2011 ADA Posters 1261-2041.indd - Diabetes

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Observations: NDCo (n=30) NDCa (n=30) Baseline Mean Final Mean p value Baseline Mean Final Mean p value Wt (Kg) 96.10±7.76 92.70±8.42 0.004 93.30±10.45 87.90±11.96 0.0003 BMI (Kg/M2 ) 38.31±4.28 36.74±4.62 0.006 37.51±4.28 35.28±4.06 0.0004 WC (Cm) 99.00±4.00 97.10±5.13 0.003 102±6.61 100.50±7.26 0.0014 BFP (%) 41.01±4.70 38.98±4.90 0.002 40.99±6.02 38.64±5.42 0.00003 SBP (Hg mm) 132.80±5.67 127.60±4.19 0.003 131.00±7.37 126±.0.00 0.0263 DBP (Hg mm) 80.60±1.34 78.80±2.14 0.0148 81.00±3.16 78.80±3.15 0.0646 2DCo (n=30) 2DCa (n=30) Wt (Kg) 88.30±8.52 87.30±8.80 0.0236 89.70±8.00 85.00±8.11 0.000003 BMI (Kg/M 2 ) 36.93±3.19 36.49±3.07 0.0250 36.58±3.70 34.65±3.49 0.000003 WC (Cm) 101.00±2.86 100.40±2.45 0.0025 100.80±5.20 99.20±5.15 0.00002 BFP (%) 40.32±2.16 39.66±2.08 0.0002 39.61±3.74 38.11±3.40 0.00000 SBP (Hg mm) 132.40±6.31 128.20±3.45 0.0358 133.80±10.47 122.40±4.50 0.0014 DBP (Hg mm) 78.80±3.15 77.80±4.15 0.1231 82.00±4.32 79.60±0.84 0.052 FBG (mg%) 121.20±20.24 112.00±8.76 0.0588 131.00±18.01 106.00±7.45 0.0028 PPBG (mg%) 153.60±21.64 139.00±16.94 0.0276 165.60±27.93 122.70±10.01 0.0006 A1c (%) 7.5±0.22 7.1±0.18 0.0002 7.67±0.43 6.99±0.20 0.00006 1886-P Depot-Specifi c Expression of Adipogenic Genes in Subcutaneous and Omental Adipose Tissues of Women and Their Relationship with Dyslipidemia HONGYUN LU, XIAOFENG LI, PANWEI MU, JIANG WEI, LONGYI ZENG, Guangzhou, China Depot differences in adipose tissue function may have implications for insulin resistance (IR), the adipogenesis inability of the subcutaneous adipose tissue (SAT) may cause ectopic fat deposition and IR, but the molecular mechanism remains unclear. This study aimed to measure gene expression involved in adipocytes differentiation and adipokines secretion in human SAT and omental adipose tissue (OAT), and then investigate their relationship with obesity and IR. We examined the expression of candidate genes from 29 lean and 12 overweight non-menopausal women. Serum leptin, adiponectin, retinol-binding protein 4(RBP4) and fasting insulin (FINS) levels were measured by using ELISA. IR was evaluated by the HOMA model index (HOMA-IR). We found that serum concentrations of leptin and RBP4 were elevated and adiponectin decreased in overweight patients compared to lean controls (P
Integrated Physiology/ Obesity POSTERS different metabolic conditions can induce signifi cantly divergent exhaled gas profi les. Integrations of this information into condition-specifi c predictive models (for instance use of different gases in predictive algorithms for glycemia in obese, T1DM and T2DM) is likely to considerably improve accuracy of breath based measurements of plasma variables, accelerating the development of portable, clinically usable breath testing devices. Supported by: NIH 1UL1RR031985, K24 DK085223 <strong>ADA</strong>-Funded Research 1889-P Early Aggressive Weight Loss Efforts Using Adjustable Gastric Banding Leads to Improvement or “Remission” of Type 2 <strong>Diabetes</strong> Mellitus TED OKERSON, MICHAEL OEFELEIN, SUNIL BHOYRUL, PAMELA BARNETT, JOHN B. DIXON, APEX, Irvine, CA, La Jolla, CA, Melbourne, Australia Bariatric surgery (malabsorptive or restrictive techniques) has been established as an effective treatment to reduce weight in severely obese patients. This study reports the 1 year “remission” (elimination of hypoglycemic medication) and/or improvement (reduction in hypoglycemic medication) of type 2 diabetes mellitus (T2D) after laparoscopic placement of an adjustable gastric band (AGB) as documented by T2D medication reduction/discontinuation, and the accompanying change in BMI and comorbidities. The APEX study is an ongoing 5-year, prospective, multi-center, open-label, observational study to assess weight reduction, co-morbidities and quality of life after implantation of the LAP-BAND AP ® gastric band, a restrictive weight loss technique. This is an interim analysis of subjects who reported daily medical therapy for T2D before AGB and who have completed the 1 year post-operative scheduled visit. At baseline (BL), 94 out of 436 subjects (22%) reported T2D requiring daily medical therapy; data from 64 subjects contained suffi cient information to assess outcome at 48 weeks. Overall, 86% had remission and/or improvement in T2D, with remission more likely to occur in patients treated earlier after the diagnosis of T2D: Remission Improvement Stable Worse %(n) 34 (22) 52 (33) 13 (8) 2 (1) Mean Duration T2D(mo) 63 76 90 1 BL BMI 46 44 52 47 Δ BMI -8.9 -7.6 -8.1 -2.9 Δ Wt (lb) -55 -48 -52 -18 % Wt Δ -19 -21 -15 -6 Baseline BMI, reductions in BMI and % change in weight were not statistically different among the groups, although numbers were small. As in patients with T2D, resolution or improvement also occurred in other pre-existing co-morbidities measured: hypertension (78%), hyperlipidemia (57%), depression (71%), obstructive sleep apnea (69%) and GERD (93%). These data suggest that a minimally-invasive restrictive gastric banding procedure in obese patients with T2D results in clinically meaningful weight loss, as well as a reduction in T2D medication requirements, with an earlier For author disclosure information, see page 785. OBESITY—HUMAN CATEGORY A510 aggressive weight loss intervention being more likely to facilitate remission of disease. Larger and longer-term studies are required. Supported by: Allergan 1890-P Ectopic Fat Accumulation and Metabolic Syndrome (MSYN) Are Associated with Reduced Subcutaneous Adipose Tissue (SAT) Lipid Storage in Obese Postmenopausal Women (OPW) MONICA C. SERRA, ALICE S. RYAN, RONALD L. PRIGEON, ANDREW P. GOLDBERG, Baltimore, MD Impaired expandability of SAT and the accumulation of fat in visceral adipose tissue (VAT) and muscle (Low Density Lean Tissue [LDLT]) may lead to metabolic dysfunction in obesity. We hypothesize that a decreased ability to store triglycerides (TG) in SAT, due to low adipose lipoprotein lipase activity (LPL), results in lipid overfl ow into VAT and LDLT stores, insulin resistance (IR [measured by HOMA-IR]) and MSYN. To test this hypothesis we measured body composition (DXA, CT), MSYN variables, fat cell weight (FCW) and LPL in abdominal and gluteal adipose biopsies in 125 Caucasian overweight and OPW (25-44 kg/m 2 ; age 45-77 yrs) grouped into lowest and highest quintiles of VAT/total abdominal fat (VAT/[VAT+SAT]; mean±SD: 0.17±0.02 vs. 0.37±0.05). OPW in the highest quintile had a greater prevalence of impaired glucose tolerance (IGT; 67% vs. 20%, P
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2011 ADA Posters 1261-2041.indd - Diabetes

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