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

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Results: Data for 7,590 adults with type 2 diabetes adults were
initially identified. Of these 3,418 (45%) first started metformin
therapy during their care at QP and 2,972 (39%) had an
associated baseline serum creatinine recorded. South East
Asian (1,933, 65%) populations represent almost two-thirds of
the evaluated cohort, while Qatari nationals make up 11%
(n = 335) and 12% (n = 361), respectively.
Conclusion: The distribution of nationalities in our studied
cohort is consistent with national demographic patterns.
Our findings will help further quantify the effects of glucose
lowering therapies compared with metformin treatment in
previously understudied populations.
PE-42
The correlation between fibrinogen level and arterial stiffness
in type 2 DM patients
Hermina NOVIDA 1,2 *, Ari SUTJAHJO1,2, Soebagijo ADI1,2,
Askandar TJOKROPRAWIRO 1,2. 1Faculty of Medicine Universitas
Airlangga, 2Surabaya Diabetes and Nutrition Center Dr. Soetomo
Hospital, Indonesia
Background: Cardiovascular disease (CVD) is increased in
type 2 Diabetes Mellitus (T2DM) patients due to a complex
combination of various traditional and non-traditional risk
factors that have important roles in the evolution of athero-
sclerosis. Fibrinogen level has been described as independent
risk factor for CVD. Many studies have indicated that arterial
stiffness also plays a critical role in the pathogenesis of
atherosclerosis and CVD. Brachial-ankle pulse wave velocity
(baPWV) is a method to measure arterial stiffness. It reflects
the stiffness of both the aorta and peripheral arteries in an arm
and a leg.
Objective: The aim of this study is to analyze the correlation
between fibrinogen level and baPWV in T2DM patients.
Material and Methods: This cross sectional study was con-
ducted at diabetes outpatient clinic Dr. Soetomo teaching
hospital Surabaya Indonesia. Inclusion citerias were patiens
with T2DM aged over 45 years old and signed informed
consent. Patients with severe infection, renal and liver
dysfunction, pregnancy, fibrate treatment were excluded in
this study. We interviewed and measured body weight and
height, BMI, blood pressure and baPWV. Plasma glucose (FPG)
and post prandial glucose (PPG), HbA1c, lipid profiles, and
fibrinogen level were measured as well. Data was statistically
analyzed using Pearson correlation test.
Results: We analyzed 40 patients who have been diagnosed
with T2DM consisting of 17 males and 23 females. The overall
mean of BMI was 25.66 + 2.91 kg/m2, HbA1c was 8.01 + 1.39%,
FPG was 150.2 + 61.97 mg/dL, PPG was 214 + 74.49 mg/dL and
fibrinogen 456.75 + 142.60 mg/dL. One-sample Kolmogorov-
smirnov test indicated that the data distribution was normal.
There was significant correlation between fibrinogen level and
baPWV (r 0.336; p < 0.05).
Conclusion: There was significant correlation between fibrino-
gen level and arterial stiffness in T2DM patients.
PE-43
Cilostazol attenuates the severity of peripheral arterial disease
in type 2 diabetes: the plasma soluble receptor for advanced
glycation end-products
Jhih-Syuan LIU1, Yi-Jen HUNG 2*. 1Division of Endocrinology and
Metabolism, Department of Internal Medicine, Tri-Service General
Hospital Keelung Branch, 2Division of Endocrinology and
Metabolism, Department of Internal Medicine, Tri-Service General
Hospital, Taiwan
Recent studies have demonstrated that the plasma soluble
receptor for advanced glycation end-products (sRAGE) play
a major role in developing macrovascular complications of
type 2 diabetes, including peripheral arterial occlusion
disease (PAOD). Cilostazol is an antiplatelet, antithrombotic
agent, which has been used for the treatment of PAOD. We
hypothesized that cilostazol attenuates the severity of PAOD in
patients with type 2 diabetes through the augmentation of
plasma sRAGE. Ninety type 2 diabetic patients with PAOD
defined as intermittent claudication with ankle-brachial index
(ABI) ≦0.9 were recruited for an open-labeled, placebo-con-
trolled study for 52 weeks with oral cilostazol 100 mg twice
daily (n = 45) or placebo (n = 45). Fasting plasma sRAGE,
endothelial variables of E-selectin, soluble vascular cell
adhesion molecule-1 (sVCAM-1), and inflammatory markers
of high-sensitivity C-reactive protein (hsCRP) and tumor
necrosis factor-α (TNF- α) were determined. After completely
the 52-week treatment program, the ABI values were elevated
in cilostazol group (P < 0.001). The plasma sRAGE was signifi-
cantly increased (P = 0.007), and hsCRP, sVCAM, and E-selectin
concentrations were significantly decreased (P = 0.028, <0.001
and <0.001, respectively) with cilostazol treatment. In a partial
correlation analysis with adjustments for sex and age, the net
change of sRAGE significantly correlated with the change of
ABI in the cilostazol group (P = 0.043). In a stepwise multiple
regression model, only the change with regards to sRAGE was
significantly associated with the change of ABI (P = 0.046). Our
results suggest that cilostazol may effectively attenuate the
severity of PAOD in patients with type 2 diabetes. Plasma
sRAGE plays a role as an independent predictor for improving
the index of PAOD.
PE-44
Nonalbumin proteinuria as a simple and practical
predictor of the progression of early-stage type 2 diabetic
nephropathy
Jong Ho KIM1, Eun Heui KIM1, Min Jin LEE1, Sung Su KIM 1,
Yun Kyung JEON1, Sang Soo KIM1, Bo Hyun KIM1, Yong Ki KIM 2,
In Joo KIM1*. 1Department of Internal Medicine, Pusan National
University Hospital, 2Kim Yong Ki Internal Medicine Clinic, Korea
Recent studies have shown multi-biomarker approaches for
risk prediction in diabetic nephropathy. The aim of this study
was to pursue the simple and practical predictor among
nonalbumin proteinuria (NAP) and six urinary biomarkers
contributing to the progression of diabetic nephropathy.
In this observational study, the urine levels of albumin-to-
creatinine ratio (ACR), nonalbumin protein-to-creatinine ratio
(NAPCR) and six biomarkers [kidney injury molecule (KIM)-1,
neutrophil gelatinase-assoicated Lipocalin (NGAL), liver-type
fatty acid-binding protein (L-FABP), angiotensinogen, interleu-
kin-18 (IL-18) and YKL-40] were measured in 73 patients with
type 2 diabetes and estimated glomerular filtration rate
(eGFR) ≥ 60 mL/min/1.73 m2. We found optimal cutpoints for
ACR, NAPCR and six biomarkers and used Harrell’s concord-
ance index (C-index) to validate Cox model. The renal out-
comes were annual eGFR decline and the development of
chronic kidney disease (CKD) stage 3 or greater.
The average rate of eGFR decline over the median of 50 months
of follow up was −2.48 mL/min/1.73 m2/year. NAPCR and six
urinary biomarkers were negatively correlated with annual
eGFR decline. After adjusting for several clinical factors, only
NAPCR showed a significant association with annual eGFR
decline (Adjusted R2 = 0.141, P = 0.035). NAPCR showed a higher
predicted probability of having the CKD stage 3 or greater occur
than six urinary biomarkers (C-index 82.7). NAPCR also
showed a higher predictive value than six urinary biomarkers
applying the concept of “Panel score ”.
The results of this study suggest that NAPCR may be a better
predictor of the development and progression of CKD than the
other urinary biomarkers in patients with the early-stage type
2 diabetic nephropathy.
Poster Presentations / Diabetes Research and Clinical Practice 120S1 (2016) S65–S211 S144