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

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Methods: 500,424 diabetic patients from ambulatory care
claims and 500,424 age- and sex-matched control subjects
from registry of beneficiaries were linked to inpatient
claims (1997– 2008) to identify the admissions for HF (ICD-9:
428). With Cox proportional hazard regression mode, we
compared the relative hazards of HF in relation to diabetic
patients and control subjects under various age- and sex-
stratifications.
Results: Compared with the control subjects, diabetic
patients had increased hazards of HF [adjusted hazard ratio
(aHR): 2.30, 95% confidence interval (CI) 2.28–2.33]. After
adjustment of various coronary heart diseases such as acute
myocardial infarction, unstable angina, angina pectoris,
chronic ischemic heart disease, hypertension, hypertensive
disease, procedures of percutaneous transluminal angiog-
raphy and coronary artery bypass surgery in the model, aHR
attenuated to 1.79 (95% CI 1.77–1.81). In both genders, the
diabetic patients aged <45 years had highest risks of HF, and
the respective relative risks for diabetic men and women aged
<45 years were aHR: 8.07 (95% CI 7.03–9.26) and aHR: 12.18 (95%
CI 10.14 –14.64).
Conclusions: Optimal control of blood sugar and aggressive
management of cardiovascular risk factors are crucial in
reducing subsequent risk of heart failure especially in young
diabetic patients.
PJ-23
Inverse relationship between serum osteocalcin levels and
nonalcoholic fatty liver disease in postmenopausal Chinese
women with normal blood glucose levels
Yuqi LUO1, Xiaojing MA1, Yaping HAO1, Xiaoping PAN 1,
Yiting XU 1, Qin XIONG1, Yuqian BAO1*, 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
Aim: Osteocalcin is involved in the progression of nonalcoholic
fatty liver disease (NAFLD) in animal models and humans. In
this study we investigated the relationship between serum
osteocalcin levels and NAFLD in postmenopausal Chinese
women.
Methods: A total of 733 postmenopausal women (age range,
41 –78 years) with normal blood glucose levels were enrolled in
this cross-sectional study. Women taking lipid-lowering or
anti-hypertensive drugs were excluded from enrollment.
Serum osteocalcin levels were assessed using an electroche-
miluminescence immunoassay. Each subject’s fat liver degree
was assessed through ultrasonography, and each participant ’s
fatty liver index (FLI) was calculated to quantify the degree of
liver steatosis.
Results: The median level of serum osteocalcin in the
total enrolled subjects was 21.99 ng/mL (interquartile range,
17.84–26.55 ng/mL). Subjects with NAFLD had significantly
lower serum osteocalcin levels than those without NAFLD
(18.39 ng/mL [range, 16.03–23.64 ng/mL] vs. 22.31 ng/mL
[range, 18.55 –27.06 ng/mL], P < 0.001). Serum osteocalcin
levels decreased significantly with incremental changes in
the FLI value divided by the quartile (P-value for trend <0.001).
The serum osteocalcin levels showed a significant negative
correlation with the FLI values, even after adjusting for
confounding factors (standardized β = −0.124, P < 0.001).
Binary logistic regression analysis identified an individual ’s
serum osteocalcin level as an independent risk factor for
NAFLD (odds ratio, 0.951; 95% confidence interval: 0.911 –0.992;
P = 0.020).
Conclusion: Serum osteocalcin levels were inversely corre-
lated with NAFLD in postmenopausal Chinese women with
normal blood glucose levels.
PJ-25
Hyperglycemic crisis is associated with subsequent
major adverse cardiovascular events: A nationwide
population-based study
Li-Hsin CHANG1,2, Liang-Yu LIN2,3 , Jen-Huai CHIANG4,5,6,
Vivian Chia-Rong HSIEH7, Ming-Shun HSIEH 2,8,9,10. 1Division of
Endocrinology and Metabolism, Department of Medicine, Tauyan
Branch of Taipei Veterans General Hospital, Tauyuan, 2Faculty of
Medicine, National Yang-Ming University,3Division of Endocrinology
and Metabolism, Department of Medicine, Taipei Veterans General
Hospital, Taipei, 4Graduate Institute of Integrated Medicine, College
of Chinese Medicine, Research Center for Chinese Medicine &
Acupuncture, China Medical University, 5College of Medicine, China
Medical University, 6Management Office for Health Data, China
Medical University, 7Department of Health Services Administration,
China Medical University, Taichung, 8Department of Emergency
Medicine, Taipei Veterans General Hospital, Taoyuan Branch,
Taoyuan, 9Department of Emergency Medicine, Taipei Veterans
General Hospital, 10Institute of Occupational Medicine and Industrial
Hygiene, National Taiwan University College of Public Health, Taipei,
Taiwan
Objective: Hyperglycemic crisis is associated with significant
morbidity and mortality but the association between hyper-
glycemic crisis and long term cardiovascular outcomes was
elusive. The purpose of this study is to discuss the association
between hyperglycemic crisis and subsequent major adverse
cardiovascular events (MACE).
Participants and methods: The population-based cohort study
using data from 1996 to 2012 in the Taiwan National Health
Insurance Research Database was conducted. A total of 2,171
diabetic patients with hyperglycemic crisis fit the criteria of
analysis. The propensity score was used for matching the
baseline characters and 8,684 patients were retrieved as the
comparison cohort. The risk of subsequent MACE was
compared between two groups.
Results: Six hundred and seventy-six events occurred in group
with hyperglycemic crisis and the events rate was higher than
those without hyperglycemic crisis (31.1% versus 24.1%,
p < 0.001 by log-rank test). Subjects with Hyperglycemic crisis
were associated with higher risk of subsequent MACE even
after adjusting with all baseline characters (hazard ratio (HR)
1.76, 95% confidence interval (CI) 1.62–1.90, p < 0.001). After
age-stratification, the junior patients with hyperglycemic
crisis had higher risk of MACE than senior group (HR 2.69 for
age 20–39 years old versus HR 1.58 for age >65 years old).
Conclusion: Hyperglycemic crisis is associated with subse-
quent MACE, especially in young patients. Further plan of
primary prevention of hyperglycemic crisis should be con-
cerned in clinical practice.
PJ-26
Earlymenarche and increased risk of cardiovascular disease in
Korean women
Jong Chul WON1, Kyung Soo KO1, Sang Yong KIM2,
Hyun Jin KIM3, Sunghwan SUH4, Ji Cheol BAE5*, Dong-Jun KIM6.
1Department of Internal Medicine, Sanggye Paik Hospital,
Cardiovascular and Metabolic Disease Center, College of Medicine,
Inje University, Seoul, 2Department of Endocrinology and
Metabolism, Chosun University Hospital, Chosun University School
of Medicine, Gwangju, 3Department of Internal Medicine, Chungnam
National University School of Medicine, Daejeon, 4Division of
Endocrinology and Metabolism, Dong-A Medical Center, Dong-A
University College of Medicine, Busan, 5Division of Endocrinology and
Metabolism, Samsung Changwon Hospital, Sungkyunkwan
University School of Medicine, Changwon, 6Department of Internal
Medicine, Ilsan-Paik Hospital, College of Medicine, Inje University,
Koyang, Korea
Early menarche is strongly associated with adulthood obesity;
however, the relationship between age at menarche and
cardiovascular disease (CVD) in Korean women remains
Poster Presentations / Diabetes Research and Clinical Practice 120S1 (2016) S65–S211 S200