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Diabetic nephropathy (DN) is the most common chronic
microvascular complication in diabetes, in particular the
type 2 diabetes (T2DM). But DN is always neglected by diabetic
patients. It is need to find a simple, sensitive and specific
marker for early detection, diagnosis and treatment of DN. The
unique circulating microRNAs (miRNAs) observed in patients
with early DN are candidates as new biomarkers. In this study,
we first applied miRNA microarray techanology and identifi-
fied four miRNAs, miR27b-3p, miR215, miR3195, and miR4298,
which were increased more than 1.5 folds in pooled (n = 20 per
each group) plasma samples from DN and T2DM patients, as
compared to normal control (NC) subjects. To validate these
miRNAs as biomarkers, we measured and analyzed their
plasma levels by quantitative real-time PCR in 205 subjects
including 65 T2DM patients with early DN, 70 patients with
T2DMwithout DN and 70 NC. And the area under the curve for
circulation miRNAs was determined using Receiver Operator
Characteristic analysis. We found that the plasma concentra-
tions of miRNAs, miR-27b-3p was significantly increased
among the patients with early DN, T2DM without kidney
disease and normal controls (NC) (p = 0.007 < 0.01), within two
groups that miRNA27b-3p was significantly increased in T2DM
and DN compared with NC (p = 0.021 < 0.05 and p = 0.037 < 0.05,
respectively), but there is no significant between DN and DM
(p = 0.852 > 0.05). The plasma concentrations of miRNA3195
was no significantly among the patients with early diabetic
nephropathy and type 2 diabetes (without kidney disease) and
normal controls (P = 0.068 > 0.05), within two groups that
miRNA3195 was significantly decreased in DN compared
with T2DM and NC (p = 0.043 < 0.05 and p = 0.043 < 0.05,
respectively). While miR-215, miR-4298 were no significantly
among the three groups. According to the regression analysis,
the concentrations of miRNA27b-3p was correlation with BMI
(r = 0.163, p = 0.020) and HbA1c (r = 0.170, p = 0.015). The con-
centrations of miRNA27b
–
3p was still increased among the
three groups when BMI, HbA1c was not considered. The area
under ROC curve of miRNA27b-3p, miRNA215, miRNA3195,
and miRNA4298 were 0.406, 0.400, 0.318 and 0.500, respect-
ively), while combined miRNA27b-3p and miRNA3195, The
area under ROC curve is 0.7057 (p = 4.206 × 10
−
6
). Our results
demonstrated that the applications of circulating miR27b-3p
as a potential biomarker for DN/T2 DM and miR3195 for DN,
and thus can be used in clinical monitoring,or the combination
of elevated miR27b-3p and reduced miR3195 as biomarkers for
DN warrant further investigations.
PA-07
The presence and the extent of gastric atrophy are inversely
associated with incident diabetes
Tse-Ya YU
1
, Jung-Nan WEI
2
, Chun-Heng KUO
3
,
Jyh-Ming LIOU
4
, Mao-Shin LIN
4
, Shyang-Rong SHIH
4
,
Cyue-Huei HUA
5
, Yenh-Chen HSEIN
5
, Lee-Ming CHUANG
4
,
Ming-Shiang WU
4
, Hung-Yuan LI
4
*.
1
Far Eastern Memorial
Hospital, New Taipei City,
2
Chia Nan University of Pharmacy and
Science, Tainan,
3
Department of Internal Medicine, New Taipei City
Hospital, New Taipei City,
4
Department of Internal Medicine,
National Taiwan University Hospital, Taipei,
5
Division of Clinical
Pathology, National Taiwan University Hospital Yun-Lin Branch,
Yun-Lin, Taiwan
Objective:
Gastric atrophy results in low plasma ghrelin,
vitamin B12 deficiency, and a change in gut microbiota
because of decreased gastric acid secretion, which may lead
to the incidence of diabetes. Helicobacter pylori infection is a
major cause of gastric atrophy and is associated with diabetes
in some reports. Since there is no study which investigates
the impact of gastric atrophy on diabetes, we conducted a
prospective cohort study to examine the relationship between
H. pylori infection, gastric atrophy, and incident diabetes.
Research design and methods:
From 2006 to 2012, we enrolled
855 subjects without diabetes. Serum antibodies against
H. pylori were measured at baseline. Gastric atrophy was
defined as serum pepsinogen (PG) I
≤
70 ng/mL and PG I/II ratio
≤
3. PG I/II ratio was used as a measure for the extent of gastric
atrophy.
Results:
At baseline, 283 (36%) subjects were positive for
H. pylori infection and 78 (9%) subjects were diagnosed as
gastric atrophy. Serum PG I/II ratio was inversely correlated
with HOMA2-IR, HOMA2%B, and H. pylori IgG titer (all p < 0.05).
During an average of 3.4-year follow-up, 73 subjects (9%)
developed diabetes. Subjects with gastric atrophy had a lower
risk of incident diabetes (HR 0.28, 95%CI 0.09
–
0.91, p < 0.05),
adjusting for risk factors of diabetes, blood pressure, and lipid
profiles. Serum PG I/II ratio predicted incident diabetes
(adjusted HR 2.06, 95%CI 1.11
–
3.84, p < 0.05). However, H.
pylori infection was not associated with incident diabetes
(p > 0.05).
Conclusions:
The presence and the extent of gastric atrophy
are inversely associated with incident diabetes.
PA-08
Changes in lifestyle habits and subsequent risk of type 2
diabetes in males and females
Kaoru TAKAHASHI
1,2
, Tadashi NISHINO
1
, Toshinari YASUDA
1
,
Akiko SUGANUMA
2
, Naoki SAKANE
2
*.
1
Hyogo Health Service
Association,
2
Division of Preventive Medicine, Clinical Research
Institute, National Hospital Organization Kyoto Medical Center,
Japan
Objectives:
Several lifestyle factors have been associated with
an increased risk of type 2 diabetes (T2D). However, whether
changes in lifestyle factors are related to the subsequent type 2
diabetes risk remains unknown. The aim of the present study
was to evaluate the association between changes in lifestyle
habits during a one-year period and the subsequent 5-year risk
of type 2 diabetes.
Methods:
A prospective study of 59,400 non-diabetic partici-
pants aged from 40 to 74 years (29,253 males and 30,147
females) was performed using the Specific Health Check and
Guidance System in Japan. Inclusion criteria included being
aged 40
–
74 years. Exclusion criteria included diabetes, hyper-
tension, hyperlipidemia, and chronic kidney disease treat-
ment. The height and weight of the subjects were measured,
and information concerning lifestyle habits (eating speed,
physical activity, exercise habits, gait speed, alcohol drinking,
smoking, and restorative sleep) was obtained using a self-
administered questionnaire in 2008 and 2009. Incident cases of
T2D were defined based on FPG
≥
7.0 mmol/L, postprandial
glucose
≥
11.1 mmol/L, glucose HbA1c
≥
6.5%, and the use of
anti-diabetic agents. Cox proportional hazard models were
used to calculate hazard ratios (HRs) and 95% confidence
intervals (CI) with adjustment for age, BMI, and initial and
changes in lifestyle factors.
Results:
Over a mean follow-up period of 3.9 years, 1,223 males
(4.2%) and 427 females (1.4%) newly developed T2D. In males,
never smokershadsignificantly lowerT2Drisks comparedwith
the reference group (HR 0.65, 95% CI 0.57
–
0.74). In males with
changesof lifestyle factors, skippingbreakfastwas significantly
associated with an increase of T2D (HR 1.46, 95% CI, 1.06
–
1.99).
In females, never smoking and faster gait speed were signifi-
cantly associated with a decrease of T2D (HR 0.53, 95%CI 0.36
–
0.79; HR 0.76, 95%CI 0.58
–
0.98). In females with changes of
lifestyle factors, slower eating speed was significantly asso-
ciated with a decrease of T2D (HR 0.72, 95%CI 0.56
–
0.93).
Conclusions:
These findings suggest that several changes
of lifestyle factors were associated with an increased or
decreased rate of T2D. Lifestyle modification targeting these
factors is required to prevent T2D in the future.
Poster Presentations / Diabetes Research and Clinical Practice 120S1 (2016) S65
–
S211
S67