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PB-19
Two times elevation of CA19-9 in mitochondrial diabetes
associated with tRNA (Leu) at position 3271
Yoshihiko SUZUKI
1
*, Junichiro IRIE
2
, Motoaki SANO
3
,
Toshihide KAWAI
4
, Shu MEGURO
2
, Nobuhiro IKEMURA
3
.
1
HDC
Atlas Clinic,
2
Department of Internal Medicine, Keio University School
of Medicine,
3
Department of Cardiology, Keio University School of
Medicine,
4
Department of Internal Medicine, Saiseikai Central
Hospital, Tokyo, Japan
We first reported a case of mitochondrial diabetes associated
with a tRNA Leu(UUR) mutation (Mt-DM) at position 3271. So
far, the case has shown several important findings in practice.
He has a strong inheritance of type 2 diabetes but no hearing
loss. His mother and ten relatives in maternal side had
diabetes without hearing loss, suggesting the clear different
expression from Mt-DM at position 3243 (hearing loss is often
complicated).
In 2012, at age 57-y/o, withinweeks of stopping smoking, CA19-
9 was elevated up to 221 U/mL, five times higher than the
normal value (normal: less than 37.0 U/mL). He noticed dull
back pain. Some change in the lung
’
s tissue level associated
with emphysema was diagnosed as a plausible cause (FEV:
73.2%on spirometryandonCT). But, latent pancreatitis are also
plausible, because he had a back pain, a sign of pancreatitis.
We started taurine treatment (3.06 g/day), which was
conducted in clinical trial for mitochondrial diseases.
Interestingly, after taurine treatment, back pain disappeared.
And remarkable improvement of emphysema was noted
functionally (FEV: improved to 83.4%). Accordingly, CA19-9
returned to be normal.
We previously reported that patients of Mt-DM at position
3243 are likely to have posttreatment painful neuropathy.
Therefore, we speculate that Mt-DM is likely to cause
ischaemia/reperfution damage, triggered by rapid environ-
mental change as like rapid glycemic control or stop-smoking.
Recently, at age 59 y/o. (at 2016), he suffered from autoimmune
pancreatitis with elevation of CA19-9 (55.3 u/mL). After six
months of sodium glucose cotransporter 2 inhibitor (SGLT2i)
treatment, CA19-9 was elevated together with elevation of p-
amylase, elastase I, and IgG4. Even after stopping SGLT2i
treatment, CA19-9 was still high.
Thus, two times elevation of CA19-9 suggests that Mt-DM
patients are likely to suffer from lung or pancreatic damage
after the rapid change of environmental or habitual condi-
tions. However, question whether these phenomena are
reproducible in other Mt-DM patients remains to be a
problem. Additionally, hereditary pancreatitis (HP) is a rare,
heterogeneous familial disease. HP usually appears with an
acute, a recurrent acute, and a chronic phase. Therefore, two
times elevation of CA19-9 could be a reflection of a recurrent
acute pancreatitis. The possibility of mitochondrial DNA
abnormality as a cause of HP is the first finding in literature.
PB-20
Potential non-laboratory predictors of fitness and status of
insulin resistance among young adult Futsal players
Yi-Hung KUO
1,2
, Wen-Wei HSU
3
, Yun-Shing PENG
4
,
Zin-Rong LIN
5
, Jui-Chu HUANG
2,6,7
*.
1
Division of Colon and Rectal
Surgery, Department of Surgery, Chiayi Chang Gung Memorial
Hospital,
2
Graduate Institute of Clinical Medical Science, College of
Medicine, Chang Gung University, Taoyuan,
3
Division of Orthopedic
Surgery, Chiayi Chang Gung Memorial Hospital,
4
Division of
Endocrinology and Metabolism, Department of Internal Medicine,
Chiayi Chang Gung Memorial Hospital,
5
Graduate Institute of Sport
and Leisure Education, College of Education, National Chung Cheng
University,
6
Department of Health Care Management and Healthy
Aging Research Center, Laboratory for Epidemiology, Chang Gung
University, Taoyuan,
7
Division of Endocrinology and Metabolism,
Department of Internal Medicine, Yunlin Chang Gung Memorial
Hospital, Taiwan
Background:
Futsal is a variant of association football and
originated in Uruguay in 1930. The five-a-side football became
popular after Uruguay won the 1930 World Cup. This study
aims to assess the impacts of insulin resistance and non-
laboratory predictive factors of fitness among Futsal player
aged from 13 to 19 years.
Methods and materials:
Futsal players under agreement of
parent were divided into two groups according to the quadrant
percentiles of fitness. Anthropometric measurements, serum
glycated hemoglobin, insulin, fasting glucose were measured.
Descriptive statistics, chi-square, independent-sample t-test,
and multivariate logistic regression were performed.
Results:
Forty eight participants completed the study.
Comparing to low score (
≦
25, n = 25) group, the group with
score more than 25 presented male dominant (95.7 vs. 48%,
p < 0.001), higher height (168.9 ± 6.15 vs. 161.7 ± 6.28 cm, p <
0.001), larger waist circumference (75.9 ± 3.93 vs. 71.2 ± 5.66 cm,
p < 0.01), but lower body fat rate (12.6 ± 3.57 vs. 18.9 ± 8.31%,
p < 0.01). The high score group also shown significant low
levels of serum insulin (12.1 ± 5.91 vs. 17.9 ± 8.79 mg/dL, p <
0.05) and HOMA-IR (2.8 ± 1.44 vs. 4.2 ± 2.33, p < 0.05). The
multiple linear regression models showed body fat rate and
waist circumference to be potential predictive factors.
Conclusions:
In our study, the participants with better fitness
by quadrantile scoring showed more height, more waist
circumference, but less body fat rate than the opposite ones.
They also had lower serum insulin levels and lower insulin
resistance index. Further study to define the impacts of
sufficient physical activities on fitness and insulin resistance
would be interesting.
PB-21
Presentation of type 2 diabetes in children and adolescents
–
A
single centre experience
Ho-chung YAU
1
*, Jennifer Wing-yan TSANG
1
,
Samantha Lai-ka LEE
1
, Gary Wing-kin WONG
1
.
1
Department of
Paediatrics, Prince of Wales Hospital, The Chinese University of Hong
Kong, Hong Kong
Background:
With the increasing prevalence of childhood
obesity in Hong Kong, the number of prediabetes and type 2
diabetes is expected to be increased.
Objective:
The study aims to describe the clinical presentation
of type 2 diabetes in children and adolescents in a tertiary
referral centre.
Methods:
The study is a retrospective chart review of patients
with type 2 diabetes followed up in our diabetes clinic from
2000 to 2014. Patients aged 18 years or less at onset of diabetes
were included. Those with genetic and secondary diabetes
were excluded. Demographic, socioeconomic, clinical and
laboratory data at onset of diabetes were analyzed.
Comorbidities included hypertension, dyslipidemia, non-
alcoholic fatty liver disease, polycystic ovarian syndrome and
obstructive sleep apnoea syndrome were reviewed.
Results:
Total of 46 patients with type 2 diabetes were
diagnosed from 2000 to 2014, with median age of 14.3 years
(range 10.1
–
18.0 years). Median body mass index was 27.6 kg/
m
2
(range 18.9
–
43.2 kg/m
2
). Median weight-for-height stand-
ard-deviation-score was 2.564 (range
−
0.177 to 8.097). 65% of
the patients was female and 96% of the cohort was Chinese.
46% of them lived in public housing. 83% of the cohort had
either first or second degree relatives having type 2 diabetes.
Majority of them were picked up by screening. But there was
still 2% of the patients presented with diabetic ketoacidosis.
Median haemoglobin A1c was 8.9% (range 5.3
–
15.5%).
Although majority of them received metformin, there was
25% of the cohort required metformin plus add-on therapy.
At presentation, 22% of the patients had coexisting hyperten-
sion, 15% had dyslipidemia, and 30% had non-alcoholic
fatty liver disease. 17% of those who had undergone poly-
somnography were diagnosed with obstructive sleep apnoea
Poster Presentations / Diabetes Research and Clinical Practice 120S1 (2016) S65
–
S211
S82