PP223-MON VISCERAL ADIPOSITY INDEX IN SEVERELY OBESE PATIENTS: RELATIONSHIP TO INSULIN RESISTANCE, INFLAMMATORY PARAMETERS AND OBESITY TREATMENT

Obesity and the metabolic syndrome II There were no significant differences in terms of age, sex and levels of 25 OH D. Serum Ca and phosphate levels were normal in 96% and 88% of patients respectively. Patients with higher levels of body fat have lower serum 25 OH D (r = 0.50, p = 0.009), with no differences between men and women. Following weight loss, the prevalence of hypovitaminosis was reduced to 46% and the rate of hyperparathyroidism fell by 78%. At the same time, a significant correlation between this hormone and serum 25 OH D; r = 0.554, P = 0.01 was found. The loss of fat mass appears to be associated with the reduction of hypovitaminosis, as we observe an inverse correlation between increased serum levels of 25 OH D; r = 0.35, p = 0.001 and adipose tissue. Conclusion: hypovitaminosis D is highly prevalent in MO patients. Serum levels improve following the loss of fat mass, which suggests higher plasma availability. Disclosure of Interest: None Declared

PP223-MON VISCERAL ADIPOSITY INDEX IN SEVERELY OBESE PATIENTS: RELATIONSHIP TO INSULIN RESISTANCE, INFLAMMATORY PARAMETERS AND OBESITY TREATMENT M.D. Ballesteros-Pomar1 , R. Diez Rodriguez2 , A. Calleja Fern´ andez1 , A. Vidal Casariego1 , S. Calleja Antolin3 , I. Cano Rodríguez1 , J.L. Olcoz Go˜ ni2 . 1 Endocrinology and Nutrition, 2 Gastroenterology, 3 Inmunology, Complejo Asistencial Universitario de Le´ on, Leon, Spain Rationale: Visceral adiposity index (VAI) has been recently proposed as an indicator of “visceral adipose function”, insulin sensitivity, and cardiometabolic risk. Methods: Retrospective study of 61 severely obese patients who followed a very low calorie diet (VLCD) during 6 weeks and bariatric surgery (BS). Blood lymphocyte subpopulations (NK cells, CD3, CD4, CD8, CD 19), inflammatory parameters (IP-10, MIG, IL6, IL10, IL-8, IL 1beta, IL 12p70, MCP1, TNF alfa) and adipokines (adiponectin, leptin, soluble leptin receptor, visfatin and resistin) were measured. Insulin resistance was diagnosed whenever HOMA index was higher than 3.8. Body composition was measured by DXA (Lunar Prodigy). Multiple linear regression analysis was done to identify independent predictors of VAI. Results: Mean age 42.8 (10.6), females 71.2%, BMI 46.5 (5.3). Mean VAI was 2.31 (1.36), higher for males [2.49 (1.19)] than females [2.23 (1.43)], but no significant differences were found. Diabetic patients (13.1%) had a higher VAI [3.73 (1.58)] compared to insulinresistant [55.7%;2.36 (1.22)] or insulinsensitive [31.1%; 1.63 (1.02)] (P 0.001). After adjusting by age and sex, VAI significantly related to HOMA (p = 0.048). A significant correlation was found for VAI with CD3 + (r = 0.281, p = 0.03) and CD4+ Tcells (r = 0.273, p = 0.035). Neither body composition (fat mass, fat free mass, android fat mass), nor adipocytokines or other inflammatory parameters were found to be significantly related to VAI either in uni or multivariate analysis. After VLCD, VAI decreased to 2.10 (1.22) and after BS, to 1.79 (0.92) (p = 0.046). These changes significantly correlated with changes in HOMA after BS (r = 0.510, p = 0.001) although no after VLCD.

S205 Conclusion: VAI is significantly related to insulinresistance status in severely obese patients but not to body composition or inflammatory parameters, except for CD3+ and CD4+ cells Disclosure of Interest: None Declared

PP224-MON MANAGING OBESITY AFTER SPINAL CORD INJURY (SCI): AN INTERNATIONAL, MULTICENTRE, CROSS-SECTIONAL STUDY OF KNOWLEDGE, ATTITUDES AND PRACTICES AMONG MEDICAL STAFF WORKING IN SCI CENTRES S.S.H. Wong1,2 , A. Forbes2 , J. van Middendorp1 , M. Belci1 . 1 National Spinal Injuries Centre, Stoke Mandeville Hospital, Aylesbury, 2 Centre for Gastroenterology and Clinical Nutrition, University College London, London, United Kingdom Rationale: To (1) examine the opinion of medical staff working in the spinal cord injury (SCI) centres; (2) evaluate their knowledge, attitudes and practices towards obesity prevention and management in SCI centre and (3) To report the number of dietitian working in SCI centres. Methods: A thirty-seven item questionnaires were sent to 24 SCI centres (896 beds) in the UK, and the Netherlands, Belgium and Croatia during July 2012 October 2012. Results: Eighteen SCI centres (75%) (60 medical staff: 29 (48.3%) consultants, 33 (55%) females) returned the questionnaires for analysis. All respondents showed an interest in obesity treatment but only 2.3% of respondents received training in obesity management. Whilst a majority of respondents reported they are confident in dealing with overweight (74.5%) and obese (66.1%) SCI adults, less than half (44.1%) are confident in treating overweight/obese SCI children. This study also demonstrated areas of concerns such as lack of nationally adopted guidelines and training provision. There were 19.53 whole-time equivalent (WTE) dietitians recorded, this is equivalent to 45.8 beds per WTE dietitians (range 22 210). Other European SCI centre’s dietitian have a significant higher amount of resources than UK SCI centre’s dietitian (beds per WTE dietitian: 30.4 vs 78.2, p = 0.045). Conclusion: Medical staff showed a reasonable level of interest in participating in obesity prevention and management. Given the high prevalence of obesity after SCI [1,2], it would be a good opportunity for better practice if SCI medical staff were supported with appropriate training and the constrains of their concern such development of clinical guidelines and dietetic provision were adequately addressed. References [1] Gall A et al (2008) Clin Med 8 70 74. [2] Wong S et al (2012) Br J Nutr 108, 918 923. Disclosure of Interest: None Declared