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

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and ameliorated insulin resistance and glucose intolerance.
Throughout six months both HFHS and HFHS + NAC groups
showed a dramatic increase of mitochondrial bioenergetics,
measured as oxygen consumption rate by the Seahorse XF24
Extracellular Flux Analyzer. Compared to CD group at six
month, HFHS group exhibited a significant increase of
mitochondrial biogenesis associated with induced mitochon-
drial ROS, which was not observed in HFHS + NAC group. In
light of this study, we suggest that anti-oxidative NAC reduces
obesity and mitigates insulin resistance and glucose intoler-
ance through reducing mitochondrial ROS, oxidative damage
and changing mitochondrial bioenergetics of VF. Notably, our
study shed light on the therapeutic effect of mitochondrial
ROS-repressing anti-oxidant on obesity-prevention and devel-
opment of diabetes.
PI-39
Short leukocyte telomere length is associated with the FTO
rs9939609 polymorphism in non-obese individuals
Ji Hee YU1, Inkyung BAIK2, Kyoung Jin KIM1, Ji A SEO1,
Sin Gon KIM1, Kyung Mook CHOI1, Sei Hyun BAIK 1,
Dong Seop CHOI 1, Chol SHIN3, Nan Hee KIM1*. 1Division of
Endocrinology and Metabolism, Korea University Ansan Hospital,
2 Department of Foods and Nutrition, College of Natural Sciences,
Kookmin University, 3 Institute of Human Genomic Study, Korea
University Ansan Hospital, Korea
The fat mass and obesity-associated (FTO) gene polymorph-
ism rs9939609 has been associated with body weight and
adiposity in many studies. Obesity contributes to limited life
expectancy and short telomere length, a cellular marker for
biological age. Our study aimed to evaluate the association
between FTO rs9939609 risk variant and leukocyte telomere
length, and to investigate if this relationship is modified by the
status of obesity.
A total of 2,133 participants were recruited from the Korean
Genome and Epidemiology Study. Leukocyte telomere length
was determined using real-time quantitative polymerase
chain reaction methodology. The FTO rs9939609 polymorph-
ism was genotyped using DNA samples collected at baseline.
The proportion of the TT, TA, and AA genotypes were shown as
76.7, 21.5, 1.8%, respectively. The mean body mass index (BMI)
was significantly higher in carriers with the A-risk allele than
in those with TT genotype (25.1 vs. 24.6 kg/m2, P = 0.002). In
1,184 subjects without obesity (BMI < 25 kg/m 2), BMI, waist
circumference and visceral fat area were higher in those with
the FTO risk allele than in non-carriers. In contrast, none of
them were associated with FTO risk allele in those with
obesity. Leukocyte telomere lengthwas significantly shorter in
carriers with the FTO risk allele compared with non-carriers
after controlling for age, sex, BMI, smoking, alcohol, exercise,
hypertension, diabetes and cardiovascular disease (P < 0.01). In
particular, such significant association between the FTO risk
allele and telomere length appeared only in non-obese
subjects (P = 0.03). In stepwise multivariate linear regression
analyses, the independent risk factors affecting shorter
leukocyte telomere length were higher age, lower high-
density lipoprotein cholesterol levels and the presence of the
FTO risk allele. This finding was evident only in those without
obesity.
The FTO rs9939609 polymorphism is the independent risk
factor not only for obesity but also for biological aging in non-
obese population.
PI-40
Fatty liver changes after gastric cancer surgery
Soyoung OCK 1, Shinjun LEE 1, Sukyoung KWON1,
Youngsik CHOI1, Bukyung KIM1*. 1Kosin University School of
Medicine, Korea
Type 2 diabetes mellitus (T2DM) has been dramatically
improved after bariatric surgery especially Roux-en-Y gastric
bypass method. Immediate improvement of hepatic insulin
sensitivity is suggested one of main mechanism. The proce-
dures of gastric cancer surgeries are very similar with bariatric
surgery. However, there is no study about the fatty liver change
after gastric cancer surgery. Therefore we evaluated the fatty
liver changes after gastrectomy for gastric cancer according to
the types of surgery.
From a total 374 patients who underwent gastric cancer
surgery in Kosin University Gospel Hospital form 1 January to
31 December of 2013, 212 patients had early gastric cancer
(EGC). We evaluated hepatic steatosis for only EGC patients
using Hounsfield unit (HU) on non contrast computed tomog-
raphy (CT) imaging. Spleen and liver ratio of HU was calculated
at previous to operation, 6 months, 12 months and 24
months. We compared the preoperative results and post-
operative results according to the types of surgery: Billroth I (B
I), Billroth II (B II) and Roux-en-Y gastric bypass (RYGB).
Among the total 212 EGC patients, 62.3% (132) underwent
surgery with B I, 21.7% (46) with B II and 16% (34) with RYGB.
Initial results of HU of liver, HU of spleen and spleen and liver
ratio were not different among the three groups. After surgery,
only patients with RYGB had significant changes of spleen and
liver ratio at 6 months, 12 months and 24 months compared to
the preoperative results (from −6.0 to −9.7, − 9.2 and −10.4,
p = 0.03). In 26 patients who had higher HU levels of spleen
than liver initially, spleen and liver ratio also significantly
decreased from7.6 to −4.7 at 6mo., − 4.3 at 12mo. and −4.2 at 24
mo. (p < 0.001).
In this study we identified that even in normal patients who
had high HU of liver than spleen had significant changes of
hepatic steatosis after RYGB. The patients initially had fatty
liver had also significant decrease of spleen and liver ratio.
These results suggested that RYGB could be better choice
for patients with gastric cancer and metabolic disease
coincidentally.
PI-41
Hypoglycemia occurred in one case after liver transplantation
and bariatric surgery
He-Jiun JIANG1, Wei-Wen HUNG1, Shyi-Jang SHIN1,
Pi-Jung HSIAO1*. 1Division of Endocrinology and Metabolism,
Department of Internal Medicine, Kaohsiung Medical University
Hospital, Kaohsiung Medical University, Taiwan
Secondary diabetes frequently occurs after liver transplant-
ation under immunosuppression therapy. The accumulated
incidence is reported around 50% after immunosuppression
therapy, ex., tacrolimus. However, hypoglycemia is an import-
ant issue with emergent life-threatening risk more than
hyperglycemia. It is so rare that hypoglycemia occurred in
cases after successful liver transplantation. Here, we reported
a case of severe hypoglycemia occurring one year after liver
transplantation and treated by tacrolimus andmycophenolate
mofetil.
This 42 year-old man is a case with morbid obesity (126 kg,
BMI 44.6 kg/m2) and he received the gastric bypass bariatric
surgery in December, 2012. Then, he lost his body weight to
81 kg (BMI 28.7 kg/m2) one year later. This patient was also a
heavy drinker and chronic hepatitis B complicated with liver
cirrhosis and decompensated liver failure. Then, liver trans-
plantation was performed successfully in April, 2015.
Immunosuppression therapy was combined with tacrolimus
and mycophenolate mofetil thereafter. However, frequent
symptomatic hypoglycemia (<50 mg/dL) happened during
admission for management of the rejection. The blood
glucose was kept in the range of 55–90 mg/dL in fasting state
and 60–130 mg/dL postprandially under dextrose infusion.
The baseline evaluation revealed A1C 4.6%, ACTH 64.47 pg/mL,
cortisol 3.55 μg/dL to exclude out adrenal insufficiency and
organ failure. OGTT was performed and blood glucose
was 78 mg/dL (baseline), 196 mg/dL (1st hour), dropped to
37 mg/dL (2nd hour) with C-peptide 7.97 ng/mL and insulin:
Poster Presentations / Diabetes Research and Clinical Practice 120S1 (2016) S65–S211 S193