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

224 / 244

level. Overall and CVD mortality risks were assessed by Cox
regression analyses.
Results: When adjusted for age, sex, and body mass index, IFG
stage 2 was associated with significantly higher all-cause
mortality (HR, 1.26, 95% CI: 1.18 –1.34), and CVD mortality (HR,
1.27, 95% CI: 1.08 –1.49) compared to NGT. However, IFG stage 1
was not associated with increased risk of mortality from any
causes. Among CVD category, mortality from ischemic stroke
was significantly higher (HR, 1.60, 95% CI: 1.18 –2.18) in subjects
with IFG stage 2, but not mortality from ischemic heart
disease. The ischemic stroke mortality in IFG stage 2 remained
elevated when other CVD risk factors including smoking,
physical activity, systolic blood pressure, and total cholesterol
were adjusted for.
Conclusions: Higher degree of IFG (110–125 mg/dL of fasting
glucose) was associated with increased all-cause and CVD
mortality. The increased risk of CVD mortality in IFG was
attributable to ischemic stroke, not ischemic heart disease
among Korean adults.
PJ-46
Risk of melanoma in patients with diabetes mellitus: A
nationwide retrospective cohort study in Taiwan
Hui-Wen TSENG 1,2, Yow-Ling SHIUE2, Kuo-Wang TSAI3,
Wei-Chun HUANG4,5 , Pei-Ling TANG4, Mei-Chen LIAO6,
Chih-Kuang LIANG 5,6, Ming-Yueh CHOU5,6,
Hing-Chung LAM 6,7*. 1Department of Dermatology, Kaohsiung
Veterans General Hospital, 2Institute of Biomedical Sciences, National
Sun Yat-Sen University, 3Department of Medical Education and
Research, Kaohsiung Veterans General Hospital, 4Critical Care Center
and Cardiovascular Medical Center, Kaohsiung Veterans General
Hospital, Kaohsiung, 5School of Medicine, National Yang-Ming
University, Taipei, 6Center for Geriatrics and Gerontology, Kaohsiung
Veterans General Hospital, 7Division of Endocrinology and
Metabolism, Department of Internal Medicine, Kaohsiung Veterans
General Hospital, Kaohsiung, Taiwan
Background: Increasing evidence suggests that certain types of
cancers are more common in people with diabetes mellitus
(DM). The risk of melanoma in patients with DMwas seldomly
reported in Taiwan.
Method: In this retrospective cohort study using Taiwan
Longitudinal Health Insurance Research Database, 41,898
patients newly diagnosed as DM was matched with those
without DM by age, sex, index date, and comorbidities (obesity,
coronary artery disease, hyperlipidemia, hypertension,
chronic kidney disease, and chronic obstructive pulmonary
disease). The risk of melanoma in DM patients was analyzed
by Kaplan-Meier survival analysis and Cox regression analysis.
Results: The number of melanoma patients was 6 in the DM
cohort and 14 in the non-DM cohort. For the people in the
subgroup of age ≥ 30 years, although the risk of developing
melanoma was lower in the DM cohort than that in the
non-DM cohort, the risk was only borderline significant by
Kaplan-Meier survival analysis (log-rank test: 0.097). By
univariable Cox regression, the risk of developing melanoma
was lower but insignificant in the DM cohort [crude hazard
ratio = 0.46, P = 0.106]. By Cox regression with multivariable
adjustment, the risk of developing melanoma was also lower
in the DM cohort, but without significance [adjusted hazard
ratio (AHR) = 0.46, P = 0.11]. The only significant risk factor for
developing melanoma was cardiovascular disease (AHR = 5.38,
P = 0.001).
Conclusion: The present study indicated that there might be a
lower incidence and risk of developing melanoma in DM
patients. The non-significant result may be due to small
number of melanoma patients. Cardiovascular disease was a
significant risk factor for melanoma development even in
young adults that warranted further investigation.
PJ-47
Association of severe hypoglycemia with incident atrial
fibrillation in type 2 diabetes: a nationwide population-based
cohort study
Jae-Seung YUN1, Kyungdo HAN1 , Seon-Ah CHA1 ,
Eun-Young LEE1, Bong-Yun CHA1, Yu-Bae AHN1,
Seung-Hyun KO1*. 1The Catholic University of Korea, Korea
The association between severe hypoglycemia (SH) and atrial
fibrillation (AF) is not conclusive. The aim of this study was to
investigate the association between AF and SH in type 2
diabetes using the Korean National Health Insurance Service
cohort database from 2002 to 2013.
A National Sample Cohort (2002–2013) database consisting of
1,025,340 Koreans was released in 2014, and followed for
maximum11 years. Among them, we selected 421,626 subjects
aged over 30 years. Thereafter, we selected patients with type 2
diabetes who prescribed anti-diabetic drugs with the presence
of ICD-10 codes E11, E14, and who had not diagnosed with AF
(I48) and SH [defined by ICD-10 (E16.x, E11.63, E13.63, E14.63)
from the inpatients or emergency room claim dataset] from
the year of 2002 to 2005. The patients who diagnosed with
valvular heart disease (I34.x, I35.x, I36.x), and hyperthyroidism
(E05.x) were excluded. As a result, a total of 43,627 subjects
were included in our study. The main outcome was the
development of AF occurred after SH. A Cox proportional
hazards regression analysis was used to test the association
between the development of AF and potential explanatory
variables.
During the follow-up period, a total of 1,913 AF episode
occurred in 43,627 subjects (4.3%). The incidence of AF in the
study cohort was 2.3 times higher in the group with SH than
the group without SH (5.2 vs. 12.0 per 1,000 person-years). The
group who developed AF were older (60.9 ± 12.0 vs. 67.0 ± 10.7
years; P < 0.001), had a higher ratio of the presence of
hypertension (61.7% vs. 81.7%; P < 0.001), and congestive
heart failure (4.3% vs. 13.4%; P < 0.001). After adjustment for
age, sex, social economic status, the presence of hypertension,
and congestive heart failure, SH showed the significantly
higher risk for AF [hazard ratio (HR) 1.45, 95% CI 1.01–2.10]. In
addition, male sex (HR 1.42, 95% CI 1.29–1.55), the presence of
hypertension (HR 2.01, 95% CI 1.78–2.26), congestive heart
failure (HR 2.41 95%CI 2.11–2.76) were the significant predictive
factors for the development of AF.
SH was associated with incidence of AF in Korean patients
with type 2 diabetes. Further exploration of the underlying
mechanism is necessary.
PJ-48
Effect of obstructive sleep apnea on chronic kidney disease –
Systematic review and meta-analysis study
Der-Wei HWU1,2, Yu-Hung CHANG1 , Kun-Chen LIN1,
Yau-Jiunn LEE1*. 1Department of Internal Medicine, Lee’s
Endocrinology Clinic, 2Graduate institute of Clinical Medicine,
Kaohsiung Medical University, Taiwan
Background: Obstructive sleep apnea (OSA) is substantially
increased in patients with diabetes mellitus and contributes to
cardiovascular diseases. However, OSA also characterized of
episodic intermittent nocturnal hypoxia which may alter
intra-renal hemodynamic, increase oxidative stress and
result in renal function deterioration. Thus, the aim of this
systematic review is to summarize the effect of obstructive
sleep apnea on the development of chronic kidney disease
(CKD).
Material and methods: Our study followed the PRISMA
guideline. Two independent reviewers searched relevant
articles from the database of Pubmed, Web of Science and
CENTRAL and conducted the study selection and quality
assessment. Data extraction was performed by the main
author and checked by the other authors. Random effect
model was used to estimates the effect summary.
Poster Presentations / Diabetes Research and Clinical Practice 120S1 (2016) S65–S211 S206