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tissue and autonomic neuropathy in diabetes. Therefore, we
investigated the morphologic changes of autonomic nerves in
the adipose tissue in diabetic animal model.
Method:
Animals were divided into two groups; male db/db
mouse and age matched control mouse were used. White
adipose tissues were collected from db/db control mouse and
were stained with immunohistochemistric method. Tyrosine
hydroxylase and choline acetyltransferase were labeled for
noradrenergic sympathetic and cholinergic parasympathetic
axons of adipose tissue respectively and observed by confocal
microscopy and analyzed. And, protein gene product 9.5 used
for whole autonomic and sensory nerve staining.
Result:
Sympathetic nerve fiber density of adipose tissue was
not significantly changed in diabetic and control mouse
adipose tissue. However, Parasympathetic nerve fiber density
of adipose tissuewas significantly increased in diabeticmouse
compare to control. The sympathetic to parasympathetic
nerve density ratio of adipose tissue is lower in diabetic
group compared to control group (0.72 vs 0.55).
Discussion:
Both sympathetic and parasympathetic nerve
fibers were observed in white adipose tissue. And sympathetic
to parasympathetic nerve fiber density of adipose tissue
density ration was decrease in diabetic group. Further
evaluation for the mechanism of the parasympathetic nerve
fiber density change was needed.
PH-16
Patient with latent autoimmune diabetes in adult (LADA) and
autoimmune haemolytic anemia (AIHA), a probable case of
autoimmune cross reactivity
Andra ASWAR
1
*, Dante Saksono HERBUWONO
1
.
1
Endocrine and
Metabolic Division, Internal Medicine Departement, Faculty of
Medicine University Indonesia
–
dr. Cipto Mangunkusumo National
General Hospital, Indonesia
Introduction:
Incidence of autoimmune diseses are increasing
in many part of the world. AIHA and LADA are among the
autoimmune diseases that being studied recently. The patho-
logic correlation between AIHA and LADA in a patient is not yet
fully understood.
Case illustration:
A 34-years-old female patient came with
chief complaint of general weakness since 3 days before
admission. She was diagnosed of having ketosis and anemia.
She has the same symptom 2 year ago and was diagnosed
with anemia and got blood transfusion. About 1 year ago she
was diagnosed with diabetes mellitus and got treatment
with glibenclamide and metformin. No history of diabetes
mellitus and autimmune diseases in the family. From the
physical examination in general is within normal limit.
Laboratory examination show Coomb
’
s test positive, ANA
positive, high LDH level: 321, GAD 65: >30.0 U/mL (<1.1), ICA:
>1:8 titer (<1:2), Insulin Autoantibody <0.4 U/mL (<0.4),
Random Blood Glucose: 300 mg/dL, blood Ketone: 1,1. She
got treatment with methyl prednisolone 3 × 12 mg, folic acid
2 × 5 mg, vitamin B12 3 × 50 mg, basal insulin 1 × 30 U and
prandial insulin 3 × 28 U.
Discussion:
Prevalence of AIHA and LADA diagnosed in a
single patient is not yet known. Autoimmune cross reactivity
is one theory that suggest the connection between both
diseses. The role of HLA is another possible theory that
being studied. Management of patient with LADA and AIHA
need special concerned due to steroid used as immunosupres-
sion for AIHA that can worsen patient blood glucose profile.
Insulin is preferable for blood glucose control in this kind of
patient.
Conclusion:
Adult patient with diabetes mellitus whom
diagnosed of having an autoimmune disease such as AIHA,
should be evaluated weather the diabetes it self is due to an
autoimmune process. So the patient can have better manage-
ment and prevent complication.
Obesity/Diabetes & Bariatric Surgery
PI-01
Relation of MPV with serum PON-1 activity and BA-IMT in
diabetic patients with respect to obesity and diabetic
complications
Pinar KARAKAYA
1
*, Meral MERT
1
, Y
ı
ld
ı
z OKUTURLAR
1
,
Asuman GEDIKBAŞI
1
, Filiz İSLIM
1
, Özlem HARMANKAYA
1
,
Abdülbaki KUMBASAR
1
.
1
Department of Endocrinology, Bakirkoy
Dr. Sadi Konuk Training and Research Hospital, Turkey
Objective:
To evaluate the relation of mean platelet volume
(MPV) levels with serum PON-1 activity and brachial artery
diameter(BAd) and (BA-IMT) in diabetic patients with respect
to obesity and diabetic complications.
Methods:
A total of 201 diabetic patients grouped with respect
to obesity [obese (n = 89) and non-obese (n = 112) and diabetic
complications [with (n = 50) or without (n = 150) microvascular
complications and with (n = 91) or without (n = 108) macro-
vascular complications groups were included. Correlation of
MPV values to PON-1 activities as well as to(BAd) and (BA-IMT)
was evaluated in study groups.
Results:
PON-1 activity values were respectively in the overall
population, with no significant difference with respect to
obesity and macrovascular diabetic complications, where as
significantly lower values for PON-1 activity were noted in
patients with than without diabetic microvascular complica-
tions. MPV values were 9.10 (0.87) fL in the overall population,
with no significant difference with respect to obesity and
diabetic complications. No significant correlation of MPV
values to PON-1 activity and to(BAd) and (BA-IMT) was noted
in the overall study population as well as in study groups.
Conclusion:
In conclusion, our findings revealed a significant
decrease I PON-1 activity in diabetic patients with microvas-
cular rather than macrovascular complications, whereas
regardless of obesity and diabetic complications, no increase
in thrombogenic activity and no relation of thrombogenic
activity with PON-1 activity and(BAd) and (BA-IMT).
PI-03
Effect of bariatric surgery on diabetic complications: the
Taiwan diabesity study
Yi-Cheng CHANG
1,2,3
*
,#
, Wei-Jei LEE
4,#
, Chieh Hsiang LU
5
,
Seh-Huang CHAO
6
, Ching-Chu CHEN
7
.
1
Department of Internal
Medicine, National Taiwan University Hospital,
2
Graduate Institute
of Medical Genomics and Proteomics, National Taiwan University,
3
Institute of Biomedical Science, Academia Sinca,
4
Division of General
Surgery, Min-Sheng General Hospital,
5
Division of Metabolism &
Endocrinology, Chia-Yi Christian Hospital,
6
Division of General
Surgery, Jen-Ai Hospital,
7
Division of Endocrinology and Metabolism,
Department of Medicine, China Medical University Hospital,
Taichung, Taiwan, Taiwan
#
These two author contribute equally to this work
Background:
The effect of bariatric surgery on diabetic
microvascular complications not certain
Methods:
In this prospective multi-center study, we compared
renal and retinal complications between 10 obese/overweight
(BMI > 25 kg/m
2
) diabetic patients receiving bariatric surgery
(including gastric bypass and sleeve surgery) versus 75
patients receiving intensive medical control after follow-up
for 12 months without or with adjustment for baseline
age, gender, oral medications, insulin therapy, glucagon-like
peptide analogues therapy, and life style (including smoking,
alcohol use, and betel nut chewing).
Results:
At baseline, the mean age was 43.6 and 51.6 years
(P < 0.001); the mean body mass index (BMI) was 36.03 and
30.1 kg/m
2
(P < 0.001); the mean hemoglobin A1c (HbA1c)
was 8.6% and 8.0% (P = 0.2); mean estimated glomerular
Poster Presentations / Diabetes Research and Clinical Practice 120S1 (2016) S65
–
S211
S183