Burden Of Metabolic Diseases Research Articles

Impacts of Breakfast Eating Behaviors on Lipid Profile of University going Students

Change in dietary patterns influenced the health status of people worldwide. The devastating burden of metabolic diseases is now the major challenge for developing economies. Mostly people skip their breakfast and used to consume higher quantities of fried foods during their craving conditions. These fried foods are leading cause of various disorders in body including hyperlipidemia and cardiovascular diseases. Current study was conducted to evaluate lipid profile and physical parameters of the graduate students (Healthy breakfast eaters, fried foods breakfast eaters and breakfast skippers). For this purpose, data collected through the questionnaire was utilized to estimate and evaluate some parameters (i.e., BMI, total proteins, total carbohydrates and total fats) about dietary habits of participants. The chemistry analyzer was utilized to determine the lipid profiling (i.e., Total cholesterol, Triglycerides, HDL, LDL, and VLDL) of selected candidates. The results depicted that the total cholesterol and triglyceride levels were observed higher in no breakfast eaters as compared to breakfast eaters and healthy breakfast eaters. Moreover, TCs (206.13±24.52mg/dl) and TGs (241.40±115.17mg/dl) were extraordinary higher in females and males of NBE groups, accordingly. HDL levels were lower and LDL levels were higher in non-breakfast eaters. BMI and Total fat were also higher in non-breakfast eaters indicating the increased health risks. Thus, to prevent chronic metabolic disorders the healthy eating pattern should be promoted.

Metabolic PET/CT Analysis of Aggressive Non-Hodgkin Lymphoma Prior to Axicabtagene Ciloleucel CAR-T Infusion: Predictors of Progressive Disease, Survival, and Toxicity

Purpose: Axicabtagene ciloleucel (axi-cel) is an anti-CD19 chimeric antigen receptor T-cell (CAR-T) therapy utilized for patients with non-Hodgkin lymphoma (NHL) refractory to at least 2 lines of therapy. F-18 fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) is used to evaluate disease extent prior to CAR-T infusion at two time points: pre-leukapheresis (pre-leuk) approximately 6 weeks prior to CAR-T infusion, and pre-lymphodepletion chemotherapy (pre-LD) approximately 1 week prior to CAR-T infusion. We hypothesized that PET/CT characteristics beyond Lugano criteria, such as metabolic tumor volume (MTV), total lesion glycolysis (TLG), SUV maximum (SUVMax), and changes in these parameters from pre-leuk to pre-LD, may predict for progressive disease (PD), death, and treatment toxicity after CAR-T infusion.Methods: Patients with NHL who received axi-cel on a prospective registry at Mayo Clinic Rochester were included. Lesions on pre-leuk and pre-LD PET/CT scans were segmented with a fixed absolute SUVMax threshold of 2.5 using a semi-automated workflow (LesionID, MIM Software Inc.) with manual modification to exclude physiologic uptake as needed. MTV, TLG, SUVMax, number of lesions, and other lesion characteristics were assessed for each PET/CT, and changes from pre-leuk to pre-LD were calculated. Lesions were categorized as either nodal, spleen, bone, parenchymal (i.e. liver, lung), or soft tissue (i.e. subcutaneous, muscle), and MTV was calculated for each category. Univariate Cox modeling was used to associate relative and directional change in metabolic and volumetric PET/CT characteristics with PD and death, after adjusting for bridging therapy. LASSO method was used for multivariable model selection. Pre-LD PET/CT characteristics were also assessed for association with presence and duration of cytokine release syndrome (CRS), grade 3+ immune effector cell-associated neurotoxicity syndrome (ICANS), tocilizumab (toci) use, and corticosteroid use.Results: From 2018-2020, axi-cel was delivered to 69 patients. Histology included diffuse large B-cell lymphoma (57%), transformed follicular lymphoma (23%), or high-grade lymphoma (19%). Pre-leuk and pre-LD PET/CT scans were performed a median of 46 days and 7 days prior to CAR-T infusion, respectively. Forty patients (58%) received bridging therapy between scans, including 9 (13%) receiving radiotherapy. At a median follow-up of 13 months, 39 (57%) had died and 46 (67%) had PD.Sixty patients (87%) developed CRS following CAR-T infusion for a median duration of 5 days. Presence of pre-LD parenchymal disease was associated with longer duration CRS (p=0.032). Thirty-seven patients (54%) developed ICANS for a median duration of 4.5 days, including 12 (32%) with grade 3+ ICANS. Greater pre-LD total MTV was associated with higher risk of grade 3+ ICANS (p=0.042). Greater pre-LD SUVMax was associated with longer duration ICANS (p=0.032). Nineteen (28%) patients required toci. Greater pre-LD total MTV, SUVMax, TLG, and volume of the largest lesion were associated with increased use of toci (p<0.05 for all). Greater pre-LD total MTV and TLG of the largest lesion were associated with increased use of corticosteroid (p<0.05 for each).While no individual pre-leuk or pre-LD PET/CT characteristics were associated with risk of PD or death, increases from pre-leuk to pre-LD in total MTV, total TLG, parenchymal MTV, and nodal MTV were associated with increased risk of PD (Figure 1). Similarly, increases from pre-leuk to pre-LD in parenchymal MTV, nodal MTV, TLG of the largest lesion, and total number of lesions were associated with increased risk of death (p<0.05 for all). LASSO analysis identified increasing extranodal MTV (≥25% increase) and increasing TLG of the largest lesion (≥10% increase) as strong predictors of death (AUC 0.74, Table 1). Kaplan-Meier plots were generated for overall and progression-free survival using these risk factors (Figure 2).Additional patients and follow-up will be presented.Conclusions: Patients with greater pre-LD MTV had higher risk of grade 3+ ICANS and use of toci or corticosteroids. Increasing metabolic disease burden during CAR-T manufacturing is associated with increased risk of PD and death. A two variable risk score using increasing extranodal disease and increasing TLG of the largest lesion may stratify prognosis prior to CAR-T and inform treatment paradigms. [Display omitted] DisclosuresBennani: Verastem: Other: Advisory Board; Purdue Pharma: Other: Advisory Board; Daichii Sankyo Inc: Other: Advisory Board; Kyowa Kirin: Other: Advisory Board; Vividion: Other: Advisory Board; Kymera: Other: Advisory Board. Paludo: Karyopharm: Research Funding. Wang: Genentech: Research Funding; LOXO Oncology: Membership on an entity's Board of Directors or advisory committees, Research Funding; Eli Lilly: Membership on an entity's Board of Directors or advisory committees; Incyte: Membership on an entity's Board of Directors or advisory committees, Research Funding; InnoCare: Research Funding; Novartis: Research Funding; MorphoSys: Research Funding; TG Therapeutics: Membership on an entity's Board of Directors or advisory committees. Ansell: Bristol Myers Squibb, ADC Therapeutics, Seattle Genetics, Regeneron, Affimed, AI Therapeutics, Pfizer, Trillium and Takeda: Research Funding. Lin: Gamida Cell: Consultancy; Janssen: Consultancy, Research Funding; Legend: Consultancy; Novartis: Consultancy; Celgene: Consultancy, Research Funding; Sorrento: Consultancy; Bluebird Bio: Consultancy, Research Funding; Takeda: Research Funding; Kite, a Gilead Company: Consultancy, Research Funding; Merck: Research Funding; Vineti: Consultancy; Juno: Consultancy.

Metabolic Kinetics of Non-Hodgkin Lymphoma Prior to CAR-T Infusion: Prognostic Factors and Risk Stratification

<h3>Purpose/Objective(s)</h3> Chimeric antigen receptor T-cell (CAR-T) therapy is utilized for patients with active non-Hodgkin lymphoma (NHL) refractory to recent treatments, sometimes even requiring bridging therapy during CAR-T manufacturing to maintain clinically stability for CAR-T infusion. We examined the metabolic kinetics of these patients' lymphoma via F-18 fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) with the hypothesis that increasing metabolic disease parameters during CAR-T manufacturing are associated with increased rates of progressive disease (PD) and death after CAR-T. <h3>Materials/Methods</h3> Patients with NHL who received axicabtagene ciloleucel (axi-cel), an anti-CD19 CAR-T therapy, on a prospective registry at one institution were included. Lesions on PET/CT scans before leukapheresis (pre-leuk) and before lymphodepletion chemotherapy (pre-LD) were segmented with a fixed absolute SUV threshold of 2.5 using a semi-automated workflow with manual modification to exclude physiologic uptake as needed. Metabolic tumor volume (MTV), total lesion glycolysis (TLG), SUV maximum (SUVMax), and other lesion characteristics were assessed for each PET/CT, and changes between pre-leuk and pre-LD were calculated. Univariate Cox modeling was used to associate relative and directional change in metabolic and volumetric PET/CT characteristics with PD and death, after adjusting for bridging therapy. LASSO method was used for multivariable model selection. <h3>Results</h3> Axi-cel was delivered to 69 patients with NHL (64% DLBCL) from 2018-2020. Pre-leuk and pre-LD PET/CT scans were performed a median of 46 days and 7 days prior to CAR-T infusion, respectively. Forty patients (58%) received bridging therapy between scans, including 9 (13%) receiving radiotherapy. At data cut-off of December 2020 with a median follow-up of 13 months for surviving patients, 39 (57%) had died and 46 (67%) had PD. Increases from pre-leuk to pre-LD PET/CT in total MTV, total TLG, parenchymal MTV, and nodal MTV were associated with increased risk of PD. Increases in parenchymal MTV, nodal MTV, TLG of the largest lesion, and total number of lesions were associated with increased risk of death. LASSO analysis identified increasing total extranodal MTV (≥25% increase) and increasing TLG of the largest lesion (≥10% increase) as strong predictors of death (AUC 0.74, Table). <h3>Conclusion</h3> Increasing metabolic disease burden during CAR-T manufacturing is associated with increased risk of PD and death. A two variable tool using increasing extranodal disease and increasing TLG of the largest lesion may be able to stratify prognosis prior to CAR-T and inform treatment paradigms.

Associations of Binge Drinking and Heavy Alcohol Use on Sugar and Fat Intake in a Cohort of Southern People Living with HIV.

To assess whether binge drinking and heavy alcohol use are associated with increased sugar and fat consumption among a Southern cohort of people living with HIV (PWH). This was a cross-sectional analysis of PWH enrolled in the New Orleans Alcohol use in HIV (NOAH) Study (n = 215). Binge and heavy drinking were identified through a 30-day Alcohol Timeline-Followback and dietary intake was assessed through a 24-hour dietary recall. Participants were 65.4% male, 83.3% Black, with a mean age of 49.2 ± 9.9. Heavy drinkers consumed more total calories than abstainers (P = 0.035) and low-to-moderate drinkers (P = 0.024), and binge drinkers consumed more calories than non-binge drinkers (P = 0.025). Binge and heavy drinkers had significantly higher intake of total and saturated fat in grams. However, substantially increased caloric intake among these participants led to non-significant associations for alcohol use with high total and saturated fat intake as a percent of total energy intake (%TEI). Binge drinkers had lower odds of consuming high sugar as a %TEI (odds ratio: 0.31 [0.14, 0.68]). Additionally, sugar intake predicted total and saturated fat intake, and this association was slightly higher among binge drinkers (total fat P-value: 0.12). In this population of PWH, while binge and heavy drinking predicted higher caloric and fat intake in grams, binge drinkers were less likely to consume a high-sugar diet. This analysis suggests that interventions focused on reduced alcohol use may be especially beneficial in reducing metabolic disease burden in PWH if supplemented with information on incorporating lower energy-dense foods with reduced fat.

ID: 3527059 ENDOSONOGRAPHIC ESTIMATION OF THE CELIAC ARTERY MESENTERIC FAT THICKNESS (CAMEUS) IS RELIABLE VALIDATED ANTHROPOMORPHIC CORRELATE OF EXCESS ADIPOSITY RELATED CHRONIC DISEASE: THE METOBLIC ENDOSCOPIC ULTRASOUND STATION

Excess adiposity related chronic disease is the new medical term for obesity reflecting adipose tissue dysfunction as the sinister culprit in metabolic disease pathophysiology and burden. Visceral fat volume and inflammation, drained by the portal circulation, has been shown to have a critical role in metabolic disease, yet is difficult to quantify or sample via non-invasive modalities given deep mesenteric location (Figure 1). We hypothesize that aspects of visceral fat can be reliably measured during routine endosonography (EUS) of the gastrohepatic ligament, by estimating the celiac artery mesenteric fat thickness (CAMEUS) and this can correlate with metabolic disease burden.

Maternal Exercise Mediates Hepatic Metabolic Programming via Activation of AMPK-PGC1α Axis in the Offspring of Obese Mothers.

Maternal obesity is associated with an increased risk of hepatic metabolic dysfunction for both mother and offspring and targeted interventions to address this growing metabolic disease burden are urgently needed. This study investigates whether maternal exercise (ME) could reverse the detrimental effects of hepatic metabolic dysfunction in obese dams and their offspring while focusing on the AMP-activated protein kinase (AMPK), representing a key regulator of hepatic metabolism. In a mouse model of maternal western-style-diet (WSD)-induced obesity, we established an exercise intervention of voluntary wheel-running before and during pregnancy and analyzed its effects on hepatic energy metabolism during developmental organ programming. ME prevented WSD-induced hepatic steatosis in obese dams by alterations of key hepatic metabolic processes, including activation of hepatic ß-oxidation and inhibition of lipogenesis following increased AMPK and peroxisome-proliferator-activated-receptor-γ-coactivator-1α (PGC-1α)-signaling. Offspring of exercised dams exhibited a comparable hepatic metabolic signature to their mothers with increased AMPK-PGC1α-activity and beneficial changes in hepatic lipid metabolism and were protected from WSD-induced adipose tissue accumulation and hepatic steatosis in later life. In conclusion, this study demonstrates that ME provides a promising strategy to improve the metabolic health of both obese mothers and their offspring and highlights AMPK as a potential metabolic target for therapeutic interventions.

Metabolic disease and adverse events from immune checkpoint inhibitors.

Obese and overweight body mass index (BMI) categories have been associated with increased immune-related adverse events (irAEs) in patients with cancer receiving immune checkpoint inhibitors (ICIs); however, the impact of being overweight in conjunction with related metabolic syndrome-associated factors on irAEs have not been investigated. We aimed to evaluate the impact of overweight and obese BMI according to metabolic disease burden on the development of irAEs. We conducted a retrospective observational study of patients receiving ICIs at a cancer center. Our main study outcome was development of ≥grade 2 (moderate) irAEs. Our main predictor was weight/metabolic disease risk category: (1) normal weight (BMI 18.5-24.9 kg/m2)/low metabolic risk (<2 metabolic diseases [diabetes, dyslipidemia, hypertension]), (2) normal weight/high metabolic risk (≥2 metabolic diseases), (3) overweight (BMI ≥25 kg/m2)/low metabolic risk, and (4) overweight/high metabolic risk. Of 411 patients in our cohort, 374 were eligible for analysis. Overall, 111 (30%) patients developed ≥grade 2 irAEs. In Cox analysis, overweight/low metabolic risk was significantly associated with ≥grade 2 irAEs (hazard ratio [HR]: 2.0, 95% confidence interval [95% CI]: 1.2-3.4) when compared to normal weight/low metabolic risk, while overweight/high metabolic risk (HR: 1.3, 95% CI: 0.7-2.2) and normal weight/high metabolic risk (HR: 1.5, 95% CI: 0.7-3.0) were not. Overweight patients with fewer metabolic comorbidities were at increased risk for irAEs. This study provides an important insight that BMI should be evaluated in the context of associated metabolic comorbidities in assessing risk of irAE development and ICI immune response.

Features of patients that died for COVID-19 in a hospital in the south of Mexico: A observational cohort study.

Due to the wide spread of SARS-CoV2 around the world, the risk of death in individuals with metabolic comorbidities has dangerously increased. Mexico has a high number of infected individuals and deaths by COVID-19 as well as an important burden of metabolic diseases; nevertheless, reports about features of Mexican individuals with COVID-19 are scarce. The aim of this study was to evaluate demographic features, clinical characteristics and the pharmacological treatment of individuals who died by COVID-19 in the south of Mexico. We performed an observational study including the information of 185 deceased individuals with confirmed diagnoses of COVID-19. Data were retrieved from medical records. Categorical data were expressed as proportions (%) and numerical data were expressed as mean ± standard deviation. Comorbidities and overlapping symptoms were plotted as Venn diagrams. Drug clusters were plotted as dendrograms. The mean age was 59.53 years. There was a male predominance (60.1%). The mean hospital stay was 4.75 ± 4.43 days. The most frequent symptoms were dyspnea (88.77%), fever (71.42%) and dry cough (64.28%). Present comorbidities included diabetes (60.63%), hypertension (59.57%) and obesity (43.61%). The main drugs used for treating COVID-19 were azithromycin (60.6%), hydroxychloroquine (53.0%) and oseltamivir (27.3%). Mexican individuals who died of COVID-19 had shorter hospital stays, higher frequency of shortness of breath, and higher prevalence of diabetes than individuals from other countries. Also, there was a high frequency of off-label use of drugs for their treatment.

Burden of metabolic diseases in Indonesia: an even more critical issue during COVID-19 pandemic

[No abstract available]

Lymphoma Severity and Type Are Associated With Aortic FDG Uptake by 18F-FDG PET/CT Imaging

BackgroundThere is evidence that metabolic disease burden in lymphoma influences patient outcome. However, the impact of disease severity on the cardiovascular system is unknown. ObjectivesThe aim of this study was to examine whether lymphoma is associated with arterial inflammation by investigating the relationship between disease metabolic burden and arterial fluorodeoxyglucose (FDG) uptake. MethodsSixty-two chemotherapy-naïve patients with active Hodgkin’s or non-Hodgkin’s lymphoma were matched (2:1) to individual control groups of lymphoma patients previously treated and free of active disease. All groups underwent 18F-FDG position emission tomography–computed tomography imaging. Disease severity was quantified by metabolic tumor volume (MTV) and total lesion glycolysis corresponding to standardized uptake values (SUVs) ≥41% or ≥2.5 of the maximum SUV within lymphoma regions, and aortic FDG uptake was quantified through the target-to-background ratio (TBR). Inflammatory and disease severity biomarkers were also measured. ResultsMTV and total lesion glycolysis measurements were significantly correlated with inflammatory and disease biomarkers. Aortic TBR was higher in patients with active non-Hodgkin’s lymphoma compared with control subjects (median difference 0.51; 95% confidence interval [CI]: 0.28 to 0.78; p < 0.001). Similarly, patients with active Hodgkin’s lymphoma had higher values of aortic TBR compared with control subjects (median difference 0.31; 95% CI: 0.15 to 0.49; p < 0.001). In addition, aortic TBR was modestly increased in patients with stage III to IV disease compared with those with stage I to II disease (median aortic TBR: 2.23 [interquartile range: 2.01 to 2.54] vs. 2.06 [interquartile range: 1.83 to 2.27; p = 0.050). In multivariable analysis, aortic FDG uptake and MTV≥2.5 values were independently associated (β = 0.425; 95% CI: 0.189 to 0.662; p = 0.001; R2 = 0.208), as were aortic FDG uptake and MTV≥41% (β = 0.407; 95% CI: 0.167 to 0.649, p = 0.001; R2 = 0.191). ConclusionsAortic wall FDG uptake is related with disease severity indicative of a possible vascular effect of lymphoma. This work highlights a new potential role of molecular imaging in cardio-oncology for evaluating disease severity and its consequences on the vasculature.

Severity and type of lymphoma are associated with aortic 18-fluorodeoxyglucose (FDG) positron emission tomographic uptake assessed by FDG PET/CT imaging

Abstract Introduction There is increasing evidence that metabolic disease burden in lymphoma influence patients' outcome.However, the impact of disease severity on cardiovascular system remains unknown. Purpose To assess whether lymphoma is associated with arterial inflammation by examining the relationship between disease metabolic burden and arterial fluorodeoxyglucose (FDG) uptake. Methods Sixty-two patients (43 male, mean age 58±18 years) with Hodgkin (n=29) or non-Hodgkin lymphoma (n=33) before chemotherapy and two separate control groups of 14 and 16 healthy individuals for Hodgkin and non-Hodgkin population respectively, with similar age, sex and cardiovascular risk factors,underwent FDG position emission tomography (FDG-PET/CT) imaging.Disease severity was quantified by metabolic tumor volume (MTV) and total lesion glycolysis (TLG) corresponding to standard uptake values (SUV) ≥41% or ≥2.5 of maximum SUV within lymphoma regions, and aortic FDG uptake by target-to-background ratio (TBR). Serum high sensitivity-C-reactive protein (hs-CRP), white blood count (WBC), ratio of neutrophils to lymphocytes (N/L), albumin and lactic acid dehydrogenase (LDH) values were measured for patient group. Results MTV and TLG measurements correlated significantly with hs-CRP, WBC,N/L ratio,albumin and LDH table 1.Patients with non-Hodgkin or Hodgkin lymphoma had increased aortic TBR compared to controls (p=0.001 and p=0.023, respectively).Aortic TBR was higher in patients with stage III-IV disease compared to those with stage I-I (p=0.046).There were significant associations between aortic FDG uptake and MTV values, which remained significant after adjustment for confounders (β=0.353, p=0.001, adjusted R2=0.318 for MTV41%, β=0.442, p=0.001, adjusted R2=0.269 for MTV2.5), Figure 1. Conclusions Aortic wall FDG uptake is related with disease severity indicating a vascular effect of lymphoma, as well as a new potential role of molecular imaging in cardio-oncology for evaluating disease severity and its consequences to vascular beds with a single examination. Figure 1 Funding Acknowledgement Type of funding source: None

Mechanical Surgery Eases the Burden of Metabolic Disease

Mechanical Surgery Eases the Burden of Metabolic Disease

Potential Protective Effects of Neonatal Supplementation with Oleanolic Acid on Peroxisome Proliferator-Activated Receptor Gamma (PPARγ)-Ligand Dependent Regulation of Glucose Homeostasis in High Fructose-Fed Rats

The effect of neonatal oral supplementation of oleanolic acid (OA) on peroxisome proliferator-activated receptor gamma (PPARγ)-1 on glucose homeostasis in high fructose-fed rats was investigated. Rat pups (7 days old) were randomly assigned to and randomly administered with control (Distilled water, DW), OA (60 mg/kg), metformin (MET, 500 mg/kg), high fructose solution (HFS, 20% w/v), OA + HFS, MET + HFS, and treated till postnatal day (PND) 14. The pups were weaned onto a standard diet on PND 21 up to PND 111 and terminated on PND 112. Glucose derivatives and gene expressions of PPARγ-1 and glucose transporter type 4 (Glut-4) in the skeletal muscles were determined by using reverse transcription-quantitative polymerase chain reaction and gas chromatography-mass spectrometry, respectively. HFS significantly lowered glucose concentration and showed the propensity to suppress the expression of PPARγ-1, but not significantly. OA and MET alone significantly increased PPARγ-1 and Glut-4 expressions. There was no significant difference between the OA and OA + HFS for PPARγ-1 and Glut-4 expressions, although OA expressions were always higher than that of the OA + HFS group. An elevated level of glucose-6-phosphate was observed in OA, MET, and OA + HFS groups. Ribose-5-phosphate was significantly higher in OA and MET groups than the control. Ribose-5-phosphate was also significantly high in OA-treated group compared with OA + HFS. It is concluded that the neonatal supplementation with OA could help to improve the activity of PPARγ in reducing the burden of metabolic diseases.

Obesity and Weight Gain in Persons with HIV.

The proportion of overweight and obese persons with HIV (PWH) has increased since the introduction of antiretroviral therapy (ART). We aim to summarize recent literature on risks of weight gain, discuss adipose tissue changes in HIV and obesity, and synthesize current understanding of how excess adiposity and HIV contribute to metabolic complications. Recent studies have implicated contemporary ART regimens, including use of integrase strand transfer inhibitors and tenofovir alafenamide, as a contributor to weight gain, though the mechanisms are unclear. Metabolic dysregulation is linked to ectopic fat and alterations in adipose immune cell populations that accompany HIV and obesity. These factors contribute to an increasing burden of metabolic diseases in the aging HIV population. Obesity compounds an increasing burden of metabolic disease among PWH, and understanding the role of fat partitioning and HIV- and ART-related adipose tissue dysfunction may guide prevention and treatment strategies.

P3363Severity of lymphoma is associated with aortic FDG uptake assessed by FDG PET/CT imaging

Abstract Introduction There is increasing evidence that metabolic disease burden in lymphoma modifies patients' outcome. However, the impact of disease severity on cardiovascular system remains unknown. Purpose To investigate whether lymphoma is associated with arterial inflammation by examining the relationship between disease burden and arterial F-18 Fluorodeoxyglucose (FDG) uptake assessed by positron emission tomography/computed tomography (PET/CT) in Hodgkin and non-Hodgkin sub-types. Methods Sixty-two patients (43 male, mean age 58±18 years) with Hodgkin (n=29) or non-Hodgkin lymphoma (n=33) underwent FDG PET/CT imaging before chemotherapy. Disease severity was quantified by total metabolic tumor volume (TMTV) that represents the volume exhibiting standard uptake values (SUV) ≥41% or ≥2.5 of maximum SUV within lymphoma regions, while aortic FDG uptake assessment was based on target-to-background ratio (TBR). Serum high sensitivity-C-reactive protein (hs-CRP), white blood count (WBC), ratio of neutrophils to lymphocytes (N/L), albumin and lactic acid dehydrogenase (LDH) values were recorded in all the patients. Results TMTV measurements correlated significantly with hs-CRP, WBC, N/L ratio, albumin and LDH. (Table) Patients with advanced stage disease (III-IV) had higher aortic TBR values compared to those with stage I-II disease (median 2.19 interquartile range (1.96–2.54) vs. 2.04 (1.83–2.15) p=0.046 respectively). Aortic TBR was related with N/L ratio (R=0.370, p=0.009), while no significant correlation was observed with either WBC or hs-CRP values (p=0.930 and p=0.296, respectively). There were significant associations between aortic TBR uptake and TMTV values even after adjustment for age, sex, LDH, albumin, N/L ratio, as well as for the number of cardiovascular risk factors of each patient (β=0.353, p=0.001, adjusted R2=0.318 for TMTV41%, β=0.442, p=0.001, adjusted R2=0.269 for TMTV2.5). Table 1. Pearson correlation between indices of lymphomas' severity and serum biomarkers PET derived measurements Hs-CRP P-value Neutrophils to lymphocytes ratio P-value MTV41% 0.306 0.016 0.317 0.026 MTV2.5 0.312 0.013 0.389 0.006 Albumin LDH MTV41% −0.281 0.044 0.465 &lt;0.001 MTV2.5 −0.419 0.002 0.616 &lt;0.001 Conclusions Aortic wall FDG uptake is related with disease severity and subtype of lymphoma indicating a vascular effect of lymphoma, as well as a new potential role of molecular imaging in cardio-oncology by evaluation of disease severity and its consequences to vascular beds with a single examination.

Hyperglycaemia, adverse outcomes and impact of intravenous insulin therapy in patients presenting with acute ST-elevation myocardial infarction in a socioeconomically disadvantaged urban setting: The Montefiore STEMI Registry.

BackgroundHyperglycaemia occurs frequently in ST‐elevation myocardial infarction (STEMI) and is associated with poor outcomes, for which continuous insulin infusion therapy (CIIT) may be beneficial. Information is limited regarding hyperglycaemia in acute STEMI affecting urban minority populations, or how CIIT fares in such real‐world settings.Methods and resultsWe assembled an acute STEMI registry at an inner‐city health system, focusing on patients with initial blood glucose ≥180 mg/dL to determine the impact of CIIT vs usual care. Clinical and outcomes data were added through linkage to electronic records. Inverse‐probability‐of‐treatment weighting using propensity scores (PS) was used to compare CIIT vs no CIIT. The 1067 patients included were mostly Hispanic or African American; 356 had blood glucose ≥180 mg/dL. Such pronounced hyperglycaemia was related to female sex, minority race‐ethnicity and lower socioeconomic score, and associated with increased death and death or CVD readmission. CIIT was preferentially used in patients with marked hyperglycaemia and was associated with in‐hospital hypoglycaemia (21% vs 11%, P = .019) and, after PS weighting, with increased in‐hospital (RR 3.23, 95% CI 0.94, 11.06) and 1‐year (RR 2.26, 95% CI 1.02, 4.98) mortality. No significant differences were observed for death at 30 days or throughout follow‐up, or death and readmission at any time point.ConclusionsPronounced hyperglycaemia was common and associated with adverse prognosis in this urban population. CIIT met with selective use and was associated with hypoglycaemia, together with increased mortality at specific time points. Given the burden of metabolic disease, particularly among race‐ethnic minorities, assessing the benefits of CIIT is a prerogative that requires evaluation in large‐scale randomized trials.

Sugar ecologies: their metabolic and racial effects

ABSTRACT In this paper, we articulate sugar ecologies as the product of an unequal and racist system of food production and distribution. We trace the flow of sugar from its sources in the postcolony and racial capitalism, into sociocultural systems we call sugar ecologies the social systems that drive global sugar production, industrial processing, patterns of distribution and consumption. These systems encompass networks of economic, political, scientific, and ideological practices that link global systems of agricultural trade under racial capitalism to the hyper-local contexts of biological exposure and metabolic processing of sugar. Sugar’s pernicious effects are magnified by forces which guide sugar into Black bodies, becoming the source of extraordinary levels of toxicity and chronic metabolic disease for Black people the United States. This burden of metabolic disease, which also affects metabolic function and gene expression, also creates demand for for-profit health services that palliate, but do not treat the root causes of, chronic illness resulting from exposure to sugar. The kind of metabolic analysis we enact in this paper remains an underutilized yet illuminating framework through which to reframe our cultural stories and political analyses of sugar ecologies in the contexts of the Anthropocene, environmental racism and food justice.

MON-104 Defining the Contribution of Weight to the Extent of Metabolic Disease in FPLD: Insights from a Retrospective "Matched" Case-Control Study

Familial partial lipodystrophy (FPLD) presents with an absence of adipose tissue in the extremities, with accumulation in the upper body. Metabolic abnormalities associated with FPLD include diabetes mellitus and/or severe insulin resistance, hypertriglyceridemia, and non-alcoholic steatohepatitis. FPLD patients have a disproportionately lower BMI compared to individuals with common obesity and similar metabolic derangements. However, the extent and degree of metabolic disease at comparable truncal mass, or the “equivalent” BMI between the groups with similar metabolic disease are not known. To determine a BMI reference or “equivalence”, we performed a retrospective case control study comparing “cases” of FPLD against “controls” with severe obesity while matching for co-morbidities or total trunk mass. Baseline data were gathered to perform two k:1 nearest neighbor case-control matches using matchControls function of R’s e1071 package. MATCH1 included matching of age, sex, and total trunk mass with the hypothesis that FPLD with similar trunk mass had worse metabolic parameters. MATCH2 was performed using age, sex, and presence of comorbidities (hypertension, hypertriglyceridemia (>300mg/dL), diabetes, fatty liver, heart disease, arthritis, depression and anxiety, smoking history) with the hypothesis that there would be a significant difference in weight or BMI between the two populations. Our populations consisted of 55 FPLD cases (46F/9M, Age = 47±12 years, Total trunk mass=45.3±11.6 Kg) and a pool of 549 non-FPLD controls (338F/211M, Age = 48±10 years). MATCH1 allowed for a 2:1 nearest neighbor match with 110 obese controls (92F/18M, p=1.00, Age=48±11 years, p=0.72; Total Trunk Mass= 46.8±10.9 Kg, p=0.36). FPLD had worse glycemic control (HbA1c= 8.2±1.6%, 5.9±0.9%, respectively, p=<0.001), higher triglycerides (884±1190 mg/dL, 139±79 mg/dL, respectively, p<0.001), and lower leptin compared to obese controls (20.5±15.8 ng/mL, 41.9±29.4 ng/mL, p<0.001). MATCH2 allowed for a 1:1 nearest neighbor match with 55 controls (38F/17M, Age=53±9 years). The two groups had similar glycemic control (HbA1c = 8.2±1.6%, 7.8±1.6%, respectively, p=0.15), but the FPLD group had markedly higher triglycerides (884±1190 mg/dL, 224±123 mg/dL, respectively, p<0.001). Average BMI was 9.1 kg/m2 lower in the FPLD group compared to controls (BMI = 29.5±5.7 kg/m2, 38.6±5.2 kg/m2, respectively, p<0.001). In conclusion, FPLD patients with a similar truncal mass will have a worse metabolic profile than that of a non-FPLD obese patients despite having a lower BMI. This supports the understanding that lack of healthy fat depots drives metabolic disease in FPLD. The metabolic disease burden of the FPLD patients is equivalent to non-FPLD obesity that is at on average 9.1kg/m2 heavier than the observed BMI. This can be taken into account while defining weight goals for these patients.

Circular RNAs as Potential Biomarkers and Therapeutic Targets for Metabolic Diseases.

Epidemiological studies provide evidence of a continuous rise in metabolic diseases throughout industrialized countries. Metabolic diseases are commonly associated with different abnormalities that hold a key role in the emergence and progression of frequent disorders including diabetes mellitus (DM), non-alcoholic fatty liver disease (NAFLD), obesity, metabolic syndrome and cardiovascular diseases. The burden of metabolic diseases is believed to arise through complex interaction between genetic and epigenetic factors, lifestyle changes and environmental exposure to triggering stimuli. The diagnosis and treatment of metabolic disorders continue to be an overwhelming challenge. Thus, the development of novel biomarkers may enhance the accuracy of the diagnosis at an early stage of the disease and allow effective intervention. Over the past decade, progress has been made in exploring the potential role of noncoding RNAs (ncRNAs) in the regulation of gene networks involved in metabolic diseases. A growing body of evidence now suggests that aberrant expression of circular RNAs (circRNAs) is relevant to the occurrence and development of metabolic diseases. Accordingly, circRNAs are proposed as predictive biomarkers and potential therapeutic targets for these diseases. As the field of circRNAs is rapidly evolving and knowledge is increasing, the present paper provides current understanding of the regulatory roles of these RNA species mainly in the pathogenesis of DM, NAFLD and obesity. Furthermore, some of the limitations to the promise of circRNAs and perspectives on their future research are discussed.

Longitudinal associations of android and gynoid fat mass on cardiovascular disease risk factors in normal weight and overweight boys during puberty.

The aim of this longitudinal study was to assess associations between android and gynoid fat distribution and different cardiovascular disease risk factors in normal weight as well as overweight/obese boys during the pubertal period. In total, 146 boys (baseline age 11.9 ±0.6 years) were recruited for a 2-year longitudinal study. Total body fat percentage and android-gynoid fat distribution were measured using DXA. In addition, waist and hip circumference was measured and body mass index (BMI) was calculated. Total cholesterol, high-density lipoprotein (HDL) and low-density lipoprotein (LDL) cholesterol, triglycerides, insulin and glucose were measured, and homeostatic model assessment-insulin resistance (HOMA-IR) was calculated. Tanner stage and physical activity were assessed as covariates. Overweight subjects had worse values for most of the measured blood parameters (P <0.05). Higher android, gynoid fat mass (FM), and android/gynoid FM ratio were longitudinally associated with higher insulin and HOMA-IR values in both normal weight and overweight boys (P <0.05). In addition, higher android FM and gynoid FM were associated with worse values in HDL cholesterol, LDL cholesterol, and triglycerides in overweight boys (P <0.05). Our results suggest that higher android as well as gynoid fat have a strong impact on cardiovascular disease risk factors in both normal weight and overweight boys during the pubertal period. It can be suggested that measurement of fat distribution as android and gynoid fat is important for the assessment of the development or burden of metabolic diseases in boys with different weight statuses.