placebo-controlled 56-week study. Subjects (N=1496) were randomized 2:1 to NB32 (32mg naltrexone 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, BMI 36±4kg/m 2 , IWQOL-Lite Total score 73±17 (moderate impairment), IWQOL- Lite subscales: Physical Function 70.4±20.4, Self-Esteem 56.2±25.6, Sexual Life 75.5±26.3, Public Distress 86.6±18.0, Work 87.1±17.1, and SF-36: Physical Component 50.2±7.1 and Mental Component 54.4±7.3 (a score of 50 is equivalent to average health). Week 56 weight loss was greater (p
Integrated Physiology/ Obesity POSTERS rs29941 (KCTD15; p=0.006) and rs7561317 (TMEM18; p=0.043) had effect also on waist-hip ratio. The carriers of minor alleles G in homozygote forms in variants rs4923461 (BDNF; p=0.036) and rs1800592 (UCP1; p=0.033) had increased muscle mass in body composition, furthermore, GG homozygotes in rs1800592 had decreased fat mass (p=0.037) and also increased musclefat ratio (p=0.026). In summary, we confi rmed associations of majority of the 10 obesity-susceptibility variants with several obesity-related parameters; the most complex infl uence on anthropometric features was identifi ed in variant rs7561317 in TMEM18 gene. Supported by: IGA MHCR NS/9839-4 and NS10209-3/2009 1882-P Associations of Waist Circumference and Body Mass Index with Fasting Blood Glucose among Overweight African American Parishioners in a Southern Semi-Urban Community RICHARD W. SATTIN, LOVORIA B. WILLIAMS, JAMES K. DIAS, THOMAS JOSHUA, LUCY N. MARION, Augusta, GA African-Americans (AAs) are at high risk for type 2 diabetes (T2D) partly because rates of obesity are about twice as high as that in the overall US population. Although body mass index (BMI) has been considered an accurate clinical measure of body fat, central adiposity, approximated by waist circumference (WC), has been found to be a reliable predictor of metabolic disturbances, morbidity and mortality. Our objective is to determine, in a cohort of overweight AAs participating in the Fit Body and Soul Study (FB&S), the statistical relationships between WC, BMI, demographic characteristics, and fasting blood glucose (FBG). FB&S is a single-blinded, cluster randomized, community trial developed to test the effectiveness of a faith-based adaptation to the <strong>Diabetes</strong> Prevention Program. AA church parishioners, in a semi-urban Southern US community aged 20 to 64 years, with a BMI of 25 kg/m 2 or greater and without a self-reported history of diabetes, were eligible to participate. Baseline demographic and measurement data from the participants in the fi rst ten of 20 churches available were collected, including age, gender, BMI, WC, and FBG. Standard descriptive statistics were calculated and multiple linear regression and correlation analyses were conducted to model FBG. From September 2009 through August 2010, 393 AAs were consented. Eighty-four percent were female; the average age of those consented was 46.8 years (95% confi dence interval (CI): [45.6, 47.8]); the average BMI was 35.4 kg/m 2 (95% CI: [34.7, 36.2]); the average WC was 107.7 cm (95% CI: [106.1, 109.4]); the average FBG was 93.0 mg/ dl (95% CI: [91.4, 94.5]). The partial correlation of FBG with BMI, adjusted for age and gender, was 0.189 (p-value < 0.001). The partial correlation of FBG with WC, adjusted for age and gender, was 0.192 (p-value < 0.001). Our fi ndings suggest that both BMI and WC are important contextual variables and provide similar results for the study of T2D in AAs. Supported by: NIH grant DK082401 1883-P Bariatric Surgery in a Multi-Ethnic WITHDRAWN Type 2 <strong>Diabetes</strong> Population BRANDON J. ORR-WALKER, MARIE WHITE, IRENE ZENG, Auckland, New Zealand This study is to determine the effect of adjunctive support compared with standard care in a morbidly obese, diabetic cohort on body mass index (BMI) undergoing publicly-funded bariatric surgery with secondary endpoints of glycemic control (HbA1c), blood pressure, lipids, pulmonary function and quality of life. As the study has not yet been completed, unblinded results of recruitment and clinical response for completers to 1 year post surgery are presented. All subjects have type 2 diabetes on hypoglycaemic agents and are enrolled in a diabetes chronic care management program (CCM) which provides free quarterly review in primary care, in addition to the usual funded laboratory, pharmaceutical and hospital services. Entry to the study was for those enrolled for at least one year in CCM with a BMI ≥35, 7.0≤ HBA1c ≤10.0 on hypoglycaemic medication, serum creatinine ≤150 (≤ 120 for women) and urinary albumin creatinine ratio ≤ 200 mg/mmol. Additional surgical criteria limiting surgery to non-smokers aged 20-60, with a weight of ≤160kg were applied resulting in a potential recruitment population of 1924 patients from the total 7367 enrolled. (27% Maori, 55% Pacifi c, 11% European, 7% Asian). Informed consent for both surgery and the study was required for inclusion. Of those referred to the study team by their family practitioner, 113 were not enrolled( 63 did not meet the study criteria, 9 had other contraindications, 34 declined surgery, 2 declined study involvement but had surgery, others 5), and 9 withdrew after randomisation. Overall Pacifi c and Asian peoples are underrepresented by referral, resulting in lower inclusion in the study. Rates of non-enrolment were similar. Enrolees had a mean age of 48 years, and 64% were female, 33% Maori, 30% Pacifi c, 35% European and 1% Asian. Of For author disclosure information, see page 785. OBESITY—HUMAN CATEGORY A508 those completing the study so far(n=34) BMI fell from 49 ± 7 to 34 ± 4kg/m 2 , and weight from 137 ± 22 to 96 ± 15 kg. Median HBA1c fell from 7.8 (IQR 7.2, 9.1) to 5.9 (IQR 5.4, 6.4). Bariatric surgery provides early clinical benefi ts to a patient group already participating in fully-funded proactive chronic disease management for diabetes. Referral for surgery appears to be lower for Pacifi c and Asian peoples. 1884-P Basal Endogenous Glucose Production and Insulin Levels Are Reduced 2 Weeks after Bariatric Surgery with No Effect on Hepatic and Peripheral Insulin Sensitivity BARBARA A. DE WEIJER, EDO AARTS, IGNACE M. JANSSEN, ARNOLD VAN DE LAAR, KARIN KAASJAGER, MARIETTE T. ACKERMANS, ERIC FLIERS, MIREILLE J. SERLIE, Amsterdam, The Netherlands, Arnhem, The Netherlands Bariatric surgery has very early metabolic effects on glucose metabolism before the occurrence of clinically signifi cant weight loss. This suggests an acute effect of the surgery itself, i.e. bypassing the nutrient fl ow from the proximal gastrointestinal tract. We hypothesized that Roux-en Y gastric bypass surgery (RYGB) ameliorates glucose metabolism by increasing hepatic and peripheral insulin sensitivity. We studied glucose metabolism and lipolysis in the basal state and during a hyperinsulinemic euglycemic clamp using stable isotopes two weeks before and two weeks after RYGB. We included 12 pre-menopausal Caucasian women (median age 38 [26- 49] yrs, median BMI 45 [39.2-53.9] kg/m2) scheduled for RYGB. Two weeks after RYGB median weight loss was 5.5kg [2-14 kg]. Basal insulin and glucose levels decreased after surgery (insulin presurgery 73 [21-122] vs post-surgery 48 [15-120] pmol/L, p = 0.0025 and glucose pre-surgery 5.5 [4.4 – 6.9] vs post-surgery 4.8 [3.9 – 5.7] mmol/L, p = 0.0058 resp.). Endogenous glucose production (EGP) was lower after surgery (before 13.5 [11.3- 15.9] vs after 11.4 [10.3 – 14.2] μmol/kgFFM/ min, p = 0.0078). Insulin levels were lower during the clamp after surgery, suggesting enhanced clearance. Hepatic and peripheral insulin sensitivity (both corrected for insulin) did not change after surgery. FFA were increased after surgery in the basal state (0.76 [0.67–1.13] vs 0.94 [0.73-1.33] mmol/L, p = 0.0049) and during the fi rst step of the clamp (0.13 [0.02 – 0.29] vs 0.34 [0.06 – 0.49] mmol/L, p = 0.0010). Lipolysis expressed per REE tended to increase in the basal state (259 [182 - 426] vs 257 [167 - 384] µmol/kcal, p = 0.0674), and was higher during hyperinsulinemia (91 [70 - 298] vs 132 [100 - 403] µmol/kcal, p = 0.0020). Within 2 weeks, bariatric surgery reduces basal EGP, insulin and glucose levels but has no acute benefi cial effect on hepatic or peripheral insulin sensitivity. The latter may be explained by higher rates of lipolysis and exposure to FFA induced by the hypocaloric state. 1885-P CREW (Calcium REduces Weight) Study: Impact of Calcium Supplementation on Weight, Adiposity, Glycemia and Hypertension LAKSHMI KANT SHANKHDHAR, KSHITIJ SHANKHDHAR, UMA SHANKHDHAR, SMITA SHANKHDHAR, Lucknow, India Aims: CREW study aimed to observe impact of Calcium supplementation (CaS) on wt, waist circumference (WC), body fat% (BFP), BP, glycemia in T2 diabetic (2D) & nondiabetic (ND) women. Methods: 120 drug naïve hypertensive obese female patients, both ND & 2D, were divided into 2 control (NDCo&2DCo) & 2CaS receiving (NDCa and 2DCa) subgroups, with age (ND=44.6±9.86, 2D=50.85±7.37yrs), Wt (ND=94.7±9.07, 2D=89.0±8.07Kg), BMI (ND=37.91±4.41, 2D=36.75±3.37Kg/ M2), WC (ND=102±6.44, 2D=100.9±4.08Cm) & BFP (ND=41.0±5.26, 2D= 39.96±3.0%). They were advised 300 lesser calories, 30min brisk walk for 3 months along with education. Results: NDshowed more reduction than 2D in Wt (NDCo=3.6 vs 2DCo=1.13%, NDCa=5.78 vs 2DCa=5.23%), WC (NDCo=1.91 vs 2DCo=0.59%, NDCa=1.76 vs 2DCa= 1.58%) & BFP (NDCo=4.87 vs 2DCo=1.63%, NDCa=5.36 vs 2DCa=3.33%). CaS reduced SBP more (2DCa=8.2 Vs 2DCo=3.03%) than DBP (2DCa=2.92 vs 2DCo=1.26%) in diabetics. Glycemia improved more with CaS:2DCa (FBG=19.08, PPBG=25.9, A1c=8.8%) vs 2DCo (FBG=7.5, PPBG=8.8, A1c= 4.9%) Conclusions: CaS plays positive role in reduction of adiposity, glycemia & BP. & Guided Audio Tour poster <strong>ADA</strong>-Funded Research
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