Searchable abstracts of presentations at key conferences in endocrinology
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Society for Endocrinology BES 2019

Brighton, United Kingdom
11 Nov 2019 - 13 Nov 2019

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Come and exchange knowledge, share experiences and strengthen collaborations across our global community of endocrinologists!


Metabolism and Obesity

ea0065p166 | Metabolism and Obesity | SFEBES2019

Obesity-induced changes in hepatocyte and skeletal myocyte expression of mRNAs encoding islet GPCR peptide ligands

Atanes Patricio , Smith Lorna , Bowe James , Persaud Shanta

Introduction: Insulin-sensitive tissues such as liver and skeletal muscle modify their gene expression under conditions of obesity-induced insulin resistance, and some of these gene products may be released to maintain glucose homeostasis. This study aimed to identify mRNAs encoding liver and skeletal muscle peptides that have the potential to regulate β-cell function by binding to islet GPCRs, and to quantify changes in expression of these liver and muscle mRNAs in obese...

ea0065p167 | Metabolism and Obesity | SFEBES2019

Sarcopenic phenotypes are associated with an increased risk of type 2 diabetes: findings from the Korean Genome and Epidemiology Study (KoGES)

Son Jang Won , Lee Won Young , Yoo Soon Jib

The present study aimed to explore the relationship of sarcopenia, with or without the presence of obesity, with the risk of developing type 2 diabetes. We conducted a cross-sectional analysis of 2981 subjects in the Korean Genome and Epidemiology Study. The diabetes status of each subject was determined by using a 75 g oral glucose tolerance test, and body composition was estimated via dual-energy X-ray absorptiometry. The skeletal muscle mass index (SMI, %) was obtained by c...

ea0065p168 | Metabolism and Obesity | SFEBES2019

Long term impact of sleeve gastrectomy on metabolic parameters in morbidly obese patients

Sirbu Anca , Soare Iulia , Martin Sorina , Popa Miruna , Barbu Carmen , Copaescu Catalin , Fica Simona

Background: A large body of evidences have demonstrated that metabolic surgery is associated with significant and durable weight loss as well as a significant improvement of obesity-related comorbidities. The aim of our study was to evaluate the long term impact of gastric sleeve on metabolic parameters in morbidly obese patients.Materials and methods: We evaluated 95 (67 women) severely obese patients (mean age 43.4±10.69 years) before and approxim...

ea0065p169 | Metabolism and Obesity | SFEBES2019

Intravascular subcutaneous adipose tissue blood flow measured with Doppler ultrasound for experimental medicine studies

Lempesis Ioannis , Goossens Gijs , Manolopoulos Konstantinos

Background: Adipose tissue blood flow (ATBF) is important for delivering nutrients and oxygen to adipose tissue (AT), and distributing adipokines and metabolites into the circulation. ATBF has been measured with the 133Xenon wash-out technique (gold standard), microdialysis, laser Doppler Fluximetry, and contrast-enhanced ultrasound. However, due to decline in world-wide 133Xenon production and the invasive nature of other techniques, an alternative metho...

ea0065p170 | Metabolism and Obesity | SFEBES2019

Chronic disruption of endothelial Insulin/IGF1 signaling pathway enhances whole body insulin sensitivity

Viswambharan Hema , Yuldasheva Nadira , Imrie Helen , Cubbon Richard , Bridge Katherine , Haywood Natalie , Skromna Anna , Porter Karen , Hemmings Karen , Clark Emily , Gatenby Victoria , Abudushalamu Yilizila , Cordell Paul , Simmons Katie , Makava Natallia , Walker Andrew , Futers Simon , Shah Ajay , Beech David , Wheatcroft Stephen , Kearney Mark , Sukumar Piruthivi

Type 2 diabetes is preceded by insulin resistance, followed by increased endothelial cell production of superoxide and reduction in bioavailability of the vasoprotective signalling molecule, nitric oxide (NO). We demonstrated in preclinical models that type 2 diabetes also causes resistance to insulin-like growth factor-1 (IGF-1) mediated glucose lowering and endothelial NO release. This study aimed to examine the effect of the endothelial cell-specific combination of insulin ...

ea0065p171 | Metabolism and Obesity | SFEBES2019

5β-reductase (AKR1D1) isoforms differentially regulate natural and synthetic glucocorticoid clearance and glucocorticoid receptor activation in vitro

Appanna Nathan , Arvaniti Anastasia , Gangitano Elena , Morris Karen , George Sherly , Keevil Brian , Tomlinson Jeremy , Nikolaou Nikolaos

Metabolic syndrome and its hepatic manifestation, non-alcoholic fatty liver disease (NAFLD), are increasing in prevalence. Steroid hormones are established regulators of metabolic phenotype. 5β-reductase (AKR1D1) is highly expressed in human liver, inactivating steroid hormones, including glucocorticoids and androgens. The human AKR1D1 gene contains 9 exons; six splice variants have been identified and three lead to functional protein isoforms (AKR1D1-001, -0...

ea0065p172 | Metabolism and Obesity | SFEBES2019

Physicochemical optimization of dermal insulin patches: effects on selected metabolic parameters in STZ-induced diabetic rats

Mfayela Nokuphiwa , Mabandla Musa , Musabayane Cephas Tagumirwa , Hadebe Silindile Innocentia

Investigations conducted in our laboratory have shown that transdermal delivery of insulin has several potential advantages over the conventional route. These pectin-insulin (PI)-containing dermal patches possess the ability to maintain sustained controlled release of insulin into the bloodstream of streptozotocin-induced diabetic rats with concomitant reduction of blood glucose levels. We have successfully formulated and optimized the concoction of the PI-containing dermal pa...

ea0065p173 | Metabolism and Obesity | SFEBES2019

Effect of maternal obesity on offspring metabolic indices

Adekunbi Daniel , Morakinyo Femi , Adegoke Feyi

Maternal obesity is associated with altered metabolic function in the offspring, but its age and sex-specific metabolic effect not clearly defined. Female adult Sprague–Dawley (SD) rats were fed an obesogenic diet – high fat diet of 7.76 kcal/g (experimental group) or standard rat chow (3.52 kcal/g, control group) for 8 weeks prior to mating and throughout gestation and lactation. Proven fertile male SD rats were used for mating. Male and female offspring were weaned...

ea0065p174 | Metabolism and Obesity | SFEBES2019

Impact of free fatty acid 4 receptor internalization on signalling

Tripp Emma , O'Brien Shannon , Calebiro Davide

The free fatty acid 4 receptor (FFA4R) is highly expressed in adipose tissue and other tissues that are involved in metabolic homeostasis, where its pharmacological stimulation improves glucose uptake and insulin sensitivity. Work by our and other groups have revealed that, contrary to textbook knowledge, GPCRs are not only active at the plasma membrane, as previously believed, but also at intracellular sites such as early endosomes or the Golgi complex/trans-Golgi network. Ho...

ea0065p175 | Metabolism and Obesity | SFEBES2019

The effect of tumour necrosis factor-alpha on myogenesis in immortalised human myoblasts

Frampton James , Chang Hanna , Chambers Edward , Murphy Kevin

Skeletal muscle exists in a state of continuous synthesis and breakdown of muscle proteins in order to preserve normal metabolic and locomotive functioning. Hormones are well established regulators of this homeostatic process. Chronic systemic inflammation can dysregulate skeletal muscle homeostasis via the disruption of endocrine signalling pathways. This can result in skeletal muscle atrophy, which is strongly implicated in the pathogenesis of type 2 diabetes and sarcopenia....

ea0065p176 | Metabolism and Obesity | SFEBES2019

Brain derived neurotrophic factor (BDNF) methylation in patients with impaired glucose regulation: implications progression to type 2 diabetes mellitus (T2DM)

Fachim Helene , Siddals Kirk , Malipatil Nagaraj , Cortes Gabriela , Donn Rachelle , Dalton Caroline , Reynolds Gavin , Gibson Martin , Heald Adrian

Introduction: There is growing evidence of external factors modulating epigenetic modifications and their contribution to the development of obesity and T2DM. One of the epigenetic signatures is DNA methylation. We investigated whether a lifestyle intervention could influence DNA methylation of Brain derived neurotrophic factor (BDNF) in individuals with IGR, as BDNF is thought to play an important role in glucose metabolism.Methods: IGR participants (<e...

ea0065p177 | Metabolism and Obesity | SFEBES2019

Investigating the role of GPR119 in the vagus nerve

Cheng Sijing , Roberts Anna , Norton Mariana , Owen Bryn , Hanyaloglu Aylin , Murphy Kevin

The prevalence of obesity and its associated metabolic diseases are increasing, but current treatments are ineffective or impractical. Understanding how the gut–brain axis senses nutrients to regulate appetite and glucose homeostasis may identify new drug targets and treatments. The G protein-coupled receptor 119 (GPR119) has several endogenous lipid ligands and has been proposed to act as a nutrient sensor in the gastrointestinal tract. GPR119 is expressed on enteroendoc...

ea0065p178 | Metabolism and Obesity | SFEBES2019

Glycaemic response to a mixed meal challenge: does camel milk preload confer an advantage?

Moriarty Maura , Buckley Adam , Ashraf Tanveer , Barakat Maha T , Lessan Nader

Camel milk provides a modest portion of the overall global milk share but is an important source of protein in arid regions. Perceived health benefits include anti-diabetic properties attributed to its unique composition. We hypothesise that exogenous insulin present in camel milk mediates a hypoglycaemic effect. In a randomised, double blind crossover study, eleven normoglycaemic individuals were allocated to receive a 300 kcal pre-load of camel milk or cow milk ten minutes p...

ea0065p179 | Metabolism and Obesity | SFEBES2019

Continuous subcutaneous insulin infusion (CSII): a trust-wide audit

Tauni Rahat Ali , Marath Haris , Shipp Maxine , Griggs Susan , Orriss Karen , Davey Larissa , Hunt Mandy

Aims and objectives: Continuous subcutaneous insulin infusion (CSII) has been in clinical practice since 1970s. NICE guidance (2008) recommends CSII in adults with type 1 diabetes (T1DM) if attempts to achieve target HbA1c with multiple daily injections (MDIs) result in disabling hypoglycaemia or HbA1c levels remain above 69 mmol/mol. The aim of our audit was to check compliance of our service against NICE guidance, and to see if CSII improved glycaemic control and/or hypoglyc...

ea0065p180 | Metabolism and Obesity | SFEBES2019

Very low calorie diet (VLCD) in obese patients with longstanding type 2 diabetes mellitus: real-world outcomes with twelve months follow-up

Nana Melanie , Moore Sacha , Loganathan Ria , Williams Victoria , Rahman Mohammad , Jennings Elaine , Dixon Anthony , Bondugulapati LN Rao

Introduction: Recent randomised controlled trials have demonstrated the efficacy of very low calorie diets (VLCD) in carefully selected patients with type 2 diabetes mellitus (T2DM). However, there is paucity of evidence regarding the efficacy of VLCD in the real-world setting. We evaluated outcomes in obese T2DM patients who underwent VLCD at our institution.Methods: This retrospective observational study included all patients who had undergone VLCD fro...

ea0065p181 | Metabolism and Obesity | SFEBES2019

The progesterone metabolite epiallopregnanolone sulphate induces glucose-stimulated insulin secretion from human and mouse islets and is reduced in gestational diabetes mellitus

Fan Hei Man , Bellafante Elena , Mitchell Alice , Ovadia Caroline , Martineau Marcus , Jones Peter , McCance David , Marschall Hanns-Ulrich , Hunt Kate , Bewick Gavin , Bowe James , Williamson Catherine

Serum concentrations of progesterone sulphates are raised in intrahepatic cholestasis of pregnancy (ICP), the commonest pregnancy-specific liver disease. Women with ICP have increased rates of gestational diabetes mellitus (GDM). We hypothesised that raised progesterone sulphates may modulate glucose homeostasis. Progesterone sulphates were assayed in serum samples from participants of the hyperglycaemia and adverse pregnancy outcomes (HAPO) study (n=79–94), and ...

ea0065p182 | Metabolism and Obesity | SFEBES2019

Oral chenodeoxycholic acid increases post-prandial anorectic gut hormone levels and increases indices of insulin sensitivity

McGlone Emma Rose , Malallah Khalefah , Bloom Stephen , Tan Tricia

Background: Increased circulating bile acids may contribute to improved glucose control and augmented secretion of the gut hormones peptide tyrosine tyrosine (PYY) and glucagon-like peptide-1 (GLP-1) observed post-prandially in patients following bariatric surgery. Oral bile acids could represent a non-surgical means of improving glucose tolerance after a meal.Aim: To investigate the effects of a single oral dose of ursodeoxycholic acid (UDCA) and chenod...

ea0065p183 | Metabolism and Obesity | SFEBES2019

Hepatic effects of new anti-diabetic drugs: real world data from a retrospective study

Colosimo Santo , Brodosi Lucia , Marchignoli Francesca , Barbanti Francesca A , Marchesini Giulio , Petroni Maria Letizia

Background and aims: There is evidence that new anti-diabetic drugs may limit liver disease progression, reduce liver fat and normalize serum aminotranferase levels in patients with NAFLD. We compared the effectiveness of new drug classes on liver fat in T2DM patients by means of surrogate markers.Materials and methods: In an observational retrospective study we analysed the 12-month time-courses of clinical and anthropometric data of T2DM cases treated ...

ea0065p184 | Metabolism and Obesity | SFEBES2019

Vitamin B12 deficiency leads to fatty acid metabolism dysregulation and increased pro-inflammatory cytokine production in human adipocytes and in maternal subcutaneous and omental adipose tissue

Samavat Jinous , Adaikalakoteswari Antonysunil , Boachie Joseph , Jackisch Laura , McTernan Philip , Christian Mark , Saravanan Ponnusamy

Vitamin B12 (B12) is an essential micronutrient required for several metabolic reactions. Animal and clinical studies show that B12-deficiency is associated with metabolic syndrome. Given the key metabolic role of adipose tissue, we investigated whether B12 deficiency may affect triglyceride synthesis and lipid metabolism leading to adipose tissue inflammation. The AbdSc pre-adipocyte cell line (Chub-S7) and human AbdSc primary pre-adipocytes were differentiated under differen...

ea0065p185 | Metabolism and Obesity | SFEBES2019

Endotoxin and adiposity as mediators of down-regulating the BRITE fat phenotype

Omran Farah , Murphy Alice , Jackisch Laura , Samavat Jinus , McTernan Philip G , Christian Mark

Background: The acquisition of brown-adipocyte-properties by white-adipocytes (BRITE-adipocytes) is an appealing-prospect to combat obesity and type-2-diabetes-Mellitus (T2DM). This may support counteracting the impact of inflammation and mitochondrial-dysfunction, which contribute to the obesity-pathogenesis. However, our previous-finding shave shown that the gut-derived-inflammatory-agent endotoxin can increase the inflammatory-response in white-adipose-tissue impacted by ob...

ea0065p186 | Metabolism and Obesity | SFEBES2019

AKR1D1 (5β-reductase) deletion drives hepatic inflammation, fibrosis and tumour development in vivo

Harris Shelley , Nikolaou Nikolaos , Arvaniti Anastasia , Cox Roger , Gathercole Laura , Tomlinson Jeremy

The enzyme 5β-reductase (AKR1D1) catalyses an essential step in bile acid synthesis. In addition, it controls intra-cellular steroid hormone availability through hormone clearance. As disturbances in steroid hormones and bile acid metabolism have potent effects on metabolic health, we hypothesize that AKR1D1 may play a role hepatic lipid accumulation. We generated global AKR1D1 knockout mice (KO) alongside wild-type controls (WT). Mice were fed either normal chow (NC) or ...

ea0065p187 | Metabolism and Obesity | SFEBES2019

Low B12 is associated with increased de novo synthesis of ‘unsafe’ fatty acids in the liver

Boachie Joseph , Adaikalakoteswari Antonysunil , Samavat Jinus , Saravanan Ponnusamy

Background: Vitamin B12 (B12) deficiency is associated with obesity and was recently shown to trigger lipid accumulation in the adipose tissues and liver. The body is capable of synthesizing fatty acids (FAs) endogenously via de novo lipogenesis in the liver. However, dysregulated levels are associated with adverse consequences in subjects. We therefore assessed B12 regulation of de novo fatty acid synthesis and the profile of various FAs in hepatocytes.<...

ea0065p188 | Metabolism and Obesity | SFEBES2019

Insulin signalling in kidney podocytes: an information theoretic approach

Pope Robert JP , Welsh Gavin I , Coward Richard JM , McArdle Craig A

Glomerular podocytes are directly regulated by insulin (1) and podocyte insulin resistance is implicated in diabetic kidney disease. Information theory derived statistical measures can be used to quantify information transfer via cell signalling pathways (2). This novel approach takes into account cell-cell variation in responses and the impact that this noise has on information transfer but has not yet been applied to signalling in podocytes. Here we quantify the mutual infor...

ea0065p189 | Metabolism and Obesity | SFEBES2019

The FreeStyle libre flash glucose monitoring system: how it has improved glycaemic control for people with type 1 diabetes (T1DM) in Eastern Cheshire, UK

Dwived Shivangi , Heald Adrian , Naseem Asma , Kochhar Rupinder , Khan Inamullah , Leivesley Kate , Metters Ann , Horne Linda , Steele Tom

Introduction: Many people with type 1 diabetes continue to experience suboptimal glycaemic control. We now also know that often HbA1c levels are an inaccurate reflection of glycaemic patterns and variability. We describe here how the systematic use of the FreeStyle Libre flash monitor helped improve the glycaemic control of many people with type 1 diabetes.Methods: We report the outcomes of 92 consecutive adults (18 years of age or more) with type 1 diab...

ea0065p190 | Metabolism and Obesity | SFEBES2019

Androgen receptor reduced sensitivity is associated with increased mortality, poor glycemic control and BMI in men with type 2 diabetes – a 14-year follow up study

Heald Adrian , Yadegarfar Ghasem , Livingston Mark , Fachim Helene , Lunt Mark , Narayanan Ram Prakash , Siddals Kirk , Cortes Gabriela , Hackett Geoff , Naseem Asma , Kochhar Rupinder , Inamullah Khan , Donn Rachelle , Gibson Martin , Jones Hugh

Introduction: Hypogonadism is associated with poorer glycaemic outcomes/increased all cause and cardiovascular morbidity/mortality in type 2 diabetes mellitus (T2DM). Increasing CAG repeat number within exon 1 of the androgen receptor gene is associated with increased androgen receptor resistance/insulin resistance. We here investigated the link between CAG repeat number and outcomes in T2DM men.Methods: We determined in a long-term 14-year follow-up coh...

ea0065p191 | Metabolism and Obesity | SFEBES2019

Male testosterone levels and laboratory practice: a need for a standardised approach to measurement and reporting

Livingston Mark , Downie Paul , Hackett Geoffrey , Marrington Rachel , Heald Adrian , Ramachandran Sudarshan

Background: Diagnosis and treatment guidelines of men with adult-onset testosterone deficiency (TD) were published by the British Society for Sexual Medicine (2017). Laboratory practice has a major role in supporting these with accurate and precise total testosterone (TT) methods and standardised pre- and post-analytical protocols.Objective: Our study investigated whether laboratory practice supported management guidelines of adult-onset TD.<p class=...

ea0065p192 | Metabolism and Obesity | SFEBES2019

Lipoprotein(a) as a predictive biomarker for subclinical coronary atherosclerosis

Trivedi Namrata , Loh Wann , David Alessia , Cegla Jaimini

Background: Lipoprotein(a) (Lp(a)) is an independent, causal, genetic risk factor for cardiovascular disease (CVD). Coronary artery calcium (CAC), measured by computerised tomography (CT) scans, is a known marker for atherosclerosis. CT Agatston scores, also known as CAC scores, are thought to be better predictors of CVD than traditional risk factors. There is conflicting data regarding the relationship between Lp(a) levels and CAC. A preliminary study has suggested a positive...

ea0065p193 | Metabolism and Obesity | SFEBES2019

Modulation of vagal afferent signalling by the amino acid metabolite sensor GPR35

Roberts Anna , Cheng Sijing , Norton Mariana , Mohamed Omer , Cork Simon C , Salem Victoria , Hanyaloglu Aylin , Murphy Kevin

High dietary protein intake can suppress appetite, drive weight loss and improve glucose homeostasis. Understanding the mechanisms by which ingested protein is sensed may reveal new therapeutic targets for metabolic disease. G-protein coupled receptor 35 (GPR35) is activated by compounds including Kynurenic acid (Kyna), a product of amino acid metabolism. GPR35 is expressed in the intestines, most highly in the colon, and has recently been identified in the afferent vagus nerv...

ea0065p194 | Metabolism and Obesity | SFEBES2019

Efficacy of liraglutide in weight management post bariatric surgery patients: data from an Emirati cohort

Alnuaimi Abdulla , Radha Saradalekshmi Koramannil , AlAmeri Majid , Barakat Maha T , Lessan Nader

Introduction: Bariatric surgery (BS) is currently the most effective treatment for obesity. However, weight regain is a recognized challenge in post-surgical management. Drug treatment for weight regain after bariatric surgery has been used, but little published data is available on their efficacy. We have investigated the use of Liraglutide for relapse after BS in an Emirati population.Methods: ICLDC patients with a previous history of bariatric surgery...

ea0065p195 | Metabolism and Obesity | SFEBES2019

ISX-9 preferentially induces enterochromaffin and I-cell enteroendocrine lineages in human small intestinal organoids

Pedro Patricia Fonseca , Tsakmaki Anastasia , Bewick Gavin

Enteroendocrine cells (EECs) are a hormone-/neurotransmitter-producing population with well-defined physiological roles. Knowledge regarding their differentiation program in the human gut, however, is scarce. Deciphering endocrine specification could identify targets which allow the manipulation of specific EEC populations and form the basis for new treatments for metabolic, inflammatory and cognitive disorders. Isoxazole-9 (ISX-9) is a small molecule, previously used in proto...

ea0065p196 | Metabolism and Obesity | SFEBES2019

The differential effects of weight loss by RYGB versus very-low calorie diet (VLCD) on gut hormone levels and appetite: potential contribution to sustained weight loss

Behary Preeshila , Tharakan George , Alexiadou Kleopatra , Hope David , Anyiam Oluwaseun , Choudhury Sirazum , Alessimii Haya , Doyle Chedie , Miras Alexander , Chahal Harvinder , Purkayastha Sanjay , Moorthy Krishna , Ahmed Ahmed , Bloom Stephen , Tan Tricia

Background: Roux-en-Y gastric bypass (RYGB) leads to effective and sustained weight loss whereas a Very-Low-Calorie diet (VLCD) is normally plagued by weight regain over time. Changes in gut hormones following each intervention may play a role. The aim of this study was to investigate gut hormone responses after 4 weeks of RYGB and VLCD.Methods: We prospectively recruited 21 volunteers with obesity and type 2 diabetes undergoing RYGB, and a matched cohor...

ea0065p197 | Metabolism and Obesity | SFEBES2019

Immature β-cells are required for normal islet function and insulin release

Nasteska Daniela , Fine Nicholas H F , Ashford Fiona B , Smith Gabrielle , Bakhti Mostafa , Bastidas-Ponce Aimee , Rutter Guy A , Lickert Heiko , Zhou Qiao , Akerman Ildem , Hodson David J

Background: A normal islet includes both mature and immature β-cells, with the former possessing higher insulin content and the latter displaying better proliferative capacity. However, it remains unknown whether immature β-cells also contribute to the regulation of insulin release, especially by commanding the activity of their mature counterparts.Materials and methods: Pdx1, Mafa, and Ngn3 were overexpressed in &#94...

ea0065p198 | Metabolism and Obesity | SFEBES2019

Modulation of EGFR expression to increase islet transplantation success

Ali Usama , Suba Kinga , Bitsi Stavroula , Alonso Aldara Martin , Patel Yateen , Leclerc Isabelle , Rutter Guy A , Rothery Stephen , Salem Victoria , Tomas Alejandra

Background: Islet transplantation is an established treatment for type 1 diabetes mellitus. However, many recipients do not achieve independence from exogenous insulin since up to 50–70% of islets are lost post-transplant. An important factor determining transplant success is graft vascularisation. The epidermal growth factor receptor (EGFR) is a key pro-survival and proliferation factor. Here, we investigate for the first time if EGFR overexpression in pancreatic islets ...

ea0065p199 | Metabolism and Obesity | SFEBES2019

Systemic and femoral adipose tissue-specific nontargeted plasma metabolome during acute hypercortisolaemia

Prete Alessandro , Dunn Warwick B , Manolopoulos Konstantinos

Background: Glucocorticoids have pleiotropic metabolic functions and acute glucocorticoid excess causes dramatic disruption of human metabolism. Whether glucocorticoids exert adipose tissue depot-specific effects on the nontargeted metabolome in unknown.Aim: Assess the nontargeted metabolome in the systemic circulation and in femoral adipose tissue-specific blood samples in response to physiological hyperinsulinaemia and acute hypercortisolaemia.<p c...

ea0065p200 | Metabolism and Obesity | SFEBES2019

A role for kisspeptin in long-term islet function in females

Smith Lorna , Hill Thomas , Simpson Sian , Jones Peter , Bowe James

Although characterised predominantly for its role in the brain, the neuropeptide kisspeptin has previously been shown to potentiate glucose-stimulated insulin through its receptor, GPR54; expressed abundantly in β-cells. We have previously reported a physiological role for kisspeptin signalling in the islet adaptation to pregnancy, using a β-cell specific GPR54 knockout mouse line (βGPR54ko). The aim of the present study was to examine the effects of impaired &#...

ea0065p201 | Metabolism and Obesity | SFEBES2019

Vitamin D-binding protein is required for the maintenance of α-cell identity and function

Viloria Katrina , Nasteska Daniela , Larner Dean , Fine Nicholas , Ashford Fiona , Heising Silke , Xavier Gabriela da Silva , Briant Linford , Flaxman Christine , Morgan Noel , Richardson Sarah , Hewison Martin , Hodson David

Aim: Vitamin D-binding protein (DBP), also known as GC-globulin, transports vitamin D metabolites and is also a major actin scavenger. While DBP serum levels, gene polymorphisms and autoantigens have been associated with diabetes risk, the underlying mechanisms remain unknown. DBP is produced by the liver, but has recently been shown to be highly expressed in pancreatic α-cells. We therefore sought to investigate the role of DBP in α-cell identity and function using ...

ea0065p202 | Metabolism and Obesity | SFEBES2019

Endoplasmic reticulum stress directly impacts mitochondrial function in human adipocytes

Jackisch Laura , Murphy Alice , Kumar Sudhesh , Randeva Harpal , Tripathi Gyanendra , McTernan Philip

Background: Dysfunctional endoplasmic reticula (ER) and mitochondria contribute to the pathogenesis of obesity and type 2 diabetes mellitus (T2DM). This may, in part, be facilitated by cross-talk between the two organelles during conditions of nutrient excess such as obesity, however the potential impact of ER stress on mitochondrial function has not been well studied. This study investigated whether induction of ER stress in human adipocytes may contribute to mitochondrial dy...

ea0065p203 | Metabolism and Obesity | SFEBES2019

The track-pump study

Johnson Agnes , Oliver Nick , Godsland Ian , Hill Neil

Background: ‘Glycaemic tracking’ describes the stability of HbA1c over time commonly observed in individuals with type 1 diabetes (T1DM). Preliminary studies have noted the relationship between early metabolic control and long-term outcomes, while recent evidence has been presented for glycaemic tracking in a large number of newly diagnosed individuals with T1DM. The benefits of tight glycaemic control, in terms of reducing microvascular complications and lowering Hb...

ea0065p204 | Metabolism and Obesity | SFEBES2019

Glucocorticoid regulation of the PEPITEM pathway

Chosgora Ailbhe Ni , Hopkin Sophie , Hardy Rowan , Rainger Ed , Chimen Myriam

Dysregulated recruitment of leukocytes across endothelial cells into target tissues is a hallmark of the pathology of most chronic inflammatory diseases (CIDs). We have identified a novel homeostatic pathway that regulates T-cell migration during inflammation. The pathway is impaired in patients with CIDs such as type-1-diabetes and rheumatoid arthritis (RA), and is also attenuated in the elderly. The dysregulation of this pathway across all conditions is caused by a lower lev...

ea0065p205 | Metabolism and Obesity | SFEBES2019

The American lifestyle induced obesity syndrome diet (ALIOS) in rodents recapitulates the clinical features and sexual dimorphism of NAFLD and NASH

Harris Shelley , Arvaniti Anastasia , Cox Roger , Gathercole Laura , Tomlinson Jeremy

Non-alcoholic fatty liver disease (NAFLD) is the hepatic manifestation of metabolic syndrome, ranging from simple steatosis to the necro-inflammatory disease, non-alcoholic steatohepatitis (NASH). Development of NASH subsequently increases risk of hepatocellular carcinomas (HCC). Alongside the impact on the liver, NASH is associated with other clinical features, including insulin resistance, hyperlipidaemia and sarcopaenia. We demonstrate that mice fed the American lifestyle i...

ea0065p206 | Metabolism and Obesity | SFEBES2019

Role of palmitoylation on GLP-1 receptor responses in pancreatic beta cells

Lyu Zekun , Piedade Carolina , Bitsi Stavroula , Jones Ben , Tomas Alejandra

We have previously described how signaling responses for the glucagon-like peptide-1 receptor (GLP-1R), a class B GPCR that plays key roles in metabolic regulation and is a prime type 2 diabetes (T2D) target, are modulated by intracellular membrane trafficking. We have also recently shown that binding to the therapeutic GLP-1R agonist exendin-4 (Exenatide) triggers increased clustering and segregation of biologically active GLP-1Rs into cholesterol-rich plasma membrane nanodom...

ea0065p207 | Metabolism and Obesity | SFEBES2019

Visfatin and resistin as predictors of poor pain outcome in total hip and knee joint replacement in patients with osteoarthritis

Nanus Dominika E , Davis Edward T , Jones Simon

With an aging population the number of total joint replacements performed due to end-stage osteoarthritis is increasing. Critically, a significant proportion of patients report dissatisfaction following surgery, with around 10% of hip and 20% of knee OA patients developing chronic postoperative pain. Obesity is a well-known risk factor for the development of OA. Pre-surgical obesity has been previously associated with worse clinical outcomes following arthroplasty. Therefore, ...

ea0065p208 | Metabolism and Obesity | SFEBES2019

Assessment of cardiovascular disease risk in subjects with pre-diabetes

Petkovic Milica Marjanovic , Vuksanovic Miljanka , Sasic Ivana , Zivkovic Teodora Beljic

Introduction: Prediabetes carries a risk of diabetes and cardiovascular disease (CVD). Assessment of CVD risk in prediabetes is not as routine, as is assessment of diabetes risk. However, it is not less important. This can be done through conventional SCORE charts and through coronary artery calcium (CAC) score. CAC is examined through multislice CT. Calcifications indicate late-stage subclinical coronary atherosclerosis. The AIM of our study was to assess traditional CVD risk...

ea0065p209 | Metabolism and Obesity | SFEBES2019

Maternal diet-induced cholestasis programmes murine offspring metabolic impairment on feeding a Western diet, with altered intestinal metabolites and microbiota in the female offspring

Ovadia Caroline , Spagou Konstantina , Perdones-Montero Alvaro , Smith Ann , Papacleovoulou Georgia , Dixon Peter , Holmes Elaine , Marchesi Julian , Williamson Catherine

Background: The 16-year-old children of mothers with intrahepatic cholestasis of pregnancy demonstrate increased adiposity, dyslipidaemia, and males have raised fasting insulin. Similarly, the offspring of cholestatic pregnant mice have impaired glucose tolerance and dyslipidaemia when challenged with a Western diet. Female offspring have a more marked phenotype than males. Bile influences microbial growth, thus intestinal bile acid exposure in pregnancy may contribute to meta...

ea0065p210 | Metabolism and Obesity | SFEBES2019

All cause and cardiovascular mortality in adults with schizophrenia and diabetes – a retrospective matched study

Morrison Deborah , Frize Ryan , Sainsbury Christopher A , Wilson Ruairi , Jones Gregory C

Introduction: Increased prevalence of diabetes is found in major psychosis, and poorer outcomes occur when both diagnoses co-exist. The aim of this study was to describe the association between total and cardiovascular mortality in people with both schizophrenia and diabetes, compared to diabetes alone.Materials and methods: Data was linked from the Glasgow Psychosis Clinical Information System (PsyCIS), the Scottish national diabetes database (SCI-Diabe...

ea0065p211 | Metabolism and Obesity | SFEBES2019

Glycated haemoglobin and obstetric outcomes among patients with gestational diabetes mellitus: a single center study

Awofisoye Oyindamola , Osaji Nicole

Introduction: Despite the established role of HbA1c in assessing chronic glycaemia, its role the management of gestational diabetes mellitus (GDM) is still unclear. We aimed to determine the association between HbA1c and obstetric outcomes among our patients with GDM.Methods: We reviewed the antenatal records of 512 singleton pregnant women followed up in our center. Among the 180 patients that did a 75 g Oral Glucose Tolerance Test OGTT, 64 met the IADP...

ea0065p212 | Metabolism and Obesity | SFEBES2019

An audit of SGLT2-inhibitors in the management of type 2 diabetes in Sligo University Hospital Ireland: metabolic and haemodynamic outcomes

Radhakrishna Avinash , Mchugh Catherine

Introduction: Sodium-Glucose Co-Transporter-2 (SGLT2) inhibitors are the latest class of anti-hyperglycaemic agents which reduce blood glucose by increasing urinary glucose excretion.Aims: 1) To assess the metabolic and haemodynamic changes associated with SGLT-2 inhibitors in patients attending Sligo University Hospital (SUH) Ireland.2) To enhance prescriber awareness across disciplines regarding the metabolic and haemodynamic ben...

ea0065p213 | Metabolism and Obesity | SFEBES2019

Determinants for developing foot ulcer among persons with diabetes mellitus attending outpatient clinic in a tertiary hospital in Nigeria

Olopade Oluwarotimi , Odeniyi Ifedayo , Olusanya Adedunni , Fasanmade Olufemi , Sowemimo Oluwadamilola , Akinsola Clement

Introduction: Diabetic foot ulcer (DFU) is a chronic complication not desired in individuals with Diabetes Mellitus (DM). It reduces the productivity and economic power of affected persons. Identifying risk factors leading to development of DFU is of paramount importance in preventing its occurrence.Objective: To identify risk factors for DFU in diabetes outpatient clinic of Lagos University Teaching Hospital.Method: This was a cro...

ea0065p214 | Metabolism and Obesity | SFEBES2019

Hypoglycaemia screen (hypopak) quality improvement audit

Spence Kirsty , Beckett Rachel , Hamilton Gillian , Alcheikh Mohammad , Heffernan Emmeline , Abid Noina , O'Sullivan Siobhan , Connolly Grainne , McDonnell Margaret

In Northern Ireland hypopaks (contains samples for glucose, lactate, hydroxybutyrate, insulin, growth hormone (GH), cortisol, amino acids, organic acids and acylcarnitines) are used to investigate hypoglycaemia in children. We aimed to assess the appropriateness of hypopak requests, to determine their usefulness in diagnosing endocrine and metabolic conditions and to determine if GH is helpful. Data for hypopaks received between 01 April 17 and 31 March 18 was analysed. Hypopa...

ea0065p215 | Metabolism and Obesity | SFEBES2019

Bariatric surgery outcomes amongst older obese patients: data from an Emirati cohort

Radha Saradalekshmi Koramannil , Barakat Maha T , Lessan Nader

Background: Obesity is highly prevalent in the Middle East. Treatment is a challenge and with an aging population, therapy in the elderly poses new problems. Published data on efficacy of bariatric surgery in the older age groups are scant.Aims: The objective of this study was to assess the outcomes of bariatric surgery (BS) in the elderly (≥65 years) in the UAE population.Methods: ICLDC patient database was accessed to ident...

ea0065p216 | Metabolism and Obesity | SFEBES2019

Risk of sleep apnoea among Emirati patients with type 2 diabetes

Hassan Sama , Buckley Adam , Al Tameemi T , Fojas Esphie Grace , Barakat Maha T , Lessan Nader

Background: Type 2 diabetes (T2D) and obesity have been linked with sleeping disorders in general and obstructive sleep apnoea (OSA) in particular; both are highly prevalent amongst Emirati patients. However, little information is available in this population regarding the prevalence and symptomatology of OSA, its relationships with T2D and obesity, and its impact on health outcomes.Objectives: This study aims to investigate the risk of OSA based on the ...

ea0065p217 | Metabolism and Obesity | SFEBES2019

A novel method for analysis of 11 oestrogens using high-throughput liquid chromatography tandem mass spectrometry

Gilligan Lorna , Goymer Lauren , Toor Harjeavon , Cox Grace , Shaheen Fozia , Arlt Wiebke , Taylor Angela

Oestrogen quantification in serum is challenging as concentrations are low, especially in men and post-menopausal women. Additionally, oestrogens do not ionise readily and structure similarities can lead to cross-reactivity and reduced specificity, especially with immunoassay. Full characterisation of oestrogen metabolism and its role in disease progression has therefore not been fully investigated. We aimed to develop and validate a liquid chromatography mass spectrometry met...

ea0065p218 | Metabolism and Obesity | SFEBES2019

Inhibition of nicotinamide phosphoribosyltransferase (NAMPT) prevents cytokine-mediated beta cell dysfunction

Egbase Daniel , Sayers Sophie , Evans Elizabeth , Butterworth Sam , Greally Joshua , Bewick Gavin , Tsakmaki Anastasia , Persaud Shanta , Caton Paul

Intracellular nicotinamide phosphoribosyltransferase (NAMPT) is the rate-limiting enzyme in the NAD salvage pathway. Abnormally elevated NAMPT can promote autoimmune and inflammatory processes. Many of these processes are key to type 1 diabetes (T1D) pathogenesis. Whilst NAMPT has been examined in other inflammatory diseases, the role of NAMPT in T1D remains unclear. To investigate the role of NAMPT in T1D, we used small molecule NAMPT modulators to determine the role of abnor...

ea0065p219 | Metabolism and Obesity | SFEBES2019

Predicting mortality in both diabetes and open-source clinical datasets from free text entries using machine learning (natural language processing)

Sainsbury Christopher , Conkie Andrew , Buchner Mark , Wales Ann , Jones Gregory

Objective: We aimed to test the utility of semantic analysis to predict all-cause mortality from free-text entries from both a national diabetes database, and an open source clinical dataset (MIMIC-III). We analysed text entries alone, in order to fully understand the potential of language analysis to predict outcome.Method: Diabetes dataset: An analysis period of 3 years was defined during which clinical text data were extracted. Mortality status at 1 y...

ea0065p220 | Metabolism and Obesity | SFEBES2019

GLP-1/Glucagon dual agonist affects amino acid metabolism

Scott Rebecca , Hope David , Owen Bryn , Bloom Steve , Tan Tricia

Background: GLP-1/glucagon dual agonists are being developed as treatments for obesity due to their combined effect of reducing food intake while increase energy expenditure. Though the effect of the dual agonist on carbohydrate and lipid metabolism is well studied, little is known about the effects on protein metabolism. This study aimed to examine the acute and chronic effects of the GLP-1/glucagon dual agonist on amino acid metabolism.Methods: The lon...

ea0065p221 | Metabolism and Obesity | SFEBES2019

A digital lifestyle programme to support outpatient treatment of type 2 diabetes: a randomised controlled trial

Hilmarsdottir Eva , Sigurðardottir Arun Kristin , Arnardottir Ragnheiður Harpa

Background: Lifestyle is important in the treatment of type 2 diabetes. The aim of this study was to investigate whether a lifestyle programme through a smartphone application (digital therapeutic) could affect treatment outcomes at an endocrinology outpatient clinic.Methods: In this randomised controlled study, patients were consecutively invited to participate. Participants were randomly assigned to an intervention group or a control group. In addition...

ea0065p222 | Metabolism and Obesity | SFEBES2019

FSH levels are adversely associated with markers of regional adiposity in postmenopausal women

Armeni Eleni , Augoulea Areti , Rizos Demetrios , Kaparos George , Panoulis Konstantinos , Lambrinoudaki Irene

Background: A growing body of evidence reports implications of a direct extra-gonadal effect of follicle stimulating hormone (FSH), involving the development of obesity. The aim of this study was to evaluate the associations between traditional and local obesity indices and FSH concentrations in women after menopause.Methods: We evaluated a total of 420 postmenopausal women in a cross-sectional design (age 55.6±6.5 years, BMI were 25.8±4.0 kg/m...

ea0065p223 | Metabolism and Obesity | SFEBES2019

Untreated pre-operative mental illness is associated with poorer bariatric surgery outcomes

Sultman David , Whitelaw Benjamin

Background: Approximately 20% of bariatric surgery candidates are excluded for reasons of mental health. All bariatric patients undergo a pre-operative assessment of suitability, including a mental health assessment. There are no NICE guidelines as to what level of mental illness is considered an exclusion; it is generally regarded that ‘unstable mental health’ is a contraindication to surgery. The main reason is concern regarding adherence to essential lifestyle cha...

ea0065p224 | Metabolism and Obesity | SFEBES2019

Regulation and role of MiR-125b in β-cells

Pizza Grazia , Cheung Rebecca , Rolando Delphine , Nguyen-Tu Marie-Sophie , Cebola Ines , Chabosseau Pauline , Marchetti Piero , Shapiro James , Piemonti Lorenzo , Sakamoto Kei , Smith David M , Rutter Guy A , Martinez-Sanchez Aida

MicroRNAs (miRNAs) are small non-coding RNAs that repress protein production post-transcriptionally. MiRNAs play crucial roles in metabolism, endocrine cells development and in processes altered in T2D, such as insulin secretion. MiR-125b controls proliferation, apoptosis and differentiation of various cell types, although its role in β-cells remains unclear. Recent studies show an association between high levels of circulating miR-125b and hyperglycaemia (HbA1c) in predi...

ea0065p225 | Metabolism and Obesity | SFEBES2019

Refeeding syndrome induced hypertriglyceridemia

Boharoon Hessa , AlJaberi Asma

Introduction: Hypertriglyceridemia is an established complication associated with some parenterally fed patients. In healthy individual, lipid particles are hydrolyzed to release fatty acids via the action of lipoprotien lipase (LPL) which used eventually for energy or stored in adipose tissue. In stressed patient, the activity of LPL is decreased. We present a 16-year-old girl, who is a known case of acute myeloid leukemia on chemotherapy, was admitted to the hospital with se...

ea0065p226 | Metabolism and Obesity | SFEBES2019

Are PCSK9 inhibitors delivering as promised?

Bashir Bilal , Bharaj Harnovdeep , Hutchesson Andrew , Banerjee Moulinath

Background and aims: Statins has long been used as first line treatment option for hypercholesterolemia however; half of population doesn’t achieve target LDL reduction. Proprotein convertase subtilisin kexin 9 inhibitors (PCSK9i) are a promising addition to anti-dyslipidemic armamentarium. Aim of this study is to find out the efficacy of PCSK9 inhibitors in a district general hospital of Northwest of England.Method: We identified all the patient wh...

ea0065p227 | Metabolism and Obesity | SFEBES2019

Bariatric surgery outcomes in super obese Emirati patients

Radha Saradalekshmi Koramannil , Fojas Esphie Grace , Barakat Maha T , Lessan Nader

Background: Efficacy of bariatric surgery (BS) in obesity management is well-established. The super-obese (BMI >50 kg/m2) as a subgroup may have specific phenotypic and genotypic characteristics. Prevalence of complications and risks of interventions may also be different in this group.Aims: We have investigated BS outcomes and compared effects of different operations among the superobese in an Emirati population.Methods...

ea0065p228 | Metabolism and Obesity | SFEBES2019

Investigating mesenchymal stromal cell mediated support of islets after exposure to transplantation related stressors

Hubber Ella , Rackham Chloe , Pullen Timothy , Jones Peter

The success of islet transplantation in the treatment of type 1 diabetes has been limited by the progressive decline in islet function and viability during isolation and post transplantation. The aims of the current study were to investigate the capacity of a multifunctional progenitor cell type, mesenchymal stromal cells (MSCs), to improve islet insulin secretory function and viability after exposure to transplantation relevant stressors. Mouse islets were cultured with low (...

ea0065p229 | Metabolism and Obesity | SFEBES2019

Steroid deconjugation by helix pomatia – can we overcome snail speed?

Shaheen Fozia , Gilligan Lorna , Berner Camila , Callejas Jose Luis , Shackleton Cedric , Arlt Wiebke , Taylor Angela

Gas chromatography–mass spectrometry (GC–MS) has been used for urinary steroid analysis for over 50 years. The process of hydrolysis to release steroids from their conjugates is routinely performed using commercially available snail Helix-Pomatia sulfatase (HP). However, as this is a naturally occurring enzyme its production process results in batch variation and so each batch requires experimental validation to adjust for the difference in efficiency of the enzymati...

ea0065p230 | Metabolism and Obesity | SFEBES2019

Acute changes in steroid biosynthesis in patients following severe trauma: the golden hour study

Taylor Angela , Bentley Conor , Foster Mark , Lord Janet , Hazeldine Jon , Arlt Wiebke

Advancements in medical care have significantly improved survival rates following major traumatic injury. An understanding of the hormonal, inflammatory and metabolic changes that occur following trauma is still evolving but it is clear that they impact significantly upon patient prognosis. To date, studies that have examined trauma-induced changes in steroid metabolism have analysed samples taken from patients post-hospital admission, culminating in marked variability in the ...

ea0065p231 | Metabolism and Obesity | SFEBES2019

Mammary adipose tissue steroid activation and its relevance for breast cancer prognosis

Laforest Sofia , Denver Nina , Homer Natalie ZM , Durocher Francine , Walker Brian R , Andrew Ruth , Tchernof Andre

Background: Adipose tissue dysfunction could partially explain the well-demonstrated association between obesity and survival in breast cancer (BC). Oestrogen and glucocorticoid concentrations and their respective activation enzymes, oestrogenic 17β-hydroxysteroid dehydrogenases (17βHSDs) and aromatase, and 11βHSD1 are increased in adipocyte hyperplasia and hypertrophy, supporting the hypothesis of a potential role for locally generated steroids in obesity-assoc...

ea0065p232 | Metabolism and Obesity | SFEBES2019

Anti thrombin activity in newly diagnosed Type 2 diabetes subjects in a Tertiary Hospital in Calabar, Nigeria

Enang Ofem , Akaba Kingsley

Introduction: Vascular complications play a significant role in the morbidity and mortality associated with diabetes mellitus (DM). Eighty percent of deaths in patients with diabetes are related to thromboembolic complications. Significant alteration in haemostatic indices have been documented in these patients. However, this has not been investigated in our environment.Objectives: This study aims to evaluate antithrombin activity (AT) in newly diagnosed...

ea0065p233 | Metabolism and Obesity | SFEBES2019

L-Phenylalanine simulates the secretion of pancreatic hormones via vagal CaSR

Norton Mariana , Cork Simon C , Roberts Anna , Patel Yateen , Cheng Sijing , Hansford Robert , Cao Ye , Hanyaloglu Aylin , Chang Wenhan , Murphy Kevin G

High protein diets are effective at promoting weight loss and stimulating the secretion of pancreatic hormones. Understanding the mechanisms underlying these effects may highlight new potential therapeutic targets. The calcium sensing receptor (CaSR) is stimulated by calcium and plays a critical role in calcium homeostasis. However, it is also found in many tissues unrelated to calcium regulation. CaSR activity can be modulated by aromatic amino acids, most potently by ...

ea0065p234 | Metabolism and Obesity | SFEBES2019

Adhesion G-protein coupled receptors as novel players in islet development

Olaniru Oladapo Edward , Atanes Patricio , Toczyska Klaudia , Piao Xianhua , Persaud Shanta

Adhesion GPCRs (aGPCRs) have been implicated in developmental processes and deletion of some aGPCRs in neonatal mice results in decreased β-cell differentiation capacity, leading to glucose intolerance in adult life. Here, we investigated the expression of aGPCR mRNAs in mouse islets and determined the expression and function of GPR56, the most abundant aGPCR in islets, in developing mouse pancreas. Quantitative PCR indicated that mouse islets expressed mRNAs encoding 26 ...

ea0065p235 | Metabolism and Obesity | SFEBES2019

Insights into the mechanisms underpinning the physiological effects of biased GLP-1 receptor agonists

Lucey Maria , Pickford Phil , Ma Yue , Shchepinova Maria , Tate Ed , McGinty James , French Paul , Davies Samuel , Xavier Gabriela Da Silva , Stolarczyk Emilie , Minnion James , Rutter Guy , Bloom Steve , Tomas Alejandra , Jones Ben

Glucagon-like peptide-1 receptor (GLP-1R) agonists are effective treatments for type 2 diabetes and obesity. We recently described ‘biased’ peptide GLP-1R agonists modelled on exendin-4 which uncouple the pronounced endocytosis that usually accompanies GLP-1R activation, leading to prolongation of intracellular signalling responses. Here, we show that the metabolic consequences of biased GLP-1R activation in vivo are dominated by improvements in blood glucos...

ea0065p236 | Metabolism and Obesity | SFEBES2019

Case reports of immunosuppression therapy for anti-insulin receptor and anti-insulin antibodies in patients attending the national severe insulin resistance service

Liu Charlotte Jenkins , Adams Claire , Church David , Flanagan Catherine , Gaff Lisa , Jayne David , Melvin Audrey , O'Rahilly Stephen , Pizirtzidou Eirini , Savage David , Semple Robert , Withers Elaine , Stears Anna

Introduction: Immune mediated cases of severe insulin resistant diabetes are very rare. We report responses to immunosuppression with rituximab in two patients.Case 1: A 31 year old black African female, BMI 22.84 kg/m², was referred with new onset diabetes, diagnosed shortly following a miscarriage. She had weight loss, acanthosis nigricans, nocturnal hypoglycaemia and severe hyperandrogenism . She was on an insulin pump and required >1000 units in...

ea0065p237 | Metabolism and Obesity | SFEBES2019

Obesity induces cardiac hypertrophy without functional or fibrotic alterations

Villalobos Elisa , Criollo Alfredo , Schiattarella Gabriele , Altamirano Francisco , Gillette Thomas , Lavandero Sergio , Hill Joseph

Background: Cardiac fibrosis is a common biological response to cardiovascular injury. Maladaptive cardiac fibrosis as observed in patients with hypertension, obesity or diabetes mellitus contributes to contractile dysfunction and electrophysiological disorders. Currently, there is controversy regarding whetherexposure to a high fat diet (HFD) in isolation induces cardiovascular damage and fibrosis. Here, we set out to explore the contribution of different models of obesity to...

ea0065p238 | Metabolism and Obesity | SFEBES2019

Idiopathic gigantomastia: newer mechanistic insights implicating the paracrine milieu

Das Liza , Dutta Pinaki , Rai Ashutosh , Bhansali Anil , Tripathy Satyaswarup , Vaiphei Kim , Garg Akhil , Mohsina Subair

Objective: The primary objective was to characterise the paracrine milieu in three subjects with apparently idiopathic gigantomastia and to study the relative expression of implicated factors in these pathological specimens as compared to tissue samples from normal breast, gynecomastia and breast cancer.Background: Gigantomastia refers to pathological breast enlargement usually occurring in the peripubertal or peripartum period. Idiopathic gigantomastia,...

ea0065p239 | Metabolism and Obesity | SFEBES2019

Weight loss and change in obesity related comorbidities in patients undergoing laparoscopic adjustable gastric banding at UHCW between 2009 and 2012

Leca Bianca , Dimitriadis Georgios K , Khan Uzma , Abraham Jenny , Halder Louise , Shuttlewood Emma , Shah Neha , Barber Thomas M , Menon Vinod , Randeva Harpal S

Background: The Royal College of Physicians (RCP) called earlier this year for obesity to urgently be recognized as a disease, and warned that until this happens its prevalence is unlikely to be reduced. Obesity is associated with multiple comorbidities, including type 2 diabetes mellitus (T2DM), hypertension (HT), and dyslipidemia. Bariatric surgery (BS) produces dramatic weight loss, with improvement of obesity associated comorbidities and decrease of overall mortality.<...

ea0065p240 | Metabolism and Obesity | SFEBES2019

Safe use of variable rate intravenous insulin infusion: a trust wide audit

Siddique Rana , Tauni Rahat Ali

Aims and objectives: Variable rate insulin infusion (VRII) is commonly used to achieve normoglycaemia in hospitalised patients. Joint British Diabetes Society (JBDS) produced guidelines on VRIII in 2014 to minimise complications related to inpatient VRII use. Local guidance along with a new VRII chart was introduced in 2017 at the West Suffolk NHS Foundation Trust and staff training provided. We performed an audit to review compliance to national and local VRII guidance.<p...

ea0065p241 | Metabolism and Obesity | SFEBES2019

Investigating the role of microRNA-7 in pancreatic islet development

Kane Eva , Mak Tracy C S , Latreille Mathieu

Cadaveric islet transplantation can cure diabetes, however scarcity of donor islets means that this approach cannot be used for large-scale treatment. An alternative source of insulin-producing β-cells or whole islets would be step-wise in vitro differentiation from either human embryonic stem cells or induced pluripotent stem cells, which could be transplanted directly into patients. However, ‘β-like’ cells generated from existing differentiation ...

ea0065p242 | Metabolism and Obesity | SFEBES2019

Glucocorticoid treatment is associated with dose-dependent effects in healthy male volunteers

Pofi Riccardo , Bonaventura Ilaria , Othonos Nanthia , Marjot Thomas , Moolla Ahmed , Isidori Andrea M , Hodson Leanne , Tomlinson Jeremy W

Objective: 2–3% of the population of the UK receive glucocorticoid (GC) therapy. Significant adverse effects are not confined to chronic use: recurrent short-course administration is associated with increased morbidity and mortality. Data about the cumulative dose responsible for drawbacks during GC treatment are still lacking. The aim of this study was to test the impact of 7 days of 10 or 15 mg of Prednisolone on metabolism in healthy male volunteers.<p class="abste...

ea0065p243 | Metabolism and Obesity | SFEBES2019

Mass spectrometric characterisation of circulating proinsulin-derived peptides in insulin autoimmune syndrome

Church David , Halsall David , Gribble Fiona , Reimann Frank , Semple Robert , Kay Richard

Autoimmune immunoglobulins directed against peptide hormones are well-described. These are often clinically benign, but may cause a deleterious effect on the accuracy of clinical immunoassays. A notable exception is Insulin Autoimmune Syndrome (IAS, also known as Hirata disease), where antibody-binding has a direct effect on insulin kinetics resulting in aberrant glucose control. Current methods to diagnose IAS rely on crude immune-subtraction techniques such as polyethylene g...

ea0065p244 | Metabolism and Obesity | SFEBES2019

Hepatic steatosis in rats with dexamethasone-induced metabolic syndrome: a role for Ocimum gratissimum leaf extract

Shittu Shehu-Tijani , Adeoye Tolulope , Shittu Seyyid , Lasisi Taye

Ocimum gratissimum (OG) was shown to reverse dyslipidemia in diabetes mellitus. The present study investigates the effect of OG on hepatic lipid synthesis in animals with metabolic syndrome induced by dexamethasone. Twenty male Wistar rats (130 ± 20 g) were randomly grouped into four (n=5 each) as control, normal+OG, Dex and Dex+OG. Dexamethasone (1 mg/kg) was administered intraperitoneally to Dex and Dex+OG groups followed by normal saline and OG (400 m...

ea0065p245 | Metabolism and Obesity | SFEBES2019

Glycaemic control in patients with diabetes mellitus in a Tertiary Hospital in South-West, Nigeria

Owolabi Funmilayo , Soyoye David , Imarhiagbe Laura , Adepoju Ayanbola , Kolawole Babatope , Ikem Rosemary

Background: Diabetes Mellitus (DM) is a metabolic disorder characterized by elevated blood glucose with accompanying microvascular and macrovascular complications resulting in increased morbidity, mortality and reduce quality of life in an individual living with the disease. Studies have shown that tight glycaemic control contributes immensely to the reduce risk of microvascular complications, and to a certain extent macrovascular complications. Achieving tight glycaemic contr...

ea0065p246 | Metabolism and Obesity | SFEBES2019

Presentation, investigations and management of suspected Gitelman syndrome in pregnancy

Silveira Maria , Haynes Shelly , Bujanova Jana

G2, P1, IUGR in previous pregnancy. Presented in 34/40 of pregnancy with profound lethargy, muscle weakness and fatigue. Found to have normotensive hypokalaemia − 2.6 mmol/l and mild metabolic alkalosis. No preceding vomiting, diarrhoea or nutritional cause. Pre-natal blood results were not available but reported low K+ in 2009. Required intravenous potassium replacement and symptoms improved dramatically with restoring normokalaemia. Results at diagnosis: K+ ...

ea0065p247 | Metabolism and Obesity | SFEBES2019

Audit on initial investigation and management of hyponatraemia in inpatients

Alabaf Setareh , Soong Elaine , Misra Sushil , Majeed Joohi

Background: Hyponatraemia is encountered in 15−20% of inpatients but remains suboptimally managed. It leads to increased morbidity, length of stay and mortality. A closed-loop audit on investigating and managing inpatients with hyponatraemia was conducted, to identify pitfalls in management.Method: A retrospective audit of general medical inpatients admitted over three months with a serum sodium level of less than 130 mmol/l was conducted. Relevant...

ea0065p248 | Metabolism and Obesity | SFEBES2019

Using problem-based learning (PBL) to engage undergraduate medical students in endocrinology at Edinburgh Medical School

Pender Frederic T , Morley Steven D

Background: Endocrinology, taught in Year 2 of the Edinburgh undergraduate MBChB curriculum to approximately 200 medical students, can present a complex challenge and a test of engagement. Core biomedical curriculum content is delivered as large group teaching (lectures) and then revisited in smaller groups (clinical-cased based tutorials, PBL) designed to integrate learning by applying basic knowledge in a clinical context. PBL first implemented in the 1960s at McMaster Unive...

ea0065p249 | Metabolism and Obesity | SFEBES2019

‘H’ syndrome; a rare case with novel symptoms

Shah Shanty , DSilva Deborah , Arunachalam Col. , Ganesh MK , Shenoy Ram , Sudeep K

Background: ‘H’ syndrome is a rare autosomal recessive disorder characterised by hyperpigmentation, hypertrichosis, hepatosplenomegaly, hearing loss, hypogonadism, hyperglycaemia (insulin-dependent diabetes), hallux valgus and low height (short stature) and systemic inflammation. Caused by mutations in SLC29A3 gene located on chromosome 10q23 which encodes the human equilibrative nucleoside transporter 3 (hENT3). We report this case to highlight the rarity of the Syn...

ea0065p250 | Metabolism and Obesity | SFEBES2019

Abstract withdrawn....

ea0065p251 | Metabolism and Obesity | SFEBES2019

Five-year review of diabetic foot ulcer admissions at Obafemi Awolowo University Teaching Hospital, Ile-Ife, Nigera

Adetunji Tajudin , Yusuff Olaoluwatomi , Ezekpo Okechukwu , Soyoye David , Kolawole Babatope , Ikem Rosemary

Background: Diabetic foot disease is a major cause of morbidity and mortality in people living with diabetes. It is a leading cause of minor or major limb loss with attendant huge economic ruins. Objective: The aim of the study was to determine pattern of presentation of diabetic foot ulcer (DFU), assess co-morbid conditions at admission and determine the overall outcome of patients managed over the 5 year study period. Materials a...

ea0065p252 | Metabolism and Obesity | SFEBES2019

Molecular interactions of cashew leaf (Anacardium occidentale) derived compounds with anti-diabetic targets: in silico and in vivo studies

Ukwenya Victor , Omotuyi Olaposi , Enejo Ojochenemi , Alese Olutayo

Anacardium occidentale (cashew tree) belongs to the Anacardiaceae family and has been well used in folklore medicine for the treatment of various ailments such as gastrointestinal disorders, hypertension and diabetes. Literature is replete with reported anti-diabetic actions of cashew leaf. The molecular mechanism of the hypoglycemic activity of A. occidentale was investigated in this study. Insulin, Glucagon like peptide-1 (GLP-1), dipeptidyl peptidase-4 (DP...

ea0065p253 | Metabolism and Obesity | SFEBES2019

Juvenile type 2 diabetes and Klinefelter syndrome

Lang Ailidh , Stirling Angus , Maitland Rahat

Introduction: Klinefelter Syndrome (KS) is the most common male sex-chromosome abnorrmality, typically presenting with features of hypogonadism. The association between KS and Type 2 Diabetes is not fully understood as early treatment with testosterone does not minimise this complication. We present an unusual case of simultaneous diagnosis of T2DM and Klinefelter Syndrome in a young adult.Case: A 17 year old Pakistani gentleman presented with a short hi...

ea0065p254 | Metabolism and Obesity | SFEBES2019

St James’s Hospital intensive care unit insulin discharge policy – A quality improvement project

Quinn Mark , Courtney Ashling , Smyth Coilin-Collins , Healy Marie-Louise , Pazderska Agnieszka , O'Connor Enda

Background: Many patients require IV insulin during their critical illness. Maintenance of insulin in St James’s Hospital ICU is governed by a local protocol. At the time of ICU discharge, IV insulin therapy is often stopped. Transitioning from IV to subcutaneous insulin is often done with endocrinology input. If this is unavailable inappropriate insulin dosing may increase the risk of hypo-/hyperglycaemia.Aims: To reduce the number of episodes of h...

ea0065p255 | Metabolism and Obesity | SFEBES2019

Ten years type 2 diabetes risks among doctors in Ondo State, South West Nigeria

Enikuomehin Adenike , Adejumo Oludamola , Ajiboye John , Junaid Oladimeji , Muhammad Fakhraddeen , Kolawole Babatope , Ikem Rosemary , Lawal Oluwatoyin

Background and objective: Diabetes mellitus is assuming worldwide increase with Doctors not being an exception. This study was carried out among Doctors in Ondo State South West Nigeria to assess 10 years risk of developing Diabetes using the Finish Diabetes Association assessment form.Subjects, materials and method: This is a cross sectional study carried out in March 2019 at the Ordinary General Meeting. Two hundred and two (202) Doctors were screened ...

ea0065p256 | Metabolism and Obesity | SFEBES2019

Diabetic lipemia − acute pancreatitis and new diagnosis of diabetes

Ventress Luke , Ahmad Waqar , Artham Satish

Diabetic lipemia, remains a well recognized but rare manifestation of uncontrolled diabetes mellitus. Although prompt diagnosis and insulin treatment have probably reduced the incidence of hyperlipemia in symptomatic diabetes, reports of this poorly understood syndrome continue to appear. 48 year old male presented with a 2 day history of severe epigastric pain, radiating to his back. Associated symptoms included nausea with vomiting. Lethargic, tired and associated headaches....

ea0065p257 | Metabolism and Obesity | SFEBES2019

Life threatening hypoglycaemia associated with illicit benzodiazepines

Naasan Adeeb , Connelly Paul , Brown Chris , Stevenson Richard , Carty David

A 53 year old male with a history of polysubstance abuse was admitted to A&E, having been found unconscious in the community with a blood glucose level of 1.2 mmol/l. Despite intramuscular glucagon and intravenous 20% dextrose administration, his blood glucose was confirmed to be 2.6 mmol/l on arrival in A&E. Neuroglycopaenia was refractory to multiple dextrose boluses and only stabilised following a continuous 20% 125 ml/hr dextrose infusion. Following admission to th...

ea0065p258 | Metabolism and Obesity | SFEBES2019

Severe peri-partum hyponatraemia: is oxytocin always the culprit?

Ali Tauni Rahat

A 34-year old pregnant lady had induction of labour with prostaglandins and oxytocin infusion after her due date. She failed to progress in labour and became slightly disoriented. Urgent biochemistry revealed serum sodium of 124 mmol/l. She delivered a healthy baby by forceps but had post-partum haemorrhage of 1.5 l. Oxytocin infusion was continued along with Hartmann’s solution. She became drowsy and biochemistry revealed serum sodium of 118 mmol/l, low serum osmolality,...

ea0065p259 | Metabolism and Obesity | SFEBES2019

Effectiveness of bariatric surgery – impact and metabolic outcome in different co-morbidities – a single center study in UK

Rafai Wajid , Ester Dubiwa , Beck Lana Faraj , Grive Anne , Hollywood Amelia , Aung Theingi

Introduction: Obesity is a global problem and its prevalence is on the rise in the U.K. It is associated with multiple co-morbidities with high mortality and has significant impact on healthcare costs. Bariatric surgery in recent past has revolutionized obesity treatment.Aims: To assess effectiveness of bariatric surgery in terms of metabolic outcomes in patients with obesity in a single center in the UK.Methods: Retrospective anal...

ea0065p260 | Metabolism and Obesity | SFEBES2019

Diabetes-related knowledge, attitude and practice among patients attending a Tertiary Hospital in Kano, Northwestern Nigeria

Muhammad Fakhraddeen , Enikuomehin Adenike

Introduction: Diabetes mellitus is the second non-communicable disease in Kano affecting 4.2% of the population.Purpose/Specific aim: The aim is to assess the level of diabetes-related knowledge, attitude, and practice (KAP) among patients with diabetes in Kano. Also, the study sought to determine the relationship between the KAP and glycemic control.Methods: This was a hospital-based cross-sectional study conducted at the diabetic...

ea0065p261 | Metabolism and Obesity | SFEBES2019

Challenges in management of hypoglycemia presented post bariatric surgery

Alkaabi Fatima , Al Juboori Ahmed , Ismail Mohamed

A 39 years old lady who started to develop hypoglycemia three month following gastric bypass surgery. She is known to have Type 2 DM, dyslipidemia hypertension and Hirsutism. Her weight on presentation was 93.5 kg (pre operation was 104 kg) and Ha1c was 6% (pre operation was 10.5%). She was off diabetes medications. Hypoglycemia mainly fasting some readings < 3 mmol/l, with symptoms (diaphoresis, fatigue and weakness) but sometime hypoglycemia occur 2–3 h post prandia...

ea0065p262 | Metabolism and Obesity | SFEBES2019

Audit on sodium glucose cotransporter-2 inhibitors (SGLT2) at Nottingham University Hospitals

Vyas Abhishek , Yahia Seif , Mendis Buddhike

Aims/objectives: The aims of the audit were to assess if Sodium Glucose Cotransporter-2 inhibitors (SGLT2) were initiated in accordance with National institute of clinical excellence guidelines and appropriate effectiveness and reviews were performed in accordance with these guidelines.Methods: A retrospective audit of 31 patients with Type 2 diabetes prescribed Sodium Glucose Cotransporter-2 inhibitors (SGLT2) between March 2014 and January 2017 at Nott...

ea0065p263 | Metabolism and Obesity | SFEBES2019

BMI concordance in the United Arab Emirates (UAE): a study of 200 twin pairs

Wazan Mariam , Ali Tomader , Barakat Maha , Lessan Nader

Background and aims: We previously reported BMI heritability in the UAE to be 39.9%; indicating a high (60.1%) contribution of environmental factors to obesity. This study aims to determine and compare co-twin monozygotic (MZ) and dizygotic (DZ) BMI concordances.Materials and methods: 200 twin pairs were identified (ICLDC patient database) and split into two age groups (≤18 and >18 years old). Opposite gender twin sets were considered DZ. In same g...

ea0065p264 | Metabolism and Obesity | SFEBES2019

Dapsone-induced discordant glycated haemoglobin values in a patient with type 1 diabetes

Sagi Satyanaraynana V , Hikmat Mondy , Lum Mark , Rajkanna Jeyanthy , Seechurn Shivshankar B , Oyibo Samson O

Introduction: Glycated haemoglobin (HbA1c) is used to measure glycaemic control in patients with diabetes, and accuracy depends on normal erythrocyte lifespan. Dapsone causes spuriously low HbA1c results by reducing erythrocyte lifespan through haemolysis and methaemoglobin formation, which interferes with the liquid-chromatography method used to measure HbA1c. Dapsone-induced haemolysis (DIH) is mostly reported in patients with glucose-6-phosphate dehydrogenase (G6PD) deficie...

ea0065p265 | Metabolism and Obesity | SFEBES2019

Emphysematous pyelonephritis − medical management, a viable option

Udo Chinyere , Olopade Oluwarotimi , Odeniyi Ifedayo

Introduction: Emphysematous pyelonephritis(EPN) is a necrotizing infection of the renal parenchyma. Most cases occur in the setting of uncontrolled diabetes mellitus(DM). Presentation ranges from mild symptoms to shock and altered sensorium.Objective: To highlight efficacy of intensive, appropriate medical therapy in management of a rare but life-threatening infection.Case presentation: A 54-year old man presented with 3 week histo...

ea0065p266 | Metabolism and Obesity | SFEBES2019

Cushing’s or not − a diagnostic dilemma

Patel Nishchil , Choudhary Nidhi

We present the case of a 49 year old Caucasian lady who was referred for urgent evaluation to rule out Cushing’s syndrome. She had progressive increase in bulk of her shoulders and upper arms over several months. She had a history of asthma, hypertension, and alcohol excess. She had inadvertently been using fostair (steroid inhaler) as a reliever up to 10 times a day. She denied anabolic steroid or drug use. She had no clinical features of Cushing’s syndrome. There w...

ea0065p267 | Metabolism and Obesity | SFEBES2019

Social support and medication adherence among type 2 DM (T2DM) patients attending a public hospital in Lagos, Nigeria

Olabode Olufolake , Omoluru Timothy , Olagundoye Olawunmi , Akinlade Akinyele , Akujobi Henry , Olopade Oluwarotimi

Background: Diabetes Mellitus is a chronic metabolic disorder with grievous complications affecting every aspect of patients’ life. Availability of social support helps patients to cope better with the disease, hence positively affecting medication adherence and glycemic control.Objectives: To assess the types of perceived social support and its relationship to medication adherence among T2DM patients attending a public hospital in Lagos, Nigeria.</...

ea0065p268 | Metabolism and Obesity | SFEBES2019

Social support and health-related quality of life among type 2 DM (T2DM) patients attending a public hospital in Lagos, Nigeria

Olabode Olufolake , Omoluru Timothy , Olagundoye Olawunmi , Akinlade Akinyele , Akujobi Henry , Olopade Oluwarotimi

Background: Diabetes Mellitus is a chronic metabolic disorder with grievous complications affecting every aspect of the patients’ life. Availability of social support helps patients to cope better with the disease, hence positively affecting their quality of life.Objectives: To assess the level of perceived social support and its relationship to health-related quality of life of T2DM patients attending a public hospital in Lagos, Nigeria.<p clas...

ea0065p269 | Metabolism and Obesity | SFEBES2019

Severe symptomatic hyponatraemia following a minor surgical procedure

Nawaz Zahrah , Joshi Hareesh , Mehmood Taiyyab , Ukpabi Oyidiya , Oyibo Samson O , Sagi Satyanarayana V

Introduction: Hyponatraemia following surgery is usually due to a mismatch between fluid input and output peri- and post-operatively. Syndrome of inappropriate antidiuretic hormone secretion (SIADH) is another important cause of hyponatraemia, commonest cause being medications, and intrathoracic and intracranial infections and neoplasia. SIADH has been reported to occur after pituitary surgery but rarely after other types of surgery. We present a severe case of SIADH-related h...