Diabetes Research and Clinical Practice - Volume 120 - Supplement 1

fluid examination in both groups were compared in STATA by

using chi squared test and t-test.

Results:

The mean age of TB with DM is higher than TB only

(63.07 ± 13.85 vs. 54 ± 19.41 p 0.04). The Epidemiological

Features and clinical signs and symptoms are similar in both

groups. In diabetic group the sputum smear is positive in

64.29% while in non-diabetic group it is positive in 45.31%,

which is statistically significant (p 0.04). There is no statistic-

ally difference in radiological features. And it is noted in our

study most of diabetic patients are not well controlled.

Conclusions:

Epidemiological, clinical and radiological fea-

tures of pulmonary tuberculosis in both diabetic and non-

diabetic patients are similar. The rate of sputum smear

positivity in TB with DM is higher than TB without DM. The

burden of diabetes mellitus is increasing worldwide. The

association between diabetes and tuberculosis is the next

challenge for global tuberculosis control and in particular in

Cambodia.

PB-03

Metabolic endotoxemia and an alterlation in the gut

microbiota composition are present in Japanese type 2

diabetes

Emi SOHARA

*, Ikue NAKADAIRA

, Megumi GONAI

Kotaro KURASAI

, Kumiko HAMANO

Department of Diabetes

and Endocrinology Kantoh Rosai Hospital, Japan

Recently the potential role of the gut microbiota andmetabolic

disorders such as obesity or type 2 diabetes has been inten-

sively explored. Endotoxemia, a process resulting from trans-

location of lipopolysaccharides (LPS) of gram-negative

intestinal bacteria is related to low grade inflammation asso-

ciated with insulin resistance or diabetes. Data on Japanese are

scarce and may be different from those of Western subjects

because of the ethnicity and dietary habit. In the present study,

we examined LPS-binding protein (LBP) in Japanese type 2

diabetes and investigated the relationships between LBP and

various clinical indices. We also valued fecal microbiota by

16SrRNA sequence analysis.

Fifty-two consecutive type 2 diabetes patients were recrui-

ted. The exclusion criteria were those with acute illness,

malignancy or pregnancy. Patients taking antibiotics or alfa-

glucosidase inhibitors were also excluded. The blood samples

were obtained after overnight fast. The plasma level of LBP

was measured by human LBP ELISA kit (Hycult Biotech,

Netherland). The average age (±SD) was 50 ± 10, BMI, 28 ± 4.4,

HbA1c, 6.9 ± 1.2(%), respectively. The duration of diabetes was

7 ± 8 years. Thirty Japanese healthy adults with no history of

diabetes were recruited as control subjects.

The mean LBP level was 12.3 ± 1.9 ug/mL, which was signifi-

cantly higher compared to that of control subjects. LBP was

positively correlated with BMI (p < 0.001), HbA1c (p < 0.001),

FBS (p < 0.001), TG (p < 0.05) and ALT (p < 0.001), but was not

associated with LDL-C.

The counts of the Bifidobacteriaceae, Clostridiales incertae

sedis XIV, and Peptostreptococcaceae were significantly lower

(p < 0.05), while the counts of the Enterobacteriaceae and

Vellonellaceae were significantly higher (p < 0.05) in fecal

samples of diabetic patients than in those of control subjects.

Changes in the composition of microbiota were correlated

with metabolic marker.

In conclusion, Japanese obese type 2 diabetes had metabolic

end toxemia.

The next step in this research protocol is to perform interven-

tional studies to investigate whether improvement of gut

dysbiosis by the administration of probiotics or prebiotics can

reduce the levels of circulatory inflammation markers and the

microbiota diversity, with improvement of glycemic control.

Double blind randomized intervention trial (UMIN00001234) is

to be undertaken.

PB-06

High glucose induces human endothelial dysfunction through

an Axl-dependent mechanism

Chien-Hsing LEE

*, Yi-Shing SHIEH

, Fone-Ching HSIAO

Feng-Chih KUO

, Chih-Yuan LIN

, Chang-Hsun HSIEH

Yi-Jen HUNG

Division of Endocrinology and Metabolism,

Department of Internal Medicine, Tri-Service General Hospital,

National Defense Medical Center,

2School of Dentistry, National

Defense Medical Center,

Division of Cardiovascular Surgery,

Department of Surgery, Tri-Service General Hospital, National

Defense Medical Center, Taipei, Taiwan

Background:

The receptor tyrosine kinase Axl and its ligand

growth arrest-specific protein 6 (Gas6) are involved in the

diabetic vascular disease. The aim of this study was to explore

the role of Gas6/Axl system in high glucose (HG)-induced

endothelial dysfunction.

Methods:

We investigated the effect of various glucose

concentrations on Axl signaling in human microvascular

endothelial cells (HMEC-1 s).

Results:

Human plasma Gas6 value inversely correlated with

glucose status, endothelial markers. HG decreased Gas6/Axl

expression and increased intercellular adhesion molecule-1

(ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1)

expression in HMEC-1 s. HG significantly decreased HMEC-1 s

cell viability and tube formation and promoted monocyte-EC

adhesion. Down-regulation of Akt phosphorylation was found

in HG culture. Axl transfection significantly reversed HG-

induced Akt phosphorylation, VCAM-1 expression and endo-

thelial dysfunction. We also found additive changes in Axl-

shRNA-infected HMEC-1 cells in HG culture. Furthermore, Axl

overexpression in HMEC-1 s significantly reversed HG-induced

vascular endothelial growth factor (VEGF) and VEGF receptor 2

(VEGFR2) expression. In addition, significantly lower Axl and

VEGFR2 expression in arteries were found in diabetic patients

as compared with non-diabetic patients.

Conclusions:

This study demonstrates that HG can alter

Gas6/Axl signaling and may through Akt and VEGF/VEGFR2

downstream molecules and suggests that Gas6/Axl may

involve in HG-induced EC dysfunction.

PB-07

Mitochondrial diabetes associated with tRNA Leu (UUR)

mutation at position 3271 and two times of GAD antibody

negative conversion

Yoshihiko SUZUKI

*, Junichiro IRIE

, Motoaki SANO

Toshihide KAWAI

, Shu MEGURO

, Nobuhiro IKEMURA

HDC

Atlas Clinic,

Department of Internal Medicine, Keio University School

of Medicine,

Department of Cardiology, Keio University School of

Medicine,

Department of Internal Medicine, Saiseikai Central

Hospital, Tokyo, Japan

The proband has been followed up as a patient of mitchondrial

diabetes associated with tRNA Leu (UUR) mutation at position

3271 for over 20 years. We first reported this case in 1996. We

report here that this case has had phenomena of GAD antibody

positive-negative conversion two times in his life.

1. First episode:

When he was 54 y/o, his GAD antibody became positive,

glycemic control got worse. It was transient phenomena,

then, GAD antibody became negative and glycemic con-

trol improved. The etiology was unknown. To our knowl-

edge, only seven cases were reported as mitochondrial

diabetes having GAD antibody. However, among them,

this case is the first as having negatively-converted GAD

with insulin independent state.

When we started sitaglipitin, DPP4-inhibitor, 50 mg/day

and observed 9 months, HbA1c improved remarkably

and oral glucose tolerance test showed increase of early

phase insulin secretion and suppression of postprandial

hyperglycemia.

Poster Presentations / Diabetes Research and Clinical Practice 120S1 (2016) S65

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