2011 ADA Posters 1261-2041.indd - Diabetes

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& 1870-P Relationship between Total Body Fat and Body Fat Distribution and Left Ventricular Diastolic Dysfunction in Men with the Metabolic Syndrome ANNIE MORIN, JEAN-PIERRE DESPRÉS, MARIE ARSENAULT, MARIE-KRISTELLE ROSS, JEAN BERGERON, ANGELO TREMBLAY, NATHALIE ALMERAS, PAUL POIRIER, Quebec, QC, Canada Left ventricular diastolic dysfunction (LVDD) has been observed in subjects with metabolic syndrome. We examined the relationship between several indices of adiposity (waist circumference, waist-to-hip ratio, waistto-height ratio, body mass index, body fat estimated by bioimpedance, and visceral adiposity assessed with computed tomography) and LVDD in men with metabolic syndrome without heart disease. A total of 76 men between 30-65 years (age 48.5 yrs) evaluated by echocardiography for the presence of LVDD, using doppler mitral infl ow with/without Valsalva maneuver, pulmonary venous fl ow and tissue doppler imaging, were included. LVDD was graded according to guidelines. All had normal left ventricular ejection fraction. Twenty-one subjects were classifi ed as normal, whereas 55 were classifi ed as abnormal in terms of LVDD, including 17 grade I, 33 grade 2, and 5 as unclassifi ed. Groups were comparable regarding adiposity indices. Visceral adipose tissue volume was also similar between groups: normal diastolic function (mean volume 1778±480 cm 3 ) vs. LVDD (1938±460 cm 3 ); grade I (1924±531 cm 3 ) vs. grade II (1923±439 cm 3 ). However, subcutaneous adipose tissue volume was different between groups; 2121±828 cm 3 for the group with normal function vs. 1698±499 cm 3 for LVDD (p=0.04). There was no signifi cant difference between grades I and II. Ratio of visceral adipose tissue volume on total adipose tissue volume was also statistically different between normal function (0.47±0.11) and LVDD (0.53±0.07) (p=0.01). Again, no signifi cant difference was found between grades I and II. Thus, after adjustment for age, no adiposity indices explained the presence or the severity of LVDD. Furthermore, there was no difference regarding fasting glucose, insulinemia, C-peptide, insulin resistance, lipid profi le, C-reactive protein and adiponectin between groups. In conclusion, with age taken into consideration, we did not observed any signifi cant relationship between indices of adipose tissue distribution and LVDD in our sample of asymptomatic men with features of the metabolic syndrome. Guided Audio Tour: Pharmacologic Treatment of Obesity (<strong>Posters</strong> 1871-P to 1878-P), see page 15. & 1871-P Reduction in the Expression of β-Amyloid Precursor Protein (APP) Following Roux-en-Y Gastric Bypass Surgery (RYGB) and Weight Loss PARESH DANDONA, HUSAM GHANIM, SCOTT MONTE, CHANG LING SIA, JEROME SCHENTAG, SANDEEP DHINDSA, JOSEPH CARUANA, Buffalo, NY Obesity and type 2 diabetes are associated with an increase in the incidence and prevalence of Alzheimer’s disease (AD). We have recently demonstrated that peripheral blood mononuclear cells (MNC) express APP, the precursor of β-amyloid, which forms the pathognomonic plaques in the brain. We hypothesized that APP expression diminishes after the marked caloric restriction and weight loss associated with RYGB. Fifteen type 2 diabetic patients with morbid obesity underwent RYGB following which their caloric intake diminished and they lost 38.5 ±2.9 Kg in weight over 6 months. BMI fell from 54.4±3.1 to 40.5± 2.9 Kg/m 2 . There was a signifi cant fall in plasma concentrations of glucose (from 148±8 to 101±4mg/dl), insulin (from 18.5±2.2 to 8.6±1.0µU/ml) and HOMA-IR (from 7.1±1.1 to 2.1±0.3).). The expression of APP mRNA fell by 31±9% and that of protein fell by 22±12%. In addition, there was a reduction in other AD related genes including presinilin 2 (PN2) which fell by 27±10%, <strong>ADA</strong>M-9 which fell by 35±12% and GSK-3β which fell by 28±6% (P
Integrated Physiology/ Obesity POSTERS before 63 ± 8 vs. after 69 ± 8 bpm, p = 0.049). Low frequency gain (LF-gain), a measure for barorefl ex sensitivity, decreased after the HD (LF-gain before 13.0 ± 9.7 vs. after 9.5 ± 6.1 msec/mmHg, p = 0.017). HF variability (HFvar), primarily determined by respiratory vagal functions, decreased after the HD (HFvar before 496 ± 795 vs. after 354 ± 519 msec², p = 0,050). LF/HF ratio, an indicator of sympathovagal balance, did not change after the HD. Our results indicate that a hypercaloric diet induces insulin resistance in lean healthy men and has signifi cant effects on cardiovascular autonomic indices which point to changes towards sympathetic predominance/vagal withdrawal. This suggests that functional changes in the autonomic nervous system are part of the adaptive response to a hypercaloric milieu and may in part mediate the changes in glucose metabolism. & 1874-P Naltrexone SR/Bupropion SR Combination Therapy Improves Control of Eating and Reduces Food Cravings in Overweight and Obese Subjects JAMES O. HILL, HOLLY WYATT, SONJA K. BILLES, COLLEEN BURNS, RAUL HARRIS-COLLAZO, EDUARDO DUNAYEVICH, JOHN BLUNDELL, Denver, CO, La Jolla, CA, Leeds, United Kingdom The effects of naltrexone/bupropion combination therapy (NB) on obesity and eating behavior (Control of Eating Questionnaire: CoEQ, twenty 100mm visual analog scales) were evaluated in obese/overweight individuals in the COR-II study at baseline and Weeks 8, 16, 28, and 56. This Phase 3, double-blind, placebo-controlled, 56-week study, randomized 1496 subjects in a 2:1 ratio to NB32 (32mg naltrexone sustained-release [SR]/360mg bupropion SR) or placebo. The completion rate was 54% in each group. Baseline characteristics for the modifi ed ITT-LOCF population (subjects with ≥1 post-baseline weight on study drug) were: 84% female, 85% Caucasian, mean±SD age 44±11y, weight 100±16kg, and BMI 36±4kg/m 2 . Week 56 weight loss was greater (p
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2011 ADA Posters 1261-2041.indd - Diabetes

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