- Email: [email protected]
Correlations between resting metabolic rate and anthropometric parameters in newly diagnosed type 2 diabetic patients
e190
Abstracts / Atherosclerosis 235 (2014) e84–e191
Both groups were comparable, except for higher A1c levels in the LSG group.
Remission (%) LRYGB
LSG
p
Time to reach metabolic objectives (months)* LRYGB LSG p
Classical criteria
91,2
95,2
0,504
4,64,5
6,15,8
0,307
ADA partial remission
85,3
81,0
0,473
3,82,4
3,92,4
0,883
ADA complete remission
61,8
52,4
0,493
4,7 2,7
8,43,9
0,005
ADA complete without time
50,0
33,3
0,176
5,1 2,9
9,03,8
0,014
Conclusion: T2DM remission rate varies widely depending on the criteria used for its definition. Remission occurred sooner after LRYGB when the strictest criteria to define remission were used. 37 - Diabetes, insulin sensitivity and resistance EAS-0872. THE LONG TERM EFFICACY OF INSULIN TREATMENT IN TYPE 2 DIABETIC PATIENTS, 36-MONTHS OBSERVATION PERIOD E. Farcasiu Diabetes, NIDNMD "Prof. N. Paulescu", Bucharest, Romania Objectives: The achievement of the target HbA1c in patients with type 2 diabetes mellitus reduces the risk of the related complications. As glycemic control progressively worsens, the introduction of insulin is required. We analyzed the efficacy of insulin treatment regimen in T2DM patients for a 36-months observation period. Methods: 46 patients that were considered for insulin (in routine ambulatory practice) were observed and included in the analysis. After failing on oral therapy, 19 patients were intensified on basal analogue on top of their existing oral agents, representing group A. 27 patients in group B initiated insulin with two premix analogue. HbA1c, daily insulin dose, and body mass index (BMI) were recorded and compared at the initiation of insulin and at 36 months for each patients group (no randomization, but clinical decision). Statistical analysis was performed using non parametrical tests. Results: Insulin regimen was selected based on age, diabetes duration, HbA1c level, comorbidities, CV risk (SCORE test). In group A, at baseline mean values were: age 55, HbA1c 8,6 1,1 %, BMI 29,6 4,1kg/m2. Mean reduction of HbA1c was -0,5% at 36 months. BMI increased to 30,97 3,8 kg/m2.The daily insulin dose required increase from 16,74 to 27,05 ui. In group B, at baseline, the mean age was 52,14 years, HbA1c 10,2 2,2 % and BMI 27,60 5,1 kg/m2. Reduction in HbA1c was -2% while BMI increased to 29,225,7. Daily insulin dose was increased to 53,70 13,6 vs 35,7 11,0. ui.From the 46 patients, 3 cases (2 in group A and 1 in group B) presented CV events that required hospitalization during the observation period. Conclusion: In daily practice the introduction of insulin regimen facilitates the glucose control in T2DM patients but weight gain is a key drawback. With the new agents that have possibility to reduce weight when added to insulin the long term prognosis is expected to increase. 37 - Diabetes, insulin sensitivity and resistance EAS-0827. INSULIN RESISTANCE, HYPERINSULINEMIA, HYPERALDOSTERONISM AND ENDOTHELIAL DYSFUNCTION IN YOUNG HEALTHY MEN – BYSTANDERS OR TEAM PLAYERS? A. Janusa, A. Doroszkoa, E. Szahidewicz-Krupskaa, M. Jakubowskia, G. Mazurb, A. Derkacza
a
Wrovasc - Integrated Cardiovascular Centre Provintional Specialized Hospital Wroclaw Poland, Department of Internal Occupational Medicine and Hypertension Wroclaw Medical University Wroclaw Poland, Wroclaw, Poland; b Department of Internal Occupational Medicine and Hypertension, Wroclaw Medical University Wroclaw Poland, Wroclaw, Poland Objectives: Insulin resistance and hyperinsulinemia are pathological disorders associated with obesity, hypertension, policystic ovary syndrome or diabetes mellitus. Those endocrinological impairments are closely related to metabolic syndrome, which correlate with endothelial dysfunction and increased cardiovascular risk. Numerous studies show that insulin resistance, hyperinsulinemia and endothelial dysfunction precede cardiovacular diseases. Nonetheless, there are no studies regarding clinical consequences of insulin resistance, hyperinsulinemia, hyperaldosteronism and endothelial dysfunction in young and healthy individuals. We analyzed if there is a cross-talk between glucose metabolism disorders and endothelial impairment. Methods: Group of 80 men aged 18-40 were enrolled to the study. HOMA –IR, HOMA b, NO pathway metabolites (ADMA, L-arginine and SDMA), cardiovascular risk markers, oxidative stress markers (malonylodialdehyde MDA, thiol index), prostanoids, plasma renin activity in vertical position, aldosterone levels and the aldosteron/renin ratio were measured. Flow mediated vasodilation as a endothelial function marker and pulse wave velocity as a arterial stiffness marker were studied. Results: Hyperinsulinemia, Insulin level and insulin resistance correlated with aldosterone level and ARO. Insulin resistant state correlated with diminished FMD. Conclusion: : Greater aldosterone and ARO level (reflecting activation of RAAS) are features of insulin resistent subjects. Futher insulin resistant young men follow up to confirm the clinical significance of the phenomenon of insulin resistance and hyperaldosteronism in population without cardiovascular disorders is needed. Early findings of hyperinsulinemia, insulin resistance, hyperaldosteronism and endothelial dysfunction, easy to evaluate, may help in prevention of vascular events in population. 37 - Diabetes, insulin sensitivity and resistance EAS-0556. CORRELATIONS BETWEEN RESTING METABOLIC RATE AND ANTHROPOMETRIC PARAMETERS IN NEWLY DIAGNOSED TYPE 2 DIABETIC PATIENTS M. Mitua, L. Petcua, J. Tudosoiua, A. Mihaib, S. Carniciua, P. Gagniuca, D. Lixandruc, C. Ionescu-Tirgovistea Research, NIDNMD "Prof. N. Paulescu", Bucharest, Romania; b Diabetes Nutrition and Metabolic Disease, UMF "Carol Davila", Bucharest, Romania; c Biochemistry, UMF "Carol Davila", Bucharest, Romania a
Objectives: Resting metabolic rate (RMR) is an important parameter in the assessment of nutritional status in humans. Information on resting energy expenditure is necessary to calculate energy needs in the initial treatment for a newly diagnosed type 2 diabetic patient (ND-T2D). The aim of our study was to correlate values for RMR with some anthropometric parameters in ND-T2D. Methods: 110 (58 men, 52 women) ND-T2D were evaluated for: RMR by indirect calorimetry (continuous VO2, VCO2, COSMED; Rome, Italy), weight, height, body mass index (BMI), visceral fat index, waist (WC) and hip circumference (HC). Fasting plasma glucose (FPG), HbA1c and insulin were measured as well. Body fat percentage, trunk fat content and visceral fat rating (VFR) were measured using bioelectrical impedance analysis (TANITA BC-418). We calculated: waist to hip ratio (WHR) and HOMA-IR index (Homeostasis Model Asessment for Insulin Resistance): [fasting plasma glucose (mmol/l) x fasting insulin (mU/ml)]:22.5. Results: Measured RMR was statistically significant higher in males compared with females (159337.41 Kcal/day vs 120523.73 Kcal/day; p<0.001), but differences between measured and predicted RMR values were statistically significant higher in females (p<0.001) and did not differ
Abstracts / Atherosclerosis 235 (2014) e84–e191
in males. These values decreased slightly with age both men and women. The relationship with weight and age were stronger than that with lean mass. The RMR was also correlated with glycemia (p<0.05), HOMA-IR (p<0.05) and various anthropometric indicators, of which the strongest was WC (p<0.001). Conclusion: Our results suggest lower values of RMR at higher ages, as apparent from age effect. Understanding the importance of measured vs predicted values could give us a useful tool for a ND-T2D being useful early in monitoring diabetes and its complications. Acknowledgements: This work was supported by a grant of the Romanian National Authority for Scientific Research, CNCS-UEFISCDI, project number PN-II-ID-PCE-2011-3-0429. 37 - Diabetes, insulin sensitivity and resistance EAS-0651. THE EFFECT OF HYPERTRIGLYCERIDEMIA ON CARBONYL AND OXIDATIVE STRESS IN AN EXPERIMENTAL MODEL OF INSULIN RESISTANCE H. Malinska, O. Oliyarnyk, L. Kazdova Center for Experimental Medicine, Institute for Clinical and Experimental Medicine, Prague 4, Czech Republic Objectives: Reactive dicarbonyls seems to be a common product of both carbonyl and oxidative stress and their biogenesis is related to glycemic and lipid status in diabetes. Excessive generation of dicarbonyls leads to production of advanced glycation end products (AGE), activates inflammatory pathway, increases oxidative stress and can play a key role in the development of diabetic vascular complications. Dicarbonyls determination could be early biomarker risk for these complications. The effect of dyslipidemia on dicarbonyl stress is not fully clarified. In our study we analyzed level of individual reactive dicarbonyls – methylglyoxal (MG), glyoxal (GL) and 3-deoxyglucosone (3-DG) in relation to parameters of oxidative stress and lipid disorders in non-obese rats with hereditary hypertriglyceridemia (HHTg rats).
e191
Objectives: Antioxidant and hepatoprotective effect of oral supplementation of silymarin is well established, but its low absorbtion from the gastrointestinal tract and rapid excretion limite its bioavailability. Using micronized extracts and phytosomes formulation might be beneficial for increase of its metabolic activity. We investigated the effects of these compounds on metabolic disorders associated with metabolic syndrome in nonobese model of insulin resistance, hereditary hypertriglyceridemic rats (HHTg). Methods: Adult male HHTg rats were fed ad libitum with standard laboratory diet without supplementation (control group) or supplement with non-complexed silymarin extract (1%)-SE; or with micronized extract- ME (1%) or with phytosomes containing silymarin extract- PhE (1.5%, Siliphos, Indena, Italy). After tree weeks lipid, insulin sensitivity and antioxidant parameters in tissues were analyzed. Activities of antioxidant enzymes were measured using kits from Cayman Chemicals, USA. Results: Supplementation with silymarin and its complexed forms decreased serum triacylglycerols (SE- 48%, ME-61%, PhE-61%), insulin and increased HDL (SE-47%, ME-82%, PhE-43%). Silymarin protected against ectopic lipid accumulation determined as triacylglycerols concentration in myocardium (SE-33%, ME-50%, PhE-50%), aorta (ME-36%, PhE-36%), m.soleus (PhE-22%) and increased muscle insulin sensitivity (SE-39% , ME-66%. PhE-90%). Treatment with silymarin extracts activated antioxidant enzymes in liver: superoxide dismutase (SE-40%, PhE-43%) and glutathione reductase (SE-24%, ME-20%, PhE-50%). Only ME increased catalase activity (134847 vs. 110442 mmol H2O2 min/mg protein, p<0.01) and GSH concentration (586 vs. 443 mM/mg protein, p<0.05) compared to controls. Activation of antioxidant system decreased concentration of lipoperoxidation products: conjugated dienes (SE-17%, PhE-19%) and TBARS (SE-23%, PhE-29%). Conclusion: Treatment with silymarin extracts improved serum dyslipidemia and hyperinsulinemia in HHTg rats. Moreover, using of complexed forms of silymarin increased efficiency of treatment and protected against ectopic lipid accumulation in aorta and musculus soleus and increased skeletal muscle insulin sensitivity. In addition, all used forms of silymarin have an antioxidant effect in liver. Supported grant P303/13-108135 of Czech Science Foundation 37 - Diabetes, insulin sensitivity and resistance
Methods: Adult Wistar rats (controls) and HHTg rats, which exhibit hypertriglyceridemia, tissue insulin resistance, impaired glucose tolerance, hyperinsulinemia and ectopic lipid accumulation, were fed a standard laboratory diet. The concentration of dicarbonyls were determined by derivatisation with 1,2-diamino-4,5-dimethoxy-benzene and HPLCmethod with fluorescence detection. Results: Compared with controls, HHTg rats exhibited markedly elevated serum levels of triacylglycerol (4.050.39 vs 1.880.23 mmol/l, p<0.001), FFA (0.970.19 vs 0.470.13 mmol/l, p<0.01) and significantly decreased serum level of reduced glutathione (p<0.05). In HHTg rats we observed markedly increased serum level of MG (p<0.01), but level of GL and 3-DG were not significantly different between HHTg and control rats. Serum level of MG negatively correlated with level of glutathione (r¼0.71, p<0.01) as a consequence of detoxification pathway of MG. Parameter of lipoperoxidation measured as TBARS levels (p<0.05) was increased in HHTg rats compared to controls. Conclusion: Results indicate that chronically elevated hypertriglyceridemia and FFA was associated with increased levels of methylglyoxal which negatively correlated with glutathione. Results supported hypothesis that lipids can be associated in the reactive dicarbonyl generation. 37 - Diabetes, insulin sensitivity and resistance EAS-0635. EFFECT OF MICRONIZED EXTRACT AND PHYTOSOMES CONTAINING EXTRACT FROM SILYBUM MARIANUM ON METABOLIC DISORDERS IN NONOBESE MODEL OF INSULIN RESISTANCE O. Oliyarnyka, H. Malinskaa, J. Trnovskaa, V. Skopa, R. Vecerab a Center for Experimental Medicine, Institute for Clinical and Experimental Medicine, Prague, Czech Republic; b Institute of Pharmacology, Palacky University, Olomouc, Czech Republic
EAS-0431. PREVALENCE AND MANAGEMENT OF TYPE II DIABETES IN CAUCASIAN AND ASIAN SUBPOPULATIONS WITH ACS J.R.J. Foley, P.A. Patel, C. Yau, Y. Zheng, Y. Blackburn, S. Bulugahapitiya Cardiology, Bradford Royal Infirmary, Bradford, United Kingdom Objectives: Diabetes Mellitus (DM) is a significant risk factor for acute coronary syndromes (ACS) and glycaemic control is critical in secondary prevention. Bradford has the highest density of South Asians per capita in the UK at 20.3%, predominantly originating from Pakistan. We sought to compare prevalence of DM and glycaemic control in Asians versus Caucasians presenting to Bradford Royal Infirmary (BRI) with ACS. Methods: Notes of consecutive patients attending a 6 week post-ACS clinic at Bradford Royal Infirmary between March 2012 and September 2013 were retrospectively reviewed for data on demographics and biochemical profiles. Results: 185 patients were included. The prevalence of DM was 19% higher in Asians (41%) than Caucasians (22%); 95% CI: 5-32%, p¼0.009. Patients predominantly had type II DM, with only 2 Caucasians having type I DM. Glycaemic control was sub-optimal in both ethnic sub-groups. 78% of Asians compared with 58% of Caucasians had a HbA1c > 48 mmol/mol, a difference of 20% (95% CI: 8-47%, p¼0.321). Mean HbA1c was 58mM in Asians and 53mM in Caucasians. Conclusion: This study corroborates with large epidemiological studies in demonstrating an increased prevalence of DM in Asians compared with Caucasians. Significantly, glycaemic control in both ethnic groups was poor, increasing the risk for further cardiac events. Consideration should be made for aggressive management and surveillance in such populations, as inpatients and at subsequent follow up.
Abstracts / Atherosclerosis 235 (2014) e84–e191
Both groups were comparable, except for higher A1c levels in the LSG group.
Remission (%) LRYGB
LSG
p
Time to reach metabolic objectives (months)* LRYGB LSG p
Classical criteria
91,2
95,2
0,504
4,64,5
6,15,8
0,307
ADA partial remission
85,3
81,0
0,473
3,82,4
3,92,4
0,883
ADA complete remission
61,8
52,4
0,493
4,7 2,7
8,43,9
0,005
ADA complete without time
50,0
33,3
0,176
5,1 2,9
9,03,8
0,014
Conclusion: T2DM remission rate varies widely depending on the criteria used for its definition. Remission occurred sooner after LRYGB when the strictest criteria to define remission were used. 37 - Diabetes, insulin sensitivity and resistance EAS-0872. THE LONG TERM EFFICACY OF INSULIN TREATMENT IN TYPE 2 DIABETIC PATIENTS, 36-MONTHS OBSERVATION PERIOD E. Farcasiu Diabetes, NIDNMD "Prof. N. Paulescu", Bucharest, Romania Objectives: The achievement of the target HbA1c in patients with type 2 diabetes mellitus reduces the risk of the related complications. As glycemic control progressively worsens, the introduction of insulin is required. We analyzed the efficacy of insulin treatment regimen in T2DM patients for a 36-months observation period. Methods: 46 patients that were considered for insulin (in routine ambulatory practice) were observed and included in the analysis. After failing on oral therapy, 19 patients were intensified on basal analogue on top of their existing oral agents, representing group A. 27 patients in group B initiated insulin with two premix analogue. HbA1c, daily insulin dose, and body mass index (BMI) were recorded and compared at the initiation of insulin and at 36 months for each patients group (no randomization, but clinical decision). Statistical analysis was performed using non parametrical tests. Results: Insulin regimen was selected based on age, diabetes duration, HbA1c level, comorbidities, CV risk (SCORE test). In group A, at baseline mean values were: age 55, HbA1c 8,6 1,1 %, BMI 29,6 4,1kg/m2. Mean reduction of HbA1c was -0,5% at 36 months. BMI increased to 30,97 3,8 kg/m2.The daily insulin dose required increase from 16,74 to 27,05 ui. In group B, at baseline, the mean age was 52,14 years, HbA1c 10,2 2,2 % and BMI 27,60 5,1 kg/m2. Reduction in HbA1c was -2% while BMI increased to 29,225,7. Daily insulin dose was increased to 53,70 13,6 vs 35,7 11,0. ui.From the 46 patients, 3 cases (2 in group A and 1 in group B) presented CV events that required hospitalization during the observation period. Conclusion: In daily practice the introduction of insulin regimen facilitates the glucose control in T2DM patients but weight gain is a key drawback. With the new agents that have possibility to reduce weight when added to insulin the long term prognosis is expected to increase. 37 - Diabetes, insulin sensitivity and resistance EAS-0827. INSULIN RESISTANCE, HYPERINSULINEMIA, HYPERALDOSTERONISM AND ENDOTHELIAL DYSFUNCTION IN YOUNG HEALTHY MEN – BYSTANDERS OR TEAM PLAYERS? A. Janusa, A. Doroszkoa, E. Szahidewicz-Krupskaa, M. Jakubowskia, G. Mazurb, A. Derkacza
a
Wrovasc - Integrated Cardiovascular Centre Provintional Specialized Hospital Wroclaw Poland, Department of Internal Occupational Medicine and Hypertension Wroclaw Medical University Wroclaw Poland, Wroclaw, Poland; b Department of Internal Occupational Medicine and Hypertension, Wroclaw Medical University Wroclaw Poland, Wroclaw, Poland Objectives: Insulin resistance and hyperinsulinemia are pathological disorders associated with obesity, hypertension, policystic ovary syndrome or diabetes mellitus. Those endocrinological impairments are closely related to metabolic syndrome, which correlate with endothelial dysfunction and increased cardiovascular risk. Numerous studies show that insulin resistance, hyperinsulinemia and endothelial dysfunction precede cardiovacular diseases. Nonetheless, there are no studies regarding clinical consequences of insulin resistance, hyperinsulinemia, hyperaldosteronism and endothelial dysfunction in young and healthy individuals. We analyzed if there is a cross-talk between glucose metabolism disorders and endothelial impairment. Methods: Group of 80 men aged 18-40 were enrolled to the study. HOMA –IR, HOMA b, NO pathway metabolites (ADMA, L-arginine and SDMA), cardiovascular risk markers, oxidative stress markers (malonylodialdehyde MDA, thiol index), prostanoids, plasma renin activity in vertical position, aldosterone levels and the aldosteron/renin ratio were measured. Flow mediated vasodilation as a endothelial function marker and pulse wave velocity as a arterial stiffness marker were studied. Results: Hyperinsulinemia, Insulin level and insulin resistance correlated with aldosterone level and ARO. Insulin resistant state correlated with diminished FMD. Conclusion: : Greater aldosterone and ARO level (reflecting activation of RAAS) are features of insulin resistent subjects. Futher insulin resistant young men follow up to confirm the clinical significance of the phenomenon of insulin resistance and hyperaldosteronism in population without cardiovascular disorders is needed. Early findings of hyperinsulinemia, insulin resistance, hyperaldosteronism and endothelial dysfunction, easy to evaluate, may help in prevention of vascular events in population. 37 - Diabetes, insulin sensitivity and resistance EAS-0556. CORRELATIONS BETWEEN RESTING METABOLIC RATE AND ANTHROPOMETRIC PARAMETERS IN NEWLY DIAGNOSED TYPE 2 DIABETIC PATIENTS M. Mitua, L. Petcua, J. Tudosoiua, A. Mihaib, S. Carniciua, P. Gagniuca, D. Lixandruc, C. Ionescu-Tirgovistea Research, NIDNMD "Prof. N. Paulescu", Bucharest, Romania; b Diabetes Nutrition and Metabolic Disease, UMF "Carol Davila", Bucharest, Romania; c Biochemistry, UMF "Carol Davila", Bucharest, Romania a
Objectives: Resting metabolic rate (RMR) is an important parameter in the assessment of nutritional status in humans. Information on resting energy expenditure is necessary to calculate energy needs in the initial treatment for a newly diagnosed type 2 diabetic patient (ND-T2D). The aim of our study was to correlate values for RMR with some anthropometric parameters in ND-T2D. Methods: 110 (58 men, 52 women) ND-T2D were evaluated for: RMR by indirect calorimetry (continuous VO2, VCO2, COSMED; Rome, Italy), weight, height, body mass index (BMI), visceral fat index, waist (WC) and hip circumference (HC). Fasting plasma glucose (FPG), HbA1c and insulin were measured as well. Body fat percentage, trunk fat content and visceral fat rating (VFR) were measured using bioelectrical impedance analysis (TANITA BC-418). We calculated: waist to hip ratio (WHR) and HOMA-IR index (Homeostasis Model Asessment for Insulin Resistance): [fasting plasma glucose (mmol/l) x fasting insulin (mU/ml)]:22.5. Results: Measured RMR was statistically significant higher in males compared with females (159337.41 Kcal/day vs 120523.73 Kcal/day; p<0.001), but differences between measured and predicted RMR values were statistically significant higher in females (p<0.001) and did not differ
Abstracts / Atherosclerosis 235 (2014) e84–e191
in males. These values decreased slightly with age both men and women. The relationship with weight and age were stronger than that with lean mass. The RMR was also correlated with glycemia (p<0.05), HOMA-IR (p<0.05) and various anthropometric indicators, of which the strongest was WC (p<0.001). Conclusion: Our results suggest lower values of RMR at higher ages, as apparent from age effect. Understanding the importance of measured vs predicted values could give us a useful tool for a ND-T2D being useful early in monitoring diabetes and its complications. Acknowledgements: This work was supported by a grant of the Romanian National Authority for Scientific Research, CNCS-UEFISCDI, project number PN-II-ID-PCE-2011-3-0429. 37 - Diabetes, insulin sensitivity and resistance EAS-0651. THE EFFECT OF HYPERTRIGLYCERIDEMIA ON CARBONYL AND OXIDATIVE STRESS IN AN EXPERIMENTAL MODEL OF INSULIN RESISTANCE H. Malinska, O. Oliyarnyk, L. Kazdova Center for Experimental Medicine, Institute for Clinical and Experimental Medicine, Prague 4, Czech Republic Objectives: Reactive dicarbonyls seems to be a common product of both carbonyl and oxidative stress and their biogenesis is related to glycemic and lipid status in diabetes. Excessive generation of dicarbonyls leads to production of advanced glycation end products (AGE), activates inflammatory pathway, increases oxidative stress and can play a key role in the development of diabetic vascular complications. Dicarbonyls determination could be early biomarker risk for these complications. The effect of dyslipidemia on dicarbonyl stress is not fully clarified. In our study we analyzed level of individual reactive dicarbonyls – methylglyoxal (MG), glyoxal (GL) and 3-deoxyglucosone (3-DG) in relation to parameters of oxidative stress and lipid disorders in non-obese rats with hereditary hypertriglyceridemia (HHTg rats).
e191
Objectives: Antioxidant and hepatoprotective effect of oral supplementation of silymarin is well established, but its low absorbtion from the gastrointestinal tract and rapid excretion limite its bioavailability. Using micronized extracts and phytosomes formulation might be beneficial for increase of its metabolic activity. We investigated the effects of these compounds on metabolic disorders associated with metabolic syndrome in nonobese model of insulin resistance, hereditary hypertriglyceridemic rats (HHTg). Methods: Adult male HHTg rats were fed ad libitum with standard laboratory diet without supplementation (control group) or supplement with non-complexed silymarin extract (1%)-SE; or with micronized extract- ME (1%) or with phytosomes containing silymarin extract- PhE (1.5%, Siliphos, Indena, Italy). After tree weeks lipid, insulin sensitivity and antioxidant parameters in tissues were analyzed. Activities of antioxidant enzymes were measured using kits from Cayman Chemicals, USA. Results: Supplementation with silymarin and its complexed forms decreased serum triacylglycerols (SE- 48%, ME-61%, PhE-61%), insulin and increased HDL (SE-47%, ME-82%, PhE-43%). Silymarin protected against ectopic lipid accumulation determined as triacylglycerols concentration in myocardium (SE-33%, ME-50%, PhE-50%), aorta (ME-36%, PhE-36%), m.soleus (PhE-22%) and increased muscle insulin sensitivity (SE-39% , ME-66%. PhE-90%). Treatment with silymarin extracts activated antioxidant enzymes in liver: superoxide dismutase (SE-40%, PhE-43%) and glutathione reductase (SE-24%, ME-20%, PhE-50%). Only ME increased catalase activity (134847 vs. 110442 mmol H2O2 min/mg protein, p<0.01) and GSH concentration (586 vs. 443 mM/mg protein, p<0.05) compared to controls. Activation of antioxidant system decreased concentration of lipoperoxidation products: conjugated dienes (SE-17%, PhE-19%) and TBARS (SE-23%, PhE-29%). Conclusion: Treatment with silymarin extracts improved serum dyslipidemia and hyperinsulinemia in HHTg rats. Moreover, using of complexed forms of silymarin increased efficiency of treatment and protected against ectopic lipid accumulation in aorta and musculus soleus and increased skeletal muscle insulin sensitivity. In addition, all used forms of silymarin have an antioxidant effect in liver. Supported grant P303/13-108135 of Czech Science Foundation 37 - Diabetes, insulin sensitivity and resistance
Methods: Adult Wistar rats (controls) and HHTg rats, which exhibit hypertriglyceridemia, tissue insulin resistance, impaired glucose tolerance, hyperinsulinemia and ectopic lipid accumulation, were fed a standard laboratory diet. The concentration of dicarbonyls were determined by derivatisation with 1,2-diamino-4,5-dimethoxy-benzene and HPLCmethod with fluorescence detection. Results: Compared with controls, HHTg rats exhibited markedly elevated serum levels of triacylglycerol (4.050.39 vs 1.880.23 mmol/l, p<0.001), FFA (0.970.19 vs 0.470.13 mmol/l, p<0.01) and significantly decreased serum level of reduced glutathione (p<0.05). In HHTg rats we observed markedly increased serum level of MG (p<0.01), but level of GL and 3-DG were not significantly different between HHTg and control rats. Serum level of MG negatively correlated with level of glutathione (r¼0.71, p<0.01) as a consequence of detoxification pathway of MG. Parameter of lipoperoxidation measured as TBARS levels (p<0.05) was increased in HHTg rats compared to controls. Conclusion: Results indicate that chronically elevated hypertriglyceridemia and FFA was associated with increased levels of methylglyoxal which negatively correlated with glutathione. Results supported hypothesis that lipids can be associated in the reactive dicarbonyl generation. 37 - Diabetes, insulin sensitivity and resistance EAS-0635. EFFECT OF MICRONIZED EXTRACT AND PHYTOSOMES CONTAINING EXTRACT FROM SILYBUM MARIANUM ON METABOLIC DISORDERS IN NONOBESE MODEL OF INSULIN RESISTANCE O. Oliyarnyka, H. Malinskaa, J. Trnovskaa, V. Skopa, R. Vecerab a Center for Experimental Medicine, Institute for Clinical and Experimental Medicine, Prague, Czech Republic; b Institute of Pharmacology, Palacky University, Olomouc, Czech Republic
EAS-0431. PREVALENCE AND MANAGEMENT OF TYPE II DIABETES IN CAUCASIAN AND ASIAN SUBPOPULATIONS WITH ACS J.R.J. Foley, P.A. Patel, C. Yau, Y. Zheng, Y. Blackburn, S. Bulugahapitiya Cardiology, Bradford Royal Infirmary, Bradford, United Kingdom Objectives: Diabetes Mellitus (DM) is a significant risk factor for acute coronary syndromes (ACS) and glycaemic control is critical in secondary prevention. Bradford has the highest density of South Asians per capita in the UK at 20.3%, predominantly originating from Pakistan. We sought to compare prevalence of DM and glycaemic control in Asians versus Caucasians presenting to Bradford Royal Infirmary (BRI) with ACS. Methods: Notes of consecutive patients attending a 6 week post-ACS clinic at Bradford Royal Infirmary between March 2012 and September 2013 were retrospectively reviewed for data on demographics and biochemical profiles. Results: 185 patients were included. The prevalence of DM was 19% higher in Asians (41%) than Caucasians (22%); 95% CI: 5-32%, p¼0.009. Patients predominantly had type II DM, with only 2 Caucasians having type I DM. Glycaemic control was sub-optimal in both ethnic sub-groups. 78% of Asians compared with 58% of Caucasians had a HbA1c > 48 mmol/mol, a difference of 20% (95% CI: 8-47%, p¼0.321). Mean HbA1c was 58mM in Asians and 53mM in Caucasians. Conclusion: This study corroborates with large epidemiological studies in demonstrating an increased prevalence of DM in Asians compared with Caucasians. Significantly, glycaemic control in both ethnic groups was poor, increasing the risk for further cardiac events. Consideration should be made for aggressive management and surveillance in such populations, as inpatients and at subsequent follow up.