Metabolic control from diabetic type 1 patient in C.R.

Track 2. Clinical Research & Care fer in mitochondrial membranes and induces heat production in brown adipocytes. A variant (A-3826G) in the promoter region of the UPC-1 gene has recently been associated with body weight gain, and is possibly involved in the development of obesity, diabetes and related metabolic disorders. It is unknown if variant in the UCP-1 gene polymorphism is associated with development of gestational diabetes mellitus (GDM). This study was initiated to examine the allelic frequency of the UCP- 1 genotype in pregnant women and to relate this genotype to body weight gain and glucose tolerance during pregnancy. In 214 Chinese pregnant women (mean age, 314-1 yr), a 1-h OGTT with 50 g glucose was performed between gestational weeks 24-28. The 3-h OGTT with 100 g glucose was performed if the 1-h plasma glucose value during the 50 g OGTT was >140 mg/dl. GDM was diagnosed by the criteria from American Diabetes Association. The U I ~ - I genotype was assessed by genomic PCR and Bcl I restriction fragment length polymorphism analysis. The genotype frequencies were AA genotype, 22.0%; AG genotype 51.4%; GG genotype 26.6%; with allelic frequency of 0.52 for allele G. No significant differences were found in allelic frequencies of the G between women with GDM (n=31) and with normal glucose tolerance (n=183) (56.5% and 51.6%, p=0.483). Women with G polymorphism showed neither enhanced increase in body weight and BMI during pregnancy, nor increased postload glucose, insulin and C-peptide values during the OGTT. Using a logistic regression model with the absence or presence of GDM as the dependent variable, it revealed that age, family history of DM, pregravid BMI but not UCP-1 genotype, was independently predictors. In summary, our observation showed that the A-3826G polymorphism of UPC-I gene was not associated with GDM in Chinese women. Further larger pregnant populations study will be required to confirm this finding.

P421 A Relation between Serum Ferritin and Insulin Resistance Syndrome Is Present in Nondiabetie Women but Not in Nondiabetie Men WAYNE H.H. SHEU l, Wen-Jane Lee t, Ro-Lin Chang ], Ying-Tsung Chen 2. t Endocrinology and Metabolism, Taichung Veterans General Hospital, Taichung, Taiwan, Province of China; 2 Cardiology, Taichung Veterans General Hospital, Taichung, Taiwan, Province of China Previous studies have suggested that serum ferritin is one of the components of insulin resistance syndrome in Caucasians. Since serum ferritin levels differ significantly between men and women, variation in the role of ferritin in insulin resistance between sexes, particularly in Asian populations, is still unknown. Three hundreds and fifty-eight nondiabefic Chinese subjects (140 men and 218 women) were studied. Fasting plasma glucose, insulin, leptin, lipoprotein, and serum ferritin concentrations, as well as plasma glucose and insulin responses to 75 g oral glucose testing (n=172) were determined. Fasting serum ferritin concentrations (mean+SEM) were significantly higher in men than in women (2295:15 vs 105-1-9/xg/1,p<0.001). In women, fasting serum ferritin concentrations correlated significantly with age, body mass index (BMI), amount of body fat, fasting plasma glucose, insulin, cholesterol, triglyceride concentrations, glucose response to oral glucose load, and Homeostasis model assessment (HOMA) insulin resistance but not with blood pressure, high density lipoprotein (HDL) cholesterol levels and insulin response to oral glucose challenge. On the contrary, none of above anthropometric and metabolic variables was related to fasting serum ferritin levels in men. HOMA insulin resistance increased progressively across three different degrees of serum ferritin concentrations in women (p<0.003). In men, HOMA insulin resistance levels were not different among three differing degrees of insulin sensitivity (p=0.424). Adjustment for age, BMI, and menopause status did not change the relation between HOMA insulin resistance and serum ferritin in women (p<0.04). In conclusion, we observed that a relation between serum ferritin levels and insulin resistance exists in women but not in men. This sex dimorphism characteristic merits further investigations.

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P422 Autoimmune Thyroid Disease in ~ p e 1 Diabetes Mellitns SHYAMSUNDER PORANDALA ], Sridhar Chitturi l, Bipin Kumar Sethi I 1Endocrinology, Osmania Medical College, Hyderabad, Andhra Pradesh, India; 2 General Medicine, Osmania Medical College, Hyderabad, Andhra Prasesh, India; z Endocrinology, Osmania Medical College, Hyderabad, Andhra Pradesh, India Aims: To evaluate the prevalence of goitre, thyroid autoimmunity, and hypothyroidism in Type 1 diabetics. Methods: Thyroid status was studied in 24 consecutive Type 1 diabetics (20 females, 4 males), aged between 3 and 18 years (mean age 9.1 44.25 years), having diabetes for 2 months to 5 years (mean duration 3.1 + 1.26 years). The subjects were evaluated for the size of goitre, thyroid peroxidase (TPO) antibodies [by ELISA], and thyrotropin (TSH) levels [by immuno radiometrc assay (IRMA)]. Results: 5 children (20.8%) had goitre (grade 0B or more), 4 of them (16.6%) had positive T t ~ antibodies (> 1:640 dilution) and one of these children had elevated TSH (176/zIU/ml). Conclusions: Autoimmune thyroid disease is prevalent in q~ype 1 diabetics. Given the impact of untreated hypothyroidism in this age group, screening for thyroid dysfunction is recommended in all Type 1 diabetics.

P423 Metabolic Control from Diabetic Type 1 Patient in C.R. C. FUSCALDO l, L. Calzada 1, y. Estrada l, E. Artavia 1, S. Monge ], J. Ibarra 2, V. Figueroa 2, K. Urroz 2, C. Arguedas 2. t Division of Endocrinology, Childrens National Hospital; 2Division of Internal Medicine, M~xico Hospital, San Jos~Costa Rica Objectives: In CR exist an only Sistem of Health and a CNH, theorically all DM 1 patients, they have been seen in this hospital, the objective it is expose the quality of the metabolic control from these patients in CR. Research Design and Methods: 246 DM 1 patients they were evaluated in 1998, with average of glycohemoglobin (HbA1C), The group was divided in: whom they had HbA1C under 8% (good control), HbAIC over 8% (bad control), HbAIC under 7% or ideal control and HbAIC over 10% alarming control. According to age in under 10 years and over 10 years old. Finally according to the type of treatment (Conventional or Intensified). Results: General average HbA1C 8,36%, 114 patients had good control (46%) and 54% bad control. 37,8% had ideal control, 19,9% had alarming control, average HbA1C under 10 years: 7,7% and over 10 years 8,67%. According to the type of treatment, we have 52% of total patients had treatment Intensified and 44% of them had good control, 48% receiving conventional therapy, 48,7% of them had good control, in the poster we compared our results with Finland. Conclusions: the quality control of DM 1 in CR is good and similar to Finland. 46% patients had good control, the patients under 10 years had better control comparing to the over 10 years old. Near 20% patients had alarming control. In Costa Rica an 52% patients they receive Intensified Therapy.

P424 Subclinical Autoimmune Hypothyroidism (SCAH) In Patients with Type 1 Diabetes UDMI) and Their Non Diabetic Siblings (NDS) J. LIBMAN, A. Menechini, A.J. Muniagurria, A.M. Libman. School of

Medicine, University of Rosario, Argentina DM1 and other associated endocrine disorders have an autoimmune pathogenesis. It is well known the higher prevalence of clinical hypo and hyperthyroidism in patients with DM1. The aim of this study was to evaluate the prevalence of SCAH in patients with DMI and their NDS not previously suspected of having thyroid disease, and to compare it with that observed in a control group (C). TSH levels before and following