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SUN-PP002: Fish Intake and Incident Type 2 Diabetes Mellitus in Patients with Coronary Artery Disease
Clinical Nutrition (2015) 34(S1), S23–S234
Contents lists available at ScienceDirect
Clinical Nutrition journal homepage: http://www.elsevier.com/locate/clnu
Poster presentations Poster tour 1: Chronic Disease SUN-PP001 Outstanding abstract ORAL SUPPLEMENT ENRICHED IN HMB COMBINED WITH PULMONARY REHABILITATION IMPROVES BODY COMPOSITION, BONE MINERAL DENSITY, MUSCLE STRENGTH AND HEALTH RELATED QUALITY OF LIFE IN PATIENT WITH BRONCHIECTASIS (PROSPECTIVE, RANDOMISED STUDY) G. Olveira1 , C. Olveira2 , E. Do˜ na3 , F.J. Palenque4 , N. Porras5 , 6 7 A. Dorado , A.M. Godoy , E. Rubio8 , G. Rojo9 , R. Martín10 . 1 UGC Endocrinología y Nutrici´ on, Instituto de Investigaci´ on Biom´ edica de M´ alaga, Hospital Regional Universitario de M´ alaga/Universidad de M´ alaga. CIBERDEM, CIBER of Diabetes and Associated Metabolic Diseases (CB07/08/0019), Instituto de Salud Carlos III, 2 UGC Neumologia, Instituto de Investigaci´ on Biom´ edica de M´ alaga, Hospital Regional Universitario de M´ alaga/Universidad de M´ alaga, 3 Neumología, Hospital de Alta Resoluci´ on de Benalm´ adena, 4 UGC Rehabilitaci´ on, Hospital Regional Universitario de M´ alaga, 5 UGC Endocrinología y Nutrici´ on, 6 UGC Neumologia, 7 UGC Rehabilitaci´ on, Hospital Regional Universitario de M´ alaga, 8 UGC Endocrinología y Nutrici´ on, Instituto de Investigaci´ on Biom´ edica de M´ alaga, 9 UGC Endocrinología y Nutrici´ on, Instituto de Investigaci´ on Biom´ edica de M´ alaga, Hospital Regional Universitario de M´ alaga/Universidad de M´ alaga, 10 Fisioterapia y Rehabilitaci´ on, Escuela Universitaria Francisco Maldonado de Osuna, Malaga, Spain Rationale: Pulmonary rehabilitation (PR) is recommended for bronchiectasis but there is no data about its effect on body composition. The aim of this study is to assess the response of a Pulmonary Rehabilitation (PR) in normally-nourished non-cystic-fibrosis bronchiectasis compared with PR plus hyperproteic oral nutritional supplement enriched with betahydroxy-beta-methylbutyrate (HMB) on body composition, muscle strength, Quality of Life and serum biomarkers. Methods: Single center randomized controlled trial, parallel treatment design: Participants were randomized assigned either receive PR, for 12 weeks vs PR plus ONS (PRONS) (one can per day). Outcome assessments was performed at baseline, 12 and 24 weeks: body composition (Dualenergy X-Ray Absorptiometry, mid-arm muscle circumference, phase ankle by bioimpedance), health related quality of life (Spanish QOL-B-V3.0, Physical Functioning scale), handgrip strength, diet questionnaire, and plasma levels of prealbumin, myostatin and somatomedin c. Results: Thirty patients were randomized (15 per group) sin diferencias en variables clínicas y respiratorias. In the PRONS
group bone mineral density (BMD), mean and maximal hand grip dynamometry, mid-arm muscle circumference, QOLB and prealbumin were significantly increased from baseline at 12 and 24 weeks and Fat free Mass (FFM) and FFM index, at 12 weeks. In the PR group only mean hand grip dynamometry and prealbumin were significantly increased at 12 and 24 weeks. In both groups plasma myostatin were reduced at 12 w (without significant differences) Conclusion: The addition of a hyperproteic ONS enriched with HMB to Pulmonary rehabilitation could improve body composition, BMD, muscle strength and health related quality of life in bronchiectasis patients. Disclosure of Interest: None declared
SUN-PP002 Outstanding abstract FISH INTAKE AND INCIDENT TYPE 2 DIABETES MELLITUS IN PATIENTS WITH CORONARY ARTERY DISEASE T. Karlsson1 , E. Strand1 , C.A. Drevon2 , J. Dierkes3 , O. Nyg˚ ard1,4 . 1 Department of Clinical Science, Faculty of Medicine and Dentistry, University of Bergen, Bergen, 2 Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, 3 Department of Clinical Medicine, Faculty of Medicine and Dentistry, University of Bergen, 4 Department of Heart Disease, Haukeland University Hospital, Bergen, Norway Rationale: Evidence on the association between fish intake and risk of type 2 diabetes is inconsistent. Our aim was to investigate the relation between dietary intake of fish and incident type 2 diabetes in patients with coronary artery disease. Methods: A total of 2099 patients from the Western Norway B-vitamin Intervention Trial with dietary intake data and without diabetes at baseline were included. Participants were randomized to a combination of B-vitamin supplementation. Dietary intakes of total fish (shellfish not included), fatty fish, lean fish, processed fish, fish on sandwich, and shellfish were estimated from a food frequency questionnaire, and were energy-adjusted using the residual method. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using logistic regression, and adjusted for age, sex, BMI, hypertension, and smoking. Results: Median age at inclusion was 62 y, 80% were males, and 84% had stable angina pectoris. During follow-up, 1999 2004 through Dec 2009, 149 incident cases of type 2 diabetes were registered. Median (IQR) intakes of total fish were 50.0 (35.2), 86.7 (35.8), 151 (62.3) g/day for tertiles 1 3, respectively. There was a trend towards increased risk of incident type 2
S24 diabetes with higher total fish intake; adjusted OR (95% CI) for highest versus lowest tertile was 1.58 (1.00, 2.51), P for trend = 0.07. Fatty fish, lean fish, processed fish, fish on sandwich or shellfish consumption was not associated with diabetes risk. Further adjustment for the B-vitamin intervention did not alter the results. Conclusion: In patients with coronary artery disease, higher intake of total fish tended to be associated with increased risk of incidence type 2 diabetes. Disclosure of Interest: None declared
SUN-PP003 Outstanding abstract BMI, LEPTIN AND PAI-1 IN POLYCYSTIC OVARY SYNDROME PATIENTS, CARRIERS OF SND rs1799889( ) R. Komsa-Penkova1 , G. Golemanov1 , P. Ivanov2 , N. Slavov3 , K. Kovacheva4 , P. Tonchev5 . 1 Biochemistry, Medical University, Pleven, 2 Clinical Institute for Reproductive Medicine, Pleven, 3 MBAL AVIS-MEDIKA, 4 Med. Genetics, Medical University, 5 Surgery, University hospital “dr G. Stranski”, Pleven, Bulgaria Rationale: Polycystic ovary syndrome (PCOS) is an endocrine disorder of multifactorial origin, associated in 60 70% of patients with obesity. Adipocytokines leptin and PAI-1 are discussed among the feasible factors related to PCOS and its complications. The aim of the study was to evaluate genetic influence of the of carriage of rs1799889( ) in PAI-1 gene on PAI-1 levels and its interplay with leptin in obese and non-obese PCOS and PCOM (polycystic ovary morphology) patients. Methods: To evaluate genetic influence of the of carriage of rs1799889( ) in PAI-1 gene on PAI-1 levels and its interplay with leptin, 92 obese and non-obese PCOS and PCOM (PCO morphology) patients with and 102 healthy controls were genotyped. PAI-1 and leptin plasma levels were analysed by ELISA; LH, FSH, testosterone and prolactin by Electrochemiluminescence immunoassay. Results: A significantly higher carriage of rs1799889( ) was found in women with PCOS (OR 1.739; p = 0.042) and in total group of patients with high BMI (OR 1.843, p = 0.037). The levels of PAI-1 correlated with carriage of rs1799889( ) genotype, levels of leptin and BMI, (correspondingly Pearson R = 0.534, R = 0.574, R = 0.418; p = 0.03), like correlation coefficients were higher in the group with PCOS. The patients carriers of rs1799889( ) genotype were at higher risk to develop early pregnancy losses as compared to the noncarriers (OR 2.12; p = 0.061). Conclusion: The present study provides evidence that carriage of rs1799889( ) genotype SNP in PAI-1 gene is associated with PCOS and possibly reproductive complications. Further to this, the correlation between PAI-1, leptin levels and BMI in the patients with PCOS indicate a feasible role of obesity as a risk factor for PCOS. Disclosure of Interest: None declared
Poster presentations SUN-PP004 Outstanding abstract COMBINED INTERVENTION WITH PIOGLITAZONE AND n-3 FATTY ACIDS IN METFORMIN-TREATED DIABETIC PATIENTS ON POSTPRANDIAL LIPID CLEARANCE AND SELECTED CYTOKINES J. Kopecky1 , J. Veleba1 , P. Wohl1 , P. Janovska2 , O. Kuda2 , O. Horakova2 , H. Malinska1 , L. Kazdova1 , P. Flachs2 , K. Bardova2 , M. Rossmeisl2 , J. Olza3 , P. Calder3 , A. Gardlo2,4 , E. Fiserova4 , J. Jensen5 , M. Bryhn6 , J. Kopecky Sr.2 , T. Pelikanova1 . 1 Diabetes Center, Institute for Clinical and Experimental Medicine, 2 Department of Adipose Tissue Biology, Institute of Physiology Academy of Sciences of the Czech Republic v.v.i., Prague, Czech Republic; 3 Human Development & Health Academic Unit, Faculty of Medicine University of Southampton, Southampton, United Kingdom; 4 Department of Mathematical Analysis and Applications of Mathematics, Faculty of Science, Palacky University in Olomouc, Olomouc, Czech Republic; 5 University of Oslo, Oslo, 6 Silentia A.S., Svelvik, Norway Rationale: Marine n-3 fatty acids eicosapentaenoic (EPA) and docosahexaenoic (DHA) acids help in primary prevention of cardiovascular disease, but their impact on metabolic aspects in type 2 diabetic (T2D) patients remains unclear. We aimed to evaluate the effect of a combination intervention using EPA+DHA and an insulin-sensitizing drug pioglitazone on lipid and glucose metabolism. Methods: In a double-blind, placebo-controlled trial, 69 patients with T2D already treated by metformin, were randomized to 24-week-intervention using: (i) corn oil (5 g/day; Placebo), (ii) pioglitazone (15 mg/day; Pio), (iii) EPA+DHA (2.75 g/day; Omega3), or (iv) pioglitazone and EPA+DHA (Pio+Omega3). The primary endpoints were the changes from baseline in triacylglycerol (TG) clearance and in insulin sensitivity assessed using a meal test and hyperinsulinemicisoglycemic clamp. Secondary endpoints included changes in HbA1c, glucose and NEFA clearance and selected cytokines, oxidative stress and inflammation markers. Results: TG and NEFA clearance were increased by Pio+Omega3. Both fasting glycaemia and HbA1c were increased by Omega3, but unchanged by Pio+Omega3. Insulin sensitivity was improved by Pio + Omega3. Adiponectin concentrations were increased by the intervention in Pio, Pio+Omega3 and Omega3 vs placebo. Oxidative stress markers (SOD activity, TBARS, GSSG/GSH) were not influenced. sPselectin had a lower concentration after intervention it the Pio+Omega3 group. Conclusion: The combination of pioglitazone and EPA+DHA can be used to increase postprandial lipid clearance in T2D patients on stable metformin therapy. Modest negative effect of Omega-3 on glycemic control can be prevented by combined Pio+Omega3 treatment. Combined treatment is also accompanied by adiponectin concentration rise and sPSelectin decrease. Supported by NT13763 4, NT14250 3 and IN 00023001 Disclosure of Interest: None declared
Contents lists available at ScienceDirect
Clinical Nutrition journal homepage: http://www.elsevier.com/locate/clnu
Poster presentations Poster tour 1: Chronic Disease SUN-PP001 Outstanding abstract ORAL SUPPLEMENT ENRICHED IN HMB COMBINED WITH PULMONARY REHABILITATION IMPROVES BODY COMPOSITION, BONE MINERAL DENSITY, MUSCLE STRENGTH AND HEALTH RELATED QUALITY OF LIFE IN PATIENT WITH BRONCHIECTASIS (PROSPECTIVE, RANDOMISED STUDY) G. Olveira1 , C. Olveira2 , E. Do˜ na3 , F.J. Palenque4 , N. Porras5 , 6 7 A. Dorado , A.M. Godoy , E. Rubio8 , G. Rojo9 , R. Martín10 . 1 UGC Endocrinología y Nutrici´ on, Instituto de Investigaci´ on Biom´ edica de M´ alaga, Hospital Regional Universitario de M´ alaga/Universidad de M´ alaga. CIBERDEM, CIBER of Diabetes and Associated Metabolic Diseases (CB07/08/0019), Instituto de Salud Carlos III, 2 UGC Neumologia, Instituto de Investigaci´ on Biom´ edica de M´ alaga, Hospital Regional Universitario de M´ alaga/Universidad de M´ alaga, 3 Neumología, Hospital de Alta Resoluci´ on de Benalm´ adena, 4 UGC Rehabilitaci´ on, Hospital Regional Universitario de M´ alaga, 5 UGC Endocrinología y Nutrici´ on, 6 UGC Neumologia, 7 UGC Rehabilitaci´ on, Hospital Regional Universitario de M´ alaga, 8 UGC Endocrinología y Nutrici´ on, Instituto de Investigaci´ on Biom´ edica de M´ alaga, 9 UGC Endocrinología y Nutrici´ on, Instituto de Investigaci´ on Biom´ edica de M´ alaga, Hospital Regional Universitario de M´ alaga/Universidad de M´ alaga, 10 Fisioterapia y Rehabilitaci´ on, Escuela Universitaria Francisco Maldonado de Osuna, Malaga, Spain Rationale: Pulmonary rehabilitation (PR) is recommended for bronchiectasis but there is no data about its effect on body composition. The aim of this study is to assess the response of a Pulmonary Rehabilitation (PR) in normally-nourished non-cystic-fibrosis bronchiectasis compared with PR plus hyperproteic oral nutritional supplement enriched with betahydroxy-beta-methylbutyrate (HMB) on body composition, muscle strength, Quality of Life and serum biomarkers. Methods: Single center randomized controlled trial, parallel treatment design: Participants were randomized assigned either receive PR, for 12 weeks vs PR plus ONS (PRONS) (one can per day). Outcome assessments was performed at baseline, 12 and 24 weeks: body composition (Dualenergy X-Ray Absorptiometry, mid-arm muscle circumference, phase ankle by bioimpedance), health related quality of life (Spanish QOL-B-V3.0, Physical Functioning scale), handgrip strength, diet questionnaire, and plasma levels of prealbumin, myostatin and somatomedin c. Results: Thirty patients were randomized (15 per group) sin diferencias en variables clínicas y respiratorias. In the PRONS
group bone mineral density (BMD), mean and maximal hand grip dynamometry, mid-arm muscle circumference, QOLB and prealbumin were significantly increased from baseline at 12 and 24 weeks and Fat free Mass (FFM) and FFM index, at 12 weeks. In the PR group only mean hand grip dynamometry and prealbumin were significantly increased at 12 and 24 weeks. In both groups plasma myostatin were reduced at 12 w (without significant differences) Conclusion: The addition of a hyperproteic ONS enriched with HMB to Pulmonary rehabilitation could improve body composition, BMD, muscle strength and health related quality of life in bronchiectasis patients. Disclosure of Interest: None declared
SUN-PP002 Outstanding abstract FISH INTAKE AND INCIDENT TYPE 2 DIABETES MELLITUS IN PATIENTS WITH CORONARY ARTERY DISEASE T. Karlsson1 , E. Strand1 , C.A. Drevon2 , J. Dierkes3 , O. Nyg˚ ard1,4 . 1 Department of Clinical Science, Faculty of Medicine and Dentistry, University of Bergen, Bergen, 2 Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, 3 Department of Clinical Medicine, Faculty of Medicine and Dentistry, University of Bergen, 4 Department of Heart Disease, Haukeland University Hospital, Bergen, Norway Rationale: Evidence on the association between fish intake and risk of type 2 diabetes is inconsistent. Our aim was to investigate the relation between dietary intake of fish and incident type 2 diabetes in patients with coronary artery disease. Methods: A total of 2099 patients from the Western Norway B-vitamin Intervention Trial with dietary intake data and without diabetes at baseline were included. Participants were randomized to a combination of B-vitamin supplementation. Dietary intakes of total fish (shellfish not included), fatty fish, lean fish, processed fish, fish on sandwich, and shellfish were estimated from a food frequency questionnaire, and were energy-adjusted using the residual method. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using logistic regression, and adjusted for age, sex, BMI, hypertension, and smoking. Results: Median age at inclusion was 62 y, 80% were males, and 84% had stable angina pectoris. During follow-up, 1999 2004 through Dec 2009, 149 incident cases of type 2 diabetes were registered. Median (IQR) intakes of total fish were 50.0 (35.2), 86.7 (35.8), 151 (62.3) g/day for tertiles 1 3, respectively. There was a trend towards increased risk of incident type 2
S24 diabetes with higher total fish intake; adjusted OR (95% CI) for highest versus lowest tertile was 1.58 (1.00, 2.51), P for trend = 0.07. Fatty fish, lean fish, processed fish, fish on sandwich or shellfish consumption was not associated with diabetes risk. Further adjustment for the B-vitamin intervention did not alter the results. Conclusion: In patients with coronary artery disease, higher intake of total fish tended to be associated with increased risk of incidence type 2 diabetes. Disclosure of Interest: None declared
SUN-PP003 Outstanding abstract BMI, LEPTIN AND PAI-1 IN POLYCYSTIC OVARY SYNDROME PATIENTS, CARRIERS OF SND rs1799889( ) R. Komsa-Penkova1 , G. Golemanov1 , P. Ivanov2 , N. Slavov3 , K. Kovacheva4 , P. Tonchev5 . 1 Biochemistry, Medical University, Pleven, 2 Clinical Institute for Reproductive Medicine, Pleven, 3 MBAL AVIS-MEDIKA, 4 Med. Genetics, Medical University, 5 Surgery, University hospital “dr G. Stranski”, Pleven, Bulgaria Rationale: Polycystic ovary syndrome (PCOS) is an endocrine disorder of multifactorial origin, associated in 60 70% of patients with obesity. Adipocytokines leptin and PAI-1 are discussed among the feasible factors related to PCOS and its complications. The aim of the study was to evaluate genetic influence of the of carriage of rs1799889( ) in PAI-1 gene on PAI-1 levels and its interplay with leptin in obese and non-obese PCOS and PCOM (polycystic ovary morphology) patients. Methods: To evaluate genetic influence of the of carriage of rs1799889( ) in PAI-1 gene on PAI-1 levels and its interplay with leptin, 92 obese and non-obese PCOS and PCOM (PCO morphology) patients with and 102 healthy controls were genotyped. PAI-1 and leptin plasma levels were analysed by ELISA; LH, FSH, testosterone and prolactin by Electrochemiluminescence immunoassay. Results: A significantly higher carriage of rs1799889( ) was found in women with PCOS (OR 1.739; p = 0.042) and in total group of patients with high BMI (OR 1.843, p = 0.037). The levels of PAI-1 correlated with carriage of rs1799889( ) genotype, levels of leptin and BMI, (correspondingly Pearson R = 0.534, R = 0.574, R = 0.418; p = 0.03), like correlation coefficients were higher in the group with PCOS. The patients carriers of rs1799889( ) genotype were at higher risk to develop early pregnancy losses as compared to the noncarriers (OR 2.12; p = 0.061). Conclusion: The present study provides evidence that carriage of rs1799889( ) genotype SNP in PAI-1 gene is associated with PCOS and possibly reproductive complications. Further to this, the correlation between PAI-1, leptin levels and BMI in the patients with PCOS indicate a feasible role of obesity as a risk factor for PCOS. Disclosure of Interest: None declared
Poster presentations SUN-PP004 Outstanding abstract COMBINED INTERVENTION WITH PIOGLITAZONE AND n-3 FATTY ACIDS IN METFORMIN-TREATED DIABETIC PATIENTS ON POSTPRANDIAL LIPID CLEARANCE AND SELECTED CYTOKINES J. Kopecky1 , J. Veleba1 , P. Wohl1 , P. Janovska2 , O. Kuda2 , O. Horakova2 , H. Malinska1 , L. Kazdova1 , P. Flachs2 , K. Bardova2 , M. Rossmeisl2 , J. Olza3 , P. Calder3 , A. Gardlo2,4 , E. Fiserova4 , J. Jensen5 , M. Bryhn6 , J. Kopecky Sr.2 , T. Pelikanova1 . 1 Diabetes Center, Institute for Clinical and Experimental Medicine, 2 Department of Adipose Tissue Biology, Institute of Physiology Academy of Sciences of the Czech Republic v.v.i., Prague, Czech Republic; 3 Human Development & Health Academic Unit, Faculty of Medicine University of Southampton, Southampton, United Kingdom; 4 Department of Mathematical Analysis and Applications of Mathematics, Faculty of Science, Palacky University in Olomouc, Olomouc, Czech Republic; 5 University of Oslo, Oslo, 6 Silentia A.S., Svelvik, Norway Rationale: Marine n-3 fatty acids eicosapentaenoic (EPA) and docosahexaenoic (DHA) acids help in primary prevention of cardiovascular disease, but their impact on metabolic aspects in type 2 diabetic (T2D) patients remains unclear. We aimed to evaluate the effect of a combination intervention using EPA+DHA and an insulin-sensitizing drug pioglitazone on lipid and glucose metabolism. Methods: In a double-blind, placebo-controlled trial, 69 patients with T2D already treated by metformin, were randomized to 24-week-intervention using: (i) corn oil (5 g/day; Placebo), (ii) pioglitazone (15 mg/day; Pio), (iii) EPA+DHA (2.75 g/day; Omega3), or (iv) pioglitazone and EPA+DHA (Pio+Omega3). The primary endpoints were the changes from baseline in triacylglycerol (TG) clearance and in insulin sensitivity assessed using a meal test and hyperinsulinemicisoglycemic clamp. Secondary endpoints included changes in HbA1c, glucose and NEFA clearance and selected cytokines, oxidative stress and inflammation markers. Results: TG and NEFA clearance were increased by Pio+Omega3. Both fasting glycaemia and HbA1c were increased by Omega3, but unchanged by Pio+Omega3. Insulin sensitivity was improved by Pio + Omega3. Adiponectin concentrations were increased by the intervention in Pio, Pio+Omega3 and Omega3 vs placebo. Oxidative stress markers (SOD activity, TBARS, GSSG/GSH) were not influenced. sPselectin had a lower concentration after intervention it the Pio+Omega3 group. Conclusion: The combination of pioglitazone and EPA+DHA can be used to increase postprandial lipid clearance in T2D patients on stable metformin therapy. Modest negative effect of Omega-3 on glycemic control can be prevented by combined Pio+Omega3 treatment. Combined treatment is also accompanied by adiponectin concentration rise and sPSelectin decrease. Supported by NT13763 4, NT14250 3 and IN 00023001 Disclosure of Interest: None declared