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Association between serum white blood cell counts and hemoglobin A1c in a Korean adult population
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Poster Presentations / Diabetes Research and Clinical Practice 120S1 (2016) S65–S211
regulation of glucose and fatty oxidative metabolism in animal models. The effects of GDF15 on metabolism have similarities with the muscle fiber-derived or cytokines or peptides called as “mytokine”. However, the study whether exercise have effects on the plasma level of GDF15 has not been reported. Therefore, we examined the change of GDF15 level with metabolic parameters, including glucose and various kinds of cholesterol after regular exercise. Methods: We enrolled the 20 subjects to be able to do aerobic and strength exercise at least 3 times a week during 12 weeks. All subjects had baseline records, including age, body mass index (BMI), waist to hip ratio, body fat percentage. Blood samples were collected the fasting, 2 and 4 hour after taking the high calorie mixed meal at the starting and ending time of study. Results: Two people excluded the study because of anemia and laboratory errors. Total 18 subjects were enrolled and women with average age of 37 ± 10 years. 4 subjects were glucose intolerance (22.2%). 7 subjects had dyslipidemia (38.9%). Body weight, BMI, waist to hip ratio, and body fat percentage had no difference. Metabolic parameters in fasting state, including glucose, insulin, cholesterol, HOMA-IR, and HOMA-β had no difference. We investigated the differentials between fasting and 2 hr postprandial glucose level (2 hr postprandial glucose – fasting glucose, ΔGlu 2-0) and between fasting and 2 hr postprandial GDF15 level (2 hr postprandial GDF15 – fasting GDF15, ΔGDF 2-0) in subgroup according to glucose intolerance. ΔGlu 2-0 showed significantly higher variation in Subjects with glucose intolerance than in subjects with normal glucose tolerance at time before exercises. However, two groups showed no difference in ΔGlu 2-0 at time after exercise. ΔGDF 2-0 in subjects with normal glucose tolerance showed positive values at all of times before and after exercise. However, in subjects with glucose intolerance showed negative ΔGDF 2-0 at times before exercise, but positive ΔGDF 2-0 at times before exercise. Conclusion: Our data suggested that exercise in subjects with glucose intolerance could result in recovery of GDF15 response at postprandial times with improvement of postprandial glucose level. PA-04 Association between serum white blood cell counts and hemoglobin A1c in a Korean adult population DongJun KIM1*, JaeWon HONG1, JungHyun NOH1, JongChol WON2, KyungSoo KO2. 1Inje University Ilsanpaik Hospital Department of Internal Medicine, 2Inje University Ilsanpaik Hospital Department of Internal Medicine, Cariovascular and Metabolic Disease Center, Korea Few studies have investigated the clinical effect of subclinical inflammation on the use of the hemoglobin A1c (HbA1c) as a screening parameter for diabetes or prediabetes. We investigated the association between serum white blood cell counts (WBC) within normal ranges as a marker of subclinical inflammation and HbA1c levels in a Korean adult population. Among 11,472 adults (>/=19 years old) who participated in the 2011–2012 Korea National Health and Nutrition Examination Survey, participants with anti-diabetes/anti-hypertensive/ anti-lipid drugs, or history of previous cancer, or the presence of chronic kidney disease, or positivity of HBsAg, or abnormal WBC (<4000 micro/L or >10000 micro/L) were excluded. Finally in 7116 participants, we investigated the association between quartile (Q) of WBC and HbA1c. After adjusting for age, sex, fasting plasma glucose (FPG), the presence of college graduation, smoking history, the presence of hypertension, serum total cholesterol, serum triglyceride, and the presence of anemia, the level of HbA1c increased with increase of WBC (HbA1c, mean+/−SEM, 5.55+/−0.01% in Q1, 5.58+/−0.01% in Q2, 5.60+/−0.01% in Q3, and 5.65+/−0.01 in Q4, p < 0.001). After adjusting for above mentioned covariates, the proportions (%)
of an HbA1c level of >/=5.7%, and >/=6.5% were also higher in participants with the increase of WBC ( proportion of >/=5.7%, 30.9+/−1.0% in Q1, 34.1+/−1.0% in Q2, 36.6+/−1.0% in Q3, and 39.3+/−1.0% in Q4, p < 0.001; proportion of >/=6.5%, 3.1+/−0.4% in Q1, 2.9+/−0.4% in Q2, 4.1+/−0.4% in Q3, and 4.1+/−0.4% in Q4, p = 0.022). In logistic regression analyses with above mentioned variables as covariates, the proportions of an HbA1c level of >/=5.7%, and >/=6.5% increased with increase of WBC (odds ratio [95% CI] for HbA1c level of >/=5.7%, 1.20 [1.02–1.42], p = 0.028 in Q2, 1.37 [1.16–1.62], p < 0.001 in Q3, and 1.59 [1.35– 1.89], p < 0.001 in Q4; for HbA1c level of >/=6.5%, 0.85 [0.45–1.63], p = 0.632 in Q2, 1.79 [1.01–3.18], p = 0.048 in Q3, and 2.03 [1.13– 3.64], p = 0.018 in Q4). Our study showed that serum WBC count within normal ranges, marker of subclinical inflammation, are associated with the increase of HbA1c after adjusting for several covariates including FPG. The data suggested that the subclinical inflammation need to be considered before using HbA1c as a screening test for prediabetes or diabetes. PA-05 Incidental risk for diabetes according to the change level of body mass index in Korean men Mi Hae SEO1, Sung Keun PARK2, Jae-Hong JAE-HONG3 *, Chang-Mo OH4. 1Department of Internal Medicine, Gumi Hospital, Soon Chun Hyang University, School of Medicine, 21Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University, School of medicine, 3Departments of Preventive Medicine, School of Medicine, Kyung Hee University, 4The Korea Central Cancer Registry, National Cancer Center, Korea Objective: Although accumulated evidence implies that change of body mass index (BMI) have deep relation with diabetes, there is little information about longitudinal relationship between the BMI change and diabetes in Asian. Therefore, this study was conducted to evaluate the incidental risk of diabetes according to the change of body mass index Research design and methods: Cohort of 31,138 middle aged nondiabetic Korean men was followed-up annually or biennially from 2005 to 2010. On the basis of BMI in 2005, study participants were categorized into 5 groups according to their change levels of BMI for follow-up period from the lowest quintile to the highest quintile (1stquintile – 5thquintile). The incidence and adjusted hazard ratios (HRs) for diabetes were evaluated in 5 quintiles. Results: During 120,785.3 person-years of follow-up, 1,687 (5.3%) incident cases of diabetes developed between 2006 and 2010 (quintile 1: 6.6%, quintile 2: 4.3%, quintile 3: 4.0%, quintile 4: 5.0%, quintile5: 7.2%). When quintile 3 was set as a reference, in adjusted model, the adjusted hazard ratios for diabetes showed the J-shaped relationship with the levels of BMI change [quintile 1: 1.52 (1.27–1.82), quintile 2: 0.85 (0.70–1.04), quintile 3: 1 (reference), quintile 4: 1.27 (1.05–1.53), quintile 5: 2.85 (2.39–3.40), respectively]. Conclusions: In this study, J-shaped relationship pattern was demonstrated between risk for diabetes and the change levels of BMI. This finding indicates that the risk of diabetes can paradoxically increase not only by decreased BMI and but also by increased BMI in Korean men. PA-06 Elevated circulating plasma miRNA27b-3p in type 2 diabetes and reduced miRNA3195 in diabetic nephropathy Rui HAN1, Xu LIU3, Dian-ping SONG1, Xiaochen LIU2, Wei YANG1, Hsiang-fu KONG3 *, Marie Chia-mi LIN3. 1 Department of Endocrinology, The first Affiliated hospital of Kunming medical University, Yunnan, China; 2Department of Epidemiology, School of Public Health, Brown University, USA; 3HF Kung Academician Workstation, Kunming Medical University, Chunrong Road, Yunnan, 4School of Biomedical Sciences, The Chinese University of Hong Kong, China
Poster Presentations / Diabetes Research and Clinical Practice 120S1 (2016) S65–S211
regulation of glucose and fatty oxidative metabolism in animal models. The effects of GDF15 on metabolism have similarities with the muscle fiber-derived or cytokines or peptides called as “mytokine”. However, the study whether exercise have effects on the plasma level of GDF15 has not been reported. Therefore, we examined the change of GDF15 level with metabolic parameters, including glucose and various kinds of cholesterol after regular exercise. Methods: We enrolled the 20 subjects to be able to do aerobic and strength exercise at least 3 times a week during 12 weeks. All subjects had baseline records, including age, body mass index (BMI), waist to hip ratio, body fat percentage. Blood samples were collected the fasting, 2 and 4 hour after taking the high calorie mixed meal at the starting and ending time of study. Results: Two people excluded the study because of anemia and laboratory errors. Total 18 subjects were enrolled and women with average age of 37 ± 10 years. 4 subjects were glucose intolerance (22.2%). 7 subjects had dyslipidemia (38.9%). Body weight, BMI, waist to hip ratio, and body fat percentage had no difference. Metabolic parameters in fasting state, including glucose, insulin, cholesterol, HOMA-IR, and HOMA-β had no difference. We investigated the differentials between fasting and 2 hr postprandial glucose level (2 hr postprandial glucose – fasting glucose, ΔGlu 2-0) and between fasting and 2 hr postprandial GDF15 level (2 hr postprandial GDF15 – fasting GDF15, ΔGDF 2-0) in subgroup according to glucose intolerance. ΔGlu 2-0 showed significantly higher variation in Subjects with glucose intolerance than in subjects with normal glucose tolerance at time before exercises. However, two groups showed no difference in ΔGlu 2-0 at time after exercise. ΔGDF 2-0 in subjects with normal glucose tolerance showed positive values at all of times before and after exercise. However, in subjects with glucose intolerance showed negative ΔGDF 2-0 at times before exercise, but positive ΔGDF 2-0 at times before exercise. Conclusion: Our data suggested that exercise in subjects with glucose intolerance could result in recovery of GDF15 response at postprandial times with improvement of postprandial glucose level. PA-04 Association between serum white blood cell counts and hemoglobin A1c in a Korean adult population DongJun KIM1*, JaeWon HONG1, JungHyun NOH1, JongChol WON2, KyungSoo KO2. 1Inje University Ilsanpaik Hospital Department of Internal Medicine, 2Inje University Ilsanpaik Hospital Department of Internal Medicine, Cariovascular and Metabolic Disease Center, Korea Few studies have investigated the clinical effect of subclinical inflammation on the use of the hemoglobin A1c (HbA1c) as a screening parameter for diabetes or prediabetes. We investigated the association between serum white blood cell counts (WBC) within normal ranges as a marker of subclinical inflammation and HbA1c levels in a Korean adult population. Among 11,472 adults (>/=19 years old) who participated in the 2011–2012 Korea National Health and Nutrition Examination Survey, participants with anti-diabetes/anti-hypertensive/ anti-lipid drugs, or history of previous cancer, or the presence of chronic kidney disease, or positivity of HBsAg, or abnormal WBC (<4000 micro/L or >10000 micro/L) were excluded. Finally in 7116 participants, we investigated the association between quartile (Q) of WBC and HbA1c. After adjusting for age, sex, fasting plasma glucose (FPG), the presence of college graduation, smoking history, the presence of hypertension, serum total cholesterol, serum triglyceride, and the presence of anemia, the level of HbA1c increased with increase of WBC (HbA1c, mean+/−SEM, 5.55+/−0.01% in Q1, 5.58+/−0.01% in Q2, 5.60+/−0.01% in Q3, and 5.65+/−0.01 in Q4, p < 0.001). After adjusting for above mentioned covariates, the proportions (%)
of an HbA1c level of >/=5.7%, and >/=6.5% were also higher in participants with the increase of WBC ( proportion of >/=5.7%, 30.9+/−1.0% in Q1, 34.1+/−1.0% in Q2, 36.6+/−1.0% in Q3, and 39.3+/−1.0% in Q4, p < 0.001; proportion of >/=6.5%, 3.1+/−0.4% in Q1, 2.9+/−0.4% in Q2, 4.1+/−0.4% in Q3, and 4.1+/−0.4% in Q4, p = 0.022). In logistic regression analyses with above mentioned variables as covariates, the proportions of an HbA1c level of >/=5.7%, and >/=6.5% increased with increase of WBC (odds ratio [95% CI] for HbA1c level of >/=5.7%, 1.20 [1.02–1.42], p = 0.028 in Q2, 1.37 [1.16–1.62], p < 0.001 in Q3, and 1.59 [1.35– 1.89], p < 0.001 in Q4; for HbA1c level of >/=6.5%, 0.85 [0.45–1.63], p = 0.632 in Q2, 1.79 [1.01–3.18], p = 0.048 in Q3, and 2.03 [1.13– 3.64], p = 0.018 in Q4). Our study showed that serum WBC count within normal ranges, marker of subclinical inflammation, are associated with the increase of HbA1c after adjusting for several covariates including FPG. The data suggested that the subclinical inflammation need to be considered before using HbA1c as a screening test for prediabetes or diabetes. PA-05 Incidental risk for diabetes according to the change level of body mass index in Korean men Mi Hae SEO1, Sung Keun PARK2, Jae-Hong JAE-HONG3 *, Chang-Mo OH4. 1Department of Internal Medicine, Gumi Hospital, Soon Chun Hyang University, School of Medicine, 21Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University, School of medicine, 3Departments of Preventive Medicine, School of Medicine, Kyung Hee University, 4The Korea Central Cancer Registry, National Cancer Center, Korea Objective: Although accumulated evidence implies that change of body mass index (BMI) have deep relation with diabetes, there is little information about longitudinal relationship between the BMI change and diabetes in Asian. Therefore, this study was conducted to evaluate the incidental risk of diabetes according to the change of body mass index Research design and methods: Cohort of 31,138 middle aged nondiabetic Korean men was followed-up annually or biennially from 2005 to 2010. On the basis of BMI in 2005, study participants were categorized into 5 groups according to their change levels of BMI for follow-up period from the lowest quintile to the highest quintile (1stquintile – 5thquintile). The incidence and adjusted hazard ratios (HRs) for diabetes were evaluated in 5 quintiles. Results: During 120,785.3 person-years of follow-up, 1,687 (5.3%) incident cases of diabetes developed between 2006 and 2010 (quintile 1: 6.6%, quintile 2: 4.3%, quintile 3: 4.0%, quintile 4: 5.0%, quintile5: 7.2%). When quintile 3 was set as a reference, in adjusted model, the adjusted hazard ratios for diabetes showed the J-shaped relationship with the levels of BMI change [quintile 1: 1.52 (1.27–1.82), quintile 2: 0.85 (0.70–1.04), quintile 3: 1 (reference), quintile 4: 1.27 (1.05–1.53), quintile 5: 2.85 (2.39–3.40), respectively]. Conclusions: In this study, J-shaped relationship pattern was demonstrated between risk for diabetes and the change levels of BMI. This finding indicates that the risk of diabetes can paradoxically increase not only by decreased BMI and but also by increased BMI in Korean men. PA-06 Elevated circulating plasma miRNA27b-3p in type 2 diabetes and reduced miRNA3195 in diabetic nephropathy Rui HAN1, Xu LIU3, Dian-ping SONG1, Xiaochen LIU2, Wei YANG1, Hsiang-fu KONG3 *, Marie Chia-mi LIN3. 1 Department of Endocrinology, The first Affiliated hospital of Kunming medical University, Yunnan, China; 2Department of Epidemiology, School of Public Health, Brown University, USA; 3HF Kung Academician Workstation, Kunming Medical University, Chunrong Road, Yunnan, 4School of Biomedical Sciences, The Chinese University of Hong Kong, China