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

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of HCV infection on the incidence of dialysis in patients with
T2DM in Taiwan.
Research design and methods: This was a population-based
retrospective study employed the Taiwan National Health
Insurance Research Database covering the claim data between
1998 and 2012.
Results: Among a total of 1,940,005 patients with T2DM, 53,477
had HCV infection. In 2012, the incidence of dialysis among
patients with T2DM was 308.1 per million person-years.
Among those with diabetes, the incidences of dialysis with
or without HCV infection were 379.7 per million person-years
and 305.9 per million person-years, respectively. After adjust-
ing gender, age, insured-premium salary, low-income house-
holds, urbanization levels, comorbidity and disease severity,
the incidences of dialysis were significantly higher in T2DM
patients with HCV infection than those without HCV through-
out the observational period (p value = 0.0025). Although the
incidence for HCV-associated dialysis was relatively stable, its
trend continued rising during the past decade.
Conclusions: HCV infection increases the risk for dialysis in
patients with T2DM. Prevention and early effective manage-
ment of the infection to decrease the incidences of progression
to chronic kidney disease and the subsequent burden of
dialysis in patients with T2DM are clearly warranted.
PJ-42
Effects of hypoglycemia on soluble endoglin in patients with
type 2 diabetes
Doo-Man KIM 1*, Juri PARK1, Hoyoung SON1, Younjung KIM1,
Moonki CHOI 1, Hyungjoon YOO1. 1Hallym University College of
Medicine, Korea
Background: Hypoglycemia can be associated with an increase
in cardiovascular mortality in type 2 diabetes. But the impact
of hypoglycemia on endothelial dysfunction is still unknown
in patients with type 2 diabetes. Recently, it was reported that
early decreased plasma soluble endoglin levels represent
impaired endothelial function in patients with acute myocar-
dial infarction. But there are no researches of the relation
between endoglin and hypoglycemia.
Aim: We studied the relationship between hypoglycemia and
plasma soluble endoglin in patients with type 2 diabetes.
Method: This is a cross-sectional study performed in patients
with hypoglycemia with or without type 2 diabetes. Patients
enrolled in the study from September 2011 to December 2012
were from Hallym University Medical Center and National
Medical Center. We analyzed 117 patients with type 2 diabetes
and 10 patients without diabetes visited emergency room for
hypoglycemia. We excluded patients with malignancies.
Markers of endothelial dysfunction and hypoxia, VEGF (vas-
cular endothelial growth factor), EPO (erythropoietin), VCAM-1
(vascular cell adhesion molecule-1) and endoglin, were
measured; the levels of soluble plasma endoglin were mea-
sured by enzyme-linked immunosorbent assay. The 10-year
cardiovascular event risks in patients with diabetes were
estimated using the UK Prospective Diabetes Study (UKPDS)
risk engine.
Results: The levels of endoglin were significantly, negatively
correlated with age. Endoglin levels in patients with type 2
diabetes were significantly lower than in non-diabetic controls
during hypoglycemia after adjustment for age and sex
(poster table 1). The difference remained marginally signifi-
cant (4.47 ± 0.13 ng/mL vs 5.94 ± 0.48 ng/mL, p = 0.05) after
adjusting for age, sex, body mass index, AST, ALT and systolic
blood pressure (poster figure 1). But there were no significant
differences on levels of VEGF, EPO and VCAM-1 between
diabetic and non-diabetic patients during hypoglycemia.
Plasma soluble endoglin levels in diabetic groups showed a
significantly negative correlation with 10-yrear risk for fetal
stroke calculated using UKPDS risk engine (r = −0.312, p =
0.039). However, this phenomenon was not seen on other
vascular markers.
Discussion: This data suggest that plasma soluble endoglin
is related to hypoglycemia and associated with vascular
pathologies as endothelial dysfunction in patients with type
2 diabetes. Endoglin may therefore be considered as a new
marker of hypoglycemic responsiveness in patients with type
2 diabetes.
PJ-43
The association of Sitagliptin treatment with all-cause
mortality and renal outcomes in diabetic patients with chronic
kidney disease
Ping-Hsun WU1,4, Ming-Yen LIN1,5 , Teng-hui HUANG1,
Yi-Ting LIN2,3,4, Jer-Chia TSAI1,5*. 1Division of Nephrology,
Department of Internal Medicine, Kaohsiung Medical University
Hospital, 2Department of Family Medicine, Kaohsiung Medical
University Hospital, 3Department of Family Medicine, Kaohsiung
Municipal Hsiao–Kang Hospital, 4Institute of Clinical Medicine,
College of Medicine, Kaohsiung Medical University, 5Faculty of
Renal Care, College of Medicine, Kaohsiung Medical University,
Taiwan
Backgrounds: The association between Dipeptidyl peptidase 4
(DPP-4) inhibitors and cardiovascular outcomes was reported
in large randomized control trials and cohort studies. However,
limit data focus on renal outcomes. We investigated the
effect of Sitagliptin on all-cause mortality and renal outcomes
in a nationwide cohort of Chronic kidney disease (CKD).
Methods: Using data from the multidisciplinary team care pay
for performance (P4P) program, a part of National Health
Insurance Research Database, we identified CKD patients with
diabetes mellitus (DM) between 2007 and 2011. We used
intention-to-treat analysis and multivariate Cox proportional
hazards to evaluate the association between Sitagliptin use
and risks of death and renal outcomes, controlling for medical
history, laboratory results, medications, and comorbidities.
Patients were followed to death, end-stage renal disease, or the
end of 2012. Residual confounding was assessed by sensitivity
analysis.
Results: Cumulative mortality rates were lower for Sitagliptin-
treated CKD patients with DM than for untreated patients
(Incident rate ratio: 0.70, 95% confident interval [CI]: 0.58–0.85).
Sitagliptin use was independently associated with lower all-
cause mortality after multivariate adjustment (adjusted
hazard ratio [aHR]: 0.80, 95% CI: 0.65–0.99). In multivariable
analysis, Sitagliptin use was not significant difference in the
risk of end-stage renal disease (aHR: 1.05, 95% CI: 0.91–1.20) in
CKD patients with DM after adjusting for comorbidities,
medications, and competing risk of mortality.
Conclusions: The Sitagliptin was associated with decreased
risk of all-cause mortality but not end-stage renal disease in
CKD patients with DM. More studies focus on kidney outcomes
warrants further investigation.
PJ-45
Impaired fasting glucose and risk of cardiovascular mortality
in Korean adults
Nam Hoon KIM1, Kyoung Jin KIM1, Kyeong Jin KIM 1,
Jee Hyun AN1, Hye Jin YOO1, Hee Young KIM1, Ji A. SEO1,
Nan Hee KIM1, Kyung Mook CHOI1, Sei Hyun BAIK 1,
Dong Seop CHOI1, Sin Gon KIM1*. 1Korea University College of
Medicine, Korea
Background: To assess the association between impaired
fasting glucose and overall and cardiovascular disease (CVD)
mortality among Korean adults.
Methods: From the nationwide cohort provided by the
National Health Insurance Service in Korea (2002– 2013),
subjects were stratified as normal glucose tolerance (NGT,
fasting glucose <100 mg/dL), impaired fasting glucose (IFG)
stage 1 (100–109 mg/dL), IFG stage 2 (110–125 mg/dL), and
diabetes mellitus (DM) groups based on serum fasting glucose
Poster Presentations / Diabetes Research and Clinical Practice 120S1 (2016) S65–S211 S205