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Low skeletal muscle mass is associated with increased mortality in postmenopausal women with type 2 diabetes mellitus
Poster Presentations / Diabetes Research and Clinical Practice 120S1 (2016) S65–S211
syndrome. Furthermore, 23% of the females had polycystic ovarian syndrome. Conclusion: In our cohort, type 2 diabetes is more common in girls. Most of our patients are picked up by screening. Family history of type 2 diabetes is very common. And a significant portion of our patients already has comorbidities at diagnosis. There are limitations in our retrospective cohort study. A diabetes registry is the way forward to better understand the characteristics of type 2 diabetes in children and adolescents. Hence, a one-stop clinic for cardiometabolic health can be planned for our next generations. PB-22 Association of glucokinase regulator genetic variant and metabolic syndrome in Taiwanese adolescents Hsiao-Wen CHANG1, Chang-Hsun HSIEH2*. 1Department of Internal Medicine, Kaohsiung Armed Forces General Hospital, Kaohsiung, 2Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taiwan Background: Variants of the glucokinase regulator (GCKR) gene are associated with components of the metabolic syndrome (MetS). This study explores the association between a common variant of this gene and metabolic syndrome (MetS) and its related traits in a population of Taiwanese adolescents. Methods: The prevalence of MetS and its components were compared between individuals (962 adolescents; 468 boys, 497 girls) with different genotypes or alleles of the GCKR rs780094 single-nucleotide polymorphism (SNP). Logistic regression analysis was performed to explore the independent roles of MetS and metabolic traits. Results: Subjects with the T-allele had a higher prevalence of low HDL-C and MetS than did those with the C-allele (p = 0.009 and 0.044, respectively). Subjects with T-carrying genotypes had a higher prevalence of low HDL-C (p = 0.028) but a similar prevalence of MetS as compared to those with non–T-carrying genotypes. After adjusting for confounding factors, the odds ratio (OR) for low HDL-C in subjects with T-carrying genotypes was 1.64 (95% confidence interval [CI]: 1.07–2.53). Similarly, the OR for MetS prevalence in subjects with T-carrying genotypes was 2.79 (95% CI: 1.09–7.11). Conclusions: The GCKR rs780094 polymorphism is associated with low HDL-C levels and MetS in a Taiwanese adolescent population. PB-23 Potent anti-obesity effect of acetate; acetate may alter the expression of genes involved in beige adipogenesis in obese KK-Ay mice Hiroyuki MOTOSHIMA1 *, Satoko HANATANI2, Yuki TAKAKI2, Shuji KAWASAKI2, Motoyuki IGATA2, Takafumi SENOKUCHI2, Norio ISHII2, Junji KAWASHIMA2, Daisuke KUKIDOME2, Tatsuya KONDO2, Takeshi MATSUMURA2, Eiichi ARAKI2. 1 Department of Molecular Diabetology, Faculty of Life Sciences, Kumamoto University, 2Department of Metabolic Medicine, Faculty of Life Sciences, Kumamoto University, Japan Potent anti-obesity effect of acetate; acetate may alter the expression of genes involved in beige adipogenesis in obese KK-Ay mice. Recently, overweight and obesity rates have been increasing in Asian countries and Asians tend to have higher amounts of abdominal fat at lower body mass indexes. Carrying higher amounts of abdominal fat is associated with increasing risks of a number of health problems including insulin resistance, hypertension, dyslipidemia, impaired glucose tolerance, type 2 diabetes mellitus as well as cardiovascular diseases. Notably, recent animal experiments revealed that induction of “browning of white adipose tissue (WAT)” or “thermogenic beige adipogenesis in visceral WAT” appears as a powerful strategy to combat obesity and obesity-associated complications including insulin resistance and diabetes.
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Among short-chain fatty acids (SCFAs), acetate is the most abundant end product generated by colonic fermentation of undigested carbohydrates, and it is detected in the systemic circulation. Oral administration of acetate has been reported to suppress weight gain and postprandial plasma glucose levels in rodents and human. Although several molecular mechanisms including activation of AMP-activated protein kinase (AMPK) as beneficial effects of acetate are proposed, its potential effects on the beige adipogenesis in visceral WAT has not been investigated. In the present study, we examined the effects of acetate administration in KK-Ay mice, and show that acetate reduced food efficiency ratio, increased whole-body oxygen consumption rate, and improved glucose tolerance of KK-Ay mice. In both epididymal WAT from acetate-treated mice and differentiating 3T3-L1 preadipocytes incubated with acetate, the elevated mRNA expression of PRDM16, PGC1α and PPARα (all of which involve in the differentiation into beige adipocytes) and of beige-adipocyte selective markers TMEM26 and CD137 were observed. In differentiating 3T3-L1 preadipocytes, treatment with acetate did not increase phosphorylation of either AMPK or acetyl-CoA carboxylase, and an inhibitor of AMPK failed to inhibit acetate-induced elevations in gene expression mentioned above. In conclusion, these observations suggest that acetate may alter the gene expression involved in thermogenic beige adipogensesis in an AMPK-independent manner in obese diabetic KK-Ay mice and may provide a potential therapeutic strategy to fight obesity. PB-24 Low skeletal muscle mass is associated with increased mortality in postmenopausal women with type 2 diabetes mellitus Hitomi MIYAKE1, Ippei KANAZAWA1 *, Toshitsugu SUGIMOTO1. 1 Internal Medicine 1 Ahimane University Faculty of Medicine, Japan Background: Diabetes mellitus is known to be associated with deteriorated quality of life as well as increased mortality. Previous studies have shown that low skeletal muscle mass is associated with all-cause mortality in elderly population. Although patients with type 2 diabetes are reported to have lower muscle mass of limbs than healthy people, little is known about the association between muscle mass reduction and mortality in type 2 diabetes. In this study, we thus examined the association between skeletal muscle mass index (SMI) and all-cause mortality in postmenopausal women with type 2 diabetes mellitus. Methods: This is a historical cohort study with the end-point of all-cause mortality in postmenopausal women with type 2 diabetes. We recruited 141 postmenopausal women with type 2 diabetes whose appendicular skeletal muscle mass (ASM) were previously evaluated by dual-energy X-ray absorptiometry at Shimane University Hospital. Asian Working Group for Sarcopenia suggested that SMI is calculated by the following formula; ASM/height2, and its reference value in Asian women is 5.4 kg/m2. The participants were observed up to 7 years from the start of this study, and the association between SMI at baseline and mortality rate was examined. The association between all-cause mortality and SMI was explored using the Kaplan-Meier method, the logrank test, and Cox regression analysis. Results: At the entry of this study, mean age and duration of diabetes were 66.1 and 11.6 years, respectively. Of 141 postmenopausal women, 17 died during the follow-up period (average time: 6.2 years). Dead patients were significantly older and had longer duration of diabetes compared to survivors (74.9 ± 7.1 v.s 64.9 ± 9.6 years old, and 18.2 ± 12.1 v.s 10.6 ± 9.6 years, respectively). SMI was significantly lower in dead patients than in survivors (5.93 ± 0.94 kg/m2 v.s 6.46 ± 0.85 kg/ m2, p = 0.019). Unadjusted survival analyses indicated that
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Poster Presentations / Diabetes Research and Clinical Practice 120S1 (2016) S65–S211
patients with SMI < 5.4 kg/m2 had higher mortality rate than those with SMI >=5.4 kg/m2 ( p = 0.014). Moreover, in the Cox regression analysis adjusted for age, duration of diabetes, HbA1c, and serum creatinine, SMI was significantly and inversely associated with the mortality (hazard ratio = 6.39, 95% confidence interval = 1.42–28.68, p = 0.016). Conclusion: The present study showed that lower SMI was associated with the increased all-cause mortality in postmenopausal women with type 2 diabetes mellitus, suggesting that muscle mass reduction is an important complication which is involved in the risk of mortality in type 2 diabetes. PB-25 The influence of diabetes on eradication rate of Helicobacter pylori Yurika IKEGAMI1, Akahito SAKO2 *, Hiroyuki ADACHI2, Tomoyuki YADA1, Hitohiko KOIZUKA1, Naomi UEMURA1, Hidekatsu YANAI2. 1Department of Gastroenterology & Hepatology, Kohnodai Hospital, National Center for Global Health and Medicine, 2 Department of Internal Medicine, Kohnodai Hospital, National Center for Global Health and Medicine, Japan Introduction: The prevalence of Helicobacter pylori (HP) infection is high in Asia. Although eradication therapy of HP has been strongly recommended to prevent gastric cancer and peptic ulcer, several studies reported the lower success rate of eradication in diabetic patients. We aimed to elucidate the influence of diabetes and glycemic control on eradication rate of HP. Method: We retrospectively investigated the patients who underwent first line HP eradication therapy (Proton Pump Inhibitor, Clarithromycin, Amoxicillin) from January 2011 to December 2013. We excluded the patients who did not complete the eradication therapy and the assessment test of HP infection. We collected information about patient characteristics, smoking history, laboratory data, endoscopic findings, regimen of HP eradication, status of diabetes, and anti-diabetic drugs. We compared eradication success group and failure group by t-test and chi-square test, and used logistic regression model to analyze the factors associated with eradication of HP. Study protocol was approved by institutional review board. Result: Of the 546 patients who underwent first line HP eradication from 2011 to 2013, 415 patients were eligible. Mean age was 64.2 years old and 192 patients were male. Sixtythree patients had diabetes and mean HbA1c was 6.9%. Eradication rate in total was 75.7%. Age, sex, smoking status, dose of clarithromycin, type of proton pump inhibitor, and atrophy of gastric mucosa were not significantly associated with eradication rate. Diabetic patients had significantly higher eradication rate than non-diabetic patients (85.7% vs 73.9%). In diabetic patients, mean HbA1c before eradication therapy was not significantly different between eradication success group and failure group. HbA1c and body mass index before and after eradication were similar. Multivariate analysis showed that adjusted odds ratio of successful eradication in diabetic patients was 2.00 (95% confidence interval: 0.86–4.31, p = 0.11). Conclusion: Contrary to previous small scale studies, eradication rate was relatively better in diabetic patients. We need the prospective, larger scale study to clarify the relationship between diabetes and eradication of HP. PB-26 The glycemic control of adult population in Nauru Chang-Hsun HSIEH1*, Samuela KOROVO2, Silina MOTUFAGA3, Chun-Jui HUANG4,5, Yi-Jen HUNG1. 1Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; 2 Naoero Public Health Centre, 3Republic of Nauru Hospital, Republic of Nauru, Fiji; 4Division of Endocrinology and Metabolism,
Department of Medicine, Taipei Veterans General Hospital, 5Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan Background: Nauru is one of the countries with high prevalence of diabetes mellitus (DM). However, diabetic control among overall and newly diagnosed DM adult population had not evaluated in the past. Methods: This is a retrospective observational cohort study. All of the data come from the Nauru Diabetes Registry database from Naeoru Public Health Center from 2011 to 2015. All patients with their hemoglobin A1C (HbA1C) will be analyzed and compared between year of 2011–2012 and 2014–2015. Results: A total of 614 patients were enrolled for analysis with mean age of 49.8 year-old and mean diabetic duration of 10.1 years. The mean age of onset of DM is 40.4 year-old. The female population had long duration of DM than male population. The overall HbA1C levels are slightly greater in 2014–2015 than 2011–2012 without statistical significance (10.9 ± 2.7 and 10.6 ± 2.2% respectively). The HbA1C levels also do not differ among DM patients with regular outpatient visits. The mean HbA1C of newly diagnosed DM is significant higher in 2014–15 than that in 2011–2012 (11.5 ± 2.4 and 10.6 ± 2.1% respectively, p = 0.039), but not different from HbA1C levels in 2013 in DM patients who received ongoing treatment (10.9 ± 2.3%). Furthermore, HbA1C worsened significantly in 2 of the 15 districts between 2011–2012 and 2014–2015. Conclusions: Nauru has a high prevalence rate with early onset and inadequately controlled diabetes. It needs to propose strategy to early detect and improve glycemic control early to prevent future diabetic complications. PB-27 Association between CAG repeat length polymorphism of androgen receptor gene, cardio-metabolic risk factors and clinical outcomes in Chinese men Poon Wing WONG1,2 *, Andrea O.Y. LUK1,2, Heung-Man LEE1,2, Eric S.H. LAU1,2, Kitty K.T. CHEUNG1,2, Alice P.S. KONG1,2, Ronald C.W. MA1,2, Wing-Yee SO1,2, Juliana C.N. CHAN1,2. 1 Department of Medicine and Therapeutics, The Chinese University of Hong Kong, 2Hong Kong Institute of Diabetes and Obesity Li Ka Shing Institute of Health Sciences, Hong Kong Low testosterone is linked to metabolic syndrome and increased risks of cardiovascular morbidity and mortality. Cellular effects of testosterone are mediated by its binding to androgen receptor (AR), and CAG repeat length polymorphism of receptor gene correlates with its function with longer length being associated with reduced receptor sensitivity. We explored the relationship between AR CAG repeat length and cardio-metabolic parameters, total testosterone levels, and incident cardiovascular disease (CVD), chronic kidney disease (CKD) and all-cause death in a prospective cohort of Chinese men with type 2 diabetes. From January 2008 to December 2011, 495 men with type 2 diabetes underwent structured assessment of metabolic profile and complications. DNA was extracted from whole blood and the region containing AR CAG repeat was amplified by polymerase chain reaction using primers that flank the region. Patients were followed for new-onset CVD (coronary heart disease, stroke, peripheral vascular disease), CKD as defined by estimated glomerular filtration rate (GFR) <60 mL/ min/1.73 m2, and/or death until 31 May 2016. In this cohort (mean ± standard deviation [SD] age: 57.9 ± 12.2 years, disease duration: 14.3 ± 7.3 years), CAG repeat number ranged from 12 to 31 with median of 23 (interquartile range [IQR]: 21,25). Patients were stratified into two groups by median of CAG repeat number for comparison of risk factors and outcome. The two groups did not differ with respect to age, disease duration, total testosterone, anthropometric (body mass index, waist circumference) and glycaemic (HbA1c, fasting plasma glucose) indices, but noted that low density-
syndrome. Furthermore, 23% of the females had polycystic ovarian syndrome. Conclusion: In our cohort, type 2 diabetes is more common in girls. Most of our patients are picked up by screening. Family history of type 2 diabetes is very common. And a significant portion of our patients already has comorbidities at diagnosis. There are limitations in our retrospective cohort study. A diabetes registry is the way forward to better understand the characteristics of type 2 diabetes in children and adolescents. Hence, a one-stop clinic for cardiometabolic health can be planned for our next generations. PB-22 Association of glucokinase regulator genetic variant and metabolic syndrome in Taiwanese adolescents Hsiao-Wen CHANG1, Chang-Hsun HSIEH2*. 1Department of Internal Medicine, Kaohsiung Armed Forces General Hospital, Kaohsiung, 2Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taiwan Background: Variants of the glucokinase regulator (GCKR) gene are associated with components of the metabolic syndrome (MetS). This study explores the association between a common variant of this gene and metabolic syndrome (MetS) and its related traits in a population of Taiwanese adolescents. Methods: The prevalence of MetS and its components were compared between individuals (962 adolescents; 468 boys, 497 girls) with different genotypes or alleles of the GCKR rs780094 single-nucleotide polymorphism (SNP). Logistic regression analysis was performed to explore the independent roles of MetS and metabolic traits. Results: Subjects with the T-allele had a higher prevalence of low HDL-C and MetS than did those with the C-allele (p = 0.009 and 0.044, respectively). Subjects with T-carrying genotypes had a higher prevalence of low HDL-C (p = 0.028) but a similar prevalence of MetS as compared to those with non–T-carrying genotypes. After adjusting for confounding factors, the odds ratio (OR) for low HDL-C in subjects with T-carrying genotypes was 1.64 (95% confidence interval [CI]: 1.07–2.53). Similarly, the OR for MetS prevalence in subjects with T-carrying genotypes was 2.79 (95% CI: 1.09–7.11). Conclusions: The GCKR rs780094 polymorphism is associated with low HDL-C levels and MetS in a Taiwanese adolescent population. PB-23 Potent anti-obesity effect of acetate; acetate may alter the expression of genes involved in beige adipogenesis in obese KK-Ay mice Hiroyuki MOTOSHIMA1 *, Satoko HANATANI2, Yuki TAKAKI2, Shuji KAWASAKI2, Motoyuki IGATA2, Takafumi SENOKUCHI2, Norio ISHII2, Junji KAWASHIMA2, Daisuke KUKIDOME2, Tatsuya KONDO2, Takeshi MATSUMURA2, Eiichi ARAKI2. 1 Department of Molecular Diabetology, Faculty of Life Sciences, Kumamoto University, 2Department of Metabolic Medicine, Faculty of Life Sciences, Kumamoto University, Japan Potent anti-obesity effect of acetate; acetate may alter the expression of genes involved in beige adipogenesis in obese KK-Ay mice. Recently, overweight and obesity rates have been increasing in Asian countries and Asians tend to have higher amounts of abdominal fat at lower body mass indexes. Carrying higher amounts of abdominal fat is associated with increasing risks of a number of health problems including insulin resistance, hypertension, dyslipidemia, impaired glucose tolerance, type 2 diabetes mellitus as well as cardiovascular diseases. Notably, recent animal experiments revealed that induction of “browning of white adipose tissue (WAT)” or “thermogenic beige adipogenesis in visceral WAT” appears as a powerful strategy to combat obesity and obesity-associated complications including insulin resistance and diabetes.
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Among short-chain fatty acids (SCFAs), acetate is the most abundant end product generated by colonic fermentation of undigested carbohydrates, and it is detected in the systemic circulation. Oral administration of acetate has been reported to suppress weight gain and postprandial plasma glucose levels in rodents and human. Although several molecular mechanisms including activation of AMP-activated protein kinase (AMPK) as beneficial effects of acetate are proposed, its potential effects on the beige adipogenesis in visceral WAT has not been investigated. In the present study, we examined the effects of acetate administration in KK-Ay mice, and show that acetate reduced food efficiency ratio, increased whole-body oxygen consumption rate, and improved glucose tolerance of KK-Ay mice. In both epididymal WAT from acetate-treated mice and differentiating 3T3-L1 preadipocytes incubated with acetate, the elevated mRNA expression of PRDM16, PGC1α and PPARα (all of which involve in the differentiation into beige adipocytes) and of beige-adipocyte selective markers TMEM26 and CD137 were observed. In differentiating 3T3-L1 preadipocytes, treatment with acetate did not increase phosphorylation of either AMPK or acetyl-CoA carboxylase, and an inhibitor of AMPK failed to inhibit acetate-induced elevations in gene expression mentioned above. In conclusion, these observations suggest that acetate may alter the gene expression involved in thermogenic beige adipogensesis in an AMPK-independent manner in obese diabetic KK-Ay mice and may provide a potential therapeutic strategy to fight obesity. PB-24 Low skeletal muscle mass is associated with increased mortality in postmenopausal women with type 2 diabetes mellitus Hitomi MIYAKE1, Ippei KANAZAWA1 *, Toshitsugu SUGIMOTO1. 1 Internal Medicine 1 Ahimane University Faculty of Medicine, Japan Background: Diabetes mellitus is known to be associated with deteriorated quality of life as well as increased mortality. Previous studies have shown that low skeletal muscle mass is associated with all-cause mortality in elderly population. Although patients with type 2 diabetes are reported to have lower muscle mass of limbs than healthy people, little is known about the association between muscle mass reduction and mortality in type 2 diabetes. In this study, we thus examined the association between skeletal muscle mass index (SMI) and all-cause mortality in postmenopausal women with type 2 diabetes mellitus. Methods: This is a historical cohort study with the end-point of all-cause mortality in postmenopausal women with type 2 diabetes. We recruited 141 postmenopausal women with type 2 diabetes whose appendicular skeletal muscle mass (ASM) were previously evaluated by dual-energy X-ray absorptiometry at Shimane University Hospital. Asian Working Group for Sarcopenia suggested that SMI is calculated by the following formula; ASM/height2, and its reference value in Asian women is 5.4 kg/m2. The participants were observed up to 7 years from the start of this study, and the association between SMI at baseline and mortality rate was examined. The association between all-cause mortality and SMI was explored using the Kaplan-Meier method, the logrank test, and Cox regression analysis. Results: At the entry of this study, mean age and duration of diabetes were 66.1 and 11.6 years, respectively. Of 141 postmenopausal women, 17 died during the follow-up period (average time: 6.2 years). Dead patients were significantly older and had longer duration of diabetes compared to survivors (74.9 ± 7.1 v.s 64.9 ± 9.6 years old, and 18.2 ± 12.1 v.s 10.6 ± 9.6 years, respectively). SMI was significantly lower in dead patients than in survivors (5.93 ± 0.94 kg/m2 v.s 6.46 ± 0.85 kg/ m2, p = 0.019). Unadjusted survival analyses indicated that
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Poster Presentations / Diabetes Research and Clinical Practice 120S1 (2016) S65–S211
patients with SMI < 5.4 kg/m2 had higher mortality rate than those with SMI >=5.4 kg/m2 ( p = 0.014). Moreover, in the Cox regression analysis adjusted for age, duration of diabetes, HbA1c, and serum creatinine, SMI was significantly and inversely associated with the mortality (hazard ratio = 6.39, 95% confidence interval = 1.42–28.68, p = 0.016). Conclusion: The present study showed that lower SMI was associated with the increased all-cause mortality in postmenopausal women with type 2 diabetes mellitus, suggesting that muscle mass reduction is an important complication which is involved in the risk of mortality in type 2 diabetes. PB-25 The influence of diabetes on eradication rate of Helicobacter pylori Yurika IKEGAMI1, Akahito SAKO2 *, Hiroyuki ADACHI2, Tomoyuki YADA1, Hitohiko KOIZUKA1, Naomi UEMURA1, Hidekatsu YANAI2. 1Department of Gastroenterology & Hepatology, Kohnodai Hospital, National Center for Global Health and Medicine, 2 Department of Internal Medicine, Kohnodai Hospital, National Center for Global Health and Medicine, Japan Introduction: The prevalence of Helicobacter pylori (HP) infection is high in Asia. Although eradication therapy of HP has been strongly recommended to prevent gastric cancer and peptic ulcer, several studies reported the lower success rate of eradication in diabetic patients. We aimed to elucidate the influence of diabetes and glycemic control on eradication rate of HP. Method: We retrospectively investigated the patients who underwent first line HP eradication therapy (Proton Pump Inhibitor, Clarithromycin, Amoxicillin) from January 2011 to December 2013. We excluded the patients who did not complete the eradication therapy and the assessment test of HP infection. We collected information about patient characteristics, smoking history, laboratory data, endoscopic findings, regimen of HP eradication, status of diabetes, and anti-diabetic drugs. We compared eradication success group and failure group by t-test and chi-square test, and used logistic regression model to analyze the factors associated with eradication of HP. Study protocol was approved by institutional review board. Result: Of the 546 patients who underwent first line HP eradication from 2011 to 2013, 415 patients were eligible. Mean age was 64.2 years old and 192 patients were male. Sixtythree patients had diabetes and mean HbA1c was 6.9%. Eradication rate in total was 75.7%. Age, sex, smoking status, dose of clarithromycin, type of proton pump inhibitor, and atrophy of gastric mucosa were not significantly associated with eradication rate. Diabetic patients had significantly higher eradication rate than non-diabetic patients (85.7% vs 73.9%). In diabetic patients, mean HbA1c before eradication therapy was not significantly different between eradication success group and failure group. HbA1c and body mass index before and after eradication were similar. Multivariate analysis showed that adjusted odds ratio of successful eradication in diabetic patients was 2.00 (95% confidence interval: 0.86–4.31, p = 0.11). Conclusion: Contrary to previous small scale studies, eradication rate was relatively better in diabetic patients. We need the prospective, larger scale study to clarify the relationship between diabetes and eradication of HP. PB-26 The glycemic control of adult population in Nauru Chang-Hsun HSIEH1*, Samuela KOROVO2, Silina MOTUFAGA3, Chun-Jui HUANG4,5, Yi-Jen HUNG1. 1Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; 2 Naoero Public Health Centre, 3Republic of Nauru Hospital, Republic of Nauru, Fiji; 4Division of Endocrinology and Metabolism,
Department of Medicine, Taipei Veterans General Hospital, 5Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan Background: Nauru is one of the countries with high prevalence of diabetes mellitus (DM). However, diabetic control among overall and newly diagnosed DM adult population had not evaluated in the past. Methods: This is a retrospective observational cohort study. All of the data come from the Nauru Diabetes Registry database from Naeoru Public Health Center from 2011 to 2015. All patients with their hemoglobin A1C (HbA1C) will be analyzed and compared between year of 2011–2012 and 2014–2015. Results: A total of 614 patients were enrolled for analysis with mean age of 49.8 year-old and mean diabetic duration of 10.1 years. The mean age of onset of DM is 40.4 year-old. The female population had long duration of DM than male population. The overall HbA1C levels are slightly greater in 2014–2015 than 2011–2012 without statistical significance (10.9 ± 2.7 and 10.6 ± 2.2% respectively). The HbA1C levels also do not differ among DM patients with regular outpatient visits. The mean HbA1C of newly diagnosed DM is significant higher in 2014–15 than that in 2011–2012 (11.5 ± 2.4 and 10.6 ± 2.1% respectively, p = 0.039), but not different from HbA1C levels in 2013 in DM patients who received ongoing treatment (10.9 ± 2.3%). Furthermore, HbA1C worsened significantly in 2 of the 15 districts between 2011–2012 and 2014–2015. Conclusions: Nauru has a high prevalence rate with early onset and inadequately controlled diabetes. It needs to propose strategy to early detect and improve glycemic control early to prevent future diabetic complications. PB-27 Association between CAG repeat length polymorphism of androgen receptor gene, cardio-metabolic risk factors and clinical outcomes in Chinese men Poon Wing WONG1,2 *, Andrea O.Y. LUK1,2, Heung-Man LEE1,2, Eric S.H. LAU1,2, Kitty K.T. CHEUNG1,2, Alice P.S. KONG1,2, Ronald C.W. MA1,2, Wing-Yee SO1,2, Juliana C.N. CHAN1,2. 1 Department of Medicine and Therapeutics, The Chinese University of Hong Kong, 2Hong Kong Institute of Diabetes and Obesity Li Ka Shing Institute of Health Sciences, Hong Kong Low testosterone is linked to metabolic syndrome and increased risks of cardiovascular morbidity and mortality. Cellular effects of testosterone are mediated by its binding to androgen receptor (AR), and CAG repeat length polymorphism of receptor gene correlates with its function with longer length being associated with reduced receptor sensitivity. We explored the relationship between AR CAG repeat length and cardio-metabolic parameters, total testosterone levels, and incident cardiovascular disease (CVD), chronic kidney disease (CKD) and all-cause death in a prospective cohort of Chinese men with type 2 diabetes. From January 2008 to December 2011, 495 men with type 2 diabetes underwent structured assessment of metabolic profile and complications. DNA was extracted from whole blood and the region containing AR CAG repeat was amplified by polymerase chain reaction using primers that flank the region. Patients were followed for new-onset CVD (coronary heart disease, stroke, peripheral vascular disease), CKD as defined by estimated glomerular filtration rate (GFR) <60 mL/ min/1.73 m2, and/or death until 31 May 2016. In this cohort (mean ± standard deviation [SD] age: 57.9 ± 12.2 years, disease duration: 14.3 ± 7.3 years), CAG repeat number ranged from 12 to 31 with median of 23 (interquartile range [IQR]: 21,25). Patients were stratified into two groups by median of CAG repeat number for comparison of risk factors and outcome. The two groups did not differ with respect to age, disease duration, total testosterone, anthropometric (body mass index, waist circumference) and glycaemic (HbA1c, fasting plasma glucose) indices, but noted that low density-