk (score &lt;3) . Binomial logistic regression was used for risk factor analysis among groups with low score and high-medium score.
Results: The risk of prediabetes was low in 21 %, medium in 65 % and high in 12 % of participants. Out of all the participants 44 % had age ≥ 40 years, 71% were male, 96 % were asian, 74 % had BMI ≥ 23 kg/m2, 59 % of total participants have a family history of diabetes (first-degree relatives) , 17 % had high blood pressure, and 44 % were performing physical activity below recommended level of 150 mins per week. Among people with BMI ≥ 23 kg/m2, 89 % were having either high or medium risk scores. Among young people (age &lt; 40 years) , 67 % were having high or medium scores. The odds ratio for score in high or medium range for people with BMI ≥ 23 kg/m2 and age ≥ 40 years was 38.51 (95% CI: 24.19-61.30, P&lt;0.001) and 78.89 (95% CI: 41.21-136.06, P&lt;0.001) respectively.
Conclusion: The study showed that out of all the participants, 77% had a high or medium risk score. The study highlights the importance of using a prediabetes risk calculator as a tool for improving awareness about the risk of developing prediabetes.

Disclosure
R.Verma: Employee; Fitterfly Healthtech Pvt Ltd, Wellthy Therapeutics Pvt Ltd. A.K.Singal: Other Relationship; Fitterfly Healthtech Pvt Ltd. R.Sahay: Advisory Panel; Torrent Pharmaceuticals , Speaker's Bureau; Dr. Reddy’s Laboratories Ltd., Eli Lilly and Company, Eris Lifesciences Ltd., Intas Pharmaceuticals Ltd., Novo Nordisk, USV Private Limited. G.Bantwal: None. S.Kalra: Speaker's Bureau; Boehringer Ingelheim International GmbH, Novo Nordisk A/S, Sanofi. A.D.Agnihotri: None. M.H.Tiwaskar: None. S.F.Ade: None. A.M.Juneja: None. O.J.Lakhani: Advisory Panel; FITTERFLY, Speaker's Bureau; Eli Lilly and Company, Novo Nordisk Global Business Services, Sanofi, Stock/Shareholder; Zydus Cadilla.
1138-P: Impact of Continuous Glucose Monitoring (CGM) on Glycemic Control and Acute Complications in Type 2 Diabetes (T2D) in the Veterans Health Administration (VHA)
Authors: REAVEN PETER , NEWELL MICHELLE , RIVAS SALVADOR , ZHOU XINKAI , NORMAN GREGORY J. , ZHOU JIN 
Published: May 2022

Use of CGM in T2D is rising rapidly, yet little is known regarding its effects on glucose management in the VHA. We thus identified new CGM users (new CGM sensor prescriptions for T2D on insulin) and non-users (T2D receiving glucose strips) during the years 2015-2020 and used national VHA healthcare data from visit encounters to compare change over 12 months in glucose control and new emergency room (ER) or hospital admissions. Changes in HbA1c and acute admissions were compared by linear mixed models and generalized linear models, respectively. Compared with 36,082 non-users, CGM users (n=16,013) differed in many ways but were well-balanced with overlap weighting from propensity score modeling. CGM users had a greater reduction in HbA1c over 12 months (-0.25%; 95% CI -0.21-0.29, p&lt;0.0001) and a decline in hypoglycemia related ER visits/hospitalizations (OR = 0.78; CI 0.62-0.97) . Among CGM users, those &lt; 65 years old or with initial HbA1c &gt; 8. 4% (median) had greater reductions in HbA1c, while those at higher hypoglycemia risk had reduced hypoglycemia and hyperglycemia related ER visits/hospitalizations and all-cause hospitalizations (Table) . In this large national study in T2D, CGM initiation was linked with better glucose control and reduced ER and/or hospital admissions for hypoglycemia and showed even greater benefits in subsets of CGM users.

Disclosure
P.Reaven: Research Support; AstraZeneca, Dexcom, Inc. M.Newell: Research Support; Dexcom, Inc. S.Rivas: None. X.Zhou: None. G.J.Norman: Employee; Dexcom, Inc. J.Zhou: Research Support; Dexcom, Inc.

Funding
DexCom, Inc
1140-P: Twenty-Year Trends in Vision Impairment among U.S. Adults with Diabetes
Authors: LUNDEEN ELIZABETH A. , KIM MINCHUL , EHRLICH JOSHUA R. 
Published: May 2022

Previous research found a decline in vision impairment (VI) prevalence among US adults with diabetes mellitus (DM) from 1997-2010. However, from 2007-20to 2015-2018, there was a decrease in glycemic control in US adults with DM, potentially leading to a worsening of ocular complications that can result in VI. We examined 20-year trends (1999-2018) in VI prevalence among adults ≥18 years with diagnosed DM, using self-reported data from the U.S. National Health Interview Survey. Annual prevalence is presented as single years and a 3-year moving average, age-standardized to the 20U.S. Census. Trends were analyzed using Joinpoint regression with single years of data. Annual Percent Change (APC) is presented. Using the 3-year moving average, the prevalence of adults with DM who reported VI decreased from 21.5% in 1999 to 20.7% in 2018. This trend was not statistically significant (APC: -0.47; p=0.2) . However, Joinpoint regression found distinct trends, with VI prevalence decreasing significantly from 1999-2012 (APC: -1.93; p&lt;0.001) followed by an inflection point at 2012, resulting in an increase in prevalence from 2012-2018 that was not statistically significant (APC: 2.86; p=0.1) . These results suggest that declines in VI among adults with DM seen in the first decade of the century may have plateaued in 2012. Future research could identify determinants, including glycemic management, vision screening, and healthcare utilization.

Disclosure
E.A.Lundeen: None. M.Kim: None. J.R.Ehrlich: Consultant; MetLife.