Diabetes Research and Clinical Practice - Volume 120 - Supplement 1 - October 2016

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PE-26
Physical activity and albuminuria were associated with
painful diabetic polyneuropathy in type 2 diabetes in an ethnic
Chinese population
Sheng-Shu CHIANG 1,2, Chia-Lin LEE1, Hsiu-Chen LIU1,
Jun-Sing WANG 1, I-Te LEE1, Yuh-Min SONG1, Chia-Po FU1,
Shih-Yi LIN 1*, Wayne H.-H. SHEU 1. 1Divisions of Endocrinology
and MetabolismDepartment of Internal Medicine, Taichung Veterans
General Hospital, 2Divisions of Internal Medicine, Sinying Hospital,
Taiwan
Diabetic neuropathy is a common complication in patients
with type 2 diabetes. However, prevalence of painful diabetic
polyneuropathy (PDPN) and potential influences of physical
activity and albuminuria on development of PDPN have been
rarely studied. The aim of this study was to examine the
prevalence of PDPN as well as the independent and joint
effects of physical activity and albuminuria on it.
This retrospective study enrolled 2,359 outpatients with type 2
diabetes with completed survey of Douleur Neuropathique en
4 Questions (DN4) questionnaire from January 2013 to October
2013 in one of medical center in central Taiwan. Painful
neuropathy was defined as a total score exceeding 3 points.
Independent and joint effects of physical activity and albu-
minuria on PDPN were assessed by fixed effect with logistic
regression.
Overall, 179 (7.6%) patients were diagnosed as having PDPN.
Both less physical activity and albuminuria were associated
with a higher mean DN4 score (1.07 for no exercise, 0.87 for
daily exercise duration ≦30 minutes, and 0.56 for daily
exercise duration >30 minutes, p for trend <0.001; 1.51 for
macroalbuminuria, 1.10 for microalbuminuria, and 0.78 for
normal UACR, p for trend <0.001). Adjusted analysis showed
that the risk of painful neuropathy increased in the groups
without physical activity (Odds ratio (OR) = 3.38, 95% CI 1.54–
9.79) and daily exercise duration ≦30minutes (OR = 3.33, 95%CI
1.27 –8.73), when compared with the group with daily exercise
duration >30 minutes (p for trend 0.006). Comparing with
normal UACR, the OR for PDPN were 0.96 (95% CI 0.61 –1.50)
and 2.31 (95% CI 1.44 –3.73) for microalbuminuria and macro-
albuminuria respectively (p for trend 0.002). In addition, we
observed a joint effect of macroalbuminuria and physical
inactivity on PDPN risk (OR = 6.68, 95% CI 2.23–20.04).
Less physical activity and albuminuria, respectively, increased
the risk of PDPN and had a joint effect.
PE-27
Osteocalcin improves nonalcoholic fatty liver disease in mice
through activation of Nrf2 and inhibition of JNK
Yuqian BAO1*, Jing DU1, Mingliang ZHANG1, Junxi LU1,
Xueli ZHANG 1, Qin XIONG1, Yiting XU 1, Weiping JIA1.
1 Department of Endocrinology and Metabolism, Shanghai Jiao Tong
University Affiliated Sixth People’s Hospital; Shanghai Clinical Center
for Diabetes; Shanghai Diabetes Institute, China
Objective: Recent studies have demonstrated a protective
effect of osteocalcin against nonalcoholic fatty liver disease
(NAFLD), although the specific underlying mechanisms
remain unclear. Nuclear factor erythroid 2-related factor 2
(Nrf2) and c-Jun N-terminal kinase (JNK) pathways play
important roles in the pathogenesis of NAFLD. The present
study aimed to investigate whether osteocalcin protects
against NAFLD by regulating these pathways.
Methods: Male C57/BL6J mice were fed a high-fat diet for 12
weeks to induce NAFLD and were treated with recombinant
uncarboxylated osteocalcin (30 ng/g) or vehicle by daily
intraperitoneal injection during this period. Intraperitoneal
glucosetolerance test, insulin tolerance test, measurement of
serum lipid profiles, liver enzymes and hepatic triglyceride
content were carried out. Hepatic redox state was examined.
The role of osteocalcin on Nrf2 and JNK were investigated by
Western blot and Real-time PCR.
Results: Daily injections of osteocalcin can significantly
improve lipid metabolism, glucose tolerance and insulin
sensitivity in mice fed a high-fat diet (P < 0.05). Osteocalcin
treatment protected mice from diet-induced hepatic triglycer-
ide accumulation and liver injury. Increased levels of mal-
ondialdehyde, 8-iso-prostaglandin F2α and a higher ratio of
oxidized/reduced glutathione (GSSG/GSH) in the liver of mice
fed a high-fat diet were decreased by osteocalcin (P < 0.05).
Meanwhile, treatment with osteocalcin resulted in increases
in hepatic reduced GSH levels in mice fed a high-fat diet
(P < 0.05). Osteocalcin treatment not only activated Nrf2
nuclear translocation and up-regulated the expression of
antioxidant enzyme genes (catalase, superoxide dismutase,
and glutathione peroxidase) (P < 0.05), but also inhibited the
activation of JNK in the liver (P < 0.05). G protein coupled
receptor family C, group 6, subtype A (GPRC6A), the putative
receptor of osteocalcin, was found in the liver.
Conclusions: Osteocalcin improves NAFLD by activating the
Nrf2 pathway to alleviate oxidative stress, and inhibiting JNK
pathway.
PE-28
Anterior compartment syndromewith type 1 diabetesmellitus
Min Ji KIM1, Sung DaeMOON1*, Eun Sook KIM1, Eun YeongMO1,
Je Ho HAN1. 1Division of Endocrinology & Metabolism, Department
of Internal Medicine, Incheon St. Mary’s Hospital, The Catholic
University of Korea, Incheon, Korea
Compartment syndrome is defined as an elevation of the
interstitial pressure in a closed osteofascial compartment
causing microvascular compromise. The common causes
include trauma, arterial injury, limb compression and burns.
Rarely, it can also occur spontaneously in association with
type 1 diabetesmellitus. We report a case of a patient with type
1 diabetes mellitus who presented with lower limb pain
without any obvious injury and had a subsequent diagnosis
of acute compartment syndromes. Non traumatic acute
compartment syndrome secondary to diabetic muscle infarc-
tion should be considered in any diabetic patient presenting
with pain out of proportion to sustained injury.
PE-29
Prevalence of chronic kidney disease among adults with
diabetes or prediabetes in China
Qian DENG1, Tengfei MAN2, Mei ZHANG1, Shusen LIU2,
Zhenping ZHAO1, Tongtong WANG 3, Zhengjing HUANG1 ,
Yichong LI1, Samuel S. ENGEL3, R. Ravi SHANKAR3,
Kimberly G. BRODOVICZ3, Yingmei TU 2, Linhong WANG 1,
LiminWANG1. 1National Center for Chronic and Non-communicable
Disease Control and Prevention, Chinese Center for Disease Control
and Prevention,2Merck Sharp & Dohme (China) R&D Co., Ltd., China;
3Merck Research Laboratories, Merck & Co., Inc., United States of
America
Background: Chronic kidney disease (CKD) is recognized as a
global public health problem. Diabetes mellitus is the leading
cause of CKD, but little is known about the relationship
between CKD and prediabetes, especially among those who
remained long-term prediabetic state.
Objectives: To compare the prevalence of CKD among Chinese
adults with pre-diabetes and diabetes to those with normal
glucose tolerance (NGT). To examine whether the prediabetes
progression was associated with CKD prevalence.
Methods: 1,149 Chinese adults aged over 18 years old with
prediabetes and 997 with NGT were identified from four
counties/districts in 2010, and were followed up to 2014. Blood
and urine samples were collected to assess the presence of
CKD in 2014. CKD was defined as eGFR less than 60 mL/min
per 1.73 m2 or the presence of albuminuria (urinary albumin
to creatinine ratio >=30 mg/g), and estimated at the end of
follow-up. Pre-diabetes and diabetes were based on the criteria
Poster Presentations / Diabetes Research and Clinical Practice 120S1 (2016) S65–S211 S139