10.1515 - CCLM 2023 7044

Poster Abstracts – WorldLab • EuroMedLab Roma 2023 – Rome, Italy, May 21-25, 2023 • DOI 10.
1515/cclm-2023-7044
Clin Chem Lab Med 2023; 61, Special Suppl, pp S87 – S2222, May 2023 • Copyright © by Walter de Gruyter • Berlin • Boston S856
Diabetes, obesity, metabolic syndrome

P0769
COMPARISON OF POINT-OF-CARE AND LABORATORY GLYCATED HEMOGLOBIN A1C AND ITS RELATIONSHIP TO TIME-
IN-RANGE AND GLUCOSE VARIABILITY
A. Al Hayek 1, S. Sobki 2
1
1. Department of Endocrinology and Diabetes, Diabetes Treatment Center, Prince Sultan Military Medical City, Riyadh, Saudi
Arabia
2
Saudi Society for Clinical Chemistry (SSCC), PO BOX 22490. LABORATORY. Riyadh, Saudi Arabia
BACKGROUND-AIM
The main objective of the current study was to perform a comparison of point-of-care testing for hemoglobin A1c
(POCT-HbA1c) versus standard laboratory method (Lab HbA1c) and their relationship to time-in-range (TIR) and
glucose variability (GV) among patients with diabetes mellitus (DM) presented to the outpatient diabetes clinics.
METHODS
This single-center cross-sectional study was carried out on diabetic patients (aged ≥14 years of both genders) who
undergo routine follow-up at our institution and whose physicians ordered HbA1c analysis for routine care. The
included patients were using the isCGM Abbott’s FreeStyle Libre system for at least three months and regular CGM
users with at least 70% use.
RESULTS
We included 97 diabetic patients (41 female and 56 male), with a mean age of 29.75±13.55 years and a mean DM
duration of 10.33±5.48 years. The mean values of Lab-HbA1c and POCT HbA1c were 8.82%±0.85% and 8.53%±0.89%.
The TIR, time below range, and time above range were 33.47±14.38 minutes (47.78%±14.32%), 5.44±2.58 minutes
(8.41%±4.42%), and 28.8±8.27 minutes (43.81%±13.22%). According to the Bland-Altman plot analysis, the POCT-
HbA1c values are consistent with the standard Lab-HbA1c values (SD of bias= 0.55, and 95% CI= -0.78 to 1.4). Using
the univariate linear regression analysis showed a statistically significant relationship between laboratory HbA1c and
POCT HbA1c (R2= 0.637, p <0.001), TIR (R2= 0.406, p <0.001), and GV (R2= 0.048, p= 0.032). After adjusting for age,
gender, disease duration, diabetes type, and percentage of sensor data in a multivariable linear regression model, the
linear associations remained significant (all p < 0.05).
CONCLUSIONS
TIR and GV have promise as preferred measures for identifying clinical trial endpoints, estimating the likelihood of
DM-related complications, and gauging a patient’s glycemic condition.
Poster Abstracts – WorldLab • EuroMedLab Roma 2023 – Rome, Italy, May 21-25, 2023 • DOI 10.1515/cclm-2023-7044

P0770
THE POTENTIAL ROLE OF VITAMIN D SUPPLEMENTATION AS A GUT MICROBIOTA MODIFIER IN HEALTHY INDIVIDUALS
P. Singh 2, A. Rawat 2, M. Alwakeel 1, E. Sharif 1, S. Al Khodor 2

1
College of Health Sciences, Qatar University, Doha, Qatar
2
Research Department, Sidra Medicine, Doha
BACKGROUND-AIM
Vitamin D deficiency affects approximately 80% of individuals in some countries and has been linked with gut dysbiosis
and inflammation. While the benefits of vitamin D supplementation on the gut microbiota have been studied in
patients with chronic diseases, its effects on the microbiota of otherwise healthy individuals is unclear. Moreover,
whether effects on the microbiota can explain some of the marked inter-individual variation in responsiveness to
vitamin D supplementation is unknown.
METHODS
Here, we administered vitamin D to 80 otherwise healthy vitamin D-deficient women, measuring serum 25(OH) D levels
in blood and characterizing their gut microbiota pre- and post- supplementation using 16S rRNA gene sequencing.
RESULTS
Vitamin D supplementation significantly increased gut microbial diversity. Specifically, the Bacteroidetes to Firmicutes
ratio increased, along with the abundance of the health-promoting probiotic taxa Akkermansia and Bifidobacterium.
Significant variations in the two-dominant genera, Bacteroides and Prevotella, indicated a variation in enterotypes
following supplementation. Comparing supplementation responders and non-responders we found more pronounced
changes in abundance of major phyla in responders, and a significant decrease in Bacteroides acidifaciens in non-
responders
CONCLUSIONS
Altogether, our study highlights the positive impact of vitamin D supplementation on the gut microbiota and the
potential for the microbial gut signature to affect vitamin D response.

P0771
TLR4 RECEPTOR D299G/T399I HAPLOTYPE POLYMORPHISM IS ASSOCIATED WITH INSULIN RESISTANCE IN OBESE
FEMALE SUBJECTS
E. Sharif 1, M. Alwakeel 1, A. Mohamed 1, A. Kerkadi 1, N. Rizk 1

1
Department of Biomedical sciences , college of health and sciences, Qatar university
BACKGROUND-AIM
Activation of Toll-like-receptor 4 (TLR4) causes chronic inflammation that can result in obesity and metabolic
syndrome (MeS). Aim: This study aimed to investigate the role of TLR4 polymorphisms of TLR4D299G/T399I, and its
impact on protein expression of TLR4 in obese female subjects.
METHODS
A prospective cross-sectional association study was performed on Arab female subjects from Qatar University. The
subjects were categorized according to BMI classifications into two groups: “obese; n = 69” and “non-obese; n = 136”.
Anthropometric measurements, weight (kg), height (m) and waist circumference (WC) were evaluated, and the body
mass index (BMI) was calculated. Fasting blood samples were collected, and assessment of glucose, lipid profile,
C-reactive protein (CRP), leptin, IL-6 and insulin was performed. Insulin resistance was computed using HOMA-IR.
Genotyping of the TLR4 polymorphisms of TLR4D299G (rs4986790) and TLR4T399I (rs4986791) was performed by the
5 nuclease assay by TaqMan MGB probe. Flow cytometry was used to evaluate the monocyte cell surface expression
of TLR4.
RESULTS
The frequency distribution of the genotype revealed that homozygous AA is the most frequent among obese subjects
(86.4%) for (TLR4D299G, A > G) and the homozygous CC genotype is the most frequent (92.4%) for (TLR4T399I, C
> T). Haplotype analysis of TLR4 D299G/T399I showed that GT carriers had a significant association with increased
probability of insulin resistance (odds ratio = 4.73; 95% CI 1.19–18.90; p-value = 0.016). The monocyte cell surface of
TLR4 was significantly higher by 1.3 folds in obese compared to non-obese subjects.
CONCLUSIONS
TLR4 D299G/T399I haplotype polymorphism is associated with an increased risk of insulin resistance with the
upregulation of TLR4 protein expression in obese subjects.

P0772
DETECTION OF FALSELY LOW HBA1C VALUE IN BIO-RAD D-10 HBA1C PROGRAMME DUE TO PRESENCE OF A RARE
HEMOGLOBIN VARIANT
A. Mathew 1, P. Chauhan 1, E. Debnath 2, S. Sharma 1

1
Lady Hardinge Medical college, New Delhi
2
Maulana Azad Medical College, New Delhi
BACKGROUND-AIM
HbA1c, one of the most important monitoring markers for diabetes mellitus complications. HbA1c is measured by
HPLC, Immunoassay etc and can be affected by the presence of hemoglobinopathies. We present a case where falsely
low HbA1c lead to the detection of a rare Hemoglobin variant.
METHODS
1. HbA1c: Biorad D-10 HPLC HbA1c variant programme
2. Fasting Blood Glucose: Beckman coulter 680
3. Formula for HbA1c conversion to Glucose level and vice versa: ADA eAG/A1C Conversion Calculator
4. Complete Blood Count (CBC) was performed on sysmex cell (XN series) counting system
5. Hbf and HbA2 levels- Biorad D-10 Thalassemia variant programme
6. Hb variant analysis- Biorad Hb Varient II system- Hemoglobin variant analysis programme
RESULTS
46 year old female submitted her plasma sample for HbA1C analysis in view of her raised fasting blood glucose levels
(180 mg/dl) however her HbA1c levels were very low i.e. 3.0%. Similar findings were seen even with a fresh repeat
sample. HPLC HbA1c graph was analysed, unknown peaks were found alongside other parameters with a raised total
area (Normal area=9 lakhs to 15 lakhs) of 1881681. Both thalassemia variant analysis and Hemoglobin variant analysis
was performed, where it was found patient had a rare Hb varient- J meerut. Similar finding was seen in her daughter’s
sample as well. In HPLC Chromatogram, peaks of unknown Hb alongside the peaks of HbA1c and A0 were present,
indicating the presence of a hemoglobin variant. Both mother and daughter had similar presence of unknown peak
with 49.9% area and retention time around 1.23 min.
CONCLUSIONS
Knowledge of presence of Hemoglobin variants is very important for estimation of HbA1c to prevent mismanagement.
Our patient had conflicting HbA1c values where her fasting blood glucose levels did not match her HbA1c level.
Hemoglobin J is a heterogenous Hb which usually result from substitution of negatively charged amino acid residue
in either α, β, or γ chain. Due to its interference with A1c levels, it is advised to pursue alternate methods of glucose
monitoring like fructosamine or HbA1c methods such as borate affinity method which have shown acceptable values
in presence of hemoglobinopathies

P0773
ASSOCIATED NON-INVASIVE BIOMARKERS FOR RISK OF LIVER DISEASE IN TYPE 2 DIABETES MELLITUS PATIENTS
S. Pokhrel 2, B.R. Bhattarai 3, S. Aryal 3, K. Acharya 3, R. Pokhrel 1

1
Department of Biochemistry, Maharajgunj Medical Campus, Kathmandu, Nepal
2
Department of Laboratory Medicine, Manmohan Memorial Institute of Health Sciences, Kathmandu, Nepal
3
Department of Pathology, Nepal Lab House, Kathmandu, Nepal
BACKGROUND-AIM
Non-invasive assessment for analysis of risk of liver disease are based on clinical parameters such as age, sex, BMI, lipid
profile test, liver function test, and platelet count. Risk of liver disease increases in Type 2 diabetes mellitus (T2DM)
patients. This study aimed to find the association of liver biomarker with diabetes population.
METHODS
This cross-sectional study was carried out among 297 attended at Nepal Lab House, Kathmandu, Nepal. Fasting plasma
glucose, HbA1c, lipid profile, liver function test, and platelet count was measure in diabetes population participating in
the study. Aspartate to platelet ratio index (APRI), gamma-glutamyl transpeptidase to platelet ratio (GPR), fibrosis-4
index (FIB-4), and triglyceride and glucose index (TyG) were assess for non-invasive biomarkers as risk liver disease.
Correlation with HbA1c and different biomarkers was performed by spearman’s correlaton. Different liver marker index
were subjected to multiple linear regression analysis to estimate the association with glycemic control in diabetes
population.
RESULTS
The prevalence of abnormality liver function test in diabetic population is 46.8%. Patient with poor glycemic control
had a significantly higher level of AST (p=0.012), ALT (p=0.048), GGT (p = 0.034) and ALP (p = 0.006) whereas lower
level of albumin (p=0.044). Higher HbA1c showed significantly positive correlation with APRI (r=0.185, p=0.001), GPR
(r=0.193, p=0.001), FIB4 (r=0.198, p=0.001), and TyG (r=0.575, p<0.001) in diabetic population. Glycemic control was
inversely associated with APRI (β = -0.222, p = 0.025), while positively associated with FIB-4 (β = 0.234, p = 0.007) and
TyG (β = 0.591, p <0.001).
CONCLUSIONS
APRI, GPR, FIB4 and TyG can be associated biomarker to define the risk of liver disease in T2DM. Routinely screening
for markers may prevent progression of liver disease in T2DM patients.

P0774
CAN LEPTIN/GHRELIN RATIO AND RETINOL-BINDING PROTEIN 4 PREDICT IMPROVED INSULIN RESISTANCE IN
PATIENTS WITH OBESITY UNDERGOING SLEEVE GASTRECTOMY?
H. M Demerdash 1, M. Hany 3, A. Agayby 3, M. Ibrahim 3, B. Torensma 2

1
Alexandria University Hospitals
2
Leiden University Medical Centre
3
Medical Research Institute Alexandria University Egypt*******
BACKGROUND-AIM
Obesity is associated with metabolic syndrome (MBS), a cluster of components including central obesity, insulin
resistance (IR), dyslipidemia, and hypertension. IR is the major risk factor in the development and progression of type
2 diabetes mellitus in obesity and MBS. Predicting preoperatively whether a patient with obesity would have improved
or non-improved IR after bariatric surgery would improve treatment decisions.
METHODS
A prospective cohort study was conducted between August 2019 and September 2021. We identified pre- and
postoperative metabolic biomarkers in patients who underwent laparoscopic sleeve gastrectomy. Patients were
divided into two groups: group A (IR < 2.5), with improved IR, and group B (IR ≥ 2.5), with non-improved IR. A prediction
model and receiver operating characteristics (ROC) were used to determine the effect of metabolic biomarkers on IR.
RESULTS
Seventy patients with obesity and MBS were enrolled. At 12-month postoperative a significant improvement in lipid
profile, fasting blood glucose, and hormonal biomarkers and a significant reduction in the BMI in all patients (p =
0.008) were visible. HOMA-IR significantly decreased in 57.14% of the patients postoperatively. Significant effects on
the change in HOMA-IR ≥ 2.5 were the variables; preoperative BMI, leptin, ghrelin, leptin/ghrelin ratio (LGr), insulin,
and triglyceride with an OR of 1.6,1.82, 1.33, 1.69, 1.77, and 1.82, respectively (p = 0.009 towards p = 0.041). Leptin
had the best predictive cutoff value on ROC (86% sensitivity and 92% specificity), whereas ghrelin had the lowest (70%
sensitivity and 73% specificity).
CONCLUSIONS
Preoperative BMI, leptin, ghrelin, LGr, and increased triglycerides have a predictive value on higher postoperative, non-
improved patients with HOMA-IR (≥ 2.5). Therefore, assessing metabolic biomarkers can help decide on treatment/
extra therapy and outcome before surgery.

P0775
CORRELATION OF TOLL LIKE RECEPTORS 2 AND 4 WITH THEIR ADAPTOR PROTEINS IN TYPE 2 DIABETES MELLITUS
A. Anbhule 1, A. Ramteke 1, M. Arora 1, S. Yadav 1, Y. Porwal 1, A. Yadav 1, C. Kaur 1

1
Vardhaman Mahavir Medical Collage and Safdarjung Hospital, New delhi
BACKGROUND-AIM
Toll-like receptors (TLRs) are central to innate immunity. The Toll-like receptors 2 and 4 plays a crucial role in the
pathogenesis and progression of type 2 diabetes and its related complications. The increased activity of TLRs in
diabetes could be the result of both endogenous and exogenous ligands. TLRs could be beneficial in predicting diabetic
complications given the pivotal role of inflammation in both micro vascular and macro vascular complications.
AIM and OBJECTIVE
To study the correlation of expression of Toll like receptors 2 and 4 with adaptor proteins in type 2 Diabetes Mellitus.
METHODS
The case control study conducted on diagnosed cases of Type 2 Diabetes mellitus. RNA was extracted to synthesize
Cdna. template DNA in the gradient PCRs for standardization of primers for gene expression studies.
RESULTS
Data were presented as mean ± standard deviation, unless otherwise indicated. Correlation and linear regression were
used to see the association between different variables. For all analysis, P value < 0.05 was considered significant.
TLR2 showed the highest expression, followed by TLR4 in type 2 DM subjects and there was significant difference from
healthy subjects (P < 0.05).
Expression levels of TLRs increased significantly with increasing type 2 DM (TLR2: r = 0.91; TLR4: r = 0.88, P < 0.0001).
The expression of TLRs’ adaptor proteins MyD88 and IRAK1 were significantly increased in PBMCs from type 2 DM
subjects (P < 0.05).
CONCLUSIONS
1) Down regulation of TLR2 can be considered as a novel approach for the treatment of these conditions.
2) There are no approved therapeutic agents targeting TLR2/TLR4 that have been shown to play a pivotal role in
initiating and propagating persistent inflammation in diabetes.
3) The systemic inflammatory profile with activation of PBMC could be an important factor in the accelerated
atherosclerosis observed in type 2 diabetes mellitus.
4) The potential of targeting mediators of inflammation like toll-like receptors (TLRs) are part of current investigation
by the scientific community. Hence, the aim of the present review is to discuss the role of TLRs as a potential drug
target for diabetes and diabetes associated complications.

P0776
C-MICRORNAS ASSOCIATED WITH HIGH HBA1C, PLATELET AGGREGATION, AND VITAMIN D DEFICIENCY IN TYPE 2
DIABETES PATIENTS
M. Sultan 2, H. Abu-Toamih Atamni 2, T. Tohami 4, O. Twito 3, E. Neumark 1, G. Rashid 2

1
Biochemistry Laboratory, Meir Medical Center, Kfar Saba, Israel
2
Clinical Laboratories, Meir Medical Center, Kfar Saba, Israel
3
Endocrinology, Diabetes and Metabolism Institute, Meir Medical Center, Kfar Saba, Israel
4
Hematology Laboratory, Meir Medical Center, Kfar Saba, Israel
BACKGROUND-AIM
Based on recent studies, certain microRNAs are involved in the pathogenesis of Type 2 diabetes (T2D). Previous studies
at our lab showed that glycemic control (HbA1c) of patients with or without diabetes is inversely associated with
high platelet aggregation and low vitamin D levels. Following these findings, we aim to identify circulating miRNAs
variations in diabetic versus non-diabetic patients in correlation with glycemic control, vitamin D deficiency and
platelet activation.
METHODS
Plasma samples were collected from eight non-diabetic (control) and diabetic (DM) patients classified based on their
HbA1c, vitamin D and platelet aggregation levels; Control:DM - HbA1c <5.7%: >6.4%, vitamin D>76nmol/L: <76nmol/
L, %max platelet aggregation<50: >50. We performed screening of 179 miRNAs in plasma samples using the miRCURY
LNA miRNA Serum/Plasma Focus PCR Panel (Qiagen). The relative expression of circulating miRNAs in the plasma was
calculated using geNorm algorithm of the GeneGlobe data analysis center (Qiagen).
RESULTS
Data analysis revealed miRNAs expression variations between diabetic to non-diabetic samples, 24 miRNAs were up-
regulated (three sig.: miR 17-5p/miR92b-3p/miR629-5p) and 27 down-regulated (two sig.: miR-497-5p/miR-200c-3p).
miR-17-5p negatively correlates, and miR-497-5p positively correlates with vitamin D levels, while miR-92B-3p and
miR-629-5p positively correlates with HbA1c, and miR-200c-5p negatively correlates with platelet aggregation, in
contrast to miR-629-5p and miR-17-5p.
CONCLUSIONS
Our findings support the important role of C-microRNAs in the regulation of glucose homeostasis, vitamin D levels,
platelet activation, and pathogenesis of DM. Further investigation of candidate miRNAs could reveal a new biomarker
for the early diagnosis and prevention of DM complications.

P0777
ASSOCIATION OF TOLL LIKE RECEPTORS 2 AND 4 WITH THEIR ADAPTOR PROTEINS IN TYPE 2 DIABETES MELLITUS
A. Amol 1, R. Alka 1, A. Megha 1, Y. Surabhi 1, Y. Porwal 1, Y. Amita 1, K. Charanjeet 1

1
VARDHAMAN MAHAVIR MEDICAL COLLAGE AND SAFDARJUNG HOSPITAL, NEW DELHI,INDIA
BACKGROUND-AIM
Type 2 diabetes is associated with a low-grade systemic persistent inflammation. Structurally TLRs are characterized
by an extracellular leucine rich repeat domain, This domain activates MyD88, IRAKs and TRAF6 are called adaptor
protein. Activation of these adaptor protein stimulates multiple cascades and activation of NF-kB result up regulation
of inflammatory mediators which together lead to promote inflammation. Therefore this study has been designed to
find the changes in expression of TLRs with adaptor proteins of type 2 diabetes Mellitus in Indian population.
AIM
To study the correlation of expression of Toll like receptors 2 and 4 with adaptor proteins MyD88, IRAKs and TRAF6
in type 2 Diabetes Mellitus.
METHODS
The case control study conducted on diagnosed cases of Type 2 DM in the dept of Biochemistry &Medicine in Safdarjung
Hospital. Total 226 samples (113 cases and 113 controls) were collected. RNA was extracted to synthesize cDNA and
used as template DNA for gene expression studies peripheral blood.
RESULTS
TLR2 mRNA showed the increased expression, followed by TLR4 in type 2 DM and there was significant difference from
healthy subjects (P <0.05). On comparison of mRNA Expression in Controls and cases for TLR 2 and 4 with adaptor
protein we have found an increase in expression in cases as compared to controls.
In control The correlation of TLR 2 with MYD 88 2^delta Ct (r=0.74, p <0.001,), IRAK 12^delta Ct (r=0.72, p<0.001,)
and TRAF 6 2^delta Ct (r=0.78, p<0.001,) respectively. In Cases The correlation TLR 2 with MYD 88 2^delta Ct (r=0.55,
p<0.001), IRAK 1 2^delta Ct (r=0.57, p<0.001)& TRAF 6 2^delta Ct (r=0.78, p<0.001) TLR 4 was also positively correlated
with r value 0.625, 0.623, 0.856 respectively for the adaptor proteins. This correlation was statistically significant
(p<0.0001).
CONCLUSIONS
These results suggest that the overexpression of TLR2 and TLR4 in PBMCs enhanced production of proinflammatory
cytokines may pave way for the development of insulin resistance in obese individuals, leading to type 2 diabetes.
Down regulation of TLR2 can be considered as a novel approach for the treatment of these conditions.

P0778
AN EXTREME IATROGENIC HYPERGLYCEMIA DUE TO AN INTENTIONAL OVERDOSE OF THE GROWTH HORMONE
O. Ciepiela 1, M. Małecka-Giełdowska 1, M. Paskudzka 1

1
Medical University of Warsaw, Department of Laboratory Medicine
BACKGROUND-AIM
Metabolic acidosis may be a severe and acute complication of diabetes. It includes both ketoacidosis or lactic acidosis.
Here we present an unusual case of metabolic acidosis associated with extreme hyperglycemia in patient with no
previous history of diabetes mellitus.
METHODS
A 59-years-old man was admitted to the hospital emergency department due to disturbances of consciousness. Acid
base balance analysis showed deep acidosis with pH of 6.891 with increased pCO2 of 63.5 mmHg and low HCO3- of 11.5
mmol/L. He presented low sodium (124 mmol/l) and potassium concentration (2.5 mmol/l) with significantly increased
anion gap (24.0 mmol/l) and lactates (6.4 mmol/l). Glucose concentration could not been measured with glucometer
during POC testing – an analyzer repeatedly showed an error.
RESULTS
Tests performed at central laboratory showed extreme hyperglycemia of 2081 mg/dl, increased urea (64 mg/dl),
creatinine (2.69 mg/dl) and serum osmolality of 393 mOsm/kg H2O.
Family members reported, that the patient for the last 6 weeks has been administering Genotropin (growth hormone)
in a dose of 12 mg every two days for weight reduction, and was drinking 6-10 liters of cola daily.
Patient’s condition was still worsening, ketoacidosis was still persisting, multiorgan failure was developed with
increasing urea, creatinine, lactates, lipase, amylase, troponin I and d-dimers. Despite introduced treatment patients
had still low sodium and deepening hypokalemia (up to 1.6 mmol/l). He died 36 hours after hospital admission due to
multiorgan disfunction and metabolic acidosis.
CONCLUSIONS
Growth hormone administration is routinely used for patients with growth deficiency, either in childhood and
adulthood. Its anabolic and lipolytic action, however, is thought by some people as a good medicament for weight
loss and muscles developing. Nevertheless, it has to be underlined, that metabolic action of growth hormone is
multidirectional and affects several pathways, that may lead to serious homeostasis disorders.

P0779
URINE PROTEOMICS ANALYSIS OF TYPE 2 DIABETES MELITUS PATIENTS: A NOVEL APPROACH TO PREDICT THE RISK
OF DIABETES NEPHROPATHY
S. Darmayanti 3, R. Lesmana 2, A. Meiliana 3, R. Abdulah 1

1
Center of Excellence in Higher Education for Pharmaceutical Care Innovation, Universitas Padjadjaran, Jatinangor,
Indonesia.
2
Department of Biomedical Sciences, Faculty of Medicine, Universitas Padjadjaran, Jatinangor, Indonesia
3
Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Jatinangor, Indonesia
BACKGROUND-AIM
The prevalence of Diabetes Melitus Type 2 (T2DM) keep increasing worldwide. The glycated end products, oxidative
stress, low grade chronic inflammation, and neovascularization in T2DM result in long-term vascular alterations and
organ damage. Diabetes Nephropathy (DN) is one of the most common T2DM consequences, yet microalbuminuria
remains the main standard for early detection of DN which is not accurate enough and often shows false positive
results in patients with uncontrolled hyperglycaemia, hypertension, urinary tract infections, stress, and cardiovascular
decompensation.
In this study, we aimed for a novel and simple approach to detect DN earlier, with better specificity and sensitivity for
appropriate and targeted diagnostic therapy.
METHODS
The urine proteomic profiling of T2DM patients (n=94) and control group (n=32) were compared using liquid
chromatography-tandem mass spectrometry, and the untargeted low molecular weight (LMW) protein profiles were
analysed with Progenesis Q1 For Proteomics v4.2
RESULTS
A total of 32 differentially abundance expressed proteins (P<0.05) were identified and quantified. This protein seems
to have a variety of roles, including the ß-cell pathway signalling, extracellular components, and antioxidant activity.
Further analysis with heat maps identified two potential proteins with highest folding alterations in urine: V-type
proton ATPase subunit C1 (V-ATPase subunit C1) and Inhibitor of Nuclear Factor Kappa-B Kinase Interacting Protein
(IKBKB-IP). V-ATPase subunit C1 abundance was significantly inversely correlated with microalbumin and significantly
decreased in urine, whereas increased IKBKB-IP was positively correlated with microalbumin.
CONCLUSIONS
The findings of our study indicates that the decreasing V-ATPase subunit C1 together with increasing IKBKB-IP in urine
might predict T2DM patients to develop DN.

P0780
DOES INTERMITTENT FASTING CONTROL THE DIABESITY EPIDEMIC?
K. Mehta 3, R. Maskey 3, P. Devkumar 2, S.P. Ramachandrarao 1

1
Michigan University (MU) Ann Arbor, USA
2
2. Transdisciplinary University of Health Sciences and Technology (TDU), Bangalore, India
3
B.P. Koirala Institute of Health sciences (BPKIHS), Ghopa, Dharan, Nepal
BACKGROUND-AIM
Intermittent Fasting (IF) is a fasting strategy that cycles between fasting and eating over a period of time. IF prevents
the development of insulin resistance by creating extended periods of low Insulin that maintain the body’s sensitivity
to insulin. It also helps autophagy, cellular repair, microbiome and inflammation levels. The main objective is to
determine the effect of IF on glycemic control in subject with pre-diabetes and diabetes.
METHODS
Newly diagnosed prediabetes subjects (n=20) and diabetes subjects (n=13) were recruited as per ADA 2017 criteria
from endocrinology clinics, Department of Medicine, BPKIHS. After taking signed consent, subjects counseled about
the implementation of IF in their daily life event. Subjects were advised to provide blood samples for biochemistry
analysis and Urine for Exosome isolation for proteomics. After three months, subjects were contacted to give post
blood and urine samples to see the effect of IF in their body.
RESULTS
Out of 33 subjects, 10 subjects (pre diabetes (n=7) and diabetes (n =3) had come to give blood samples and urine
after three months. 56.4% compliance towards IF strategy were observed. Pearson correlation between Pre and Post
IF management strategy HbA1c and fasting blood glucose significantly lowered in the post sample by 0.54% and 23.71
mg/dl respectively. Lipid profile in the post samples were also seen marked improvement.
CONCLUSIONS
No doubt, IF is the most powerful natural therapy available for Type 2 diabetes and diabesity. However, keeping the
mind of poor compliance (56.49%±13.18%) and high dropout rate (69.7%), there is a need to focus on planned with
determination in this research.

P0781
SERUM LEPTIN, SOME LIPID FRACTIONS AND FASTING BLOOD GLUCOSE(FBS) LEVEL(S) IN OVERWEIGHT, AND OBESE
SUBJECTS IN A RURAL TOWN (NNEWI) SOUTH EAST NIGERIA.
J.C. Nnamdi 1, U.K. Amah 1, J.A. Onuegbu 1, H.C. Okpara 1

1
DEPARTMENT OF CHEMICAL PATHOLOGY, FACULTY OF BASIC CLINICAL SCIENCES, COLLEGE OF HEALTH SCIENCES, NNAMDI
AZIKIWE UNIVERSITY, AWKA, ANAMBRA STATE, NIGERIA.
BACKGROUND-AIM
Obesity emanates from an imbalance between food intake and energy expenditure, which results to excessive
accumulation of fat in adipose tissue, liver, muscle, and other organs involved in metabolism. Leptin is an adipokine
that acts, at the level of the brain, and reflects the degree of adiposity of an organism. Obesity is associated with
hyperlipidemia (mixed) and these medical problems are substantially greater among obese individuals. We looked at
the association of leptin, lipid profile and FBS with BMI in normal weight, overweight and obese participants in Nnewi
south east Nigeria.
METHODS
This is a cross- sectional study. A total of 90 apparently healthy obese, overweight and normal weight participants who
met the inclusion criteria were randomly enrolled into the study. They were grouped using their body mass index. The
measured parameters were analyzed using standard methods.
RESULTS
There was increased difference in the mean level of Leptin (ug/l) of the obese and overweight participants when
compared to normal weight participants. Significant positive correlation was observed between leptin and BMI of obese
subjects.
CONCLUSIONS
The level of leptin was increased in the overweight and obese groups when compared to the control groups and
correlates positively with BMI of obese participants.

P0782
IMPROVE THE UTILIZATION OF THE IMMEDIATE HBA1C TESTING IN MANAGING DM
C. Kao 1, J. Lin 1, Y. Hsu 1

1
Department of Laboratory Medicine, St. Martin De Porres Hospital, Taiwan
BACKGROUND-AIM
Diabetes mellitus (DM) is a common chronic metabolic disorder. In 2011 the WHO advocated using HbA1c for the
type 2 DM diagnosis. HbA1c is also an important indicator of long-term glycemic control with the ability to reflect the
cumulative glycemic history of the preceding 8 to 12 weeks. However, in most hospital settings, the process to assess
patients with suspected DM or monitor the treatment typically involves at least two appointments with a physician;
blood samples are taken during the first visit, and HbA1c results are discussed with the patient after laboratory
analysis 1-2 weeks later, adding the length of time taken to reach a diagnosis or monitoring. Why are HbA1c results
not available during their first outpatient visits? This study aimed to assess the performance of an immediate HbA1c
testing workflow and endorse the new approaches in our 554-bed regional hospital in Taiwan.
METHODS
We relocated the HbA1c measurement system from the serology department to the hematology workstation near
the phlebotomy station and transformed to an immediate testing workflow in January 2011, intending to report
HbA1c within 30 minutes will contribute to therapeutic decisions to be made at the earliest possible opportunity, and
then implemented an auto-verification middleware for automating selection and reporting results in June 2015. More
recently, our laboratory was equipped with two ARKRAY HA-8180v HbA1c instruments that replaced an obsolete Tosoh
G8 analyzer to perform about 150 outpatient samples every morning in March 2019, with an objective of turnaround
time (TAT) within 20 minutes since June 2019.
RESULTS
We evaluated the outpatient's HbA1c testing TAT as a monthly quality indicator from 2011 to 2022. The rates of
overdue TAT per month were found to range from 0.24% to 7.65%, and the overall mean was 2.23%. This study has
shown that 96.78% of HbA1c tests took less than 20 minutes to complete from July 2019 to December 2022. Namely,
the rate of overdue TAT for HbA1c patient samples over nearly four years was 3.22%.
CONCLUSIONS
This study has shown and verified the performance of our new continuously improved workflow in the hospital setting
to get HbA1c results in 20 minutes. We suggest changes in the traditional practice and recommend offering clinical
clinicians and patients immediate HbA1c results.

P0783
LEPTIN INCREASES THE EXPRESSION OF AQP-9 AND CHOLESTEROL TRANSPORTERS (ABX-A1 AND ABC-G1) IN HUMAN
TROPHOBLASTIC CELLS
T. Vilariño-García 2, M. Tami 1, C. Rodríguez-Chacón 1, G. Alba 1, A. Pérez-Pérez 1, V. Sánchez-Margalet 1

1
Laboratotry Medicine Department/Virgen Macarena University Hospital
2
Laboratotry Medicine Department/Virgen Rocio University Hospital
BACKGROUND-AIM
Gestational diabetes is the most frequent pathology of pregnancy, and it increases the incidence of complications
both in the mother and fetus. The macrosomía that occurs in these fetus may be related with some changes in
the mechanisms of transport in placenta. Leptin is a placental hormone that regulates growth and proliferation in
trophoblast in an autocrine and paracrine manner. Placenta has the important function of providing nutrients and
oxygen to the fetus. In this sense, leptin seems to play a role in the feto-maternal dialogue. Since placental leptin
expression and circulating levels are increased in gestational diabetes, our aim was to determine the effect of leptin in
the expresión of the nutrient transporter AQP-9 (water and glycerol) and ABC-A1 and ABC-G1 (cholesterol transporters)
in human trophoblast cells.
METHODS
Human trophoblastic cells (BeWo cell line) were used in culture. Cells were incubated in the presence of increasing
concentrations of leptin for 48 h. The expresión of transporters in response to leptin was carried out by quantitative
PCR. Statistical differences were analysed by ANOVA followed by Bonferroni post-test.
RESULTS
After 48 h incubation, leptin increases the expresión of AQP-9, ABC-A1 and ABC-G1 in human tophoblastic cells (BeWo)
in a dose-depencent manner. Maximal effect was achieved at 10 nM leptin.
CONCLUSIONS
Leptin seems to positively regulate the expression of nutrients from the mother to the fetus, since leptin increases the
expresión of glycerol and cholesterol transporters in human trophoblastic cells.

P0784
ZONULIN FAMILY PEPTIDES AND OBESITY PHENOTYPES
A. Stefanska 1, P. Cembrowska 1, M. Krintus 1, G. Sypniewska 1

1
Department of Laboratory Medicine, Collegium Medicum, Nicolaus Copernicus University, Sklodowskiej-Curie 9, 85-094
Bydgoszcz, Poland
BACKGROUND-AIM
Zonulin family peptides (ZFPs), the regulators for intestinal tight junctions, were considered as markers of intestinal
wall permeability. Recent studies also found an association between ZEP levels and cardiometabolic features like
obesity, insulin resistance, dyslipidemia or liver dysfunction. Due to the fact that body weight assessed with the use of
BMI does not always reflect the patient's metabolic state, definitions of four obesity phenotypes have been proposed:
metabolically obese normal-weight (MONW), normal-weight obese (NWO), metabolically healthy obese (MHO) and
metabolically unhealthy obese (MUO). We aimed to evaluate serum ZEP levels in middle-aged women representing
four obesity phenotypes, and in the control group.
METHODS
Two-hundred women (40-60 years), classified into five groups: control n= 36, women with normal BMI and total
body fat (TBF) below 30% without metabolic syndrome (MetS); NWO n=39, women with normal BMI and TBF above
30% without MetS; MONW n=41, women with normal BMI and TBF above 30% with MetS; MHO n=40, obese women
according to BMI without MetS and MUO n=44, obese women according to BMI with MetS. The amount of adipose
tissue was assessed by whole-body densitometry. ZEPs were determined using enzyme-linked immunosorbent assay
(Immundiagnostik AG). Biochemical and anthropometric measurements as well as blood pressure were performed.
RESULTS
ZFP levels were significantly higher (p<0.05) in groups with MetS (MONW and MUO) when compared to the control
group and NWO. ZFPs showed the positive weak correlations with anthropometric measurements, glucose, HOMA-
IR, alanine aminotransferase, fatty liver index, uric acid and the number of the MetS components. While the positive
moderate correlations were shown between ZFPs and glycated hemoglobin, aspartate aminotransferase and gamma
glutamyltransferase. In logistic regression analysis ZFPs were significantly associated with MONW and MUO phenotype
[OR 1.09 (1.01-1.18) p=0.037 and OR 1.07 (1.0-1.14) p=0.04]. We also observed that ZFPs were predictors for MetS
occurrence [1.07 (1.02-1.12) p=0.003] and this association was independent of BMI.
CONCLUSIONS
ZFP levels are associated with metabolic risk factors and obesity phenotypes with MetS.

P0785
LIPID PROFILE IN DIABETES AND PREDIABETES
R.K. Chaudhari 1, B. Gelal 1, N. Baral 1, B. Pradhan 2, M. Lamsal 1

1
Department of Biochemistry, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
2
Gastroenterology and Hepatology, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
BACKGROUND-AIM
Prevalence of type-2 diabetes mellitus and prediabetes [impaired glucose tolerance (IGT) and impaired fasting glucose
(IFG)] are rapidly rising due to sedentary life style. It is well established that type 2 diabetes is the secondary cause of
dyslipidemia and associated with higher cardiovascular risk. There are conflicting reports from various studies whether
cardiovascular risk is more associated with isolated IGT, IFG or having both IGT and IFG. Therefore we have evaluated
the lipid parameters for assessing the cardiovascular risk in type-2 diabetes mellitus and prediabetes subjects.
METHODS
This is a hospital based cross-sectional study conducted at BPKIHS, Dharan. 34 normal, 104 type-2 diabetes mellitus
and 110 prediabetes subjects were recruited using purposive sampling. Their fasting, postprandial blood sugar, HbA1c
and lipid profiles were measured by cobas c 311, Roche autoanalyser. The ADA criteria and NCETP ATP III guidelines
were applied for diagnosis of diabetes, prediabetes and dyslipidemia. Chi-Square test, one way ANOVA and Kruskal-
Wallis test were applied to test the significance considering p value ≤0.05 as statistically significant.
RESULTS
Participants age varies from 15 to 89 years with 1:1 male and female ratio. Lipid profile parameters including TC/
HDL and TG/HDL ratio are not statistically different among the groups. Dyslipidemia (65.2% male vs 82.7% female)
was found significantly higher in female (p<0.001). Total Cholesterol (193.32± 44.51 mg/dL vs 156.86± 37.02 mg/dL;
p=0.001) and LDL cholesterol (114.96±34.56 mg/dL vs 90.00±31.78 mg/dL; p=0.004) levels are significantly higher
among subjects with IFG as compared to subjects with IGT.
CONCLUSIONS
IFG group have high LDL and total cholesterol level as compared to IGT group among Prediabetes. Dyslipidemia is
found higher in female.

P0786
UTILITY OF GROWTH DIFFERENTIATION FACTOR 15 (GDF-15) IN THE ASSESSMENT OF LIVER DISEASE NON-ALCOHOLIC
FATTY ACID (NAFLD) IN OBESE PATIENTS
I. Cebreiros-López 1, R. Sansano-Galiano 1, D. Calvo-Sánz 1, M.D. Frutos-Bernal 4, F. Guzmán-Aroca 3, A.J. Ruiz-Alcaraz

2
, B. Ramos-Molina 2, J.A. Noguera-Velasco 1
1
Clinical Analysis Service. University Hospital Virgen de la Arrixaca, Murcia, Spain
2
Obesity and Metabolism Laboratory, Biomedical Research Institute of Murcia (IMIB-Arrixaca), Murcia, Spain
3
Radiology Service. Clinical University Hospital Virgen de la Arrixaca, Murcia, Spain
4
Surgery Service. Clinical University Hospital Virgen de la Arrixaca, Murcia, Spain
BACKGROUND-AIM
Nonalcoholic fatty liver disease (NAFLD) progresses from simple steatosis to nonalcoholic steatohepatitis (NASH),
fibrosis, cirrhosis and hepatocellular carcinoma. NAFLD is considered the most prevalent chronic liver disease in
western countries, with special incidence in obese patients.
Liver biopsy is the gold standard for the diagnosis of NAFLD but it is a very invasive technique, therefore it is urgent
to develop noninvasive diagnostic biomarkers.
Growth differentiation factor 15 (GDF15), a stress-induced cytokine belonging to the transforming growth factor beta
superfamily, key role as an anti-inflammatory molecule and has been associated with many conditions. Recent studies
have shown that GDF15 is associated with NAFLD.
Our objective was to evaluate GDF15 in a population of obese patients with NAFLD and to study its relationship with
the different stages of the disease.
METHODS
We selected morbidly obesity patients who were to undergo bariatric surgery and were classed according to their
hepatic biopsy findings. Group A: normal liver; Group B: NAFLD and Group C: NASH. The previous day of surgery, blood
samples were collected for laboratory evaluation of GDF15 (Cobas 8000, Roche Diagnostics).
RESULTS
The study population consisted of 107 patients; group A: n=32 (34.24%), group B: n=52 (55.64%) and group C: n=23
(10.12%).
74,3% of subjects were female and the mean age in the study was 49 years. The mean BMI was 43,22 Kg/m2 and
an 45,9% of subjects had evidence of diabetes, 87,2% of dislipemia 42,2% of hypertension and 71,6% of metabolic
syndrome (MS).
GDF15 values in serum (mean [p25-p75]) were: group A=757.9[561.5-979.45], group B 837.15[595.9-1164] and group
C=933.2[708.75-1579]. Significant differences were found between groups (p=0,037).
We found significantly higher GDF15 values in patients with MS (p=0.008).
CONCLUSIONS
A proper hepatic assessment enabling NAFLD to be differentiated from NASH would be fundamental for establishing a
risk population. Our data suggest that that GDF15 is a useful diagnostic tool for differentiating this in morbidly obesity
patients.
GDF15 is postulated as a suitable biomarker in NAFLD context, that allows a complete assessment of liver damage and
its relationship with metabolic syndrome.

P0787
GLYCATED ALBUMIN LEVELS PREDICT THE TYPE OF KIDNEY DAMAGE IN DIABETIC PATIENTS
P. Pontrelli 2, F. Conserva 2, M. Fiume 2, C. Cinefra 2, A. Schirinzi 1, F. Di Serio 1, F. Pesce 2, L. Gesualdo 2

1
Clinical Pathology Unit, University Hospital Policlinico-Bari
2
Dept. of Precisione and rigenerative Medicine and Jonian area, University of Bari Aldo Moro
BACKGROUND-AIM
Diabetes mellitus is the most frequent cause of end stage renal disease. Glycemic control by Glycated albumin (GA)
is not influenced by anemia and associated treatments; however, K-DIGO Guidelines still recommend HbA1c in the
diabetic patients with chronic kidney disease. Renal damage in diabetes can range from real diabetic nephropathy (DN)
to non-diabetic renal disease (NDRD), thus influencing prognosis and treatment. The aim of the study was to evaluate
the clinical utility of the GA dosage, for the prediction of the type of kidney damage in the diabetic patient.
METHODS
We enrolled 108 diabetic patients, 90 with a biopsy proven diagnosis of kidney disease and 18 with no kidney
dysfunction. 51 patients had real DN or mixed forms (DN + NDRD) and 39 had NDRD. GA dosage was obtained by
QuantILab® Glycated Albumin assay. qPCR was used to evaluate urinary levels of miR27b-3p, a biomarker that predict
the kind of renal damage in diabetic patients.
RESULTS
GA values were differently distributed among patients (p=0.003) and correlated with Hb1Ac levels, in the whole cohort
(p<0.001) as well as in the different groups of patients (DN: p<0.001; NDRD: p=0,01). GA also correlated with glycaemia
(Whole cohort: p<0.07; DN: p=0.01; NDRD: n.s.) and diabetes duration (Whole cohort: p=0.001; DN: p=0.008; NDRD:
n.s.) in particular in patients with real DN. GA also correlated with: sCr and eGFR (p=0.001); resistive index evaluated
by ultrasound (p<0.001); histological features: glomerular fibrosis (p=0.04) and % of sclerotic glomeruli in the kidney
biopsy (p=0.02). We confirmed a different distribution of miR-27b-3p among the patient’s populations (p<0.01).
Interestingly, only GA levels, but not Hb1Ac levels, were significantly and inversely correlated with miR-27b-3p (All
cohort: p=0.011; DN: p=0.049; NDRD: p=0.01). Finally, in a multivariate logistic regression model corrected for sex,
age and serum creatinine, we demonstrated that GA is the only significant predictor of real DN vs NDRD (p=.019;
OR=0.780-0.978; 95% CI).
CONCLUSIONS
Our study described for the first time the role played by GA as a diagnostic marker in the identification of the different
kind of renal damage in diabetic patients, thus supporting the need to introduce GA as an index of glycaemic control
in diabetic patients with renal damage.

P0788
CORRELATION BETWEEN MAGNESIUM AND HBA1C IN TYPE 2 DIABETES MELLITUS
H.S. Makaju 1, V.K. Sharma 2, B.K. Yadav 2, E.T. Tuladhar 2, R. Bhandari 3, A. Bhattarai 2, M. Raut 2, R.K. Dubey 2, A. Niraula
2
, A. Sapkota 2, A. Neupane 2, R. Ramtel 4
1
Clinical Biochemistry Department, Kathmandu PathLab and Diagnostic Center
2
Department of Biochemistry, Institute of Medicine ,Kathmandu, Nepal
3
Department of Internal Medicine, Institute of Medicine ,Kathmandu, Nepal
4
Kist Medical College and Teaching Hospital
BACKGROUND-AIM
Magnesium (Mg) is most abundant electrolyte with unlimited physiologic importance in the body, playing a vital
role in many fundamental processes. Cellular magnesium is an essential cofactor for various enzymes involved in
glucose transport, insulin release and glucose oxidation. Mg has potential role in improving insulin sensitivity and
preventing diabetes and its complications. Hypomagnesemia promotes to the initiation and progression of DM and its
macrovascular and microvascular complications. The aim of this study was to evaluate the correlation of magnesium
with HbA1C in T2DM.
METHODS
This cross sectional study conducted at Tribhuvan University Teaching Hospital, included 85 diagnosed with type 2
diabetes Mellitus visiting Medicine OPD and 85 apparently healthy controls. Clinical and anthropometric characteristics
were documented using clinical proforma. The fasting blood samples were collected for estimating serum glucose,
HbA1C and magnesium
RESULTS
The mean values of BMI, FBG, HbA1C were found to be significantly elevated in T2DM, but that of Mg were higher in
healthy controls (p<0.05). The prevalence of hypomagnesemia in T2DM was found to be 32.94%. The Serum magnesium
levels were moderate negatively correlated (r = -0.544, P<0.001) with HbA1C.
CONCLUSIONS
Patient with Type 2 Diabetes Mellitus showed significantly low magnesium levels compared to heathy controls as well
as uncontrolled HbA1C levels also showed significantly low magnesium level than controlled HbA1C level. There was
significant inverse correlation between serum Mg level and HbA1C level in patients with T2DM. So if serum magnesium
values are made to rise, HbA1C values will fall.

P0789
DIAGNOSTIC ACCURACY EVALUATION OF GLYCATED ALBUMIN IN HAEMODIALYZED PATIENTS TREATED WITH
ERYTHROPOIETIN
F.G. Martino 1, M.A. Isgro' 1, M.A. Stigliano 2, M. Vitillo 1

1
CLINICAL PATHOLOGY UNIT, LABORATORIES DEPARTMENT, S. FILIPPO NERI HOSPITAL, ASL ROMA 1, ROME
2
TRANSFUSION MEDICINE, SANTO SPIRITO – SAN FILIPPO NERI HOSPITAL, ASL ROMA 1, ROME
BACKGROUND-AIM
Glycated albumin (GA) has been proposed as a short- and medium- term indicator of glycaemic homeostasis. The
association between GA and glycaemic status has been investigated in patients with advanced chronic kidney disease,
but not fully described in haemodialyzed patients. The aim of our study was to evaluate GA diagnostic accuracy in
detecting glycaemic homeostasis alterations in haemodialyzed patients treated with erythropoietin (HPE).
METHODS
This prospective study was conducted on 142 HPE: 78 (of which only 43 with a diagnosis of diabetes) with impaired
fasting glucose (IFG) detected by 2 consecutive findings of fasting plasma glucose (FPG) ≥ 5.6 mmol/L and 64 (of
which 8 with compensated diabetes) with no FPG alterations. GA was measured on patients’ plasma samples using
an enzymatic method (quantILab Glycated Albumin, IL Werfen, Germany) on Roche Cobas C 702 module. The upper
reference limit (URL) was calculated using the non-parametric percentile method on patients with no FPG alterations.
GA diagnostic accuracy was evaluated using URL as cut-off and was compared with that of HbA1c. Statistical analyses
were performed using SPSS software, version 27.0. The study was approved by the Local Ethics Committee and all
patients provided their informed consent.
RESULTS
Patients with IFG (median age 72 years, Interquartile Range - IR 65-77) presented GA levels (median 16.8%, IR
13.0-20.0) significantly higher than patients with no IFG (68 years, IR 54-75) (12.6%, IR 11.7-14.2) (p < 0.001). At
calculated cut-offs (95th percentile) of 16.8% and 40 mmol/mol, GA and HbA1c showed sensitivities of 48.7% and
37.2%, specificities 95.3% and 96.9%, positive predictive values 92.7% and 93.5%, negative predictive values 60.4%
and 55.9%, positive likelihood ratios 10.393 and 11.897, negative likelihood ratios 0.538 and 0.648, diagnostic odds
ratio 19.3 and 18.4, with overall diagnostic accuracies of 69.7% and 64.1%, respectively.
CONCLUSIONS
In our study, at proposed cut-offs, GA would seem to be a more reliable marker of IFG status than HbA1c, presenting
better diagnostic performances. Therefore, it could be proposed as an indicator of IFG in HPE, particularly in monitoring
and dealing with IFG long-term complications. Its role as early marker in HPE diabetes diagnosis should be more
investigated.

P0790
ASSESSMENT OF RISK OF DEVELOPING DIABETIC HEPATOPATHY IN NEPALESE SUBJECTS WITH TYPE 2 DIABETES
MELLITUS
U. Budhathoki 1, R. Pokhrel 1, A. Mishra 1, V.K. Sharma 1, R. Bhandari 2, A. Bhattarai 1, T. Eans Tara 1, M. Raut 1
1
Department of Biochemistry ,Tribhuvan University Teaching Hospital ,Kathmandu, Nepal
2
Department of Medicine ,Tribhuvan University Teaching Hospital ,Kathmandu, Nepal
BACKGROUND-AIM
Diabetes Mellitus causes or worsens liver diseases known as diabetic hepatopathy. Type 2 Diabetes Mellitus (T2DM),
the most common form of diabetes mellitus, occurs when the body becomes insulin resistant or is unable to produce
enough insulin. Even though type 2 diabetes mellitus is a significant public health problem in Nepal, accurate and
comprehensive data on the disease prevalence are lacking. There exist the association between diabetes and hepatic
changes. Although some diabetic patients experience liver dysfunction, the exact pathophysiological mechanism of
diabetes mellitus to induce the haptopathy is still unclear. Diabetes awareness as a major risk factor for liver injury
may help with early detection and subsequent interventions.
METHODS
A cross sectional observational study was conducted in Tribhuvan University Teaching Hospital (TUTH), Kathmandu,
Nepal. Patients diagnosed with type 2 diabetes mellitus visiting Medicine OPD of TUTH were included in the study.
Control group consists of individuals with normal test parameters visiting for General Health Checkup (GHC). The study
was conducted from September 2021 to September 2022.
Liver Function Tests, lipid profile tests, blood sugar fasting and post prandial were analyzed by using BT 1500, BT 3500
and vitros 3600 chemistry analyzer. Quality control was maintained through run of controls each day prior to each test.
Collected data were analyzed using Statistical Package for Social Sciences (SPSS) Version 21.
RESULTS
The prevalence of abnormal level of Liver function tests in T2DM was higher (33.85%) than a control group (7.08%).
The mean values of the liver enzymes and Total bilirubin in patients with T2DM were significantly higher than that of a
control group (p≤0.001). In addition, T2DM patients had lower level of TP (p≤0.01) and albumin (p=0.006) in comparison
to the control group. The most frequent abnormal LFT was ALT (27.55%) which was followed by AST (15.74%), ALP
(11.81%), TBIL (2.36%) and Alb (1.57%) in T2DM patients.
CONCLUSIONS
In comparison to the non-diabetic control group, Type 2 diabetes Mellitus patients reported a greater prevalence of
abnormal Liver Function Tests. Therefore, our study recommends liver function tests to monitor the liver conditions
in Type 2 diabetes Mellitus patients.

P0791
PERCENTILE EQUIVALENTS FOR ENZYMATIC FRUCTOSAMINE AND GLYCATED ALBUMIN IN A POPULATION WITHOUT
DIAGNOSED DIABETES
A. Valle Rodríguez 1, A. Navarro Murillo 1, J. Rodríguez Garcia 1, S. Rodriguez-Segade Villamarin 1

1
Hospital Clínico Universitario de Santiago de Compostela
BACKGROUND-AIM
Fructosamine and glycated albumin (GA) are extracellular markers of the presence of chronic hyperglycemia and are
independent of changes in erythrocytes or hemoglobin. Previous studies have examined that the clinical potential
of the cutpoints is small, since the population studied is not representative and the determinations use colorimetric
methods.
The aim of this study is to obtain cutpoints for enzymatic fructosamine (EFA) and GA equivalent to those for HbA1c
and fasting glucose (FG) for diabetes in a well-characterized, community-based white population in Spain.
METHODS
EFA was determined by the diazyme serum glycated protein enzymatic method (Diazyme, UK), FG by the glucose
hexokinase method and total albumin by the bromocresol green method (Siemens Diagnostics, Spain) and HbA1c by
the Arkray Adams HA-8180T analyzer from Menarini Diagnostics.
To derive cutpoints for EFA and GA that are equivalent to the cutpoints for HbA1c and FG we used the AEGIS study
population of 1335 participants with no history of diagnosed diabetes including 12 participants with unknown diabetes
(0.9%) and 387 with prediabetes (29%).
RESULTS
The EFA concentrations that correspond to the clinical cutpoints for prediabetes and diabetes of 5.7% and 6.5%
for HbA1c based on percentiles are 246 µmol/L (81st percentile) and 328 (99.2nd percentile), respectively. The
corresponding values for GA are 13.7% and 17.1%.
While the corresponding EFA concentrations for the FG prediabetes and diabetes cutpoints (100 mg/dL and 126 mg/
dL, respectively) are 225 µmol/L (86.5 percentile) and 322 (98.9 percentile). The corresponding values of GA are 14.1%
and 16.9%.
CONCLUSIONS
The equivalent "diagnostic" cutpoints may be useful in studies that do not have fasting samples for glucose
measurement or whole blood samples for HbA1c measurement.

P0792
COMPARISON OF SERUM LEVELS OF SOME TRACE ELEMENTS AND MARKERS OF GLYCEMIC CONTROL BETWEEN TYPE 2
DIABETICS AND NON-DIABETIC NIGERIANS
G.G. Aliyu 3, A.B. Okesina 1, I.M. Abudulazeez 1, S.A. Biliaminu 1, A. Muhammed 2

1
Department of Chemical Pathology and Immunology, Faculty of Basic Clinical Sciences, College of Health Sciences,
University of Ilorin, Ilorin, Kwara State, Nigeria
2
Department of Chemical Pathology, Gombe State University, Gombe State, Nigeria
3
Department of Chemical Pathology, Modibbo Adama University Teaching Hospital, Yola, Adamawa State, Nigeria.
BACKGROUND-AIM
Trace metals such as magnesium (Mg), zinc (Zn), and manganese (Mn) have been shown to adversely affect pancreatic
islets and cause the development of diabetes or worsened its progression. Serum levels of these antioxidant trace
elements may reflect their metabolic abnormalities and contribute to disease severity. This study measured serum
mean values of these elements and markers of glycaemic control among type 2 diabetics and compared results with
those of non-diabetic controls.
METHODS
A total of 300 participants, 150 type 2 diabetics and 150 age and sex-matched nondiabetics as controls were recruited
for this study. The trace metals (Mg, Zn, and Mn) were analyzed using the atomic absorption spectrophotometry
method. Glycated Albumin (GA) was measured using two steps: the ELISA method for determining glycated serum
albumin (GSA) and the colorimetric method for serum albumin. The HbA1c was assayed using the immuno-
nephelometry method and fasting plasma glucose (FPG) was measured using the glucose oxidase method.
RESULTS
The mean value of HbA1c among the diabetics (7.51 ± 2.50%) was significantly higher when compared to that of non-
diabetic controls (5.40 ± 0.51%) (p = <0.001). The mean FPG in diabetics (8.53 ± 3.11mmol/L) was significantly higher
when compared to that of the controls (5.35 ± 0.39mmol/L) with p= <0.001. The mean value of GA in diabetics (23.48
± 6.58%) was significantly higher when compared to controls (12.49 ± 1.98%) (p< 0.001). The mean value of serum
Mg among diabetics (0.69 ± 0.09mmol/l) was significantly lower when compared with that of nondiabetic controls
(0.86 ± 0.12mmol/l) (p= <0.001). The mean serum Zn in diabetics (14.49 ±.2.10µmol/l) was significantly lower when
compared with the nondiabetic controls (16.21 ± 2.23 µmol/l) and p= <0.001. The mean serum Mn among diabetics
(21.04 ± 1.56nmol/l) was slightly higher than in the nondiabetic control (20.54 ± 0.99nmol/l) however, the difference
was not statistically significant with p= 0.237.
CONCLUSIONS
This study demonstrates significant changes in the serum levels of Mg and Zn between diabetic patients and
the controls. This result indicates the important role these trace metals (Mg and Zn) may be contributing in the
maintenance of optimal plasma glucose among diabetic patients.

P0793
DETERMINATION OF SERUM COPPER STATUS IN TYPE 2 DIABETIC PATIENTS TREATED WITH METFORMIN
N. Kacimi 1, G. Kacimi 1, S. Hatri 1

1
Hospital Med Seghir Nekkache
BACKGROUND-AIM
An alteration of the metabolism of certain trace elements in type 2 diabetics is described by certain studies. This
alteration could play a role in pathogenesis and the progression of the disease. The objective of this study is to
determine the status of an oligoelement Copper (Cu) among Algerians with type 2 diabetes and treated exclusively
by metformin.
METHODS
160 type 2 diabetic subjects treated with metformin have been selected. The average age is estimated at 49.57 ±
6.70 years. A biochemical assessment was carried out on the serums of each subject : a dosage of blood sugar, a
complete lipid assessment and the measurement of certainoplasmine levels on the Cobas 501 of Roche Diagnostic. A
dosage of the HBA1C on Integrat 400 of Roche Diagnostic. A dosage of insulin on Cobas E411 of Roche Diagnostic. The
measurement of serum Copper levels was done on the ICE3300 atomic absorption spectrometer of Thermo Fisher.
RESULTS
Significant difference (p <0.001) between copper rates in diabetic subjects which are higher than in witnesses.
Significant difference (p <0.001) between ceruloplasmine levels in diabetic subjects which are higher than in witnesses.
Significant positive correlation of copper with fasting blood sugar and HBA1C(p <0.05).
CONCLUSIONS
In this study , high copper levels were observed in diabetics under Metformin, proving the involvement of this element
in the pathogenesis of type 2 diabetes. Other studies must be envisaged in order to define the role of copper in the
development of complications of type 2 diabetes, as well as to determine whether copper chélators could represent
a future therapeutic strategy in this disease.

P0794
ASSOCIATION OF THE SERUM MAGNESIUM AND THE C REACTIVE PROTEIN IN ALGERIAN SUBJECTS WITH INSULIN
RESISTANCE
G. Kacimi 1, N. Kacimi 1, S. Hatri 1

1
Hospital Med Seghir Nekkache
BACKGROUND-AIM
Magnesium (MG) is the cofactor of several enzyme involved in particular in carbohydrate metabolism, several
mechanisms are envisaged to explain insulin resistance in particular, the lack of magnesium which would prevent
insulin receptors, located on the periphery of the cells, from functioning properly. This MG deficit which would also
play a role in modulating the processes of inflammation. Our aim is to assess the link between serum magnesium and
C-Reactive protein (CRPUS) levels in subjects with insulin resistance .
METHODS
The study focused on a total of 90 subjects with insulin resistance Homa-IR index (> 3) .The average age is estimated
at 57.94 ± 7.68 years. On the serum of each subject, a dosage of blood sugar, a complete lipid assessment, a dosage
of the serum Mg and the measurement of CRPUS levels were carried out on the Cobas 501 of Roche Diagnostic. The
dosage of the serum insulin necessary for the calculation of the Homa-IR index was carried out on the Cobas E411 of
Roche Diagnostic.
RESULTS
In this study, there is a reverse correlation between the levels of serum Mg and CRPUS (R = -0.478), a negative
correlation was also found between the serum Mg and the Homa-IR index (R = -0.331).
CONCLUSIONS
Insulin resistance is significantly associated with low levels in serum magnesium and inflammation by raising CRPUS
levels. Supplementation should be considered in this category of subjects to improve insulinosensitivity and to combat
inflammation by decreasing CRPUS levels.

P0795
REAL-TIME CONTINUOUS CONTINUOUS GLUCOSE MONITORING AFTER LIVER TRANSPLANTATION
J. Franekova 3, B. Hagerf 4, M. Protus 1, V. Svirlochova 2, A. Jabor 3

1
Anesthesiology and Intensive Care Clinic, Institute for Clinical and Experimental Medicine, Prague, First Faculty of Medicine,
Charles University, Prague
2
Department of Laboratory Methods, Institute for Clinical and Experimental Medicine, Prague
3
Department of Laboratory Methods, Institute for Clinical and Experimental Medicine, Prague, Third Faculty of Medicine,
Charles University, Prague
4
Diabetes Clinic, Institute for Clinical and Experimental Medicine, Prague, First Faculty of Medicine, Charles University,
Prague
BACKGROUND-AIM
Glucose homeostatic mechanisms are influenced in post-transplant period with different stressors in liver, kidney,
pancreas or Langerhans islets transplantation (Tx). The aim was to compare results of continuous glucose monitoring
(CGM) in the setting of early post-transplant and postoperative period.
METHODS
In a pilot study, a total of 61 patients after liver (N=41), Langerhans islets (Li, 9), kidney+pancreas (5) transplantation
(Tx) and total pancreatectomy (TP, 6) was evaluated within 10 days after Tx. CGM was monitored by Dexcom G6
(Dexcon, Inc., San Diego, USA), glucose was measured by ABL800 Radiometer, Copenhagen, Denmark and StatStrip,
NOVA Biomedical Corp., USA.
RESULTS
Median number of days with CGM was 9.0 days (IQR 7.0-9.3) with median number of calibrations per days 0.7 (0.5-1.2).
Medians of mean glucose during monitoring and glucose variation coefficients were 8.4 mmol/L (7.5-9.7) and 28.0%
(20.2-33.8), respectively. Median of percentage of time with glucose above 10 mmol/L was 23.0% (6.0-38.0), there were
22.8% of glucose concentrations above 10.0 mmol/L (6.4-38.2). Percentage of time above 10 mmol/L was significantly
different among 4 respective groups (Kruskal-Wallis, p<0.0001). Highest percentage was in LTx (median 28.0%, IQR
15.0-39.5) and TP (22.0%, IQR 3.0-45.0), both significantly higher than KPTx and LiTx (p<0.05). Similarly, mean glucose
concentration was different among groups (p<0.01), with highest glucose concentration in LTx (median 9.0 mmol/L,
IQR 8.0-9.7) and TP (8.9 mmol/L, IQR 7.2-10.2), both significantly higher than KPTx (p<0.05). Highest variability of
glucose, assessed as coefficient of variation, was different among groups (p<0.0001), with highest variability in TP
(median 28.8%) and LTx (36.3), both significantly higher than LiTx (14.7%) and KPTx (7.8%) (p<0.05).
CONCLUSIONS
Preliminary data revealed, that liver Tx and total pancreatectomy were associated with worse glucose homeostatic
parameters in comparison with kidney and pancreas Tx or Tx of Langerhans islets. Liver Tx and pancreatectomy require
more attention and a higher level of monitoring can be obtained with CGM to provide reliable information on glucose
homeostasis in terms of hypo- and hyperglycemia.
Supported by Cooperatio, Charles University, Prague.

P0796
HEALTH EFFECTS OF CLINOPTILOLITE ZEOLITE SUPPLEMENTATION, AN IN VIVO APPROACH
S. Salazar García 1, E. Lares Villaseñor 1, P. Hernández Morales 1, B.B. Jurado Manzano 1, A. Rodríguez Rodríguez 1, S.
Zarazúa Guzmán 1, L.G. Noriega López 2, J.M. Vargas Morales 1
1
Facultad de Ciencias Químicas, Universidad Autónoma de San Luis Potosí. México.
2
Instituto Nacional de Ciencias Médicas y Nutrición “Salvador Zubirán”, México.
BACKGROUND-AIM
Zeolites are microporous aluminosilicate minerals. Zeolite Clinoptilolite (ZC) is of great interest for its use in
supplementation, since due to its novel physical and chemical properties it could confer benefits to human health.
Scientific evidence has shown beneficial effects of ZC, such as hypoglycemic and lipid-lowering capacity, and anti-
oxidative stress. However, these studies are not conclusive and further analysis is required to assess the potential
benefit and/or possible adverse effects that ZC supplementation may confer. The objective of this work is to evaluate
the effects that 2% ZC supplementation can confer on health, through the evaluation of body weight and food
consumption and the measurement of biochemical, hematological, hepatic and renal biomarkers, in biomodels with
a normal diet and a high-fat diet.
METHODS
The study was experimental, cross-sectional and prospective. Twenty-four male Wistar rats were used, divided into 4
groups (n=6 per group). Group 1 consumed a standar diet (AIN93), group 2 a normal diet with 2% ZC (AIN93-ZC), group
3 a high-fat diet (DHF) and group 4 a high-fat diet with 2% ZC (DHF- ZC), all for 28 days. The measured parameters were
analyzed using ANOVA and Tukey's Post hoc test.
RESULTS
It was found that the biomodels of the AIN93-ZC group consumed a greater amount of food without this increase in
food intake being reflected in a significant increase in weight, or changes in biochemical parameters. On the other
hand, it was found that the biomodels of the HDF-ZC group present lower levels of glycosylated hemoglobin than those
who consumed a normal diet (p=0.003). Finally, no differences were found between the rest of biochemical, hepatic,
renal and hematological biomarkers.
CONCLUSIONS
This study establishes evidence on the physiological effects that ZC might confer to supplementation, such as
increasing food intake without compromising intermediate metabolism or glycemic control in subjects on a high-
fat diet. Finally, in this study we did not find signs of alterations in biomarkers in the liver or kidneys that could be
conferred by the consumption of this supplement. The beneficial effects and mechanisms that ZC can generate in the
body remain to be elucidated in detail.

P0797
INSULIN RESISTANCE IN PATIENTS WITH DEPRESSION BEFORE AND AFTER TREATMENT
D. Janicevic Ivanovska 1, N. Manuseva 3, A. Spasovska Trajanovska 3, S. Domazetovska 2, B. Stefanovski 3

1
University Institute of Clinical biochemistry, Faculty of Medicine University “Ss. Cyril Methodius” Skopje, University “Goce
Delcev”Stip ,Republic of North Macedonia
2
University Institute of Clinical biochemistry, Faculty of Medicine University “Ss. Cyril Methodius” Skopje, Republic of North
Macedonia
3
University Psychiatric Clinic, Faculty of Medicine University “Ss. Cyril Methodius” Skopje, Republic of North Macedonia
BACKGROUND-AIM
A high proportion of patients with depression develop glucose intolerance accompanied by hyperinsulinemia,
suggestive of reduced insulin sensitivity (insulin resistance).
The aim of this study was to evaluate insulin sensitivity in patients with depression and its changes during the clinical
course and treatment of depression.
Study group consisted of 43 nondiabetic patients with depression (23 males and 20 females aged 40 ± 10 years), body
mass index BMI was 23.2 ± 2.8 kg/m2 and an age, sex, and BMI-matched control group (n = 40).
METHODS
We examined oral glucose tolerance test (OGTT) before and after psychopharmacological treatment of depression in
duration of 6-8 weeks. Metabolic indices measuring glucose effectiveness at basal insulin and insulin sensitivity were
derived from minimal model analysis. Each patient was treated with antidepressant and diet with 2,000 kcal/day food
intake and underwent no exercise therapy.
RESULTS
Insulin sensitivity was significantly lower in patients before treatment versus control subjects (6.0 ± 2.5 mmol/l 13,8 ±
8,6mmol/l P < 0.01). After treatment of depression, a significant increase in insulin sensitivity in treated patient (10.7
± 7.5 mmol/l P<0.01) followed by clinical improvement with reduction of depressive symptoms was observed without
changes in the BMI, fasting blood glucose and basal insulin. This was associated with a decrease in the insulin response
during the OGTT.
CONCLUSIONS
We can conclude that patients with depression have impaired insulin sensitivity and resultant hyperinsulinemia and
that these abnormalities can be resolved after recovery from depression

P0798
ASSOCIATION OF ACE GENE POLYMORPHISM AND DIABETIC NEPHROPATHY
K. Sifi 2, S. Hanachi 2, K. Boudaoud 1, S. Zekri 2, S. Houche 2, h. Houamel 2, S. Hassini 2, K. Benembarek 2, n. Abadi 2

1
Research laboratory in biology and molecular genetics, Department of Medicine, Salah Boubnider University,
Constantine3 / Endocrinology department, Ibn Badis University Hospital, Constantine Algeria.
2
Research laboratory of biology and molecular genetics, Department of Medicine, Salah Boubnider University
Constantine3 / Biochemistry Laboratory of Ibn Badis University Hospital of Constantine Algeria
BACKGROUND-AIM
Diabetic nephropathy is the main cause of chronic kidney disease and is the most common and serious complication
of diabetes. Its exact pathogenesis is complex and not completely understood. Several factors and mechanisms
contribute to the development and outcome of this pathology.
The objectives of our work are to determine the frequency of the polymorphism Insertion(I)/Deletion (D) of the
ACE (angiotensin-converting enzyme) gene in diabetic patients with and without nephropathy and to establish the
relationship between this polymorphism and diabetic nephropathy in a population of Eastern Algeria.
METHODS
For this purpose, we recruited twenty-nine diabetic subjects with nephropathy and thirty diabetic controls without
nephropathy.
DNA extraction was performed on fresh blood by the NaCl method and the polymorphism I/D polymorphism of the
ACE gene was determined by PCR (polymerase chain reaction).
Informed consent was obtained from all participants.
RESULTS
The average duration of diabetes with nephropathy in our cases was 19.21 ± 9.31 years; that of the controls without
nephropathy was 10.67 ± 7.66 years. Type 1 diabetes is more frequent in nephropaths (72.41%), in controls without
nephropathy, the frequency of type 2 diabetes is more important (73.33%). Macro angiopathic complications are more
prevalent in nephropaths. Moreover, the association of two or more complications is frequently found. The frequencies
of the I and D alleles are respectively 13.79% and 86.21% in the controls without nephropathy subjects, whereas the
allele frequencies in subjects with nephropathy are respectively 19.64% and 80.36%.
CONCLUSIONS
No significant association between this polymorphism and diabetic nephropathy has been demonstrated.

P0799
ANALYTICAL AND STABILITY PERFORMANCE OF THE ALINITY C HBA1C ASSAY
P. Henriques 2, M. Berman 1, E. English 4, W.G. John 3

1
Core Diagnostics, Abbott Labs, North Chicago
2
Dept Clinical Biochemistry, James Paget University Hospital, Norwich
3
Dept Clinical Biochemistry, Norfolk and Norwich University Hospital, Norwich
4
Faculty of Medicine and Health, University of East Anglia, Norwich
BACKGROUND-AIM
Haemoglobin A1c (HbA1c) is a fully standardized analyte that has been widely used in the diagnosis of Diabetes Mellitus
and monitoring of long-term blood glucose control. The Abbott enzymatic HbA1c test automatically lyses red blood
cells and utilizes an enzymatic method that specifically measures N-terminal fructosyl dipeptides of the beta-chain
of HbA1c. The clinical value of an HbA1c assay is dependent on the assay being standardized, precise and accurate.
This is the first study to assess the effect of increasing heamatocrit concentration on sample stability and carryover
on the HbA1c assay on the Alinity c system.
METHODS
A comprehensive evaluation of the Abbott Enzymatic HbA1c method was undertaken using Clinical and Laboratory
Standards Institute-based protocols. For stability testing, native and heamatocrit (0.2 – 0.8 L/L) samples (red blood
cells added to plasma) were tested. Fifty whole blood EDTA samples, with HbA1c ranging from about 20-120 mmol/
mol, were measured on both the Abbott Alinity c Analyzer and the A.Menarini Diagnostics Premier Hb9210 analyser
(boronate affinity high performance liquid chromatography). To assess imprecision, three patient pools (low, medium,
and high) were run in duplicate twice per day for 20 non-consecutive days. To evaluate linearity, two patient samples
(one low and one high HbA1c level) were mixed together incrementally to produce a set of panels at five distinct levels.
Carryover was assessed with whole blood HbA1c samples (n=5) followed by saline.
RESULTS
The Abbott Enzymatic HbA1c method correlated well with the A.Menarini Hb9210 analyser with a regression slope of
1.00 and a correlation of 0.99. Total imprecision for each patient pool was <1% at 32.2, 58.9 and 102.8 mmol/mol.
The results obtained for linearity showed acceptable linear performance. No carryover was observed from whole blood
samples into whole blood samples or saline (0 ppm). Whole blood samples (n=20) were stable with or without mixing,
</= 3% difference after 72 h at RT and 2-8C. Haematocrit concentrations from 0.2 -0.8 L/L were stable </= 3% after
8 h at RT.
CONCLUSIONS
The Alinity c Haemoglobin A1c assay is a precise and accurate method independent of the haematocrit value and with
no whole blood carryover for measuring HbA1c.

P0800
EVALUATION OF ANTHROPOMETRIC, CLINICAL AND BIOCHEMICAL BIOMARKERS THROUGH A DIETARY
INTERVENTION IN MEXICAN ADULTS WITH RISK FACTORS FOR METABOLIC SYNDROME
E. Lares Villaseñor 1, S. Salazar García 1, P. Hernández Morales 1, B.B. Jurado Manzano 1, A. Rodríguez Rodríguez 1, D.Z.
Castillo Guevara 1, D.P. Portales Pérez 1, M. Vega Cárdenas 2, C. Aradillas García 2, L.G. Noriega López 3, M. Guevara Cruz
3
, J.M. Vargas Morales 1
1
2
Facultad de Medicina, Universidad Autónoma de San Luis Potosí, México.
3
Instituto Nacional de Ciencias Médicas y Nutrición “Salvador Zubirán”, México.
BACKGROUND-AIM
Metabolic syndrome (MetS) increases the risk of developing diseases such as diabetes mellitus and cardiovascular
disease. Since the prevalence of these diseases is increasing in Mexico and the world, some of the prevention strategies
include dietary modification; however, not all diets achieve the same results in subjects, so in this study we evaluated
whether a two-month dietary intervention following the recommendations of the Adult Treatment Panel III (ATP-III)
of the National Cholesterol Education Program (NCEP) improves anthropometric, clinical and biochemical biomarkers
in Mexican subjects with risk factors for MetS.
METHODS
A prospective, longitudinal intervention study was conducted. Mexican subjects between 18 and 60 years of age were
recruited. The subjects selected had one or more of the MetS criteria according to the NCEP-ATP-III, in addition to
a body mass index (BMI) ≥30 kg/m2 and/or total cholesterol ≥200 mg/dL. The dietary intervention was established
following the NCEP-ATP-III recommendations and consisted of 50-55% carbohydrate, 15-25% protein, 25-35% fat and
20-30 g/day fiber. A reduction of 500 kcal was established. The results were analyzed using Student's t statistic or
wilcoxon.
RESULTS
A total of 98 subjects were analyzed, 63 (64.3%) women and 35 (35.5%) men, of whom 65 completed the two-
month intervention. The main baseline characteristics were abdominal obesity and hypertriglyceridemia. Two months
after the dietary intervention, changes were observed mainly in weight (p<0.001), BMI (p<0.001), waist circumference
(p<0.001), glucose (p<0.01), total cholesterol (p=0.013) and LDL cholesterol (p=0.006) in both sexes. In women there
was only a decrease in weight (p<0.001) and BMI (p<0.001) and an increase in glucose (p<0.001), while in men the
decrease was in weight (p<0.001), BMI (p=0.001) and waist circumference (p=0.001).
CONCLUSIONS
The dietary intervention for two months showed a decrease mainly in anthropometric and lipid biomarkers. There is
controversy about the optimal diet for MetS patients, however our results indicate that this dietary intervention could
be a good option as a primary prevention strategy in subjects with MetS risk factors, since in a short time there was
an improvement in some components of MetS.

P0801
SOCIODEMOGRAPHIC, LIFESTYLE AND CARDIOMETABOLIC DETERMINANTS PREDICT INCREASED GLUCOSE LEVELS IN
MEXICAN CHILDREN AND ADOLESCENTS
J.M. Vargas Morales 1, E. Lares Villaseñor 1, S. Salazar García 1, P. Hernández Morales 1, D.Z. Castillo Guevara 1, A.
Rodríguez Rodríguez 1, B.B. Jurado Manzano 1, D.L. Medina Jasso 1, P.E. Cossío Torres 2, C. Aradillas García 2, D.P. Portales
Pérez 1
1
2
Facultad de Medicina, Universidad Autónoma de San Luis Potosí, México.
BACKGROUND-AIM
Currently, hyperglycemia, defined as levels greater than 100 mg/dL, is a problem in Mexico and the world, which if
not prevented can lead to the development of type 2 diabetes mellitus and its cormorbidities, even in the pediatric
population. Risk factors include environmental, lifestyle and biological factors. However, it is necessary to deepen the
knowledge of which are the risk factors that most influence the development of hyperglycemia in order to generate
prevention strategies in the young population. Therefore, the aim of this study was to evaluate the association
of different sociodemographic, lifestyle and cardiometabolic determinants with glycemia in Mexican children and
adolescents.
METHODS
The study was cross-sectional, recruiting schoolchildren from different municipalities in the state of San Luis Potosí,
Mexico. The variables were analyzed with spearman's correlation coefficient, multiple linear regression and bivariate
logistic regression in SPSS statistics® 20 software.
RESULTS
A total of 642 schoolchildren aged 6 to 19 years were included, 395 (61.5%) females and 247 (38.5%) males. Systolic and
diastolic blood pressure presented the highest positive correlation with glucose levels (r=0.305, p<0.01 and r=0.253,
p<0.01 respectively). For both sexes, the predictors of glycemia that explained up to 15.6% (p<0.05) of the variability of
glucose concentrations were: time in front of video games, body mass index, elevated total cholesterol, diastolic blood
pressure, inadequate diet, high socioeconomic level and male sex. When subdivided by sex, glycemia was explained by
up to 17.3% (p<0.05) in men and up to 9.4% (p<0.05) in women; the determinants were the same for men, except total
cholesterol and inadequate diet, whereas in women the determinants were cholesterol levels, diastolic blood pressure
and high socioeconomic level.
CONCLUSIONS
In this study, lifestyle, sociodemographic, and cardiometabolic determinants predict glycemia by up to 17% in men and
up to 15% in both sexes. Most of these determinants are modifiable risk factors when detected early, so it is important
to generate preventive strategies and corrective measures to reduce the high prevalence of type 2 diabetes mellitus
and metabolic syndrome from an early age.

P0802
SOLUBLE PROGRAMMED CELL DEATH LIGAND 1 (SPD-L1) IN OBESE SUBJECTS ASSOCIATION WITH CHRONIC
INFLAMMATION AND DEVELOPMENT OF DIABETES
C.A. Purnama 2, A. Meiliana 2, K.L. Dandan 2, M.I. Barliana 1

1
Department of Biological Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Indonesia
2
Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Indonesia
BACKGROUND-AIM
To analyze the level of sPD-L1 in obese subjects compared with healthy controls and to explore the association of sPD-
L1 in the development of obesity with chronic inflammation and diabetes status
METHODS
The levels of sPD-L1 were measured using a flow cytometer and assessed using a bead-based immunoassay method.
The hs-CRP levels were measured using the chemiluminescent method to determine the level of inflammation. The
HbA1c levels were used to distinguish between obese subjects with and without diabetes. The NGSP-certified High
Performance Liquid Chromatography (HPLC) method was used to determine the levels of HbA1c. Materials included
human serum, which was used both as a screening test and to measure levels of sPD-L1, hs-CRP, and HbA1c.
RESULTS
In 33 obese subjects without type 2 diabetes mellitus (T2DM), 31 obese subjects with T2DM, and 17 healthy subjects,
the levels of sPD-L1 were significantly higher in obese subjects with and without T2DM than in healthy subjects.
Although the levels of hs-CRP in obese subjects were significantly higher than in healthy subjects, the levels were
maintained below the acute infection cutoff. In both groups of obese subjects, there was a significant positive
correlation between the production of sPD-L1 and the elevated hs-CRP and HbA1c levels
CONCLUSIONS
The severity of chronic inflammation and the onset of diabetes disease were associated to the elevated sPD-L1 levels
in obese subjects.

P0803
SALMONELLA INFECTION AMONG THE SUSPECTED ENTERIC FEVER PATIENTS
S. Gupta 1
1
Pokhara University, Pokara, Nepal
BACKGROUND-AIM
Enteric fever is one of the common public health problems in Nepal. The progressive increase in antibiotic resistance
among pathogens in developing countries is becoming a critical area of concern globally.
METHODS
. The present study was carried out at Everest Hospital, Kathmandu, Nepal, with an objective to determine the
prevalence of enteric fever and to analyze the status of antimicrobial resistance pattern of Salmonella enterica serovar
Typhi and Paratyphi isolated from blood specimens. Identification of the isolates was done by standard microbiological
techniques and antibiotic susceptibility testing was done by modified Kirby Bauer disc diffusion method following
clinical and laboratory standard guidelines (CLSI).
RESULTS
A total of 692 blood samples were collected during April, 2019 to September, 2020..Among them 40(5.8%) samples
were found to be culture positive whereas 652 (94.2%) cases were culture negative. Out of 40 isolates, 22 (55%) were
S. Typhi and 18 (45%) were S. Paratyphi A and the prevalence was higher in male and in the age group of 11-20 years..
Most effective antibiotics were chloramphenicol and cotrimoxazole.
CONCLUSIONS
Among the 22 S. Typhi isolates, 21 (95.5%) were nalidixic acid resistant (NAR). Out of 18 S. Paratyphi A isolates, 16
(88.9%) were nalidixic acid resistant. Among 21 nalidixic acid resistant (NAR) S. Typhi, only 2 isolates were found to
be resistant to ofloxacin and only 11 isolates were found to be sensitive to ciprofloxacin. Similarly, out of 16 isolates
of S. Paratyphi A resistant to nalidixic acid, only one of the isolate was found to be resistant for both ofloxacin and
ciprofloxacin. It was concluded that higher rate of nalidixic acid resistance as well as emerging resistant pattern to
other fluroquinolone antibiotics suggests us to follow correct treatment regimens and good infection control practices.

P0804
CORRELATION OF SERUM UREA, CREATININE AND URINARY MICROALBUMIN IN TYPE 2 DIABETIC PATIENTS IN
WESTERN, NEPAL
G. Dhakal 1
1
School of Health and Allied sciences, Pokhara University, Nepal
BACKGROUND-AIM
Diabetic Mellitus (DM) is a group of metabolic disorders in which glucose is underused, producing hyperglycemia.
Abnormal renal function is represented by an abnormality in serum creatinine, urea, and urinary microalbumin. In
diabetic nephropathy, serum urea and creatinine, and urine microalbumins known to be raised with hyperglycemia and
usually correlate with severity of kidney damage.
Objective: The objectives of this study are to compare the level and direction of urea, microalbumin, and other study
parameters such as creatinine, serum glucose among diabetic and non-diabetics in Butwal, Nepal.
METHODS
This study was a cross-sectional comparative study conducted among the type-2 diabetic and non-diabetic subjects
who visited National Path Lab, Butwal, Rupandehi for their routine blood examinations. A total of 100 samples were
collected randomly and study parameters were determined by using standard laboratory protocols.
RESULTS
In this study, 40 were diabetic and 60 were non-diabetic. The Mean±SD of serum urea, creatinine and urine
microalbumin in this study was 53.50 ± 7.68, 1.71±0.23, and 33.0±8.25 respectively for diabetic patients and
20.60±5.12, 0.73±0.19, and 11.73±4.517 for non-diabetic. There were correlations between serum urea, creatinine and
urinary microalbumin between diabetic. (r-value of urea, creatinine and microalbumin were 0.703,0.572 and 0.674
respectively). It is also statistically significant in diabetic and non-diabetic i.e. (p-value<0.001) with serum urea,
creatinine, and urinary microalbumin.
CONCLUSIONS
The present study suggests that there were correlations between serum urea, creatinine and microalbumin in diabetic
patient and statically insignificant relationship of the degree of albuminuria and creatinine with age.

P0805
GLYCATED ALBUMIN FOR GLYCEMIC CONTROL IN INDIVIDUALS WITH DIABETES: AN ITALIAN MULTI-DIMENSIONAL
ANALYSIS
L.B. Ferrario 1, F. Schettini 1, M. Corsi Romanelli 2, E. Dozio 2, S. Castaldi 2, L. Gesualdo 10, P. Pontrelli 10, A. Avogaro 8, G.
Bonetti 7, A. Ceriello 4, M. Ciaccio 3, A. Girelli 9, M. Plebani 5, M. Zaninotto 5, G. Perseghin 6, E. Foglia 1
1
Carlo Cattaneo – LIUC University and LIUC Business School, Castellanza, Italy; HD LAB – Healthcare Datascience LAB - Carlo
Cattaneo – LIUC University, Castellanza, Italy
2
Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy
3
Department of Biopathology and Medical Biotechnologies, University of Palermo, Palermo, Italy
4
Department of Cardiovascular and Metabolic Diseases, Multimedica Research Institute, Sesto San Giovanni, Milan, Italy
5
Department of Laboratory Medicine, University-Hospital of Padova, Padova, Italy
6
Department of Medicine and Surgery, Università degli Studi di Milano Bicocca, Milan, Italy; Department of Medicine and
Rehabilitation, Unit of Metabolic Medicine, Policlinico di Monza, Monza, Italy
7
Department of Medicine Services, Valcamonica Hospital, Esine, Italy
8
Department of Medicine, University-Hospital of Padova, Padova, Italy.
9
Diabetes Care Unit, Spedali Civili Hospital, Brescia, Italy
10
Nephrology, Dialysis and Transplantation Unit "Aldo Moro" University of Bari, Azienda Ospedaliero-Universitaria
Consorziale "Policlinico", Bari, Italy
BACKGROUND-AIM
Glycated haemoglobin (HbA1c) is traditionally used to monitor the glycemic control in type 2 diabetes mellitus (T2DM).
Glycated albumin (GA) has emerged as an innovative glycaemic marker, differing from HbA1c because its values are
not affected by changes in erythrocyte lifespan nor influenced by interfering conditions.
This research activity aims at defining the impacts of GA introduction, as an add-on marker to the traditional glycaemic
monitoring systems, within insulin naïve T2DM individuals, treated with oral therapies, and T2DM patients with chronic
kidney disease (CKD).
METHODS
A Health Technology Assessment was conducted in the two different settings, assuming the Italian NHS perspective.
The EUnetHTA Core Model dimensions were explored using: 1) literature evidence, to define efficacy and safety
indicators; 2) health economic tools, to study GA economic sustainability; 3) healthcare professionals’ perceptions,
examining the equity, social and organizational impacts.
RESULTS
Focusing on insulin naïve T2DM individuals, treated with oral therapies, GA introduction could lead to a greater
therapeutic success (97% vs 72%), measured as patients not experiencing any therapeutical switch. Within T2DM
individuals with concomitant CKD, GA could better identify a worst glycemic control than HbA1c alone (52% vs 19.2%).
From an economic perspective, GA would lead to an overall saving in both settings (1% within the insulin naïve T2DM
population and 2% within the T2DM individuals with concomitant CKD), being the solution presenting a better trade-
off between costs sustained and efficacy achieved.
According to experts’ opinions (based on an evaluation scale ranging from -3 to +3), lower perceptions on GA emerged
on equity aspects (p>0.05), whereas it would improve both individuals and caregivers’ quality of life (p=0.000). From
an organizational perspective, despite marginal investments are required for training courses and equipment updates,
GA would lead to an overall improvement in the patients’ care (p>0.05).
CONCLUSIONS
In conclusions, results demonstrated the strategic relevance of adding GA to traditional glycemic control instruments,
in the optimization of T2DM patients glycaemic monitoring, leading to clinical, economic, and organizational
advantages.

P0806
UNC - AN EARLY MARKER FOR KIDNEY INJURY IN PATIENTS WITH TYPE II DIABETES MELLITUS
S. Shefket 1, Y. Bocheva 1, G. Chausheva 1

1
Central Clinical Laboratory, St. Marina University Hospital, Varna, Medical University - Varna, Bulgaria
BACKGROUND-AIM
Neutrophil gelatinase-associated lipocalin (NGAL) is one of the most promising tubular biomarkers in the diagnosis of
kidney diseases. The data in the literature determine NGAL as a marker with a good diagnostic profile in the diagnosis
of diabetic kidney disease (DKD). NGAL values correlate with progression of albumin excretion and with the severity
of renal impairment.
The aim of the study to determine the diagnostic reliability of urine NGAL/Creatinine ratio (UNC) as a marker for DKD
in patients with diabetes mellitus II (DM II).
METHODS
The study included 92 patients with DM II, who were divided according to urine Albumin/Creatinine ratio (ACR) in three
subgroups - A1 - 46% (ACR <3 g/mol), A2 - 31% (ACR – 3-30 g/mol) and A3 - 23% (ACR >30 g/mol). NGAL was measured
in a first morning urine using particle-enhanced turbidimetric immunoassay (BioPorto).
RESULTS
The study group consisted of 92 patients with DM II (51 women and 41 men), the middle age was 58.28±14.69 years.
The median and interquartile range of UNC in the three subgroups of patients were: A1–2.52 (1.83-4.32), A2–7.86
(4.11-16.46) and A3–10.94 (7.63-33.26) µg/mmol. A statistically significant difference in UNC concentration was found
between all subgroups of patients (p<0.05). In each subgroup, UNC values were higher in females compared to males,
but the difference was significant only in subgroup A1 (p<0.001). The ROC analysis demonstrated good diagnostic
effectiveness of UNC in differentiating patients with DKD (A1 vs A2/A3) with AUC-ROC in females – 0.845 and in males
– 0.904. The sex-differentiated cut-off values for UNC in women was 6.87 (sensitivity and specificity – 75% and 86%)
and in men was 3.72 µg/mmol (sensitivity and specificity - 88% and 95%). A positive correlation was found between
UNC and ACR (p<0.001).
CONCLUSIONS
The UNC may be used as an early marker for the kidney damage in DM II. More studies are needed to confirm our results
and to detect the underlying mechanism of the tubular injury in diabetic patients.

P0807
LIRAGLUTIDE IMPROVES CARDIOMETABOLIC PARAMETERS IN OBESE PATIENTS WITH TYPE 2 DIABETES: A REAL-
WORLD 18-MONTH PROSPECTIVE STUDY.
R.V. Giglio 1, B. Lo Sasso 1, C.M. Gambino 1, G. Bivona 1, R. Andolina 2, M. Casisa 2, L. Agnello 1, M. Rizzo 3, M. Ciaccio 1
1
Department of Biomedicine, Neurosciences and Advanced Diagnostics, Institute of Clinical Biochemistry, Clinical Molecular
Medicine and Clinical Laboratory Medicine, University of Palermo, Italy.
2
Department of Laboratory Medicine, University Hospital “P. Giaccone”, Palermo, Italy.
3
Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties Department, University of Palermo,
Italy.
BACKGROUND-AIM
The glucagon-like peptide-1 agonist (GLP1-RA) liraglutide is currently approved for the treatment of both obesity and
type 2 diabetes (T2DM). We investigated whether the effect of this agent on cardiometabolic parameters in patients
with T2DM varied in relation to the concomitant presence of obesity.
METHODS
One hundred thirty-five subjects (78 men and 57 women; age: 62 ± 10 years) naïve to incretin-based therapies were
treated with low-dose liraglutide (1.2 mg/day) as an add-on to metformin for 18 months. Patients were divided into
two subgroups based on their body-mass index (BMI): (a) obese (BMI ≥ 30) and (b) non-obese (BMI < 30). Clinical and
laboratory analyses were assessed at baseline and every 6 months.
RESULTS
During follow-up, significant improvements were detected in both groups in fasting glycemia, glycated hemoglobin,
waist circumference, and carotid intima-media thickness (cIMT), while body weight, BMI, total cholesterol, and low-
density lipoprotein cholesterol decreased significantly in obese subjects only. Correlation analysis revealed that
changes in subclinical atherosclerosis (assessed by cIMT) were associated with changes in triglycerides (r = 0.488, p
< 0.0001) in the obese group only.
CONCLUSIONS
Liraglutide had beneficial effects on glycemic parameters and cardiometabolic risk factors in both non-obese and
obese patients with T2DM, with a greater efficacy in the latter. These findings reinforce the benefits of liraglutide for
the cardiometabolic outcomes of obese patients with T2DM in the real-world setting. This is of critical importance
during the current pandemic, since patients with diabetes and obesity are exposed globally to the most severe forms
of COVID-19, related complications, and death.

P0808
SERUM VITAMIN D STATUS IS ASSOCIATED WITH INSULIN RESISTANCE AND DYSLIPIDEMIA IN GESTATIONAL
DIABETES MELLITUS
A. Sonuga 1, O. Sonuga 2, J. Anetor 2

1
Clinical Biochemistry Unit,Biochemistry Department. Lead City University.Ibadan.Nigeria
2
Laboratory for Toxicology and Micronutrient Metabolism, Chemical Pathology Department, College of Medicine, University
of Ibadan, Ibadan
BACKGROUND-AIM
Gestational diabetes mellitus (GDM), a pregnancy complication, is any degree of glucose intolerance with onset
or first recognition during pregnancy. Vitamin D deficiency and insufficiency has recently been recognized as a
contributing factor to the pathogenesis of GDM, this link might be associated with hyperglycemia, insulin resistance,
and dyslipedemia, which are implicated in GDM. Objectives: This study aim at investigating the relationship between
vitamin D, fasting plasma glucose (FPG), insulin,ferritin and serum lipids (total cholesterol, TC; triglycerides, TG; low
density lipoprotein cholesterol, LDL-C and high density lipoprotein cholesterol, HDL-C) in GDM
METHODS
A case-control study in which 120 women attending the antenatal clinic of University College Hospital (UCH), Ibadan,
Nigeria, were recruited; the women were grouped into controls (60 nondiabetic pregnant women) and cases (60
pregnant women with GDM). Blood samples were taken at the second trimester, and metabolites were quantified
by standard laboratory methods. Student’s t test and Pearson correlation were used to compare and determine the
relationship between variables respectively.
RESULTS
Serum levels of vitamin D and HDL were significantly lower (p < 0.05) in GDM group when compared to the control group
(26.6±8.7 Vs 35.3±9.5ng/ml, 36.90±4.4 vs 61.34±2.9 mg/dl). There was a significant increase in the serum levels of FPG,
insulin and ferritin (152.15±28.6 Vs 93.2±15.4 mg/dl, 30.41±13.8 Vs 16.39±7.7pmol/l, 40.57±14.4 Vs 26.62±8.5ng/ml
respectively) in GDM group when compared to control. Also, TG, TC and LDL levels were significantly increased (p <0.05)
in the GDM group compared to the control group.( 230.3±11.43 Vs 77.81±8.3, 386.29±18.5 vs 156.36±5.3, 244.69±17.7
vs 59.64±3.85 mg/dl respectively).Vitamin D was inversely correlated with FPG, serum insulin, ferritin and LDL (r = –
0.33, –0.41,-0.20, -0.55 respectively, p < 0.05),while there was no significant relationship (p > 0.05) between vitamin
D, HDL, TG and TC in the GDM group.
CONCLUSIONS
This study suggests that low levels of serum Vitamin D might be associated with glucose intolerance, insulin
insensitivity, and dyslipidemia, which are factors implicated in the development of GDM.

P0809
RELATIONSHIP BETWEEN SELECTED IRON STATUS INDICES, BILIRUBIN AND BODY COMPOSITION IN NORMAL WEIGHT
AND OVERWEIGHT SUBJECTS – A PRELIMINARY STUDY
K. Bergmann 1, K. Olender 2, M. Kuligowska-Prusinska 1, G. Sypniewska 1, M. Krintus 1

1
Department of Laboratory Medicine, Nicolaus Copernicus University, Collegium Medicum in Bydgoszcz, Poland
2
Department of Laboratory Medicine, University Hospital No. 1, Bydgoszcz, Poland
BACKGROUND-AIM
Recent studies indicate the association of endocrine activity of adipose tissue with iron metabolism disorders and
decreased levels of bilirubin. The aim of this study was to evaluate the relationship between iron status indices
(iron, ferritin, transferrin and hepcidin), total bilirubin and body composition in normoglycemic normal wieght and
overweight individuals.
METHODS
The study included 70 healthy subjects (35 women, 35men) aged 25-40, with normal fasting glucose. Subjects were
divided by body mass index (BMI) values: normal weight BMI 18.5-24.9 kg/m2 and overweight 25.0-29.9 kg/m2. In all
subjects serum iron, ferritin, hepcidin, transferrin, total bilirubin concentrations, BMI and waist-to-hip ratio(WHR) were
measured. Percentage of water, muscle and fat tissue content was evaluated using bioelectrical impedance analysis
(BIA).
RESULTS
Significantly lower concentrations of ferritin, hepcidin, total bilirubin and lower values of WHR and muscle content were
observed in women, compared to men. Overweight subjects had significantly lower concentrations of iron (p=0.02),
total bilirubin (p<0.001), lower water and muscle content (p=0.02), compared to normal weight group. A moderate
negative correlation was noted between BMI and bilirubin concentration, water and muscle content. Significant
strong correlation was observed between hepcidin and ferritin concentrations (R=0.85; p<0.001) in overweight
subjects, as well as moderate negative correlation of hepcidin and transferrin. In subsequent tertiles of total bilirubin
concentrations a significantly lower transferrin, fat tissue and higher muscle content were found in the whole group.
Abdominal obesity and high percentage of fat tissue were more frequent in subjects with lower iron concentration (<84
mg/dL). A significant increase in WHR and ferritin concentration was observed with increasing hepcidin concentration.
In women abdominal obesity was 2-times more frequent in the third (>28.8 ng/mL) compared with the first (<13.1 ng/
mL) hepcidin tertile.
CONCLUSIONS
Concentrations of iron, transferrin and total bilirubin are significantly lower in overweight subjects, while ferritin and
hepcidin are significantly higher. This indicates the potential prooxidative activity associated with excessive adipose
tissue.

P0810
CORRELATION OF HEMOGLOBIN A1C AND PARAMETERS OF LIPID STATUS IN PATIENTS WITH TYPE 2 DIABETES
MELLITUS
V. Gluvic-Celic 1, T. Marjanovic 1, C. Oljaca 1

1
Public Health Institution "Dom zdravlja" Gradiska
BACKGROUND-AIM
Diabetes mellitus type 2 is one of the leading non-communicable diseases worldwide. Patients with type 2 diabetes
(T2DM) have an increased prevalence of dyslipidemia, which contributes to their high risk of cardiovascular diseases
(CVDs).
The aim of this work was to determine the relationship between hemoglobin A1c (HbA1c), fasting glucose levels (FBG)
and serum lipid parameters and to evaluate the importance of HbA1c as an indicator of dyslipidemia in patients with
T2DM
METHODS
A total of 337 patients with T2DM (men 157; women 180) were included in this study. The whole blood and
sera were analyzed for fasting blood sugar (FBG), HbA1c, total cholesterol (TC), triglycerides (TGs), high-density
lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) in the period from January to July 2022.
Dyslipidemia was defined according to the National Cholesterol Education Program Adult Treatment Panel III (NCEP
ATP III) guidelines. Diabetes was defined as per International Diabetes Federation (IDF) criteria. The correlation of
HbA1c, FBG with lipid parameters were analyzed. The statistical analysis was done by SPSS statistical package version
24.0.
RESULTS
The mean age ± standard deviation of male and female patients were 64.56 ± 9.22 and 67.66 ± 8.89 years respectively.
The results of this work show that the values of HbA1c, TC, TG and HDL-C were higher in women, while the values of
FBG and LDL-C were higher in men. Lipid status parameters in relation to glycemic status show a significant statistical
difference in hypercholesterolemia (p=0.004) and elevated LDL values (p=0.002). The correlation between HbA1c, FBG,
TC and LDL-C was statistically significant (FBG r=0.721; TC r=0.379 and LDL-C r=0.378, p< 0.05), while the correlation
between HbA1c and HDL-C was negative but statistically significant (HDL-r= -0.662, p<0.05). The TG correlation was
moderately positive but also statistically significant (LD-C r=0.224, p<0.05).
CONCLUSIONS
There is a significant correlation between HbA1c and lipid status parameters, especially with TC and LDL-C. Based on
results, we concluded that HbA1c can also be used as a predictor of dyslipidemia.
Key words: correlation, type 2 diabetes mellitus, HbA1c, lipid status parameters, dyslipidemia.

P0811
EVALUATION AND COMPARISON OF HBA1C DETERMINATION METHODS
S. Fuentes Cantero 1, E. Lepe Balsalobre 1, M.C. García Rivera 1, G.M. Varo Sánchez 1
1
Servicio de Análisis Clínicos. Área de Gestión Sanitaria Norte de Huelva. Hospital de Riotinto, Huelva (Spain)
BACKGROUND-AIM
Glycosylated haemoglobin (HbA1c) assesses the mean serum glucose concentration over the last 3 months. Its
quantification is key in the diagnosis and follow-up of patients with type-II diabetes mellitus and/or pre-diabetes.
There are numerous methods based on different principles for the quantification of
HbA1c. The reference method for its determination is high performance liquid chromatography (HPLC), which allows
the separation, detection and quantification of the different haemoglobin fractions.
The aim of this study is to evaluate the concordance of HbA1c measurement obtained on Hb9210 (Menarini) and Tosoh
G11 (Horiba) analysers.
METHODS
100 samples of whole blood-EDTA-K3 were analysed in a range of values between 4.9% and 11.6%. The samples
were processed in parallel and to minimise pre-analytical error, the analysis was performed on the two machines in
a sequential order: first on the Hb-9210 analyser (reference analyser) and then on the Tosoh G8 analyser (analyser
under evaluation).
Statistical analysis for method comparison was performed by Passing-Bablok Regression and Bland-Altman difference
analysis with the statistical programme MedCalc®. The cut-off point analysis was performed using ROC curves with
the SPSS 25.0 statistical software.
RESULTS
Results of the equation of the regression line (Passing-Bablok):
- Slope=0.76 (0.26-0.98).
- Ordinate at the origin= 231.11 (CI95% 52.48- 536.05).
Mean difference results (Bland-Altman): -295.40 (CI95% -356.46- -234.34); p-value 0.0001
Spearman Rank correlation coefficcient 0.395 (CI95% 0.215-0.549).
From the Bland-Altman comparison we observe that both measurements are far away from the 0 value and it is even
observed that the results with horiba are much higher than those of Menarini.
As for the Passing-Bablock, the slope and the and the ordinate at the origin show that both methods are not concordant
and present both constant and proportional differences.
In addition, the Spearman coefficient was 0.395, far from 1.
CONCLUSIONS
We conclude that the results by the two methods are completely different, so it is not possible to ensure the
transferability of the results between the two instruments.

P0812
ADIPOCYTE FATTY ACID-BINDING PROTEIN AND ADIPONECTIN LEVELS IN WOMAN WITH EARLY DIAGNOSED
GESTATIONAL DIABETES (GDM)
V. Kučerová 1, O. Krystyník 3, D. Mačáková 3, P. Petrová 1, L. Cibičková 3, J. Schovánek 3, M. Haluzík 2, D. Karásek 3

1
Department of Clinical Biochemistry, University Hospital Olomouc, Czech Republic
2
Diabetes Centre, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
3
Third Department of Internal Medicine, Faculty of Medicine and Dentistry, University Hospital and Palacky University,
Olomouc, Czech Republic
BACKGROUND-AIM
Adipocyte fatty acid-binding protein (A-FABP) and Adiponectin are adipocytokines (adipose tissue hormones) with
important metabolic effects. A-FABP increases lipolysis and insulin resistance, reduces contractility of cardiomyocytes,
supports chronic inflammation and formation of atherosclerotic plaques. Adiponectin improves insulin resistance, his
levels are decreased in obesity, type 2 diabetes, and patients with coronary artery disease.
It is suspected that disruption of the endocrine function of adipose tissue and the associated change in the expression
of these adipokines may lead to the development of hyperglycemia in woman with GDM.
Early detection of GDM allows timely intervention, improve adverse metabolic profiles and prevent adverse pregnancy
outcomes.
METHODS
23 pregnant women with early diagnosed GDM, 29 pregnant women without GDM, and 25 non-pregnant healthy
controls. Early GDM was diagnosed based on repeated fasting plasma glucose levels ≥ 5,1 mmol/l and < 7 mmol/
l during the first trimester of pregnancy and exclusion 1 or 2 type diabetes. Adiponectin was determinated with
immunochemistry kit Human Adiponectin ELISA (BioVendor, Czech Republic). Levels of A-FABP were assessed using
Human Adipocyte AFABP4 ELISA kit (BioVendor, Czech Republic). Early therapeutic intervention was introduced for
women with GDM already during their first visit (in the first trimester).
RESULTS
Levels of adiponectin were significantly descreased and levels of A-FABP were significantly elevated in woman with
GDM compared to both pregnant woman without GDM and non-pregnant healthy controls. Both adipokines were
associated with markers of visceral adiposity and glucose control. The introduction of early therapeutic intervention
was associated with the shifting of circulating concentrations of these adipokines to levels comparable with those in
healthy pregnant woman.
CONCLUSIONS
Women with GDM showed altered adipokine production already in the first trimester of pregnancy. These findings
support the importance of GDM screening in the early stages of pregnancy and the possible role of endocrine
dysfunction of adipose tissue in the development of gestational diabetes.
Supported by: Ministry of Health of the Czech Republic, NV18-01-00139, MZ CR-RVO (FNOl, 00098892), and IGA LF
2022 003.

P0813
GLYCATED HAEMOGLOBIN A1C FOR GESTATIONAL DIABETES MELLITUS SCREENING DURING THE CORONAVIRUS
PANDEMIC
A. Arbiol-Roca 1, T. Escartín-Diéz 1, D. Carrasco-Gómez 1, M. Sanz-Felisi 1, J.C. De La Cruz-Blanco 1, A. Cortés-Bosch De

Basea 1, M.R. Ruíz-Morer 1, A. Madurga-Hernández 1, D. Dot-Bach 1, N. Llecha-Cano 1
1
Laboratori Clínic Territorial Metropolitana Sud - Hospital Universitari de Bellvitge, Barcelona, Spain
BACKGROUND-AIM
During the coronavirus (COVID-19) pandemic it was necessary to implement alternative protocols for the screening of
gestational diabetes mellitus (GDM).
Some medical societies proposed guidance where they recommended the measurement of glycated haemoglobin
(HbA1c) during the first trimester for the screening of GDM.
The aim of the study is to evaluate the utility of HbA1c for GDM screening and compare it with the current protocol.
METHODS
Pregnant women who had results of HbA1c in the first trimester of pregnancy between 2020 and 2021 were
retrospectively included in the study. Data from the current screening algorithm for the second trimester were also
collected: non-fasting 50 g glucose challenge test (GCT); if the test was abnormal (≥7.8mmol/L), a subsequent 3 hours
100 g oral glucose tolerance test (OGTT) was performed. The diagnostic criteria for diagnosing GDM were according to
the Carpenter-Coustan which was considered the gold standard.
Mean and SD were calculated for HbA1c. The diagnostic accuracy of cut off proposed by the scientific societies
(HbA1c≥5.9%) was calculated. A receiver operating characteristic (ROC) curve was plotted to evaluate the utility of
HbA1c test in the diagnosis of GDM: Area Under Curve (AUC), and diagnostically specificity (Sp) and sensibility (Se).
Cut-off points were calculated to screen GDM.
Glucose concentration was measured on plasma (NaF) using Cobas8000 c702 analyser (Roche-Diagnostics®). HbA1c
levels were measured in blood (EDTAK3) through HPLC-ADAMS® HA-8180v (Menarini®).
RESULTS
A total of 747 pregnant women were recruited with HbA1c result. Out of these, 125 were also screened following the
gold standard protocol and 13 pregnant women (10.4%) had GDM. The mean HbA1c level was 5.33±0.46%. There were
no higher results than the cut-off value (HbA1c≥5.9%) therefore Se=0% and Sp=100%).
The AUC was 0.6683 (0.4837-0.8529). A new HbA1c cut-off value was calculated, and ≥4.8% was the optimal threshold
for the screening of GDM (Se:100%; Sp:3.57%).
CONCLUSIONS
Following medical societies cut off value, there were 13 pregnant women (10.4%) with GDM underdiagnosed by HbA1c.
We propose a screening of GDM with HbA1c<4.8% (Se:100%). OGTT should be performed on those patients who present
an HbA1c≥4.8%.

P0814
AMINO ACIDS PROFILE IN RELATION TO BIOCHEMISTRY INDICATORS IN OBESE PREPUBERTAL CHILDREN
J. Bugajska 1, J. Berska 1, M. Wójcik 2, K. Sztefko 1, P. Tomasik 1

1
Department of Clinical Biochemistry, Institute of Pediatrics, Jagiellonian University Medical College, Krakow, Poland
2
Department of Pediatric and Adolescent Endocrinology, Institute of Pediatrics, Jagiellonian University, Medical College,
Krakow, Poland
BACKGROUND-AIM
Branched chain amino acids (BCAAs) and aromatic amino acids (AAAs) are accepted as closely related to metabolic
risk. On the other hand, in arterial hypertension, metabolic syndrome, endothelial dysfunction, inflammation and non-
alcoholic fatty liver disease (NAFLD), conditions frequently seen in obese patients, many biochemical indicators are
increased. However, it is not known if changes of amino acids profile parallel with chemerin, hCRP, interleukin-6 (IL-6),
as well as simple biochemistry measurement in obese prepubertal children.
METHODS
The study included 20 obese children (M/F 12/8; mean age 7.7±2.3 years; BMI 26.8±5.0 kg/m2) and 12 non-obese
children (control group) (M/F 4/8; mean age 6.5±2.2 years; BMI 14.8±1.5 kg/m2). Free plasma amino acids (AAs) were
measured by the LC-MS/MS (Agilent Technologies, Jasem). The following plasma AAs were measured: aspartic acid,
glutamic acid, serine, asparagine, glycine, glutamine, taurine, histidine, citrulline, threonine, alanine, arginine, proline,
tyrosine, methionine, valine, isoleucine, leucine, phenylalanine, tryptophan, ornithine and lysine. Chemerin, hsCRP,
IL-6 and basic biochemistry were measured.
RESULTS
The mean plasma levels of leucine, isoleucine, valine, phenylalanine, tyrosine, glutamic acid, alanine were significantly
higher in obese children than in the control group (p<0.03 – p<0.0004). Conversely, the mean values of serine,
asparagine, glutamine, citrulline were significantly lower in obese children than in the controls (p<0.03–p<0.0007).
Isoleucine, leucine, valine (BCAAs) and tyrosine, phenylalanine (AAAs) levels showed a positive correlation with uric
acid, ALT, hsCRP, and chemerin (r=0.80 – 0.36; p<0.05 - p<0.00001), but not with IL-6. The mean value of glucose,
IL-6, hsCRP, chemerin, uric acid, ALT were significantly higher in obese children than in the control group (p<0.03 –
p<0.00002), whereas lipids profile did not differ between groups.
CONCLUSIONS
Differences in amino acids profile in obese children together with high ALT activity and increased uric acid level might
indicate disturbances of metabolic syndrome as well as NAFLD, even before pubertal onset.

P0815
INVERSE CORRELATION BETWEEN FECAL PROPIONATE AND SERUM ADMA IN TYPE 2 DIABETIC PATIENTS
R. Triana 2, I.R. Sukmawati 3, M.R.A. Syamsunarno 1, K. Lestari 2

1
Departement of Biomedical Sciences, Faculty of Medicine, Universitas Padjajaran, Bandung
2
Faculty of Pharmacy, Universitas Padjadjaran, Bandung
3
Prodia Clinical Laboratories, Jakarta
BACKGROUND-AIM
Type 2 diabetes mellitus (T2DM) is a worldwide issue with an increasing prevalence. Human metabolism is influenced
by the gut microbiota. Asymmetric dimethylarginine (ADMA) is a competitive inhibitor of nitric oxide synthase, and
elevated ADMA levels are associated with vascular disease in people with diabetes. Short-chain fatty acids (SCFAs) has
been reported to protect endothelial function and thus exert anti-atherosclerotic action, however, the correlation of
SCFAs and ADMA in diabetic patients is unknown yet. The study aimed to determine the correlation SCFAs and ADMA.
METHODS
The study design was an observational study with cross sectional approach. Subjects were 115 men (25 control
and 90 T2DM patients), aged 30-50 years old, and fulfilled inclusion criteria. Serum ADMA was quantified by Liquid
Chromatography–mass spectrometry (LCMS/MS). Fecal SCFAs were quantified by Gas Chromatography-MS (GCMS/MS).
RESULTS
Lower concentration of fecal SCFAs was found in subject with T2DM compared to control (Acetate 7.99±2.91 vs
9.35±2,45; p= 0.019; butyrate 2.82±1.95 vs 3.34±0.94, p=0.028; propionate 3.51±1.92 vs 4.71±1.68, p= 0.001; total
SCFAs 15.87±6.04 vs 18.31±4.15, p=0.029). The serum ADMA concentration was higher in T2DM patients compared to
control (71.27 ± 10.75 ng/ml; 67.48 ± 7.71; p=<0.05). Fecal SCFAs inversely correlate with HbA1C (acetate r=-0.234,
p=0.012; butyrate r=-0.226, p=0.015; propionate r=-0.267, p=0.004; total SCFAs r= -0.207, p=0.027). Further analysis
with SCFAs data showed only propionate inversely correlated with ADMA (r=-0.502 and p=0.000) while other SCFAs were
not correlated with serum ADMA (acetate r=-0.125, p=0.184; butirate r=-0.128, p=0.173; valerate r=0.036, p=0.704).
CONCLUSIONS
Fecal Propionate is inversely correlated with serum HbA1C and Serum ADMA in Type 2 Diabetic Patient

P0816
A FULLY AUTOMATED HBA1C ASSAY ON THE DXC 500 AU CLINICAL CHEMISTRY ANALYSER
L. Frost 1
1
Beckman Coulter Ireland
BACKGROUND-AIM
HbA1c is the major species of glycohemoglobin in human blood. HbA1c formation occurs through a non-enzymatic
reaction, called glycation, which occurs between glucose and the n-terminal valine of the hemoglobin β-chain of HbA.
A Schiff base intermediate product is formed, which rearranges to form a stable ketoamine in an irreversible reaction.
The rate of glycation is proportional to the glucose concentration in the bloodstream and is an accurate reflection
of average blood glucose over a period of eight to twelve weeks. HbA1c testing is recommended for the diagnosis of
diabetes by the International Expert Committee (IEC), the American Diabetes Association (ADA), and the WHO, who
recommended a diagnostic threshold of ≥6.5% (≥48 mmoL/moL) HbA1c and a range for pre-diabetes of 5.7%-6.4% (39–
46 mmoL/moL) HbA1c.
METHODS
The HbA1c Advanced assay on the DxC 500 AU* utilizes automatic sample pre-treatment, has batch and random
access capability. No manual pre-treatment of the whole blood sample or additional washing steps are required.
Firstly the red blood cells are hemolyzed automatically, total hemoglobin and glycated hemoglobin are then measured
colorimetrically and immunoturbidimetrically respectively.
RESULTS
Precision studies were conducted according to CLSI EP15-A3. Commercial controls and four native K2 EDTA whole blood
samples ranging from 5.1% to 12.0% HbA1c, were run twice daily, over twenty days using three lots of reagent on three
DxC500AU Clinical Chemistry analyzers at a single site. Repeatability ranged from 0.86 to 1.44% CV and Total Precision
ranged from 1.55 to 2.43% CV. Method comparison and bias estimation was evaluated using CLSI EP09-A3. Patient
samples (n=150) across the analytical range were run versus a Secondary Reference method and yielded a slope of
1.031, intercept -0.147% HbA1c, correlation coefficient R=0.997 for Weighted Deming regression.
CONCLUSIONS
The HbA1c Advanced assay on the DxC 500 AU is a precise and accurate assay, requiring no manual pretreatment and
can be used for monitoring and diagnosing diabetes.

P0817
DETERMINATION OF URINARY MAGNESIUM IN TYPE 2 DIABETICS
S. Fendri 1, D. Jallouli 1, F. Ayadi 1, R. Makhlouf 1, A. Elleuch 1, K. Chaabouni 1, F. Ayadi 1

1
Laboratory of Biochemistry, CHU Habib Bourguiba
BACKGROUND-AIM
Magnesium (Mg)’ deficiency is generally associated with endocrine and metabolic disorders, especially with type 2
diabetes. There is a close correlation between metabolic control of diabetes and Mg homeostasis. The objective of our
work was to assess Mg status in type 2 diabetics.
METHODS
This is a descriptive prospective study involving 40 patients with type 2 diabetes whose Mg status was assessed by
measuring 24-hour magnesemia and magnesuria. The determination of blood and urinary magnesium was done by a
colorimetric technique by the Cobas 6000 automaton (Roche®).
RESULTS
Our study included 25 women (62%) and 15 men (37%) with a sex ratio of 0.6. 59.1 ± 8.32 years with extremes of
[42-76]. The average duration of diabetes progression was 12.5 ± 11 years with extremes ranging from 5 months to
35 years. The average HbA1c was 10.15%. The mean magnesemia was 0.77 mmol/L and the mean 24-hour magnesuria
was 3.7 ± 2.6 mmol/24 h. Blood Mg deficiency was present in 66.6% of cases while urinary Mg deficiency was present
in 72%. Mg deficiency was correlated with poor glycemic control (p = 0.019).
CONCLUSIONS
Hypomagnesemia was linked to poor metabolic control of type 2 diabetes resulting mainly from increased urinary loss
stimulated by high blood sugar levels.

P0818
HYPONATREMIA CAUSED BY TREATMENT OF DIABETES INSIPIDUS. ABOUT A CASE
A.M. Quesada Marín 1, M. Santamaria López 1, P.A. Izquierdo Sayed 1, J. Ruiz Cara 1, R. Escobar Conesa 1, F.I. Rodriguez
Sanchez 1
1
Clinical Analysis Service, University Hospital Torrecardenas, Almería. Spain.
BACKGROUND-AIM
Diabetes insipidus (DI) is a disease caused by a deficiency of Antidiuretic Hormone (ADH)/Vasopressin (Central DI) or
by resistance to its action (Nephrogenic DI). ADH is synthesized in the supraoptic and paraventricular nuclei of the
hypothalamus and stored in the form of secretory granules in the pituitary gland.
ADH secretion is pulsatile and follows a circadian rhythm, the fundamental regulation of which is mediated by the
increase in osmolality and the decrease in plasma volumen. It main function is due to V2 receptors located in the
collecting duct of the nephron, increasing the reabsorption of water, obtaining a more concentrated urine with less
volume.
In both Central DI and Nephrogenic DI, ADH malfunction will lead to the appearance of prominent polyuria and
polydipsia.
METHODS
Monitoring a 72-year-old patient with multiple pathologies diagnosed with diabetes insipidus and myelodysplastic
syndrome recently, following a treatment with azaticidine. He was transferred to the ER because of deterioration,
instability, sweating and low blood pressure.
RESULTS
The pacient is undergone to laboratory tests with a complete blood count and biochemical parameters, whose values
are inside of reference margin, with the exception of the remarkable pancytopenia and level of sodium of 115 mEq/L,
being notified to the requesting service as a critical value.
Treatment with desmopressin for diabetes insipidus was withdrawn, furosemide was administered, and sodium
concentration was corrected to stabilize the patient.
The evolution of his biochemical parameters is successful, showed level of sodium around 119 mEq/L, 124 mEq/L and
134 mEq/L consecutively.
CONCLUSIONS
Given the complexity of polypathological patients with various pharmacological treatments, it is essential to carry out
exhaustive follow-up to avoid adverse reactions to the different drugs and subsequent complications. For this reason,
it is necessary to make the analytical determinations according to the pathology and the treatment administered. In
this case, determinations of electrolytes provided information about the patient's clinical status and made it possible
to contact those responsible for the patient, so he could be stabilized.

P0819
GLYCATED ALBUMIN AND GLYCATED HEMOGLOBIN ASSAY IN THE DIABETIC POPULATION AND PREGNANT WOMEN OF
SALENTO IN ITALY: CORRELATIONS, ACCURACY AND REFERENCE VALUES.
M. Chicone 1, G. Lobreglio 1
1
Clinical Pathology and Microbiology Unit, Vito Fazzi General Hospital, Piazza Filippo Muratore 1, 73100 Lecce, Italy
BACKGROUND-AIM
According to the American Diabetes Association (ADA) guidelines (2021), diabetes may be diagnosed basing on plasma
glucose criteria (Fasting Plasma Glucose [FPG] and 2h-plasma glucose during Oral Glucose Tolerance Test [OGTT]) or
glycated haemoglobin (HbA1c) criteria. HbA1c represents an average of blood sugar levels over the last 8-12 weeks
so it can be considered as a long-term glycemic indicator. The method used to assess this value is accurate, easy, and
reproducible but sometimes it has not a good sensitivity. Furthermore, several biological/environmental factors and
interferents could affect results. Glycated albumin (GA) measurement reflects the mean blood glucose levels over the
past 2-3 weeks. Therefore, it could be considered as a medium-term glycemic indicator, allowing to verify patient's
glycemic compensation in the initial phases of diabetes and in all those situations that require short-term monitoring
of changes in glycaemia.
METHODS
In this study, we verified the analytical performances of sensitivity and specificity of the GA test on healthy and diabetic
subjects, divided according to the clinical history and the results obtained from the HbA1c test. We compared the
results of GA with those of HbA1c in different groups of patients: diabetic subjects, subjects with impaired fasting
glucose and pregnant women during OGTT. A correlation study between the levels of GA and HbA1c in each cohort
was performed using the Pearson’s correlation coefficient. Finally, using a receiver operating characteristic curve (ROC
curve), we established the ideal cut-off value associated with the best sensitivity (76%) and specificity (73.7%) for the
tested population.
RESULTS
Comparative studies show a strong correlation between GA and HbA1c both in diabetic and at risk subjects. In these
same groups there is a moderate correlation when we compare GA and HbA1c with glycaemia. There is a weak
correlation of GA in healthy subjects with impaired fasting glucose. In pregnant women during the OGTT, GA has an
80% sensitivity for women with baseline blood glucose values > 93 g/L, while there is poor specificity with blood glucose
measured after 120 minutes.
CONCLUSIONS
These results suggest that the reference values for the diagnosis of gestational diabetes should be re-evaluated with
new studies.

P0820
IMPLEMENTATION OF A TWO-STEP CIRCUIT FOR THE DETERMINATION OF GLYCOSYLATED HEMOGLOBIN IN THE
PRESENCE OF UNCOMMON VARIANTS.
I. Domínguez Pascual 1, D. Núnez Jurado 1, M. Conde Sánchez 1, J.A. Noval Padillo 1, T. Vilariño García 1, J.M. Guerrero
Móntavez 1
1
Clinical Biochemistry Service/Virgen del Rocío University Hospital, Seville, Spain.
BACKGROUND-AIM
It is important to know the presence of hemoglobinopathies in the determination of glycosylated hemoglobin (HbA1c)
since they can influence the results with clinical consequences. Various groups of experts affirm that it is advisable
for us to report HbA1c values in diabetics with rare hemoglobin variants, proposing fructosamine determination as
an alternative, taking into account the drawbacks that this presents. The aim was the Implementation of a two-step
circuit for the determination of HbA1c by different methodologies in diabetic patients with infrequent clinically silent
hemoglobinopathies.
METHODS
The study is carried out with samples from patients whose HbA1c is routinely determined by ion exchange
chromatography (HPLC) G8 (Horiba) who present an unknown peak indicative of a rare hemoglobin variant. They are
processed in parallel by the immunochemistry Cobasb101 (Roche) and by the affinity chromatography Premier Hb9210
(Menarini), using the latter as a reference in order to investigate the interchangeability of the results. MedCal is used
to perform a Passing-Bablock regression line and the correlation coefficient.
RESULTS
In the Passing Bablok analysis, the regression lines are obtained y=-0.133 + 1.0833x; y=-2.7813+1.3750x, in the
concordance analysis, the Correlation coefficient was obtained r= 0.9703 and r= 0.4663 for Cobas b101 vs Premier
Hb9120 and HPLC G8 vs Premier Hb9210 respectively.
The HbA1c results obtained by the Point of Care device are interchangeable with affinity chromatography.
CONCLUSIONS
A two-step circuit is proposed in laboratories where the number of rare hemoglobin variants is a factor to consider.
The first step is to process the samples by the HPLC healthcare method, which has the great advantage of detecting
these rare variants, not going unnoticed and reporting the presence of clinically silent hemoglobinopathy, but of
methodological importance. In a second step, processing the samples by the Point of Care team previously evaluated
by each laboratory, and issue the HbA1c results, being results of analytical quality to be able to carry out any medical
action.

P0821
AN EXPLORATORY STUDY TO ASSESS THE RELATIONSHIP BETWEEN MARKERS OF IRON METABOLISM AND
HYPERGLYCAEMIA AMONGST WOMEN IN CAPE TOWN, SOUTH AFRICA
S.F. Davids 1, S. Raghubeer 1, R.T. Erasmus 2, G.M. Davison 1, T.E. Matsha 3

1
SAMRC/CPUT Cardiometabolic Health Research Unit, Department of Biomedical Sciences, Faculty of Health and Wellness
Sciences, Cape Peninsula University of Technology, Bellville, South Africa
2
Sciences, Cape Peninsula University of Technology, Bellville, South Africa and Department of Chemical Pathology, Faculty
of Medicine and Hea
3
Sciences, Cape Peninsula University of Technology, Bellville, South Africa and Sefako Makgatho Health Sciences University,
Ga-Rankuwa 0208,
BACKGROUND-AIM
In 2021, it was estimated that 573 million people globally were diagnosed with diabetes mellitus (DM). Amongst
predictors of DM, the micronutrient, iron, is closely associated with the development of type 2 DM. However, limited
evidence has been presented on various markers of iron metabolism(MIM) besides ferritin (FER), which is regulated
differently and may function via separate mechanisms. This study aims to explore the relationship between MIM and
hyperglycaemia amongst mixed-ancestry women in Cape Town, South Africa.
METHODS
A total of 264 women were selected as part of this study. Trained research staff collected clinical and biochemical
measurements for various test including a 75g oral glucose tolerance test, anthropometric measurements and MIM.
RESULTS
Of the women, 100 were pre-menopausal and 164 were menopausal. Hyperglycaemia was higher amongst menopausal
women compared to pre-menopausal women (p<0.001). Waist circumference, body mass index, FER, RDW, MCV,
HbA1c, and creatinine levels were significantly higher in menopausal women (p≤0.011). However, pre-menopausal
women displayed higher levels of transferrin, total iron binding capacity and platelet count, respectively (all p≤0.031).
Serum iron (Fe) and transferrin saturation were the only two iron parameters significantly correlated to HbA1c in
menopausal women (p=0.004). Furthermore, logistic regression analysis amongst menopausal women demonstrated
that Fe was the sole variable significantly associated with hyperglycaemia (p=0.028), while premenopausal females
had no significant association with MIM (all p≥0.220).
CONCLUSIONS
Menopausal women displayed higher levels of FER, but lower levels of Fe, which may indicate iron overload. As such,
this study requires further investigation to understand the link between MIM and hyperglycaemia, and the possible
role it plays in the development of DM. To our knowledge, this study is the first to be conducted in a mixed-ancestry
population and may serve as a foundation for future studies in South Africa.

P0822
INDIRECT PANCREATIC FUNCTION TEST- UTILITY OF FECAL PANCREATIC ELASTASE FOR DIAGNOSIS OF EXOCRINE
PANCREATIC INSUFFICIENCY IN CHILDREN.
S.N. Ali 1
1
AGA KHAN UNIVERSITY HOSPITAL
BACKGROUND-AIM
Testing of pancreatic function is a valuable tool in the assessment, diagnosis, overall management, and prognosis of
pancreatic disease. The “gold standard,” the direct pancreatic stimulation test is not widely used in clinical practice
because of its complexity, cost, and invasiveness particularly in Paediatric population. Human pancreatic elastase 1
(FPE) has been suggested as an alternative fecal test of exocrine pancreatic insufficiency (EPI). This study was done to
evaluate the frequency of EPI in Pakistani children based on FPE values at a clinical laboratory in Pakistan.
METHODS
This cross-sectional study was performed at the section of Chemical Pathology, Aga Khan University Karachi from
2018 to 2021. A data mining of FPE results of age birth to 16 years was done from the laboratory information
system. Duplicates were removed and only the first sample per patient was included, comprising of both inpatient and
outpatients. FPE was analyzed using an enzyme-linked immunosorbent assay (Immundiagnostik AG, Germany). Levels
> 200 µg/ml are considered normal value, 100 - 200 µg/ml as slight to moderate EPI and < 100 µg/ml suggestive of
severe EPI respectively. Data was analyzed using SPSS version 19.
RESULTS
A total of 3324 FPE results were performed during the study period. After application of exclusion criteria, a total of
551 were included in the final analysis. There were 334 (60.6 %) males and 217 (39.4%) females. The median age was
206 (IQR0-730) days. The mean FPE levels were 167 (IQR 120-249) ug/ml. Slight to moderate and severe EPI was found
in 85 (15.4%%) and 276 (50.1%) respectively.
CONCLUSIONS
A high frequency of EPI in children from a single center is alarming. There is need to advocate the utility of indirect
pancreatic function tests for optimal screening and better health outcomes.

P0823
THE RELATIONSHIP OF NOCTURNAL MELATONIN WITH IMPAIRED FASTING GLUCOSE
V. Peneva 3, D. Terzieva 1, M. Mitkov 2

1
Department of Clinical Laboratory, Faculty of Pharmacology, Medical University Plovdiv, Bulgaria,
[email protected]
2
Department of Endocrinology, Faculty of Medicine, Medical University, Plovdiv, Bulgaria, [email protected]
3
Department of Clinical Laboratory, Faculty of Pharmacology, Medical University Plovdiv, Bulgaria, [email protected]
BACKGROUND-AIM
According to modern understanding, disorders of the hypothalamic-pituitary axis are important for the development
of metabolic syndrome (MS). The study aimed to examine and compare serum concentrations of melatonin, cortisol,
and growth hormone (GH) in women with and without impaired fasting glucose (IFG).
METHODS
The study included 30 women with IFG and 30 women without IFG. For melatonin and GH determinations, blood
samples were taken at 03:00 AM and 08:00 AM, and for cortisol at 08:00 AM and 11:00 PM. Serum melatonin
(Elabscience Biotechnology Inc, China) and GH levels (IBL-Hamburg, Germany) were analyzed using Sirio S microplate
reader (SEAC, Italy). Cortisol levels were analyzed with Access, Beckman Coulter, USA. Concentrations of glucose,
total cholesterol, triglycerides, HDL-cholesterol (Olympys AU 480, Beckman Coulter, USA), and insulin levels (Access,
Beckman Coulter, USA) were analyzed from venous blood taken at 08:00 AM. Anthropometric measurements included
body mass index (BMI), waist circumference, and HOMA index. The independent sample t-test and Mann-Whitney test
were used (P<0.05).
RESULTS
There was no significant difference in the mean age of the women with and without IFG (34.63±2.39 years’ vs
28.62±2.46 years, P>0.05). Patients with IFG had a significantly higher waist than those without IFG (101.00±3.00 cm
vs. 77.73±4.64 cm, P=0.007) and a higher BMI (31.82±1.59 kg/m2 vs. 24.49±1.90 kg/m2, P=0.004). Total cholesterol,
triglycerides, and LDL-cholesterol were significantly higher in women with IFG (P<0.01).
The mean melatonin was lower in women with IFG compared to women without IFG at 03:00 AM (132.74±10.01 pg/
ml vs. 210.85±41.81pg/ml, P=0.013). Serum melatonin levels did not differ significantly between the two groups at
08:00 AM (178.57±21.48 pg/ml vs. 169.04±35.83 pg/ml, P=0.915). Serum cortisol at 08:00 AM and 11:00 PM and GH at
03:00 AM and 08:00 AM don't differentiate between the two studied groups (P=0.547 and P=0.782; P=0.308, P=0.810
respectively).
CONCLUSIONS
Women with elevated fasting glycemia have decreased nocturnal melatonin levels. Further research is imperative to
establish the role of impaired nocturnal melatonin secretion in elevated morning glycemia.
The work was financially supported by MU Plovdiv; project NO-10/2018

P0824
MELATONIN, LEPTIN AND GHRELIN VALUES DEPEND ON BMI IN WOMEN WITH METABOLIC SYNDROME
V. Peneva 2, D. Terzieva 1, M. Mitkov 3

1
Department of Clinical Laboratory, Faculty of Pharmacology, Medical University Plovdiv, Bulgaria,
[email protected]
2
Department of Clinical Laboratory, Faculty of Pharmacology, Medical University Plovdiv, Bulgaria, [email protected]
3
Department of Endocrinology, Faculty of Medicine, Medical University, Plovdiv, Bulgaria, [email protected]
BACKGROUND-AIM
The aim of the study was to analyze and compare the serum concentration of melatonin, leptin, and ghrelin in women
with BMI ≥ 26 kg/m2 and BMI ≤ 26 kg/m2.
METHODS
Women with metabolic syndrome were divided into two groups according to their BMI: with BMI ≥ 26 kg/m2 (n=26) and
with BMI ≤ 26 kg/m2 (n=18). Venous blood for determinations of melatonin, leptin, and ghrelin was taken at 03:00 AM
and 08:00 AM. These parameters were analyzed using ELISA methods and concentrations were measured with a Sirio
S microplate reader (SEAC, Italy). Body Mass Index (BMI) and Homeostatic Model Assessment for Insulin Resistance
(HOMA-IR) was calculated. The comparative analysis was performed with an independent sample t-test and Mann-
Whitney test. P-value < 0.05 was considered statistically significant.
RESULTS
There was no significant difference in the mean age of the women with BMI ≥ 26 kg/m2 and BMI ≤ 26 kg/m2 (34.31 ±
2.39 years vs. 33.61 ± 3.13 years, P= 0.857). Patients with BMI ≥ 26 kg/m2 had a significantly higher waist circumference
than those with BMI ≤ 26 kg/m2 (105.73±3.26 cm vs 79.94±2.78 cm, P=0.0001). In the group of women with BMI ≥ 26
kg/m2, mean serum glucose and HOMA-IR were significantly higher than in the group with BMI ≤ 26 kg/m2 (P<0.05).
The other metabolic parameters do not differ significantly between the studied groups (P=0.05). Leptin is statistically
significantly higher in women with a BMI ≥ 26.6 kg/m2 at 03:00 AM (17.74± 1.82 vs 5.86 ±1.79 ng/ml, P=0.001) and
08:00 AM (23.92± 4.34 vs 6.82± 1.78, P=0.0001) than those with BMI ≤ 26 kg/m2. Serum melatonin concentration did
not differ between the two groups at 03:00 AM (134.63 ± 11.53 pg/ml vs. 180.71 ± 29.35 pg/ml, P = 0.114) and 08:00 AM
(169.68 ± 23.32 pg/ml vs. 184.62±125.70 pg/ml, P=0.543). Ghrelin had no statistically significant difference between
the two studied groups either at 03:00 AM (0.96± 1.08 ng/ml vs 1.25 ±1.99ng/ml, P=0.233) or at 08:00 AM (1.35± 0.21ng/
ml vs 1.56± 0.27ng/ml, P=0.451).
CONCLUSIONS
Women with higher BMI have higher day and night leptin than those with normal BMI. The two groups did not differ
in melatonin and ghrelin levels.
The work was financially supported by MU Plovdiv; project NO-10/2018

P0825
PRECISION STUDY OF QASSAY A NEW MEDICAL DEVICE FOR QUANTITATIVE IN-VITRO ANALYSIS OF HBA1C
J. Uriarte Carpio 1, I. Benito Lorenzo 1, A. Martínez De Prado 1, Á. Collado Pérez 1, S. García Muñoz 1, L. Martínez Salazar
1
, E. Cruz Iglesias 1, F.J. Aguayo Gredilla 1
1
Osakidetza Basque Health Service, Basurto University Hospital, Department of Laboratory Medicine, Bilbao, Spain.
BACKGROUND-AIM
Since glycosylated hemoglobin (HbA1c) was introduced into clinical practice in the 1980s, it has become a vital
parameter in analysis and control of diabetes mellitus (DM). Regular monitoring of glycosylated hemoglobin levels in
diabetic patients under treatment helps to reduce glucose levels and complications associated with this disease.
Point-of-care (POC) analyzers provide results in just few minutes, thus allowing medical decisions to be made almost
immediately. The objective of this study is to assess the precision of QASSAY (P4Q®) device for measuring HbA1c in
blood samples.
METHODS
To calculate the precision, two different samples were used, one with normal HbA1c concentration (5.2%) and another
with pathological concentration (10.9%). Each sample was measured twice a day for 5 consecutive days with 3 different
instruments and by 2 different operators. An ANOVA analysis of variance components for random models (ANOVA
VCA) was performed using the software R_Core_Team (4.1.2). For this study we used inmunochromatography stripes
of SCREEN IFA ANALYZER SMART (SCREEN) from BIOPANDA®.
RESULTS
A coefficient of variation (CV) of 5.2% was obtained for the normal sample and 2.9% for the pathological sample.
Inter-day variability was the greatest imprecision factor being 4.7% and 2.7% respectively, while between instrument
imprecision was 1.9% and 0.8%, and residual error was 1.3% and 0.7%. Between operator imprecision was minimal,
being <0.01% for both samples.
CONCLUSIONS
These results are similar to those of other POC analyzers that are currently on the market. For example, the A1cNow+
analyzer has a CV <3%; the A1c EZ 2.0 CV= 3.2%; the Afinion AS100 CV <2%, and finally, in2it from Bio-Rad reports a
CV of 3.7%. However, the CV described in the SCREEN insert is ≤ 15%, much higher than those obtained in the present
study with the QASSAY reader, which happens to be much more accurate than the SCREEN reader.
Furthermore, QASSAY reader results to be a cost-effective option, compared with other POC HbA1c available readers.

P0826
PERFORMANCE COMPARISON OF DIFFERENT BLOOD COLLECTION TUBES FOR ACCURATE BLOOD GLUCOSE
CONCENTRATION MEASUREMENT, AN ONGOING STUDY
C. Yildiz 2, T. Yildiz 2, A. Sekerci 1, C. Karatoprak 1, E. Tasan 1, O.F. Ozer 2

1
Deparment of Internal Medicine, Bezmialem Foundation University Faculty of Medicine, Istanbul, Türkiye
2
Deparment of Medical Biochemistry, Bezmialem Foundation University Faculty of Medicine, Istanbul, Türkiye
BACKGROUND-AIM
Blood glucose level is a frequently requested parameter. According to American Diabetes Association, the glucose value
of a patient after 8 hours of fasting should be more than 126 mg/dL for diagnosis of diabetes. People with values more
than the upper range limit but below cut-off for diabetes fall into a zone called prediabetes. For these patients, it is
crucial to give correct results. The mechanism that causes most erroneous glucose results is in-vitro glycolysis. Greiner
Bio-One claims that its VACUETTE FC Mix Tube can stop glycolysis rapidly, and reliable glucose results are possible even
if a tube is waited for 24 hours at room temperature(RT). We aim to compare the performance of the tubes used in our
hospital (Vacusera, Disera Inc., Izmir/Türkiye) and VACUETTE FC Mix Tube (Greiner Bio-One GmbH, Austria).
METHODS
We decided to enroll people with prediabetes. In our laboratory, glucose can be measured in tubes with no additives
or sodium fluoride. We took 6 extra tubes from each patient (3 with sodium fluoride, 2 FC Mix Tube, 1 without additive)
along tubes requested. To compare them, two tubes (one with sodium fluoride and FC Mix Tube) are centrifuged no
more than 30 minutes after phlebotomy (as “baseline measurement”), one with sodium fluoride is centrifuged after 8
hours, and the others after 24 hours in RT. Glucose is measured on Siemens Atellica Solution via hexokinase method.
All patients filled out consent forms, and study was approved by ethics committee.
RESULTS
Here we are presenting our initial results. We found out significant decrease in the tube without any additive after 24
hours. Tubes with sodium fluoride also showed a decrease after 8 hours (6.50 mg/dL, p<0.01) and 24 hours (6.50 mg/
dL, p<0.01). FC Mix Tube’s performance was the best, 2.14 mg/dL difference (p=0.002) on 24 hours. These preliminary
results show that FC Mix Tube results are reliable even if the tube stays at RT for a long time.
CONCLUSIONS
Getting the correct glucose results is important for clinicians especially follow up on people with prediabetes. The
laboratory director is responsible for minimizing the errors, but they can happen even with our best intentions. The
preliminary results of our study show that FC Mix Tube performs better than the tubes we use to measure glucose in
our laboratory.

P0827
ROLE OF INTERLEUKIN - 1α, INTERLEUKIN-6 AND TNF-α IN PATIENTS WITH TYPE 2 DIABETES MELLITUS
M. Dalpath 1, A. P Bhule 2, A. Yadav 2

1
Directorate of Medical Education and Research, Panchkula, Haryana
2
VARDHMAN MAHAVIR MEDICAL COLLAGE AND SAFDARJUNG HOSPITAL, NEW DELHI,INDIA
BACKGROUND-AIM
Type 2 diabetes mellitus (T2DM) represents a significant global health problem. Inflammation is considered to be
a key regulator of the pathogenesis of T2DM, but what triggers this inflammation still unknown. Cytokines act as
pleiotropic polypeptides regulating inflammatory and immune responses through actions on pancreatic cells. The
classic proinflammatory cytokines like tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and IL-1 α, may be a
causative factor in the development of diabetes but some studies refute their association.
METHODS
A case - control study was conducted in Department of Biochemistry, VMMC and Safdarjung Hospital, New Delhi. We
included 100 patients diagnosed with Type 2 Diabetes Mellitus using ADA (American Diabetes Association) criteria.
Their results were compared with a group of 100 age and sex matched healthy controls.
Serum IL-1 α,, IL-6 and TNF-α levels were estimated using ELISA kits.
RESULTS
We found a significant increase in serum IL-1 α levels (p<0.001) in patients with DM (mean±S.D = 10.09.2±3.4 pg/mL)
as compared to healthy controls (mean±S.D = 3.2±0.9 pg/mL). Serum IL-6 were significantly increased in patients with
DM (p<0.005) (mean±S.D = 27.12±7.4 pg/mL) as compared to healthy controls (mean±S.D = 17.2±5.9 pg/mL). Serum
TNF-α levels were significantly increased in patients with DM (p<0.001) (mean±S.D = 49.0±12.5 pg/mL) as compared to
healthy controls (mean±S.D = 17.2±5.5 pg/mL).
CONCLUSIONS
We found significantly increased serum IL-1 α, IL-6 and TNF-α levels in patients with DM as compared to controls.
Raised IL-1 α leads to extensive β-cell destruction and is an indicator of continuing autoimmune aggression against
β cells. Inflammatory cytokines secreted by adipose tissue, such as IL-6 and TNF-α may exert an endocrine effect to
promote insulin resistance by interfering with the insulin signalling pathway, leading to the clinical manifestation of
T2DM. So we conclude that estimation of IL-1 α, IL-6 and TNF-α can be used as possible marker for early prediction of
T2DM in patients with family history.

P0828
AN ASSESSMENT OF THE CIRCULATING PRO- AND ANTI-ANGIOGENIC MARKERS AS INDICATORS OF ADIPOSE TISSUE
DYSFUNCTIONS IN MORBIDLY OBESE INDIVIDUALS UNDERGOING BARIATRIC SURGERY
R. Yadav 2, P. Priyadarshini 1, S. Aggarwal 3, A. Singh 2, A. Sachan 2, K. Chakraborty 2, S. Shukla 2

1
Department of Biochemistry All India Institute of Medical Sciences, New Delhi
2
Department of Biochemistry, All India Institute of Medical Sciences, New Delhi
3
Department of Surgical Disciplines, All India Institute of Medical Sciences, New Delhi
BACKGROUND-AIM
Dynamic expansion or reduction of adipose tissue (AT) requires constant remodeling of angiogenesis which is
orchestrated by various vascular remodelers, VEGF-A being most potent. Paradoxical high levels of total VEGF-A in
obesity has been found to coexist with undermined angiogenesis causing inflammation and metabolic dysfunctions.
We aimed at studying a discord in balance of serum total VEGF-A and Adiponectin as pro- and soluble Vascular
Endothelial Growth Factor Receptor 1 (sVEGFR1) and Thrombospondin 1 (TSP1) as anti-angiogenic factors in obese, and
non-obese individuals and correlated with glycemic and adipokine profiles. Their levels were followed after surgically
induced weight loss in morbidly obese individuals.
METHODS
Morbidly obese individuals (BMI ≥ 40 kg/m2; n=30) aged 18-60 years undergoing bariatric surgery and their age
matched controls (non-obese; BMI < 25 kg/m2; n=30) were included. Serum VEGF-A, sVEGFR1 and TSP1 in both groups
were estimated using ELISA based kit assays while human serum Adiponectin was measured using ProcartaPlexTM
Immunoassay. Obese subjects (n=17) were followed up at 6 months post bariatric surgery for these assays at the time
of their significant weight loss. Results were analyzed statistically by Student’s t-test, and were also correlated with
glycemic parameters, HOMA-IR and anthropometric characteristics.
RESULTS
A significant increase in the level of total VEGF-A (p value = 0.004) and soluble anti angiogenic factors, sVEGFR1
and TSP1 (p = 0.0341) were found in obese group as compared to non-obese. Mean Adiponectin level was higher
in non-obese(10.17ug/ml) as compared to obese(7.31ug/ml). Post-surgical follow up of obese individuals, showed a
gravitation towards decline in these levels. Pre-operative data, shows significant correlation between increased blood
glucose levels, HOMA-IR and a higher level of sVEGFR1.
CONCLUSIONS
Our findings provide an insight into the role of balanced angiogenesis and any perturbations in levels of VEGF-A,
SVEGFR1, TSP1 and Adiponectin may provide a putative evidence towards unhealthy vascular expansion, thereby
explaining much of the adipose tissue dysfunctions and co-morbidities of obesity.

P0829
COMPARABILITY ASSESSMENT OF TWO METHODS FOR HBA1C MEASUREMENT IN WHOLE BLOOD
A. Pocrnja 1, V. Jureša 1, S. Drmić 1, Đ. Winkler 1, M. Bodalec 1, M. Marinov 1

1
General County Hospital Vinkovci, Zvonarska 57, HR 32100 Vinkovci,Croatia
BACKGROUND-AIM
Hemoglobin A1c (HbA1c), a major portion of the glycated hemoglobins, is widely used in the management of diabetes
to monitor long-term glycemic control and to assess the risk of developing complications. In the last several years, the
American Diabetes Association (ADA) and other major organizations have approved the use of HbA1c determination
for diabetes screening and have suggested the value of 6.5% (48 mmol/mol) as a diagnostic cut-off. The aim of this
study was to compare the two analytical techniques for determination of Glycated hemoglobin (HbA1c), consisting
latex agglutination inhibition assay on DxC 700 AU (Beckman Coulter, USA) and capillary electrophoresis on Minicp
Flex-Piercing (SEBIA, UK).
METHODS
Comparability was tested on 100 blood samples in measurement range 4.5 % to 12.5 % on DxC 700 AU (Beckman
Coulter,USA) and Minicap Flex-Piercing (SEBIA, UK). We compared 100 patients admitted to the Department for Medical
Bochemistry in a four week period in 2022. Whole blood was collected from all patients in EDTA vials. Passing Bablok
regression analysis and Bland Altman plot were used to compare results in 100 samples. Statistical analysis was
performed using MedCalc for Windows, version 12.4.0.0 (MedCalc Software, Mariakerke, Belgium).
RESULTS
Passing-Bablok regression analysis revealed no significant difference; y=-0.10000(-0.10-0.18) + 1.0000(0.96-1.00).
There is no significant deviation from linearity (P=0.25). Bland Altman plot indicates significant constant (mean:–
0.07300, 95%CI: -0.1095 to -0.03646) and proportional bias (mean:-1.0350, 95%CI:-1.6018 to -0.4683) but according
to the American Diabetes Association (ADA) recommendation (CV<2%) this is not clinically significant.
CONCLUSIONS
HbA1c latex agglutination inhibition assay on DxC 700 AU (Beckman Coulter, USA) and capillary electrophoresis on
Minicp Flex Piercing (SEBIA, UK) are comparable. There is no significant difference between them and they can be used
interchangebly.

P0830
CORRELATION BETWEEN BIOCHEMICAL PARAMETERS AND DIABETIC KETOACIDOSIS SEVERITY IN PATIENTS WITH
TYPE 1 AND TYPE 2 DIABETES
A. Petca 1, B.L. Criste 1, O. Micle 2, T. Jurca 2, M. Bota 1, M.E. Muresan 2

1
County Clinical Emergency Hospital of Oradea. Bihor. Romania
2
University of Oradea, Medicine, and Pharmacy Faculty. Bihor. Romania
BACKGROUND-AIM
Ketoacidosis is a frequent and life-threatening complication of diabetes mellitus, with a mortality rate of
approximative 1%. An important risk factor associated with the mortality of diabetic ketoacidosis patients is the
decrease in kidney function, or acute kidney injury. Diabetic ketoacidosis (DKA) is characterized by a hyperglycemic
state and features acidosis, electrolyte imbalance and volume depletion, the latter being the cause of the decrease in
kidney function. This study aims to determine the differences in laboratory findings between type 1 and 2 diabetes,
and correlations between initial laboratory findings and severity of ketoacidosis, as well as the decrease in kidney
function for DKA patients.
METHODS
This is a retrospective study of type 1 and type 2 diabetes mellitus patients diagnosed with DKA between 01 January
2019 and 31 December 2021 at the County Clinical Emergency Hospital of Oradea, Romania. The severity of ketoacidosis
was determined using the classification of the American Diabetic Association. Acidosis markers were measured using
an ABL 800 BASIC blood gas analyser, and the biochemical parameters using an Architect c4000 and an Allinity AC03837
chemical analyser. IBM SPSS was used for statistical analyses.
RESULTS
A total of 114 patients who were diagnosed with DKA (mean age 44.87, 46% female, 50% type 1 diabetes) were
included in the study. There was no significant difference in the initial laboratory evaluation between type 1 and type 2
diabetes patients. Potassium (K) levels were significantly correlated with the severity of ketoacidosis (p=0.044). K levels
were also correlated with serum glucose (r=0.271), pH (r=-0.251), serum bicarbonate (r=-0.19), blood urea (r=0.277),
creatinine (r=0.239) and glomerular filtration rate (GFR) (r=-0.279). Chloride (Cl) levels were not correlated with the
severity of DKA but showed correlations with pH (r=-0.255), serum bicarbonate (r=-0.287), blood urea (r=-0.273),
creatinine (r=-0.425) and GFR (r=0.381). Serum lactate levels were correlated with GFR (r=-0.333) and creatinine
(r=0.382) levels.
CONCLUSIONS
The findings suggest that patients should be treated similarly for DKA regardless of the underlying type of diabetes,
and that electrolyte imbalances should be considered in the assessment of severity and kidney function of DKA
patients.

P0831
DIAGNOSTIC SIGNIFICANCE OF HEMOSTATIC MARKERS IN PEDIATRIC PATIENTS DIAGNOSED WITH TYPE 1 DIABETES
MELLITUS
S. Tihić-Kapidžić 1, J. Fočo-Solak 1, L. Halilović 1, B. Hasanefendić 1, N. Džananović 1, E. Begović 1

1
Department of Clinical Biochemistry and Immunology, Clinical Center of the University of Sarajevo
BACKGROUND-AIM
Diabetes is considered a prothrombotic condition where hemostatic markers play an active role. Numerous studies
point out the importance of these biomarkers in adult population with diabetes, while research data in children
with type 1 diabetes are still lacking, undermining their high risk for developing microvascular and macrovascular
complications. Our aim was to analyse commonly used hemostatic biomarkers in diabetic children and compare them
with healthy controls, as well to analyze the relationship of hemostasis biomarkers with glycemic control.
METHODS
The study included 100 healthy and 100 Bosnian children with type 1 diabetes mellitus, aged 2-18 years. Platelet
count, INR, aPTT, fibrinogen, hemoglobin A1c and glucose were tested in all children following standard laboratory
procedures. Data analysis was performed with IBM SPSS Statistics, version 23.
RESULTS
Our results point out statistically significant differences in the values of glycemic parameters, glucose and HbA1c,
between children with type 1 diabetes mellitus and their healthy peers, at the level of p <0.05, as expected. Statistically
significant differences were found in platelet count and hemostasis parameters, INR, and aPTT, at the level of p <0.05.
Children with type 1 diabetes have significantly lower values of aPTT and platelets, while significantly higher values
of HbA1c, glucose and INR, at the level of p <0.05 when compared to healthy controls. Values of fibrinogen did not
show significant difference between the groups, p=0.139. The degree of disease regulation according to HbA1c has a
significant influence on the values of INR, aPTT, fibrinogen, and the number of platelets. In children with T1DM, HbA1c
shows significant positive correlations with fibrinogen, and platelet counts, and significant negative correlations with
INR and aPTT.
CONCLUSIONS
Examining pro and inhibitory indicators of coagulation, we observed significant differences between healthy children
and children with T1DM. We conclude that hemostasis indices represent affordable, simple and inexpensive laboratory
parameters that are very useful in monitoring T1DM in children. Some of these tests can, in addition to HbA1c, serve as
a diagnostic and prognostic tool for determining the risk of diabetic microvascular and macrovascular complications.

P0832
METABOLIC SYNDROME AND LITHOGENESIS
B. Khalfa 2, R. Ghodbane 1, M. Taamlia 2, E. Anane 1, S. Hammami 2, R. Mahjoub 2, E. Talbi 1

1
Clinical Biology Laboratory, Institute of Nutrition and food technology, Tunis
2
Clinical Biology Laboratory, Zouhair Kallel Institute of Nutrition and food technology, Tunis
BACKGROUND-AIM
The association between lithogenesis and metabolic syndrome is ever increasing. The objective of our study was
to investigate the composition of urinary stones and to analyze the biological promoters and inhibitors of urinary
crystallization in patients with metabolic syndrome.
METHODS
Prospective study of 50 lithiasis patients divided into two groups: 25 with metabolic syndrome (G1) and 25
without metabolic syndrome. A morpho-constitutional analysis of the urinary stones was performed as well as the
determination of crystallization promoters (blood-urine calcium, phosphorus and uric acid and urinary oxalate) and
inhibitors (blood-urine magnesium and urinary citrate).
RESULTS
Analysis of renal stones in G1 showed a predominance of uricodependent stones (40%) followed by oxalodependent
(28%) and oxalocalcic stones (16%) in contrast to G2 where oxalocalcic stones were dominant (40%) followed
by oxalodependent (24%) and uricodependent stones (8%). A statistically significant difference was present for
uricodependent stones in G1 and oxalocalcic stones predominating in G2 (p = 0.059). Uric acid was the cause of
nucleation in 40.90% of the stones in G1. Regarding the promoters of oxalocalcic and phosphocalcic crystallization,
although the means of the different promoters were in the normal range, those of urinary calcium and oxalate,
expressed in concentration and flow rate, were found to be higher in the G1. Calciuria interpreted with respect to the
crystallization threshold of 3.8 mmol/L was higher in 36% of the G1 and 28% of the G2. As for oxaluria, it was higher
than the threshold in 44% in G1 vs.12% in G2. Taking into account urine pH and pH-dependent uric acid crystallization
thresholds, the proportion of uricuria above the crystallization threshold was higher in the G1 (32% vs. 12%; p = 0.088).
For crystallization inhibitors, the means were within the usual ranges with a higher urinary citrate value in the G1
(1.24+-0.84mmmol/L).
CONCLUSIONS
The increase in the promoters of oxalocalcic and uric crystallization observed in patients with metabolic syndrome is
secondary to insulin resistance, which increases the fraction of tubular excretion for calcium and leads to a defect in
renal ammoniogenesis explaining the lowering of urinary pH and the decrease in the solubility of uric acid.

P0833
OBESITY AND VITAMIN D DEFICIENCY
R. Mijović 2, D. Oluski 2, A. Randjelovic 1, D. Stanisic 1, B. Ilincic 2

1
Center for Laboratory medicine, Clinical Center of Vojvodina, Novi Sad, Serbia
2
University of Novi Sad, Faculty of Medicine, Department of pathophysiology and laboratory medicine, Novi Sad, Serbia
Center for Laboratory medicine, Clinical Center of Vojvodina, Novi Sad, Serbia
BACKGROUND-AIM
The lack of vitamin D is a risk factor for the development of metabolic disorders and cardiovascular diseases. It is
thought to be associated with obesity.
The aim was to evaluate the association of vitamin D and anthropometric parameters in overweight and obese subjects.
METHODS
The study included 90 subjects, tested for body weight (BW), body height, waist circumference (WC), hip circumference
(HC), body mass index (BMI) and waist to hip ratio (WHR). The subjects were divided into 3 groups: 30 overweight
(group I), 30 obese (group II) and 30 healthy age and gender matched subjects with normal body weight (control
group). 25(OH)D was measured by chemiluminescent method (CMIA) on automated immunochemistry analyzer, Alinity
i, Abbott Dg.
RESULTS
Concentrations of 25(OH)D were statistically significantly lower in groups I and II compared to the controls
(39.21±12.51vs.24.0±8.07vs.65.40±15.51;p<0.001;all). There are statistically significant lower values of 25(OH)D in
group II than in group I (24,00±8,07 vs. 39,21±12,51;p<0.001). The strong negative association between 25(OH)D and
BMI (group I: r =-0.467; p <0.01; group II: r = -0.446; p <0.05) as well as with WC (group I : r =-0.425; p <0.05; group
II : r =-0.380; p <0.05) were observed in all study groups.
CONCLUSIONS
The statistically significant negative association between serum 25(OH)D and anthropometric parametes, indicators
of obesity could indicate the possible role of obesity in the development of vitamin D deficiency.

P0834
ERYTHROCYTE MEMBRANE LIPIDOME DETERMINANTS AND VISCERAL ADIPOSITY INDEX (VAI) IN CARDIOMETABOLIC
RISK ASSESSMENT OF TESTICULAR GERM-CELL TUMOR SURVIVORS
S. Stankovic 1, U. Bumbasirevic 4, M. Zivkovic 3, M. Takic 2, N. Bojanic 4, A. Janicic 4, Z. Dzamic 4, M. Zekovic 2

1
Center for Medical Biochemistry, University Clinical Centre of Serbia, Belgrade, Serbia; Faculty of Medical Sciences,
University of Kragujevac, Kragujevac, Serbia
2
Center of Research Excellence in Nutrition and Metabolism, National Institute for Medical Research, University of Belgrade,
Belgrade, Serbia
3
Clinic of Urology, University Clinical Centre of Serbia, Belgrade, Serbia
4
Clinic of Urology, University Clinical Centre of Serbia, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade,
Serbia
BACKGROUND-AIM
Testicular cancer is the most common solid malignancy among men aged 15-40 years. Remarkably favorable prognosis
coupled with the relatively young age at diagnosis underscores the importance of clinical efforts and research
agenda addressing the optimization of survivorship care in this patient population. Exposure to platinum-based
chemotherapeutic regimens and potential hypogonadism may be associated with long-term cardiovascular toxicities
and an increased risk of metabolic disturbances. This cross-sectional study was conducted with an aim to explore
the association between the erythrocyte membrane lipidome determinants and Visceral Adiposity Index (VAI) among
testicular germ-cell tumor survivors (TGCTS).
METHODS
Erythrocyte membrane fatty acid (FA) cluster, reflecting the intricate interplay between genetic factors, metabolic
homeostasis, and the dietary pattern was determined with gas-liquid chromatography. Surrogate indices of
desaturase activities were computed as product-to-precursor FA ratios. VAI was calculated with sex-specific formula
integrating anthropometric measures and atherogenic lipoprotein phenotype indices: VAI=(waist circumference (WC)/
(39.68+1.88×body mass index (BMI))) × (triglycerides (TG)/1.03) × (1.31/high-density lipoprotein cholesterol (HDL)).
RESULTS
Among study participants (n=92, age x=35.89±8.67 years), 60.87% were overweight or obese (BMI≥25.0kg/m2)
and two-thirds displayed dyslipidemia. VAI correlated directly with stearoyl–CoA desaturase-18 activity, linoleic acid
(18:2n-6) and n-6/n-3 ratio (r =0.344, 0.289 and 0.381, all p<0.01). Conversely, an inverse association was found
between VAI and delta-5-desaturase activity and total polyunsaturated FA abundance (r=-0.294, -0.317, both p<0.05).
Based on Omega-3 index (O3I, % sum of docosahexaenoic acid and eicosapentaenoic acids), VAI was significantly
higher in patients allocated in the high cardiovascular risk category, i.e. O3I<4% (p<0.001).
CONCLUSIONS
This is the first study to report on relationship between the red blood cell FA profile and VAI among TGCTS. Although
additional research is warranted to elucidate the underlying mechanisms, results suggest that these indices may
contribute to enhanced cardiometabolic risk-assessment in this vulnerable group.

P0835
ROLE OF MATRIX-METALLOPROTEINASES AND COL4A IN TYPE 2 DIABETES MELLITUS AND DIABETIC NEPHROPATHY
PROGRESSION
P. Purohit 1, M. Khokhar 1, N.K. Bajpai 3, R.K. Shukla 2

1
Dept of Biochemistry, AIIMS Jodhpur
2
Dept of Endocrinology & Metabolism, AIIMS Jodhpur
3
Dept of Nephrology, AIIMS Jodhpur
BACKGROUND-AIM
The pathogenesis of Diabetic kidney disease (DKD) involves increased extracellular matrix (ECM) accumulation causing
thickening of the glomerular and tubular basement membranes, mesangial expansion, sclerosis, and tubulointerstitial
fibrosis. Collagens regulate immune cell activity in pathological conditions by altering the extracellular milieu. The
matrix metalloproteases (MMPs) are expressed in the kidney, nephron compartments, vasculature, connective tissue
and peripheral blood mononuclear cells. We wanted to investigate the relationship between circulating MMPs (MMP2,
MMP7, MMP9) and Collagen in the T2DM without complications, DN and healthy controls.
METHODS
Anthropometric measurements and biochemical tests were carried out from Healthy Control (N=36), T2DM (N=38)
and DN (N=35). Fasting venous blood samples were collected for blood glucose, HBA1c estimation. Total RNA was
extracted from freshly collected blood samples. RNA was reverse transcribed, and gene expression of MMP2, MMP7,
MMP9 and COL4A1 was carried out using GAPDH as an internal control. Bioinformatics analyses was done including
protein-protein interaction, gene ontology and co-expression networks of the target genes.
RESULTS
The expression of MMP2, MMP7, MMP9 and COL4A in T2DM, DN and Healthy Controls showed downregulation of MMP2
(HC: 1.00, T2DM: 0.84, DN: 0.71; (p<0.001)), MMP7 (T2DM: HC: 1.00, 0.49, DN: 0.53; (p<0.001)), MMP9 (HC: 1.00, T2DM:
0.29, DN: 0.62; (p<0.001), while COL4A showed significant upregulation (HC: 1.00, T2DM: 1.44, DN: 2.21; (p<0.001).
Fold Change expression of MMP7 and MMP9 was negatively correlated with HbA1c values. Interactomics analysis
revealed that MMP2, MMP7, MMP9 and COL4A were involved in AGE-RAGE signaling pathway in diabetic complications,
Leukocyte transendothelial migration, and ECM-receptor interaction.
CONCLUSIONS
The study results show that circulating MMP2, MMP7 and MMP9 are significantly downregulated in T2DM and DN,
with greater decrease in DN as compared to T2DM and COL4A was significantly upregulated. A significant negative
association of MMPs with HbA1c suggests a progressive decline with loss of glycemic control. And interatomic analysis
revealed mechanism involved in development of DN via MMPs, COL4A, which need further in-vivo validation.

P0836
PERFORMANCE OF SEQUENTIAL FIBROSIS-4 INDEX AND ENHANCED LIVER FIBROSIS SCORE TO ESTIMATE ADVANCED
LIVER FIBROSIS RELATED TO METABOLIC-ASSOCIATED FATTY LIVER DISEASE COMPARED TO LIVER STIFFNESS
MEASUREMENT BY TRANSIENT ELASTOGRAPHY IN TYPE 2 DIABETES
M. Sanz De Pedro 3, C. Amiama Roig 1, M. Serres Gómez 3, A. Olveira Martín 1, M. Romero Portales 1, A.P. Benitez
Valderrama 2, N. González Pérez De Villar 2, R. Rioja Gómez 3, A. Buño Soto 3
1
Digestive System Department, La Paz University Hospital, Madrid, Spain.
2
Endocrinology and Nutrition Department, La Paz University Hospital, Madrid, Spain.
3
Laboratory Medicine Department, La Paz University Hospital, Madrid, Spain.
BACKGROUND-AIM
Prevalence of Metabolic-Associated Fatty Liver Disease (MAFLD) is higher among type-2 diabetic patients (T2D) (55%)
and about 20% may develop advanced liver fibrosis (ALF). Current guidelines recommend the use of non-invasive tests
for screening in a multistep sequential algorithm before referring patients to a hepatologist.
We aimed to evaluate the diagnostic accuracy of the enhanced liver fibrosis score (ELF) to estimate ALF in T2D patients
previously recruited with fibrosis-4 (FIB4) index compared to transient elastography (TE) in a tertiary care hospital.
METHODS
FIB4 was evaluated for T2D patients <80 years attending endocrinology clinic for 8 months (n=1976). 491(25%) were
positive (cutoff ≥1.3/≥2,</>65 years respectively). 113 have been studied so far. ELF (Atellica Solution, Siemens) and
liver stiffness measurement (LSM) (Fibroscan) were measured. Ultrasound was performed on 109 patients to seek liver
nodularity. Area under the receiver operating characteristic (AUC) and diagnosis performance for ELF manufacturer's
cutoff of 9.8 and an optimized cutoff with Youden’s index were assessed. ALF was considered as LSM≥12kPa (F≥3).
RESULTS
Median age (interquartile range) was 66(13), and body mass index 28.3(6.8). ALF prevalence was 19% based on LSM and
liver nodularity was observed in 26.6% of patients. AUC for ELF was 0.86(95% confidence interval 0.8-0.9). For ELF cutoff
of 9.8, 46 patients (40.7%) with LSM<12kPa would have been referred to hepatologist and only one was undiagnosed;
sensibility, specificity, positive and negative predictive value was 95.2%, 50%, 30%, 98% respectively. At Youden’s
cutoff of 10.53 only 15 patients with LMS<12kPa would have been referred but 6 undiagnosed;71.4%, 84%, 50% and
93%. Mean ELF(SD) was different between patients <12kPa, 9.86(0.8), and ≥12 kPa, 11.01(0.82) as well as FIB4 median,
2.18(1.37) and 3.3(1.75) respectively (p<0.05). Median LSM and mean ELF among patients with/without nodularity was
15.1(12.4)/5.6(2.2)kPa and 10.8(0.89)/9.86(0.78) respectively (p<0.05).
CONCLUSIONS
Sequential algorithm based on FIB4 and ELF showed an accurate diagnosis performance to estimate ALF in T2D patients
with MAFLD compared to LSM. Adjusted cutoffs must be well selected based on the prevalence to balance costs for
unnecessary referrals and benefits of early diagnosis.

P0837
COMPARISON OF BIOCHEMICAL PARAMETERS OF CARDIOVASCULAR AND DIABETES RISK IN A CHILDREN COHORT
FROM ELOIN (ESTUDIO LONGITUDINAL DE OBESIDAD INFANTIL) AT 9 AND 14 YEARS OLD
M.E. Donoso Navarro 1, A. Martín García 1, I. Del Águila Barrado 1, M. Cuesta Sanz 1, A. Ferrando Muñoz 1, M. Díez Blanco
1
, J. Vega Benjumea 1, C. Izquierdo Álvarez 1, G. Cabañas Pujadas 2, H. Ortiz Marrón 2, F.A. Bernabeu Andreu 1
1
Servicio de Bioquímica-Análisis Clínicos, Hospital Universitario Puerta de Hierro Majadahonda
2
Servicio de Epidemiología,Dirección General de Salud Pública, Consejería de Sanidad, Madrid
BACKGROUND-AIM
ELOIN is a prospective study promoted by the Epidemiology Service of “Consejería de Sanidad de la Comunidad de
Madrid” to evaluate obesity and cardiovascular risk factors in childhood. It includes a cohort of children who are
followed from 4 to 14 years of age. Besides periodical measurements of blood pressure and anthropometric data,
questionnaires of diet, physical activity, and social environmental data are conducted. Biochemical analyses are
performed at 9 and 14 years old.
The aim is to compare the results of a series of biochemical analytes of cardiovascular risk and diabetes in a cohort of
children belonging to ELOIN at 9 and 14 years of age.
METHODS
To date, biochemical data have been collected at 14 years of age from 379 children who had previous analysis at 9
years of age, from the total of 2004 children participating in the study. The parameters compared were cholesterol,
HDL-cholesterol, triglycerides, HbA1c, and insulin. The children selected were those who at 9 years of age had any of
the following results: cholesterol > 200 mg/dL, HDL-cholesterol < 40 mg/dL, triglycerides > 150 mg/dL, HbA1c > 5.6 %
(prediabetes status) and insulin > 15 µU/mL.
RESULTS
From the 35 children who had cholesterol > 200 mg/dL at 9 years of age, only 8 maintained figures above 200 at 14 years
of age, a reduction of 77%. From the 13 with cholesterol-HDL < 40 mg/dL at age 9, only 8 maintained those figures at age
14 (38% reduction). Only 2 children had triglycerides > 150 mg/dL at 9 years, but none maintained hypertriglyceridemia
at 14 years. 25 children had HbA1c > 5.6 % at 9 years, but only 4 at 14 years (84 % reduction). 27 children had insulin
> 15 µU/mL at 9 years, which only 11 maintained (59 % reduction).
CONCLUSIONS
The results obtained to date indicate a clear improvement in the biochemical parameters related to cardiovascular risk
and diabetes in children aged 14 years compared to those presented by the same children at 9 years of age. Apart from
other factors that may be related to pubertal changes, it seems evident that early intervention campaigns (physical
exercise, changes in diet, and lifestyle) are effective in preventing the aforementioned risk factors from passing into
adulthood.

P0838
EVALUATION OF PANCREATIC ISLETS AUTOANTIBODIES IN PATIENTS WITH DIABETES MELLITUS: THIS IS OUR
REALITY.
L. Babini 2, M. Pavani 2, B. Niccoletti 2, V. Viola 2, A. Calcinari 2, N. Onori 2, J. Sabbatinelli 1, M. Moretti 2

1
DISCLIMO, Dipartimento di Scienze Cliniche e Molecolari,Università Politecnica delle Marche
2
SOD Medicina di Laboratorio, Azienda Ospedaliero Universitaria delle Marche
BACKGROUND-AIM
Pancreatic islets autoantibodies (iAb) are the keystone of autoimmunity in Type 1 Diabetes Mellitus (T1DM), an
autoimmune disorder caused by pancreatic β-cell destruction, which results in complete insulin deficiency. T1DM iAbs
recognize five specific types: Glutamic Acid Decarboxylase (GAD), Insulinoma-Associated-2/Tyrosine Phosphatase
(IA2), Insulin (IAA), Islet Cell Cytoplasmic (ICA) and Zinc Transporter-8 Autoantibodies (ZnT8A). They are also today
the only biomarkers that can distinguish Latent Autoimmune Diabetes in Adults (LADA) from phenotypically Type 2
Diabetes. The purpose of this study is to highlights the prevalence of T1DM iAbs in the patient population attending
our center from July 2021 to nowadays.
METHODS
2223 serum specimens from 1901 unique patients were collected and analyzed for routine testing at the Department
of Laboratory Medicine, AOU delle Marche. 709 samples were from 542 pediatric patients (< 20 years old). Sera were
processed on the automated MAGLUMI™ 2000 Plus CLIA platform with the GAD65, IAA, ICA, IA2 assays (Snibe). Data
were statistically analyzed to calculate the prevalence and the 95% CI of each iAb in specific subgroups of patients.
RESULTS
1123 samples were tested for one iAb, 310 for two, 141 for three and 649 samples, 537 from pediatric patients, for the
entire panel of four iAbs. GAD was dosed in 2071 samples. In adults GAD was the most prevalent iAb 0.10 (0.084-0.117),
IAA and ICA had similar prevalence of 0.102 (0.068-0.146) and 0.108 (0.076-0.147), and IA2 was the less represented
0.038 (0.020-0.065). GAD was the most prevalent iAb also in pediatric patients 0.276 (0.242-0.311) followed by ICA
0.230 (0.198-0.265), iAA 0.226 (0.194-0.261) and IA2 0.202 (0.170-0.236). In new-onset T1DM patients GAD showed
again the highest prevalence of 0.268 (0.230-0.309) respect to the other iAbs (p= 0.038).
CONCLUSIONS
Our data show the differences for iAbs testing in adult and pediatric patients in our setting. The majority of pediatric
patients (98%) were tested for the entire panel. GAD was the most frequently tested and even prevalent iAb in all
patients. As expected, all the iAbs had a higher rate of positivity in pediatric patients. In the next future we are
completing the panel with Zn-T8.

P0839
THE EFFECT OF MELATONIN SUPPLEMENTATION ON SERUM TNF-α AND OXIDATIVE STRESS PARAMETERS IN THE MODEL
OF TYPE 2 DIABETES MELLITUS
B. Djordjevic 1, T. Cvetkovic 1, V. Stojiljkovic 1, J. Basic 1, A. Veljkovic 1, A. Velickov 2, J. Milenkovic 3, D. Sokolovic 1

1
Department of Biochemistry, Faculty of Medicine, University of Nis, Nis, Serbia
2
Department of Histology and Embryology, Faculty of Medicine, University of Nis, Nis, Serbia
3
Department of Pathophysiology, Faculty of Medicine, University of Nis, Nis, Serbia
BACKGROUND-AIM
Hyperglycemia-induced oxidative stress is a major contributor to the development of diabetic complications. Excessive
formation of reactive oxygen species (ROS) has been linked to endothelial dysfunction and inflammation in obesity
and diabetes. ROS can directly modify macromolecules and impair their function. Moreover, ROS can stimulate the
production of proinflammatory cytokines, such as tumor necrosis factor-alpha (TNF-α). Endothelial dysfunction in
diabetes is, at least in part caused by an increase in serum concentration of TNF-α due to the effect on the vascular
permeability and vascular tonus. Melatonin is an indole-derived hormone produced and secreted by the pineal gland
in vertebrates and is involved in circadian rhythm regulation. Additionally, melatonin modulates several physiological
functions, such as glycemia control, inflammation, and anti-oxidative status. The study aimed to evaluate the effect
of melatonin on the serum concentration of TNF-α and oxidative stress biomarkers in a rat model of type 2 diabetes
mellitus.
METHODS
Diabetes mellitus was induced using streptozotocin (45 mg/kg, i.p.) and nicotinamide (110 mg/kg, i.p.). Melatonin was
administered orally in drinking water (2 µg/ml; 0.2 mg/kg) for two weeks.
RESULTS
Melatonin supplementation led to a reduction in the serum concentration of TNF-alpha (p<0.01). In addition, melatonin
treatment led to the lowering of oxidative stress biomarkers, thiobarbituric acid reactive substances, TBARS (p<0.01),
and advanced oxidation protein products, AOPP (p<0.01). Furthermore, there was a positive correlation between fasting
glycemia and TNF-alpha, TBARS, and AOPP.
CONCLUSIONS
Melatonin reduces circulating TNF-α and oxidative stress parameters and might be beneficial in the prevention of
endothelial dysfunction in type 2 diabetes mellitus.

P0840
CORRELATION BETWEEN DIABETES AND RISK OF DEVELOPING CIRRHOSIS. DOES THE FIB-4 RISE IN DIABETIC
PATIENTS?
V. O'Valle-Aísa 1, E. Guillén-Campuzano 1
1
Biochemistry Department, Catlab
BACKGROUND-AIM
Hepatic steatosis, obesity and insulin resistance act as cofactors to cause liver damage. Liver cirrhosis is largely
associated with diabetes mellitus (DM), their coexistence is related to a worse prognosis and greater complications of
both entities. Non-invasive serum indices are currently available for fibrosis risk stratification, such as the FIB-4 index
(FIB-4=Age(years)×AST(U/L)/[PLT(109/L)×ALT1/2 (U/L)]).
Assessment of the association between diabetes and risk of developing cirrhosis by measuring hemoglobin
glycosylated (HbA1c) and the calculation of the FIB-4 test.
METHODS
Retrospective study from September to December 2022, which enrolled 5023 primary care samples, which included
results of AST, ALT, platelets and HbA1c. AST and ALT determinations were performed by cobas c702 (Roche
Diagnostic), platelets by flow cytometry (XN-10 Sysmex); and the HbA1c by High Performance Liquid Chromatography
(HPLC). (D-100 BioRad). Classification as diabetics with HbA1c >6.5 and non-diabetics <6.5, according to the ADA
(American Diabetes Association) criteria. We used the Mann-Whitney U test for statistical analysis (spss).
RESULTS
39.26% were diabetics (males 53%; females 47%). Age Median(p25-p75) diabetic patients: 68 years (59-76). FIB-4
median (p25-p75) were for diabetics (1,39 [0,88-2,62]) and not diabetic (1,16 [0,58-2-12]). Using U de Mann-Whitney
analyzes was observed statistically significantly different median FIB-4 score between categories (p<0.0001).
CONCLUSIONS
Spite of, FIB-4 score has Worse negative predictive value in diabetic population (between 11% to 20% of diabetic people
with advanced fibrosis showed FIB4 < 1.30), our study shows Diabetic patients are at higher risk of developing fibrosis
(FIB-4 1,39 vs 1,16)
It would be interesting to expand the necessary tests for the calculation of FIB-4 index in those patients who have high
values of glycosylated hemoglobin in order to detect possible cirrhosis early.

P0841
THE EFFECTS OF SHORT-TERM HIGH-FAT AND HIGH-FAT/HIGH-SUGAR DIETS ON METABOLIC AND SPERM PARAMETERS
OF SEXUALLY MATURE RATS
N. Kozopas 1, B. Manko 2, A. Kost 1, H. Maksymyuk 1

1
Department of Clinical Laboratory Diagnostics, Danylo Halytsky Lviv National Medical University, Lviv, Ukraine
2
Department of Human and Animal Physiology, Ivan Franko National University of Lviv, Lviv, Ukraine
BACKGROUND-AIM
A body of evidence suggests that male obesity adversely impacts sperm quality. Diet-induced obesity in animal models
is a valuable tool for studying the conflicting data about the effects of excess adiposity on male fertility. The aim
of this study was to evaluate the influence of short-term high-fat (HF) and high-fat/high-sugar (HFHS) diets on the
morphometric, metabolic, and sperm parameters in male rats.
METHODS
A total of 30 sexually mature white wild-type male rats weighing 250-300g were randomized into 3 groups (n=10 in
each): control group (CG) with a standard diet, HF diet group, and HFHS group. The feeding duration was 7 weeks. Based
on morphometric body measurements, the Lee index, testicular and visceral fat coefficients were calculated. Blood was
collected before the start of the experiment from the tail vessels, and at day 50 (after euthanasia). The plasma leptin
concentration was assessed by ELISA; the lipid panel by spectrophotometry. Sperm suspension was prepared from
cauda epididymis. Sperm count and motility were rated with a hemocytometer, vitality was assessed with propidium
iodide staining using a fluorescent microscope Olympus IX73.
RESULTS
The HFHS feeding during 7 weeks caused an increase of the visceral fat index – by 40% (p<0.05). No changes in Lee
index and gonadosomatic index were found in groups (p>0.05). Total cholesterol in the HF group increased by 24.5%
(p=0.035), in the HFHS group – by 29.8% (p=0.035); the atherogenic coefficient was higher by 1.8–2.1 times (p<0.05);
and the low-density lipoprotein fraction increased by 2.1 times (p=0.025). The mean leptin concentration before diets
did not differ between the groups and amounted 0.4–0.44 ng/ml (p=0.05); a slight increase of leptin levels was observed
after 7 weeks of feeding: in the HFD by 9.0%, in the HFHS – by 14% from the initial data (p<0.05). The sperm motility
worsened: by 13% lowered in the HF group, by 18% – in the HFHS group vs CG (p<0.05). There were no changes in total
sperm number and viability (p>0.05).
CONCLUSIONS
The study results showed that only HFHS diet after 7 weeks caused a significant increase in body visceral fat. In the
HFHS group, dyslipidemia and worsened sperm motility were more substantial than in HF group, confirming the more
effective application of HFHS diet for modeling adiposity in rats.

P0842
VITROS® A1C SLIDES ENZYMATIC METHOD ON DRY MICROSLIDE FORMAT TO DETERMINE DIRECT HEMOGLOBIN A1C
CONCENTRATION WITHOUT TOTAL HEMOGLOBIN MEASUREMENT
T. Dimagno 1, M. Barbero 1, J. Fyles 1, C. Graby 1

1
QuidelOrtho
BACKGROUND-AIM
Since the Diabetes Control and Complications Trial in 1993, hemoglobin A1c (A1c) measurement has long been a
calculation of separate glycated hemoglobin (gHb) and total hemoglobin (tHb) components after the reaction has fully
completed. Thus, this method is dependent on the amount of tHb. A simplified direct measurement using a single
channel is desired. The Vitros Chemistry Products A1c Slides* now applies a direct A1c measurement method to a dry
MicroSlide that does not require the measurement of tHb.
METHODS
Undiluted whole blood is lysed and denatured in the proprietary spreading layer. A protease cleaves the Hb to form
the substrate. It is then reacted with a specific oxidase to produce H2O2 that oxidizes a leuco dye and results in a
colorimetric signal. This unique MicroSlide structure follows the Michaelis-Menten enzyme kinetics model where only a
fraction of the gHb is measured causing a pseudo first order reaction dependent on protease and not tHb concentration.
To evaluate independence of A1c measurement, multiple reagent lots were formulated with high and low TX-100
surfactant and protease concentrations and were tested with a series of Hb and patient samples.
RESULTS
To demonstrate tHb independence, Hb levels were altered by adding or removing plasma to 12 individual patient
samples. Patient bias with the Hb series ranging from 10.8 – 20.7 g/dL showed no substantial interference from the
Hb concentration as expected. The regression for bias to unaltered patient versus hemoglobin concentration yielded
a slope = 0.001 and an intercept = -0.0125.
To demonstrate protease dependence, the Vitros A1c Slides 2x2 factorial (TX-100 and protease) resulted in the reaction
rate independent of the TX-100 concentration but increased with higher protease concentration. When a patient
hemolysate series from ~ 7-23 g/dL hemoglobin was assessed with increased protease concentrations, the reaction
rate increased by the same amount for the entire hemoglobin series.
CONCLUSIONS
A1c can be measured directly without a separate tHb measurement because the unique structure of Vitros A1c Slides
controls the reaction kinetics.
*Product availability subject to regulatory approval.

P0843
ASSOCIATION BETWEEN RS11605924, RS11708067, RS340874 AND RS560887 SINGLE NUCLEOTIDE POLYMORPHISMS
AND CARDIOMETABOLIC DISEASES IN A MIXED ANCESTRY SOUTH AFRICAN POPULATION
E.N. Ndonwi 3, D.M. Matshazi 3, G.M. Davison 3, A.P. Kengne 1, T.E. Matsha 2
1
Non-Communicable Diseases Research Unit, South African Medical Research Council, Cape Town and Durban, South Africa
2
Sefako Magkatho Health Sciences University, Ga-Rankuwa, South Africa
3
South African Medical Research Council/Cape Peninsula University of Technology Cardio-metabolic Health Research Unit,
Department of Biomedical Sciences, Faculty of Health and Wellness Sciences, Cape Peninsula University of Technology, Cape
Town, South Afr
BACKGROUND-AIM
The prevalence of cardiometabolic diseases (CMDs) is increasing at an alarming rate in Africa. However, while single
nucleotide polymorphisms (SNPs) have been extensively investigated and found to be associated with CMDs, such
an association has yet to be demonstrated in the African population. Therefore, we investigated the association
between SNPs of cryptochrome 2 (rs11605924), Adenylate cyclase 5 (rs11708067), PROX1 (rs340874), and glucose-6-
phosphatase catalytic subunit 2 (rs560887) and CMDs in a south African people.
METHODS
This cross-sectional study included 1969 men and women recruited amongst the mixed ancestry population of Bellville
South in South Africa. SNP genotyping was performed by real time polymerase chain reaction and Hardy Weinberg
equilibrium (HWE) was performed on the SNPs investigated. CMDs were compared across the genotypes of the SNP in
HWE. Linear and logistic regressions adjusting for age, gender and body mass index were used to assess the risk of
CMDs across the genotypes.
RESULTS
All SNPs investigated were in HWE (rs11605924, p = 0.80; rs11708067, p = 0.21; rs340874, p = 0.18 and rs560887, p
= 0.79). The recessive CC genotype of rs11605924 was negatively associated with HOMA-IR (p = 0.028) and positively
associated with triglyceride (TG) > 1.5 mmol/L (p = 0.046) while the recessive CC genotype of rs340874 SNP was
positively associated with LDL cholesterol (p = 0.025) and total cholesterol (TC) > 5.0mmol/L (p = 0.012). Moreover,
rs11605924 was able to predict triglycerides in linear (β = -0.204, p = 0.029) and logistic regression (OR = 0.63, p =
0.017) while rs340874 SNP was able to predict TC (β = -0.315, p = 0.006) and LDL cholesterol (β = -0.346, p < 0.001) in
linear regression and TC in logistic regression (OR = 0.54, p = 0.007).
CONCLUSIONS
In this population, the SNPs investigated constitute poor markers for CMDs risk assessment given their moderate
association with HOMA-IR and TG for rs11605924, LDL cholesterol and total cholesterol for rs340874 and no
associations for rs11708067 and rs560887.

P0844
EFFECT OF DIET SUPPLEMENTED WITH OMEGA 3 ON BODY COMPOSITION, BIOCHEMICAL AND IMMUNOLOGICAL
PARAMETERS IN ADULTS WITH OBESITY
J. Torres-Vanegas 1, R. Rodríguez-Echevarría 1, D. Cambrón-Mora 1, S. Desirée-Reyes 1, W. Campos-Pérez 1, M. Pérez-

Robles 1, F. Márquez-Sandoval 1, C. Rodríguez-Reyes 1, A. Cordero-Muñoz 1, E. Martínez-López 1
1
Instituto de Nutrigenética y Nutrigenómica Traslacional (INNUGET); Departamento de Biología Molecular y Genómica,
Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara.
BACKGROUND-AIM
Obesity is a multifactorial disease that affects 36% of Mexican adults, it is characterized by excessive accumulation
of adipose tissue in the body, mainly in the abdominal region, caused primarily by energy imbalance when energy
consumption is greater than needed. Moreover, obesity triggers metabolic alterations related to the development of
non-communicable chronic diseases. Objective: To evaluate the effect of a diet supplemented with omega 3 on body
composition, biochemical and immunological parameters in adults with obesity.
METHODS
Randomized double-blind clinical trial for 8 weeks with a hypocaloric plan plus daily supplementation with 1.8 g of
omega 3 vs 1.6 g of alpha-linolenic acid. Biochemical parameters were determined by dry chemistry (Vitros 350), body
composition by electrical bioimpedance (InBody 570), the IL-6 determination was performed by ProQuantum assay,
RvD1 a by ELISA assay (Cayman Chemical). The ANOVA comparative analysis of repeated measures, Wilcoxon and
Mann–Whitney U tests were done in SPSS software v25.
RESULTS
Thirty nine subjects with a mean age of 39.5±9.8 years were included, 20 with omega 3 and 19 with placebo
intervention. Statistically significant intra-group changes were found throughout the intervention for the omega 3
group: weight -3.9% (p=0.001), body fat -7% (p=0.003), BMI -3.85% (p= 0.001), waist circumference -4.89% (p=0.001),
triglycerides -21.32% (p=0.003) and for placebo group: weight -2.14% (p=0.038), body fat -7.31% (p=0.030), BMI -1.39
% (p=0.049), waist circumference -3.31% (p= 0.001), and triglycerides -10.9% (p=0.019). However, when comparing
the two intervention groups, there were no differences. Regarding immunological variables; IL-6 was 57.4% (p=0.044)
lower in the omega 3 group vs placebo and RvD1 was 39.4% (p=0.048) higher in the omega 3 group vs placebo at the
end of the intervention.
CONCLUSIONS
The hypocaloric diet was related with lower body fat, weight, BMI, waist circumference and serum triglycerides, while
omega 3 supplementation had a greater effect than placebo with respect to immunological variables decreasing
systemic concentrations of IL-6 and increasing RvD1 inter and intra groups.

P0845
THE IMPACT OF THE TRACEABILITY CHANGE WITH NEW STANDARDIZATION OF C-PEPTIDE ON HOMA INDEX
PARAMETERS – β-CELL FUNCTION AND INSULIN RESISTANCE IN TYPE 2 DIABETIC PATIENTS
M. Krhač Grgić 1, E. Matišić 1, F. Penava 1, S. Božičević 1, M. Vučić Lovrenčić 1

1
Department of medical biochemistry and laboratory medicine, Merkur University Hospital, Zagreb, Croatia
BACKGROUND-AIM
Siemens Atellica C-peptide assay has recently undergone a change in traceability against the WHO International
Standard (IS 13/146). This assay modification led to a significant positive shift in C-peptide concentration by 29%.
The aim of this study was to evaluate the impact of the traceability change on the homeostatic model assessment
(HOMA) estimates of β-cell function (% B) and insulin resistance index (IRI) derived from C-peptide in type 2 diabetic
patients.
METHODS
A total of 126 serum samples was collected from fasting patients with type 2 diabetes for glucose (hexokinase,
Beckman Coulter, USA) and C-peptide (chemiluminescence, Atellica IM 1600, Siemens Healthineers, USA)
determination. To provide C-peptide results traceable to the new and previous standards, a regression equation derived
from an initial verification and comparison study carried out in our laboratory was used. Using the HOMA2 calculator
(https://www.dtu.ox.ac.uk/homacalculator/), %B and IRI were determined for each glucose and C-peptide pair. Bland-
Altman analysis was used to assess %B and IRI difference depending on the C-peptide concentration, and kappa and
chi-square test for testing differences in categorizing insulin-sensitive from insulin-resistant cases.
RESULTS
In comparison to previous standardization, C-peptide traceable to the WHO IS 13/146 yielded a significantly higher %B
(23,5%) and IRI (31,4%), respectively. Kappa analysis of IRI at an arbitrary cut-off of 1,4 showed a moderate agreement
(0,59) between the two C-peptide-traceability-dependent IRI estimates. The chi-squared test revealed a significantly
higher frequency of insulin-resistant cases with new C-peptide-traceability IRI estimates when compared to previous
standardization (P < 0,0001; 68% vs. 48%, respectively).
CONCLUSIONS
While the traceability change caused a linear shift in serum C-peptide concentration, the new standardization of the
assay also resulted in significant and more complex changes of C-peptide-derived HOMA estimates which need to be
recognized in patient management.

P0846
PROTHYMOSIN-ALPHA, A POTENTIAL NEW INFLAMMATORY BIOMARKER ASSOCIATED WITH OBESITY
M. Greco 2, M. Mirabelli 2, V. Tocci 2, E. Chiefari 2, O. Tripolino 1, Y. Mamula 3, A. Salatino 2, F.S. Brunetti 2, G.M. Comandatore
1
, A. Brunetti 2, D. Foti 1
1
Department of Clinical and Experimental Medicine, University “Magna Graecia” of Catanzaro, Catanzaro, Italy
2
Department of Health Sciences, University “Magna Graecia” of Catanzaro, Catanzaro, Italy
3
Taras Shevchenko National University of Kyiv, Kyiv,Ukraine
BACKGROUND-AIM
Obesity is a global health problem that increases the risk for metabolic and cardiovascular diseases. Adipose tissue
hypoxia in obesity is a trigger for fat cell dysfunction, which can lead to changes in the release of cytokines and
adipokines. Recently, we have reported that one of the proteins that is upregulated in the secretome of hypoxic
vs normoxic 3T3-L1 adipocytes is prothymosin-alpha (PTMA), a protein initially isolated in the thymus, which has
multifaceted functions, including the immunomodulatory effects. In the present study, we aimed to assess serum
PTMA levels in obese vs lean patients and attempted to establish a correlation with inflammatory and metabolic
parameters.
METHODS
Obese patients (BMI > 30 kg/m2) and lean controls (BMI < 25 kg/m2), aged 18-55 y, were recruited at the Endocrinology
Unit, University of Catanzaro, Italy. Exclusion criteria were: inflammatory states, erythrocyte sedimentation rate (ESR)
> 30 mm/h, leukocytosis, metabolic syndrome or type 2 diabetes, hepatic or renal failure, cancer, drug treatments,
smoking and alcohol. Besides routine analysis, patients’ sera were stored at –80 °C for subsequent determination of
PTMA (MyBioSource), and the multiparametric panel “Cytokine array I” (Randox Labs). Statistical comparisons and
correlation analysis were performed using SPSS 20.0 (IBM Statistics).
RESULTS
In age-matched obese patients (30 females and 10 males) and lean controls (4 females and 6 males), no statistically
significant differences were shown in relation to fasting glucose, insulin, total cholesterol, HDL-cholesterol,
triglycerides, liver enzymes, as well as circulating interleukins (IL)-1α, -1ß, -2, -4, -6, -8, -10, TNFα, MCP-1, EGF and VEGF.
Instead, significant higher mean levels were observed in obese patients vs controls for HbA1c (p = 0.012), ESR (p = 0.05)
and PTMA (769.19 ± 364.59 vs 419.94 ± 199.17 pg/mL, p < 0.0001). PTMA was found to be significantly and positively
correlated with fasting insulin (p = 0.037, r = 0.302), ESR (p = 0.039, r = 0.355), as well as with IL-6 (p < 0.0001, r =
0.649), IL-8 (p = 0.011, r = 0.465), TNFα (p = 0.007, r = 0.489, VEGF (p = 0.041, r = 0.382) and EGF (p = 0.015, r = 0.446)
(Spearman’s analysis).
CONCLUSIONS
These findings indicate PTMA as a potential new biomarker of inflammation in obesity.

P0847
PERFORMANCE EVALUATION OF THE NEW CHEMILUMINESCENCE ASSAY FOR GLUCOSE HOMEOSTASIS AND
PANCREATIC FUNCTION
F. Tomassetti 1, M. Pelagalli 1, E. Nicolai 1, S. Sarubbi 1, A. Giovannelli 1, C. Calabrese 1, S. Bernardini 1, M. Pieri 1

1
Biochemestry Laboratory, Department of Experimental Medicine, University of Rome “Tor Vergata”, Rome, Italy
BACKGROUND-AIM
Diabetes is a chronic disease spread to over 442 million people worldwide and has been steadily increasing in
recent years. It is defined by a hyperglycemic status and is clinically divided into type 1 diabetes (T1D) and type 2
diabetes (T2D). However, the division between T1D and T2D is not so sharply defined; thus, laboratory tests play
a crucial role in the diagnosis. Snibe (Snibe Diagnostics, China) suggests new tests for the evaluation of glucose
homeostasis biomarkers and diabetes diagnosis: Insulin, Insulinoma-associated antibodies (IA2), C-peptide, Anti-
GAD-65 antibodies. The aim of the study is to evaluate the performance of the new chemiluminescence (CLIA) tests for
insulin, C peptide, IA-2, and AntiGAD-65 in comparison with the routine tests present in the laboratory, Abbott Alinity
Ci-series (CLIA), and Dynex snx Medizym (ELISA).
METHODS
Leftover samples from the clinical routine were collected and analyzed by Maglumi 600 (Snibe Diagnostics, China). 50
sera were collected for insulin assay; 33 sera for C-peptide assay; 30 sera for IA-2 assay and 30 sera for anti-GAD-65
30 assay. Statistical analyses were processed.
RESULTS
The comparison analysis performed has reported a good agreement for the new tests, showing great Spearman rank
correlation coefficients: insulin R2: 0,8445, IA-2 R2: 0,6987, C-Peptide R2: 0,8862, Anti GAD-65 R2: 0,635. The Bland-
Altman analysis showed a mean bias of 2,26 (upper limit of 7,83; lower limit of -3,30) for Insulin; the mean bias of
-0,05 (upper limit of 3,39: lower limit of -3,50) for C-peptide, the mean bias of -1,61 (upper limit of 1,30: lower limit
of -4,52) for IA-2; the mean bias of -3,5 (upper limit of -0,08; lower limit of -6,91) for anti-GAD-65. Receiver operating
characteristic (ROC) curves were also examined to evaluate the sensitivity and specificity.
CONCLUSIONS
The new tests revealed an optimal correlation for insulin and C-Peptide with routine laboratory tests, while IA-2 and
anti-GAD-65 achieved just a good correlation rate, due to the comparison of different methods (CLIA vs ELISA). Overall,
the SNIBE tests have shown good performance, being easy to use, low cost, and fast processing times, merging the
need for clinicians to increase the biomarkers that would lead to a correct diagnosis of diabetes types.

P0848
GLUCOSE-6-PHOSPHATE DEHYDROGENASE (G6PD) STATUS IN TYPE 2 DIABETES MELLITUS
N. Hannachi 1, Y. Amri 1, R. Dabboubi 1, A. Dridi 1, N. Zmerli 1, S. Chelbi 1, M. Othmani 1, S. Hadj Fredj 1, T. Messaoud 1
1
Biochemistry Laboratory (LR 00SP03), Children’s Hospital-Tunis, Tunisia.
BACKGROUND-AIM
Type 2 diabetes (T2D) is a chronic metabolic disorder characterized by a persistent hyperglycemia. One of the most
feared complications of diabetes is oxidative stress. In this context, several studies have reported the association of
T2D with glucose-6-phosphate dehydrogenase (G6PD) deficiency.
This enzymatic disease is characterized by its clinical heterogeneity ranging from being asymptomatic to presenting
severe hemolytic crisis when triggered by oxidative stress.
This study was conducted to determine the prevalence of G6PD deficiency in a T2D population and to evaluate the
interest of the Fasting Glycemia/HbA1c ratio to suspect a possible G6PD deficiency in TD2 patients.
METHODS
A total of 60 patients with T2D and 53 healthy subjects were included in this study. Laboratory evaluations included
fasting glucose (FG) levels, HbA1c levels, complete blood count, and erythrocyte G6PD activity. The G6PD activity
was determined using a quantitative assay. The common G6PD mutations were determined using the amplification
refractory mutation system method. Statistics were carried out using the R software.
RESULTS
The prevalence of G6PD deficiency in the study population was 28.33% and 4% for the diabetics and non-diabetics
respectively. The results showed that the G6PD deficiency was significantly associated with T2D as compared to the
non-diabetics (p<0.005).
A negative association was found between G6PD activity and the FG/HbA1c ratio in DT2 patients. In addition, DT2
patients with G6PD deficiency had higher FG/HbA1c ratios compared to those without G6PD deficiency (21,9±2 vs 20,7
± 4; p >0.05). G6PD deficiency was confirmed by genetic analysis that revealed the predominance of the African allele
Gd A- in 21% of the deficient patients.
Our study showed that the hyperglycemia observed in T2D causes the G6PD activity to decrease. FG/HbA1c ratio served
as a good indicator and can be used in T2D to suspect possible G6PD deficiency.
CONCLUSIONS
It came to light that T2D and G6PD deficiency are presumably linked, encouraging routine screening for this enzyme
pathology in the DT2 population to refine the quality of care for this group and improve their quality of life by delaying
or even alleviating diabetes complications.

P0849
ASSOCIATION BETWEEN GLYOXALASE I GENE POLYMORPHISM AND SEVERITY OF NEPHROPATHY RISK IN TYPE 2
DIABETES AMONG INDIANS
M.K.S. Nachimuthu 1
1
All India Institute of Medical Sciences, Department of Biochemistry, Jodhpur, Rajasthan
BACKGROUND-AIM
Glyoxalase I (GLO1) is an enzyme which detoxify methylglyoxal (MGO) which is the precursor of advanced glycation
end product (AGEs) and play an important role in the development micro-vascular complications in Diabetes Mellitus.
To investigate whether the rs1049346 (c.-7C>T, 5-UTR). and rs2736654 (c. A419C) polymorphisms in GLO1 gene
influence GLO-1 activity, MGO levels and association with severity of nephropathy in Type 2 diabetic patients among
north Indian Population.
METHODS
The study included 96 type 2 Diabetic patients with nephropathy and 100 healthy controls. Ninety-six diabetic
nephropathy patients were divided into two groups with urinary albumin creatinine level <300mg/g (n=65) and
>300mg/g (n=31). The TaqMan SNP genotyping assays were performed to assess the genotype frequencies using Real
Time PCR. The circulating levels of GLO-1 and MGO were estimated using ELISA.
RESULTS
The GLO-1 C-7Tgenotype (p<0.02) and its allelic frequency of rs1049346 ((p<0.003) SNP were significantly associated
with nephropathy risk in diabetes. The mutant allele (CC) in the dominant model was significantly associated with
macro-albuminuria in type 2 diabetes (OR: 2.77, CI:0.97-7.87, p<0.001). Further haplotype analysis also showed the
association of locus with nephropathy risk (Global halotype association p=<0.001) in diabetic patients. There was
no significant association between genotype and allelic frequency of GLO-1 A419C in Diabetic nephropathy. The
GLO-1 activity is significantly decreased in diabetic patients with macroalbuminuria and compared to patients with
microalbuminuria and healthy controls. Similarly, the patients with macro-albuminuria showed higher MGO levels
when compared to healthy controls and micro-albuminuria.
CONCLUSIONS
The GLO1 C-7T polymorphism is significantly associated with the severity of nephropathy in type 2 diabetic patients.
The presence of the mutant allele confers susceptibility to nephropathy risk among type 2 diabetic patients.

P0850
CORRELATION BETWEEN SHBG SERUM LEVELS AND NON-ALCOHOLIC FATTY LIVER DISEASE
R. Sansano Galiano 2, I. Cebreiros López 2, B. Ramos Molina 5, A.J. Ruiz Alcaraz 1, F. Guzmán Aroca 4, M.D. Frutos Bernal
3
, J.A. Noguera Velasco 2
1
DEPARTMENT OF BIOCHEMISTRY AND MOLECULAR BIOLOGY "B" AND IMMUNOLOGY, UNIVERSITY OF MURCIA, MURCIA
2
DEPARTMENT OF CLINICAL ANALYSIS, VIRGEN DE LA ARRIXACA UNIVERSITY CLINICAL HOSPITAL (HCUVA), MURCIA.
3
DEPARTMENT OF GENERAL AND DIGESTIVE SURGERY, VIRGEN DE LA ARRIXACA UNIVERSITY CLINICAL HOSPITAL (HCUVA),
MURCIA.
4
DEPARTMENT OF RADIOLOGY, VIRGEN DE LA ARRIXACA UNIVERSITY CLINICAL HOSPITAL (HCUVA), MURCIA.
5
OBESITY AND METABOLISM RESEARCH GROUP, MURCIAN INSTITUTE OF BIOMEDICAL RESEARCH (IMIB), MURCIA
BACKGROUND-AIM
Non-alcoholic fatty liver disease (NAFLD) is one of the most common causes of chronic hepatic disease which is caused
by the fat accumulation in the liver. That represents an important risk factor of cirrhosis and liver transplant, whit extra
hepatic manifestations, as renal and cardiovascular problems.
The main form to detect NAFLD is hepatic biopsy, which is an expensive and invasive test. For these reasons, serum
markers to make the diagnosis have a rising interest.
Sex hormone-binding globulin (SHBG) is a 45.5 kDa glycoprotein that binds androgens and estrogens. It is synthesized
by hepatocytes and released to bloodstream. It has been correlated to insulin resistance and hepatic lipid metabolism.
For that reason, it is suggested to be associated with NAFLD.
The aim of this paper is to evaluate the correlation between the serum levels of the SHBG parameter and the presence
of NAFLD in morbidly obese patients.
METHODS
The study population consisted of 92 morbidly obese women who was suspected NAFLD and underwent bariatric
surgery.
The diagnosis of the disease was carried out by a biopsy during the intervention.
SHBG values were determined with a Cobas e801 analyzer through an electrochemiluminescence immunoassay.
Clinical data and blood samples were collected the day before of the surgical operation.
RESULTS
There were 92 patients: 35 control patients [age 45 ± 12 years] and 57 NAFLD patients [age 47 ± 11 years].
SHBG results: 51.5 ± 31.9 nmol/L for control group and 38.4 ± 29.5 nmol/L for NAFLD group.
SHBG values between control and NAFLD group had a statistically significant difference (Mann-Whitney test p=0.02).
Statistical calculation performed by SPSS 17.0.2 program.
CONCLUSIONS
Attending to data obtained, this study confirms the correlation between low serum SHBG levels and the presence of
NAFLD in women population.

P0851
CARNITINE DEFICIENCY IN CHILDREN WITH TYPE 1 DIABETES: A PILOT STUDY
E. Samborowska 2, A. Ochocińska 2, A. Kępka 2, E. Kowalska 2, M. Wysocka-Mincewicz 1, B. Cukrowska 3

1
Clinic of Endocrinology and Diabetology, The Children’s Memorial Health Institute, Warsaw, Poland
2
Department of Biochemistry, Radioimmunology and Experimental Medicine, The Children’s Memorial Health Institute,
Warsaw, Poland
3
Department of Pathomorphology, The Children’s Memorial Health Institute, Warsaw, Poland
BACKGROUND-AIM
The importance of carnitine for the lipid and carbohydrate metabolism is well know but studies investigating the
carnitine status in type 1 diabetes (T1D) are rare. The development of complications is uncommon during childhood,
however, the principles of proper metabolic control must be imparted from the onset. Recognition of carnitine
deficiency in these patients may thus have therapeutic implications. In this study, we piloted acylcarnitine profile (ACP)
in children with T1D.
METHODS
A study was performed on patients with T1D (n = 30, age range 4 - 17, median = 6,5) randomly chosen from patients
hospitalized in our hospital and healthy volunteers (n=11, age range 5 - 17, median = 11). ACP was analyzed using
LC-MS in positive mode. Statistical analysis was performed using R version 4.1.0 and heatmap figure using pheatmap
package (version 1.0.12).
RESULTS
24 types of acetylcarnitines (of the 40 tested) were identified in the T1D serum samples. 9 of them (free carnitine - C0,
acetylcarnitine - C2, hydroxybutyrylcarnitine - C4.OH, tiglyl 3-methylcrotonylcarnitine -C5.1, decenoylcarnitine - C10.1,
dodecenoylcarnitine - C12.1, tetradecenoylcarnitine - C14.1, hexadecenoylcarnitine C16.1, octadecenoylcarnitine –
C18:1) showed statistically significant differences (p-val<0.05) but only four of them: C0, C2, C4.OH, C18:1) - statistically
significant with q-val<0.05, between the study group and healthy voulonteers. Free carnitine (q-val 0,033, FC 1,42)
was the only that was lower in T1D patients compered healthy samples. Acetylcarnitine (q-val 0,034, FC 0,70) ,
hydroxybutyrylcarnitine (q-val 0,041, FC 0,65) and octadecenoylcarnitine (q-val 0,0045778, FC 0,61), were higher in T1D
samples.
CONCLUSIONS
Our preliminary data confirms the deficiency of free -carnitine and high levels of circulating acyl-carnitines in children
with T1D. Larger studies are needed to draw firm conclusions, as well as the possible role of carnitine supplementation
in preventing diabetic complications.

P0852
PLACENTAL NUTRIENT TRANSPORT IN GESTATIONAL DIABETES
C. Rodríguez-Chacón 1, R. Galván Toribio 1, I. Almazo Guerrero 1, V. Sánchez-Margalet 1, A. Pérez-Pérez 1

1
Virgen Macarena University Hospital, Seville, Spain
BACKGROUND-AIM
Gestational diabetes mellitus is characterized by a state of hyperglycaemia first diagnosed in pregnant women. It
is considered one of the most common conditions in pregnant women, affecting 3-8% of all pregnancies. It causes
an increase in maternal-fetal morbidity and mortality, mainly due to fetal macrosomia, which requires an increase
in the supply of nutrients by the placenta. Our aim is to determine whether trophoblast placentas from women with
gestational diabetes express more nutrient transporters that allow placental and fetal overgrowth, compared to control
placentas.
METHODS
The study is performed with two groups: gestational diabetes mellitus (n=7) and healthy pregnant women (n=14).
Placentas are collected for comparative transporter expression studies. Total RNA will be extracted from placental
explants using the Tripure kit (Roche Applied Science. USA) and retrotranscription will be performed with QuantiTect
Rev Transcription kit (QIAGEN). For quantitative PCR, QuantiTect SYBR Green PCR Kit (QIAGEN) will be used using a
Miniopticon (Biorad, CA. USA) and according to the 2-∆∆CT comparative method described by Livak and Schmittgen
(2001), using cyclophilin for normalization. The proteins studied were ABCA1, ABCG1 and LXR-alpha.
RESULTS
The results obtained were: ABCA1/cyclophilin expression (arbitrary units) = 1.49±1.9; ABCG1/ cyclophilin expression
(arbitrary units) = 0.48± 0.59; LXR-alpha/cyclophilin expression (arbitrary units) = 1.75±1.07 in pathological placentas
VS. ABCA1/cyclophilin expression (arbitrary units) = 0.35±0.28; ABCG1/ cyclophilin expression (arbitrary units) = 0.10±
0.07; LXR-alpha/cyclophilin expression (arbitrary units) = 0.34 ±0.17 in normal placentas.
CONCLUSIONS
A higher expression of the nutrient transporters studied was observed in placentas from women with gestational
diabetes mellitus compared to placentas from healthy women. This seems to explain the fetal macrosomia that occurs
in pregnancies of women with gestational diabetes mellitus. It is necessary to increase the number of placentas studied
to confirm these results.

P0853
A COMPARATIVE ANALYSIS OF THE GENE EXPRESSION PROFILE OF CD31, CD34, VWF ALONG WITH VEGF-A AS
VASCULOGENIC MARKERS IN VISCERAL ADIPOSE TISSUE OF MORBIDLY OBESE AND NON-OBESE INDIVIDUALS
A. Sachan 1, P. Priyadarshini 1, M. Pol 2, S. Aggarwal 2, A. Singh 1, R. Yadav 1

1
DEPT OF BIOCHEMISTRY, ALL INDIA INSTITUTE OF MEDICAL SCIENCES, NEW DELHI
2
DEPT OF SURGICAL DISCIPLINES, LAPAROSCOPIC AND BARIATRIC SURGERY, ALL INDIA INSTITUTE OF MEDICAL SCIENCES,
NEW DELHI
BACKGROUND-AIM
Unrestrained expansion of adipose tissue in obesity is associated with an inadequate vascularization rendering the
tissue hypoxic and dysfunction-prone. The existing literature documents that impaired angiogenesis in obese state
exists along with paradoxically high vascular endothelial growth factor-A (VEGF-A), the chief vascular mitogen. This
study aims at profiling and comparing the same along-with markers of endothelization von Willebrand Factor (vWF),
CD31 and CD34, in adipose tissue of both morbidly obese and non-obese individuals, and correlating those with various
patient characteristics.
METHODS
Obese subjects aged 18-60 years undergoing bariatric surgery (BMI ≥ 35; n=30) and their age matched controls (BMI <
25; n=30) were included. Expression analysis for VEGF-A, CD31, CD34 and vWF was done in visceral adipose tissue, using
qPCR. Results were analyzed statistically by Student’s t-test, and correlation analysis with anthropometric as well as
glycemic parameters, namely fasting blood glucose, fasting serum insulin, HbA1c, HOMA-IR, HOMA-β and QUICKI, was
performed.
RESULTS
Inter-group comparison revealed significantly higher expression of VEGF-A (p<0.001***) and vWF (p<0.05*) in
individuals with obesity, significantly lower expression of CD31(p<0.05*) and CD34 (p<0.05*). Significant correlations
were found between VEGF-A and insulin sensitivity (p<0.05*), and CD31 and CD34 (p<0.05*).
CONCLUSIONS
Dysregulated expression of the studied endothelial markers in VAT from obese individuals points towards a state
of compromised angiogenesis which is simultaneously the cause and effect in context of metabolic impairment
associated with morbid obesity.

P0854
IMPORTANCE OF ALTERNATIVE MARKERS FOR GLYCAEMIC CONTROL
A. Guillamón 1, D. Martín 1, A. Pérez 1, A. Verdejo 1, J. Romero 1, C. Bohigas 1, M. González 1

1
Department of Clinical Biochemistry. Hospital General Universitario Gregorio Marañón. Madrid.
BACKGROUND-AIM
The global prevalence of Diabetes mellitus has increased in recent years. Glycated haemoglobin (HbA1c) has become
the gold standard for long-term glucose monitoring in patients with diabetes. In 2010 the American Diabetes
Association (ADA) added HbA1c ≥6.5 % as a diagnostic criterion for diabetes, allowing the test to be used for both
management and diagnosis.
Many common biological and patient-specific factors can cause misleading HbA1c results. It is important to recognize
clinical scenarios that affect interpretation of HbA1c (changes in red blood cells half-life, haemoglobinopathies…) and
make even impossible to report accurate results in some cases (haemoglobin variants in which haemoglobin A is not
present, high amount of fetal haemoglobin (HbF) in adults, presence of haemoglobin E (HbE)).
The aim of this study is to describe the prevalence of haemoglobin variants in HbA1c tests performed in our centre.
METHODS
Data of HbA1c tests performed in our centre between 2017 and 2022 using high-performance liquid chromatography
were reviewed using BIWER Analytics software (Werfen S.A.).
RESULTS
In the aforementioned period 455.000 determinations of HbA1c belonging to 159.216 patients were performed. 433
patients showed some haemoglobin variant, being the most frequent heterozygous haemoglobin S (HbS).
Additionaly, 82 patients had interferences where the HbA1c value could not be provided. They presented the next
haemoglobin variants: homozygous HbS, homozygous haemoglobin C (HbC), compound heterozygous HbS and HbC,
presence of HbE and high values of HbF.
Regarding the inability to report HbA1c values in these patients, the laboratory expanded the services portfolio with
fructosamine, whose level refers to a measurement of the total stable irreversible glycated serum proteins. Although
fructosamine reflects a much shorter period of glycemic control compared to HbA1c it could be an alternative for these
patients and other situations like pregnancy.
CONCLUSIONS
In situations where HbA1c may not accurately reflect glycemic control, using an alternative index like fructosamine or
glycated albumin is desirable. Many promising alternative glycemic markers exist. The main limitation for all of them
is that there are still no guidelines or consensus of the international societies on its clinical use.

P0855
EVALUATION OF THE TRINITY PREMIER HB9210
N. Nemukondeni 2, T. Magwai 2, Z. Warasally 2, P. Naidoo 1, V. Gounden 1

1
Department of Chemical Pathology, Inkosi Albert Luthuli Central Hospital, National Health Laboratory Service and
University of KwaZulu Natal, Durban South Africa
2
Department of Chemical Pathology, Inkosi Albert Luthuli Central Hospital, National Health Laboratory Service, Durban
South Africa
BACKGROUND-AIM
Prior to the regional roll out of the Trinity Premier Hb9210 boronate affinity HPLC analyser in provincial laboratories in
KwaZulu Natal, South Africa, evaluation of the analyser was required. The aim of the study was to evaluate the Trinity
Premier Hb9210 and compare to current method in use before placement in regional laboratories.
METHODS
Evaluation consisted of - precision assessed via the CLSI EP 15 protocol ;CLSI EP 9 protocol for method comparison
was performed against the current in use Tosoh G8 ion exchange HPLC. Linearity and reportable range assessed using
the CLSI EP6 protocol with sequential mixing of different patient pools across Hba1c concentrations. Carryover studies
were performed by analyzing known high and low pooled samples in a specific sequence. Interferences studies were
performed using spiked samples for interference by fetal and carbamylated hemoglobin.
RESULTS
The precision evaluation showed repeatability and reproducibility of 0.3% for both levels of IQC material tested.57
patient samples were analysed on Tosoh G8 290 and then on the Trinity Premier Hb9210TM within 2 hours. The
alternate method comparison showed a correlation coefficient (R value) of 0.9957; a negative bias of 0.22% HbA1C
(%bias of -2.38 %).The performance at medical decision levels for the Trinity Premier based on the regression analysis
were within the 95% confidence intervals of the Tosoh G8 values. Interference studies: sodium cyanide level of up to
65mg/dl did not show any clinically significant effect on results. The presence of HbF at both 10% and 50% did not show
significant interference in HbA1c measurement (percentage difference from expected result was <5%).The linearity
was shown to within the quoted range of the analyser (3.8 to 18.5%) with a slope of 1.00. Initial carryover studies
using IQC material showed no significant carryover. When this was repeated at the end of the evaluation period using
patient pooled samples noticeable carryover was identified. The supplier was required to evaluate sample syringe wash
settings. Following correction by supplier carryover studies were repeated with both patient pools and IQC material
and were acceptable.
CONCLUSIONS
Evaluation and not merely simple verification of new methodologies are required when being introduced into a new
environment.

P0856
HEPATIC STEATOSIS AND TRIGLYCERIDE-GLUCOSE INDEX PERFORMANCE TO ESTIMATE LIVER STEATOSIS IN
TYPE 2 DIABETES PATIENTS VERSUS CONTROLLED ATTENUATION PARAMETER EVALUATED WITH TRANSIENT
ELASTOGRAPHY.
M. Serres Gómez 3, M. Sanz De Pedro 3, C. Amiama Roig 1, A. Olveira Martín 1, M. Romero Portales 1, A.P. Benítez
Valderrama 2, N. Gónzalez Pérez De Villar 1, R. Gómez Rioja 3, A. Buño Soto 3
1
Digestive System Department, La Paz University Hospital, Madrid, Spain
2
Endocrinology and Nutrition Department, La Paz University Hospital, Madrid, Spain
3
Laboratory Medicine Department, La Paz University Hospital, Madrid, Spain
BACKGROUND-AIM
The frequency of type 2 diabetes (T2D) is continuously increasing and the prevalence of Metabolic-Associated Fatty
Liver Disease (MAFLD) among these patients is significantly high (55%). Despite liver fibrosis being the major prognosis
factor in MAFLD evolution, guidelines recommend assessing liver steatosis in T2D by non-invasive scores as a first step.
Hepatic steatosis index (HIS) and triglyceride-glucose index (TyG) are scores based on serum biomarkers. Controlled
attenuation parameter (CAP) (Fibroscan) enables quantification of fatty liver infiltration. This study aimed to evaluate
the diagnostic accuracy of HIS and TyG to estimate steatosis compared to CAP in T2D patients with a positive fibrosis-4
(FIB-4) score.
METHODS
From a cohort of 110 patients with T2D and positive FIB-4 (cutoff ≥1.3/≥2,</>65 years respectively), we estimated
hepatic steatosis with HIS, TyG and CAP. We considered a cutoff of 302 dB/m for steatosis (S≥S1). Laboratory
parameters were compared between patients with and without steatosis. Diagnostic accuracy of HIS and TyG was
estimated using the area under the receiver operating characteristic (AUC) and Youden-optimized cutoffs were
obtained.
RESULTS
The prevalence of steatosis among T2D patients based on 302 dB/m cutoff was 38.2% in our cohort. Significantly higher
values (median(interquartile range)) for HIS and TyG (p<0.05) were observed in patients with steatosis (HIS 42(38-47)
vs 38(35-42) and TyG 9.2(8.9-9.7) vs 9.0 (8.6-9.3) respectively). Higher BMI, triglycerides and HDL cholesterol were also
associated with steatosis S≥S1 (p<0.05).
AUC for HIS and TyG was 0.67 (95%CI 0.57-0.67) and 0.70 (0.6-0.8) respectively. Youden cutoff for HIS was 36.5 and
showed a sensibility, specificity, positive and negative predictive value of 88%, 43%, 49%, and 85%, and for TyG a cutoff
of 8.64 showed 98%, 34%, 48% and 96% respectively.
CONCLUSIONS
Non-invasive steatosis scores such as HIS and TyG has a correct performance to estimate liver steatosis compared to
more accurate methods such as CAP. Establishing a MAFLD screening strategy for detecting liver steatosis as well as
fibrosis among T2D patients based on routinely low-price laboratory parameters is crucial since disease reversion is
possible when intervention is performed in early stages, avoiding progression to advanced liver disease.

P0857
CHARACTERIZATION OF THE GUT MICROBIOTA IN DIABETES MELLITUS TYPE 2 PATIENTS BY THE NEXT GENERATION
SEQUENCING TECHNIQUE
M. Velizarova 2, V. Yanachkova 6, T. Boneva 1, S. Giragosyan 5, P. Gateva-Andreeva 4, I. Mihaleva 4, D. Svinarov 2, I. Dimova

3
1
Alexandrovska Hospital, Medical University Sofia, Bulgaria
2
Department of Clinical laboratory, Medical University Sofia, Bulgaria
3
Department of Medical Genetics, Medical University Sofia, Bulgaria
4
Department of Pharmacology and Toxicology, Medical University Sofia, Bulgaria
5
Molecular Medicine Center, Medical University Sofia, Bulgaria
6
SAGBAL “Dr Shterev”, Sofia, Bulgaria
BACKGROUND-AIM
The human microbiome plays a very important role in the normal functioning of both metabolic and immune systems.
Healthy people have different microbiome that leads to achieve more short chain fatty acids and make up more
branched amino acids, while the gut microbiota of type 2 Diabetes Mellitus (T2DM) patients is more likely to produce
compounds that affects glucose metabolism. The objective of this study was to characterize the composition of the
gut microbiota in T2DM patients in comparison to healthy subjects.
METHODS
Totally, 17 patients with T2DM and 16 healthy individuals were enrolled in the study. The complex gut microbiome was
analyzed by the NGS (Ganzimmun Diagnostics AG, Mainz, Germany). The study of the microbiome included: assessment
of bacterial dysbiosis, analysis of the species composition of the intestinal microflora, determination of the enterotype
and distribution of bacterial strains, incl. assessment of the mucosa-protective microflora. Determination was made
for: enterotype (predominance of type/genus Bacteroides, Prevotella or Firmicutes), distribution of the most important
bacterial strains, Firmicutes/Bacteroidetes ratio and muco-protective microflora.
RESULTS
We found significant decrease in butyrate-producing bacteria Eubacterium spp. and increase in lipopolysaccharide
(LPS) - positive bacteria in T2DM patients compared to controls- T2DM patients had approximately 4 times more
bacteria from the species Enterobacter spp., Escherichia spp. and Pseudomonas spp. There was an increased amount
of Bilophila wadsworthia in T2DM patients as well. Analysis of biodiversity and other bioindicators (pH-value of
faeces, Firmicutes/Bacteroidetes ratio, Prevotella/Bacteroidetes ratio) in T2DM patients and controls did not show a
significant deviation from the reference values and did not differ statistically between patients and healthy subjects.
CONCLUSIONS
The influence of gut microbiome on the inflammatory processes and glucose homeostasis is evident and its modulation
could be a novel approach to prevent and treat T2DM.

P0858
EVALUATION OF C-REACTIVE PROTEIN AND LIPID STATUS IN WOMEN WITH POLYCYSTIC OVARIES
D. Puhalo Sladoje 1, D. Bokonjic 1, A. Mandic 1, O. Cancar 1, V. Cancar 1

1
Medical Faculty of Foča; University of East Sarajevo
BACKGROUND-AIM
Polycystic ovary syndrome (PCOS) is a heterogeneous clinical syndrome characterized by hyperandrogenism and
ovulatory dysfunction. A large number of studies have shown that hsCRP is a superior predictor of coronary events than
LDL-cholesterol. Determination of CRP and lipid status as well as insulin resistance in women with PCOS allows timely
and energetic prevention of the risk of cardiovascular diseases. Research objective: Evaluation of C-reactive protein
and lipid status in women with polycystic ovaries.
METHODS
In accordance with the set goals, the research was conducted by cross-sectional study type. The survey included 94
female respondents, aged 20 to 40. Body mass (kg), body height (cm), waist circumference (cm), hip circumference (cm)
were measured for each subject, and the body mass index (BMI, kg/m²) was calculated based on the obtained results.
The laboratory examination included: measurement of the concentration of hsCRP mg/ml, total cholesterol (mmol/L),
cholesterol in HDL (mmol/L), LDL (mmol/L) and VLDL (mmol/L) lipoproteins, triacylglycerol (mmol/L) . Measurement
of the concentration of LH (mIU/ml), FSH (mIU/ml), testosterone (ng/ml), DHEA-S (µg/dl) and insulin (µIU/ml) in the
serum. The subjects were divided into three groups: obese subjects with PCOS (N32), normal weight subjects with PCOS
(N 30) and a control group (N30) of healthy women without PCOS.
RESULTS
72% of obese patients with PCOS have hsCRP >3mg/ml (high risk for atherosclerosis), 28% hsCRP 1-3 mg/ml (medium
risk for atherosclerosis). In the PCOS group of normal body weight, 20% of subjects have hsCRP >3 mg/ml (high risk),
70% have hsCRP between 1-3mg/ml (intermediate risk) and 10% have hsCRP < 1 mg/ml (low risk). The values of hsCRP,
total cholesterol, LDL cholesterol and triglycerides were the highest in the group of obese subjects with PCOS (p<0.01),
while there were no significant differences between the group of PCOS subjects of normal body weight and the control
group (p<0.05).
CONCLUSIONS
In women with polycystic ovaries, there is a statistically significant correlation of C-reactive protein and lipids with
obesity and insulin resistance. Early recognition and treatment of obese women with PCOS and taking preventive
measures are of key importance in reducing the risk of cardiovascular diseases.

P0859
MIRS AND PROTEINS LEVELS IN ADIPOSE-DERIVED EXOSOMES (ADES), ADDRESSED IN THE CONTEXT OF METABOLIC
BIOMARKERS IN SUBJECTS WITH OBESITY
J. Noboa 2, P. Madrigal 2, J. Castro 2, M. Ramos 2, J. Leon 1, N. Rosa 2

1
INSTITUTO NACIONAL DE CIENCIAS MÉDICAS Y NUTRICIÓN SALVADOR ZUBIRÁN
2
UNIVERSIDAD DE GUADALAJARA
BACKGROUND-AIM
The epidemiological evidence highlights that adiposity status is a significant risk factor for developing chronic
metabolic diseases in the worldwide adult population, by the body white adipose tissue (WAT) accumulation, such as
in the obesity. Adipose tissue (AT) is the major producer of exosomes called adipose-derived exosomes (ADEs), and in
obesity its production is exacerbated.
microRNAs (miRs) and proteins transported by the ADEs provides information, for instance of the immunometabolic
alterations, so they have been proposed as new biomarkers, and as alternative therapy in different pathologies; so,
the aim of this study was to establish the qualitative difference of ADEs between males and females, healthy and with
obesity, and the quantitative difference of miRs and proteins levels addressed in the context of metabolic biomarkers.
METHODS
In this cross-sectional study, 81 males and females aged 20 to 59 were included, and split up into three groups, G1
healthy, G2 overweight/unhealthy, and G3, overweight/healthy, based on body mass index. Further analysis was carried
out by sex.
From blood plasm samples we isolated exosomes and compared them by transmission electron microscopy (TEM). In
parallel, we lysed exosomes and extracted total miRs and proteins by Invitrogen kits, then levels of both were measured
by the Nanodrop Onec and Qubit procedures.
RESULTS
We noted an increased qualitative difference in exosome quantity in G2 and G3 compared with G1, without an
appreciable difference between males and females in each group. We observed an increase in lipid profile levels, the
magnitude of metabolic biomarkers, and insulin-resistant status in G2 and G3 compared with G1, with no difference
between males and females within each group. Similar differences were observed in total miRs and protein levels.
CONCLUSIONS
Our results showed that in obesity there is an increased production of ADEs. In this sense, we ought to suggest that exist
an alternative molecular mechanism that develops a pathogenic process related to unbalanced WAT accumulation,
which turns dysfunctional. At the same time, the loss of the connection in regulating metabolism with the WAT function
represents a triggering factor for obesity comorbidities.

P0860
HHEX AND MTR1B GENE POLYMORPHISMS ASSOCIATED WITH THE RISK OF TYPE 2 DIABETES MELLITUS IN A MIXED
ANCESTRY SOUTH AFRICAN URBAN POPULATION
E.N. Ndonwi 4, D.M. Matshazi 4, R.T. Erasmus 2, A.P. Kengne 3, G.M. Davison 4, T.E. Matsha 1
1
Sefako Makgatho Health Sciences University, Ga-Rankuwa, 0208, South Africa
2
Division of Chemical Pathology, Faculty of Medicine and Health Sciences, National Health Laboratory Service (NHLS) and
University of Stellenbosch, Cape Town, 7505, South Africa
3
Non-Communicable Disease Research Unit, South African Medical Research Council, Parow, Cape Town, 7505, South Africa
4
SAMRC/CPUT/Cardiometabolic Health Research Unit, Department of Biomedical Sciences, Faculty of Health and Wellness
Science, Cape Peninsula University of Technology, Cape Town, 7530, South Africa
BACKGROUND-AIM
The HHEX and MTNR1B genes have been well studied across diverse ethnic populations, and variations in these
genes, manifesting as single nucleotide polymorphisms (SNPs), have been reported to play significant roles in the
pathophysiology of type 2 diabetes mellitus (T2DM). As such, we carried out this study to determine if individuals
carrying a specific genotype were at greater risk of developing T2DM when compared to those without the genotype,
especially in a South African population where we previously reported a high incidence of T2DM.
METHODS
This cross-sectional study was conducted in a total sample of 1969 male and female mixed ancestry participants with
T2DM (n=312) and without T2DM (n=1657). Two SNPs (rs10830963 of the MTR1B gene and rs1111875 of the HHEX
gene) were genotyped using quantitative real time polymerase chain reaction, after which Hardy-Weinberg Equilibrium
(HWE) was performed on the SNPs. Metabolic diseases and traits were compared across the genotypes of SNPs in HWE.
Moreover, linear and logistic regressions, adjusted for age, gender and body mass index (BMI), were used to assess the
risk of T2DM, its traits and associated diseases.
RESULTS
Both SNPs, rs10830963 (p=0.158) and rs1111875 (p=0.465) were in HWE. Whilst the two SNPs showed no association
with T2DM, they were associated with traits of T2DM. The rs10830963 recessive genotype was able to predict fasting
plasma glucose (FPG), insulin and HOMA-IR, whilst the rs1111875 recessive genotype was able to predict total
cholesterol, triglyceride, low density lipoprotein (LDL) cholesterol and fasting plasma glucose levels.
CONCLUSIONS
The two recessive SNP genotypes (rs1111875 of the HHEX gene and rs10830963 of the MTR1B gene) may increase
the risk of developing T2DM. As such, they may be used as screening targets to identify individuals in whom
interventions (lifestyle modifications) may be useful to reduce the development of T2DM. Furthermore, these SNPs
may be alternative therapeutic targets once their role in the pathophysiology of T2DM is fully elucidated.

P0861
GUT MICROBIOTA PROFILES IN TYPE 2 DIABETES PATIENTS: A PILOT STUDY CONDUCTED IN SOUTH AFRICA
S.M. Pheeha 1, S. Manda 3, B. Chale-Matsau 2, P. Nyasulu 4

1
Department of Chemical Pathology, Faculty of Medicine and Health Sciences, Sefako Makgatho Health Sciences University,
Pretoria 0208, South Africa AND Division of Epidemiology and Biostatistics, Faculty of Medicine and Health Sciences,
Stellenbosch Univer
2
Department of Chemical Pathology, Faculty of Medicine and Health Sciences, University of Pretoria, Pretoria 0028, South
Africa
3
Department of Statistics, Faculty of Natural and Agricultural Sciences, University of Pretoria, Pretoria 0028, South Africa
4
Division of Epidemiology and Biostatistics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town
7500, South Africa
BACKGROUND-AIM
Type 2 diabetes mellitus (T2DM) is one of the leading causes of morbidity and mortality worldwide, and is becoming
an even bigger threat to developing countries such as South Africa. This condition is a complex metabolic disorder that
stems from multiple pathogenic contributions, among which include the gut microbiota, particularly, gut dysbiosis.
Little is known about microbial variability and its implications for T2DM in Africa. Moreover, we have not identified
such studies in South African populations. The aim of this study is to profile gut microbiota profiles in South African
T2DM patients.
METHODS
Fecal samples were used to analyze the composition of the gut microbiota in 50 South African T2DM patients. The
PacBio 16s analysis was done using DADA 2 (https://benjjneb.github.io/dada2/index.html) and QIIME 2 (https://
docs.qiime2.org/2021.11/). To describe the composition of the microbiome, data analysis of operational taxonomic
units (OTU) were also done. Frequency statistics were conducted using Microsoft Excel.
RESULTS
The average read count of the study participants is 22669.75 with a range of 4425-56375. The average Firmicutes/
Bacteroidetes (F/B) ratio is 1.78, ranging from 0.05-11.46. Sixty-two and a half percent of the participants have an F/B
ratio of above 1 and only 7.5% of them have an F/B ratio of 1. The top 3 phyla includes Bacteroidetes, Firmicutes and
Proteobacteria. The top 3 species are mostly the ones identified as unknown, followed by Bacteroides vulgatus and
Bacteriodes dorei. The average number of species identified is 69.03, ranging from 13-127 species.
CONCLUSIONS
The range for both the read count and number of species is wide, therefore showing how variable the gut microbiota is
among the participants. These results also demonstrate that patients with T2DM in South Africa mostly present with
gut dysbiosis, as demonstrated by the Increased/ decreased F/B ratios. This indicates that there might be some form
of association between T2DM and gut dysbiosis. More studies are required to help understand the role gut microbiota/
gut dysbiosis plays in T2DM, especially in African countries were such information is limited.

P0862
CLINICAL AND BIOLOGICAL CHARACTERISTICS OF HYPERTENSIVE TYPE 2 DIABETIC PATIENTS AND CARDIOVASCULAR
RISK.
M. Nachi 1, I. Kihel 1
1
University Oran1 Ahmed Ben Bella, Faculty of Medecin
BACKGROUND-AIM
Cardiovascular disease is one of the main causes of death in type 2 diabetics. The aim of this study is to describe the
clinial and biological characteristics of type 2 diabetic patients who developed high blood pressure then to study the
relationship between high blood pressure and the occurrence of macro vascular complications.
METHODS
It is about a descriptive retrospective study of type 2 diabetic patients (T2D) who developed high blood pressure. The
clinical and biological informations were compiled on an information sheet. Statistical analysis were performed using
SPSS software.
RESULTS
they were included in this study the study 341 T2D patients with a mean age of 60.1 ± 11.71 years. The sex ratio w/m
was 1.04 (174 women and 167 men). Dyslipidemia was recorded in 205 T2D patients (60%). The average rate of HbA1c
is estimated at 9.31 ± 2.43% [5.2-16%]. 17.5% of patients had a good control of diabetes (HbA1c ≤ 7%); 27.62% of them
were moderately controled (HbA1c >7 and 1g/L with an average rate of 1.22 ± 0.52 g/. 65% of patients presented a high
blood pressure. Macrovascular complications were present in 72 patients (30.9%) These are mainly cerebrovascular
accident (CVA) in 14% of cases, obliterating arteritis of the lower limbs (AOMI) in 8% of cases and ischemic heart disease
(IC) in 15% of cases.
High blood pressure was more prevalent; in women compared to men (70 vs 61%, p = 0.08), in patients aged 60 years
old and over (74 vs 55%, p < 10-3), in those with diabetes older then (+ 10 years) (74 vs 57%, p= 0.001), and in those
with desequilibrate diabetes (HbA1c > 7%) (68 vs 44%, p= 0.001). Macrovascular complications were more frequent in
patients with high blood pressure: CVA (24 vs 6%, p= 0.006), PAD (14 vs 1.17%, p= 0.002) and CI (26 vs 6%, p= 0.002).
CONCLUSIONS
Hypertension is common in type 2 diabetic patients, it has a correlation with cardiovascular risk. Adequate glycemic
control, as well as appropriate therapy, are the priorities for the adequate management of T2D patients, and for a
better control of cardiovascular complications.

P0863
EXERCISE-METFORMIN INTERACTION ON GLUCOSE METABOLISM AND β-CELLULAR FUNCTION: PRELIMINARY RESULTS
FROM A TRIPLE-BLIND CLINICAL TRIAL.
J. Methnani 4, H. Ben Slama 4, T. Ach 3, F. Chaieb 1, N. Kalboussi 5, I. Bouhlel 6, A. Bouslama 2, M. Zaouali 3, A. Omezzine
2
, E. Bouhlel 3
1
6Department of Physiology and Functional Exploration, Farhat Hached University Hospital of Sousse, Tunisia
2
LR12SP11, Biochemistry Department, Sahloul University Hospital, Sousse, Tunisia
3
LR19ES09, Laboratoire de Physiologie de l'Exercice et Physiopathologie : de l’Intégré au Moléculaire « Biologie, Médecine
et Santé », Faculty of Medicine of Sousse, Sousse, Tunisia
4
University of Manouba, High Institute of Sport and Physical Education, Ksar Said, Tunis, Tunisia
5
University of Monastir, Faculty of Pharmacy of Monastir, Monastir, Tunisia
6
University of Sousse, Faculty of medecine of Sousse, Sousse, Tunisia
BACKGROUND-AIM
The purpose of this study was to explore the interaction between metformin and exercise on glycemic control,
pancreatic -cell function and insulin sensitivity.
METHODS
12 subjects were randomized to undergo a 5-week period of exercise training either with (metformin-exercise group)
or without (exercise-placebo group) metformin (500 mg twice daily). The training was designed to expend 500 Kcal at
60% of pic oxygen consumption. Before and after intervention a 75g 2-hour OGTT was conducted after an overnight
fast, and plasma glucose, insulin, and C-peptide were determined for calculations of skeletal muscle, hepatic (HOMA-
IR) insulin sensitivity. β-cell function was defined from glucose-stimulated insulin secretion (GSIS) prehepatic insulin
secretion (deconvolution modelling).
RESULTS
Exercise-metformin combination resulted in 19.95% decrease in postprandial glycemia (p<0.001). In contrast, for
the group placebo-exercise group, blood glucose levels increased significantly (+14.44%; p=0.002). However, we did
not detect significant differences either between groups or within groups for insulin and c-peptide (p>0.05 for both
parameters). Pre-hepatic insulin secretion decreased in the exercise-metformin group (-20.4% p=0.064) and increased
in the placebo group (+21.07%; p=0.054). Independent of the intervention, we found an increase in first phase glucose-
stimulated insulin secretion index (p<0.001). We also found the same when this index was calculated using C-peptide
concentrations where a main effect of time was noted indicating an overall improvement in first phase glucose-
stimulated insulin secretion (p<0.001). No significant differences were found in muscle and liver insulin sensitivity
(p>0.05 for both).
CONCLUSIONS
Metformin-exercise combination improved glucose tolerance compared to the exercise intervention alone. Second,
although exercise improved body composition, respiratory and functional capacity, it worsened glycemic control
without significant effects on insulin sensitivity when assessed alone. Third, both interventions improved the first
phase of insulin secretion and only the exercise-metformin combination improved the second phase of insulin
secretion calculated using C-peptide concentrations.

P0864
A PARTICIPATION IN THE ESTABLISHMENT OF A NORMAL VALUE OF GLYCATED HEMOGLOBIN HBA1C IN A NON-
DIABETIC FEMALE MOROCCAN POPULATION
A. Bayen 4, H. Chemsi 3, K. Chnaou 5, M. Mourchid 1, I. Sbai Otmani 5, S. Ibn Moussa 2

1
Biochemistry Laboratory, Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco
2
Biochemistry Laboratory, Faculty of Medicine and Pharmacy, LC-BENS Laboratory, Hassan II University, Casablanca,
Morocco
3
Biochemistry Laboratory, Ibn Rochd University Hospital, FMPC Faculty of Medicine and Pharmacy, LC-BENS Laboratory,
Hassan II University, Casablanca, Morocco
4
Biochemistry Laboratory,Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco
5
Drug Science Research Laboratory, Faculty of Medicine and Pharmacy of Casablanca-Morocco
BACKGROUND-AIM
HbA1c is frequently used to monitor the glycemia of diabetic patients to assess the efficacy of treatments and
anticipate diabetic complications.Due to the importance of this parameter and its intra individual variability, our work
consisted to participate in the establishment of a normal value of the HbA1c for a specific Groupe of people which was
a non-diabetic feminine Moroccan population.
METHODS
Our work is based on data from a private Medical Analytical Laboratory, we examined the results of 934 non-diabetic
women, , and we used the SPSS 2.0 version software with a 5% of risk for the statistic studies of data . the results are
expressed as a percentage according to the NGSP.
RESULTS
The mean age of the subjects was 53 years with extremes ranging from 16 to 100 years. The mean value of HbA1c
for the whole population was 5,44 ± 0,012 % ( p value <0.001) with extremes ranging from 4 % to 6 % , to be more
specific we have divided our population of study to four groups based on their age , the first one from 16 to 31 years ,
the second one 32-50 years , the third one 51-71 years , the fourth one 72-100 years .The results are respectively as
follows: 5,25 ± 0,026 ; 5,43 ±0,017 ; 5,57 ± 0,020 ; 5,55 ± 0,033 .It was found that the average HbA1c value of the female
population increased with age, an increase of 0.18 between the first andsecond groups, with a percentage of 3.30%
of the mean values , and an increase of 0.14 was also observed between the second and third groups, equivalent to
2.5% of the mean. The mean value of HbA1c dropped to 0.02 between the third group and the fourth group, which
represents a 0.4% decrease in the mean value of the third group.
CONCLUSIONS
Although we have established a normal value of glycated hemoglobin for a Moroccan female population and the
existence of an increase in the average value of Hba1c with age, these results do not justify
may not memorize or use thresholds in routine clinical practice.

P0865
A FRESH LOOK AT SELECTED WELL-KNOWN SEROLOGICAL MARKERS IN MONITORING THE CLINICAL COURSE OF TYPE
1 DIABETES IN PEDIATRIC PATIENTS.
A. Ochocińska 2, M. Wysocka-Mincewicz 1, J. Świderska 1, B. Cukrowska 3

1
2
Warsaw, Poland
3
Department of Pathomorphology, The Children’s Memorial Health Institute, Warsaw, Poland
BACKGROUND-AIM
Biochemical abnormalities in the course of type 1 diabetes (T1D) may cause the produc-tion/activation of various
proteins and peptides influencing the treatment and the formation of complications, which are thought to be
dependent on blood glucose levels. The aim of this study was to asses concentrations of selected serological markers
involved in the pathogenesis and course of T1D, and to correlate their concentrations to patients’ age, duration of T1D
and glycemic status. To the best of our knowledge, no one has analyzed changes in amylin (IAPP), proamylin (proIAPP),
catestatin (CST), chromogranin A (ChgA), nerve growth factor (NGF), platelet activating factor (PAF), and uromodulin
(UMOD) concentrations in the context of glucose/HbA1c levels so far. However, in a number of studies, these analytes
were indicated as contributing to the etiology (IAPP, proIAPP), course (CST, ChgA) or the development of various
complications (neuropathy - NGF, cardiovascular complications - PAF, cardiovascular complcations and nephropatia -
UMOD).
METHODS
The study included patients with T1D (n=156) in age 6 - 18 years and age matched healthy controls (n=30).
Concentrations of amylin (IAPP), proamylin (proIAPP), catestatin (CST), chromogranin A (ChgA), nerve growth factor
(NFG), platelet activating factor (PAF), and uro-modulin (UMOD) were measured in sera using immunoenzymatic tests.
RESULTS
There were significant differences in concentrations of NGF (12.7, range 3.34-17.9 vs 4.69, range 0.52-804 pg/ml), ChgA
(74.5, range 40.5-98.5 vs 52.5, range 15.5-104 ng/ml), and PAF (0.20, range 0.11-0.43 vs 0.25, range 0.12-5.18 ng/ml)
between patients with newly diagnosed T1D and those treated over 3 years, respectively. IAPP, proIAPP, and NGF were
significantly affected by the patients’ age. However, the markers were not influenced by glucose level determined by
glycated hemoglobin.
CONCLUSIONS
Concluding, the results show that study markers may reflect pathological processes continued even when the blood
glucose levels are normal.

P0866
ADIPONECTIN/LEPTIN RATIO (A/L) AMONG INSULIN RESISTANCE AND SENSITIVE INDIVIDUALS TO ASSESS THE
FUTURE RISK FOR CARDIOVASCULAR DISEASES
P. Vishwanath 1, S. Ramachandra 1, A. Prashant 1, A. Koushik 1, S. Akshitha 1, S. Meherunnisa 1

1
JSS Medical College, JSS Academy of Higher Education & Research, Mysuru, India
BACKGROUND-AIM
Obesity is the leading cause of cardiovascular disease (CVD) and metabolic syndrome (MS) and is characterized by
increased leptin and decreased adiponectin levels. We aimed to correlate the adiponectin/leptin ratio (A/L) among
insulin-resistance (IR) and insulin-sensitive (IS) individuals with their body mass index (BMI) and assess the future
risk for CVD.
METHODS
A total of 84 individuals aged 18 to 60 years without any comorbidities were enrolled in the study. The anthropometric
measurements were noted. The biochemical parameters like fasting glucose, insulin, leptin, and adiponectin were
estimated. The homeostatic model assessment of insulin resistance (HOMA-IR) was calculated. The total subjects were
divided into IR and IS based on HOMA-IR. The data were analyzed on Microsoft Excel 2010 lnk sheet. A P-value of <0.05
was considered statistically significant,
RESULTS
BMI (29.85 kg/m2± 5.92 and 24.92 kg/m2±5.04), fasting insulin (24.27 Mu/L±17.36 and 8.23 Mu/L±2.76), and leptin
(28.14ng/ml±28.64 and 14.66ng/ml±21.76) was significantly higher in IR than IS with P-value of <0.05. Whereas A/L
was significantly lower in IR (0.8) than IS (1.9). BMI showed a significant positive correlation with A/L (0.284, p=0.008),
whereas HOMA-IR did not show a significant correlation with A/L.
CONCLUSIONS
The A/L may be useful in identifying the risk of CVD and MS in obese individuals.

P0867
VON GIERKE'S DISEASE: ABOUT A CASE
M.C. Martín Fernández De Basoa 2, M.T. Concepción Masip 1

1
Hormone, Tumor Markers and Prenatal Screening of the Clinical Analysis Department. Complejo Hospitalario Universitario
Nuestra Señora de Candelaria, Santa Cruz de Tenerife
2
Hormone, Tumor Markers and Prenatal Screening Unit of the Clinical Analysis Department. Complejo Hospitalario
Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife
BACKGROUND-AIM
Von Gierke's disease or glycogenosis type Ia (GSDIa), is a rare inherited metabolic disease, including within the inborn
errors of metabolism, caused by deposition or accumulation of glycogen.
This disease was initially described by Simon Van Creveld and by Edgar Von Gierke at
early 1930s and appears with a frequency of 1/100,000. Mortality, common in other times, it has now become rare if
the metabolic control is adequate, being the main causes of death hypoglycemic seizures and/or severe acidosis.
The aim of this study is to present a case of this rare disease.
METHODS
Presentation of the case: 4-year-old girl referred to Pediatric outpatient clinics due to lack of growth, abdominal
distension, and a history of frequent episodes of weakness and paleness that disappear eating.
RESULTS
In the laboratory tests, the following stand out: hypoglycemia, hyperlipidemia, hyperuricemia and increased lactate,
pyruvate and free fatty acids in serum.
Analysis of the G6PC and SLC37A4 genes by complete PCR amplification of their exons and subsequent sequencing
allowed us to identify the presence, in homozygosis, of the P178S mutation.
This mutation is produced by a substitution of the Cytosine nucleotide for Thymine at position 649 of Exon 6 of the
G6PC gene, which causes a change of an amino acid from Proline to Serine and is described associated with GSDIa.
This mutation inhibits the efficient breakdown of glucose 6-phosphate by a deficit in the activity of the enzyme G-6-
phosphatase. Glucose 6-phosphate that is not broken down to glucose is converted to glycogen and fat and can be
stored inside cells. This buildup is toxic and causes damage to organs and tissues throughout the body, especially the
liver and kidneys, leading to the signs and symptoms of GSDIa.
The study of the parents revealed that they were healthy carriers of the same mutation.
After making the diagnosis of GSDIa, treatment with nutritional regimens was established to reduce minimize organic
acidosis and maintain blood glucose levels above 70 mg/dl.
CONCLUSIONS
Von Gierke's disease is a rare hereditary disease that, not treated, can have serious consequences. However, early
diagnosis and treatment improves the prognosis and quality of life of affected children, so the role of the Clinical
Laboratory is crucial.

P0868
EXAMINATION OF PANCREATIC BETA CELL RESERVE AND INSULIN RESISTANCE WITH FAM19A5, FGF-21, GDF-15, MOTS-
C BIOMARKERS IN PATIENTS CLASSIFIED BY K-MEANS CLUSTERING METHOD
S. Erdal 2, Z. Hekimsoy 1, P. Erbay Dündar 3, F. Taneli 2

1
Internal Medicine, Endocrinology and Metabolism Diseases Department, Manisa Celal Bayar University / Hafsa Sultan
Hospital, Manisa
2
Medical Biochemistry, Manisa Celal Bayar University / Hafsa Sultan Hospital, Manisa
3
Public Health Department, Manisa Celal Bayar University / Hafsa Sultan Hospital, Manisa
BACKGROUND-AIM
Obesity can cause insulin resistance and pancreatic beta cell insufficiency. The aim of the present is to classify the
obese cases into the groups according to insulin resistance and insulin secretion indexes using K-means clustering
method and to investigate the relationship of K-means clustering method with insulin resistance and insulin secretion
indices. The secondary aim is to evaluate adipokine (Family with Sequence Similarity 19 Member-A5 (FAM19A5))
and mitokine (Fibroblast Growth Factor-21 (FGF-21), Growth Dıfferentiation Factor-15 (GDF-15), Mitochondrial Open
Reading Frame of 12S rRNA-c (MOTS-c)) levels in K-means clustering group and World Health Organization (WHO)
classification groups.
METHODS
Thirty healthy cases who applied to the Endocrinology outpatient clinic of our hospital and 130 obese or overweight
cases with suspected type 2 diabetes (T2DM) were included in the study. The cases were classified into 4 cluster groups
according to their insulin resistance and insulin release indices by the K-means clustering method. In addition, the
cases were divided into 3 groups as T2DM, prediabetes and normal glucose tolerance (NGT) according to the WHO
diabetes mellitus classification criteria. FAM19A5, FGF-21, GDF-15 and MOTS-c levels were analyzed in all cases and
relationships were evaluated both in between cluster groups and WHO groups.
RESULTS
There was no significant difference between the FAM19A5, FGF-21, GDF-15 and MOTS-c levels in K-means cluster
groups. Serum MOTS-c was decreased in obese group compared to controls (p<0.05); FGF-21 was increased in obese
with T2DM than in obese with NGT (p<0.05), and increased in obese with NGT than in healthy controls (p<0.05); GDF-15
was found to be increased in T2DM compared to the healthy group (p<0.05). There was no significant difference in
FAM19A5 between healthy controls and obese groups.
CONCLUSIONS
We believe that K-means clustering method is superior to WHO diabetes classification because it gives detailed
metabolic data such as insulin resistance and pancreatic beta cell reserve in clarifying the pathogenesis of obesity
to T2DM. K-means clustering method enables the creation of personalized treatment protocols by elucidating the
individual metabolism data via the insulin resistance and insulin secretion levels of the individuals.

P0869
HBA1C FOR THE DIAGNOSIS OF TYPE DIABETES: AN UPDATE.
c. Bechkri 1, h. Kouissa 1, s. Hanachi 1, b. Benchaib 1, k. Benmbarek 1

1
Biochemistry laboratory CHU Constantine.
BACKGROUND-AIM
Diabetes is a serious pathology which deteriorates the quality of life of its patients. Different learned societies have
collaborated to come out with recommendations. The main objective of our study was to evaluate the place of HbA1c
in the screening and diagnosis of diabetes.
METHODS
This study represents a bibliographic synthesis. An in-depth study of 30 reference publications dealing with the subject
was carried out, for that we undertook a systematic search of electronic databases Pub Med, Google scholar, science
direct and the information of these references was compiled and summarized in guidelines.
RESULTS
hba1c is a marker used by clinicians to adjust or modify treatment, to assess the quality of care and therapeutic
compliance and to quantify the risk of developing degenerative complications of diabetes. The UKPDS study and its
main objective was to test whether better control of diabetes prevents diabetes complications. The results of this
study showed that a 1% reduction in HbA1c was associated with a 30% reduction in the relative risk of developing
microvascular complications, an 18% reduction in the risk of heart attack and a 25% reduction in the risk of diabetes-
related mortality. From these studies, it appears that HbA1c allows the monitoring of type 2 diabetes and that the
higher the HbA1c, the higher the risk of developing complications.. Diabetes is considered well controlled when HbA1c
is less than 6.5%.Diabetes is moderately controlled if HbA1c is between 6.5% and 7.5%.It is poorly controlled if HbA1c
is above 8%. The ultimate goal of the IFCC is the global standardization of all routine methods and the concentration
of this HbA1c of patients should be reported in the International system. Unfortunately, universal reporting will be
unlikely to be achieved: there has been, and still is, resistance to a change in units.
CONCLUSIONS
In the end, we note that the latest recommendations are not applied in Algeria, while the HbA1c has multiple
advantages that overcome those of the fasting blood glucose, at the same time this test needs to be studied. at large
scale studies to establish a threshold of better sensitivity and specificity.

P0870
DIABETIC KIDNEY DISEASE, ABOUT ITS ONSET AND PROGRESSION FACTORS STUDY
s. Meherhera 1, a. Taleb 1, f. Bendjabou 1, k.a. Zegnini 1, s. Abdi 1

1
SAAD DAHLAB university of Blida
BACKGROUND-AIM
Chronic kidney disease in diabetics is one of the major causes of morbidity and mortality,
Its physiopathology of installation and progression is multifactorial and complex and requires
to be studied deeply to explore its increasing incidence
we aimed to determine the frequency of nephropathy in the type 2 diabetic population of our study and look for its
onset and progression clinical-biological risk factors
METHODS
We conducted a cross-sectional study, on 96 patients type 2 diabetics, the diagnosis of nephropathy was based on
an increase in the rate albumin excretion (ACR > 30 mg/g creatinine) and/or an alteration in the glomerular filtration
rate (GFR < 60 ml/min/1.73m2).an information sheet has been duly completed, in addition, several parameters were
evaluated in these patients, in particular: fasting glycaemia, HbA1c, microalbuminuria, blood urea and creatinine, as
well as lipid profile
The two groups of patients with and without nephropathy were compared and the data were analyzed using SPSS
software (Statistical Package for the Social Sciences) version 25.
RESULTS
among 96 diabetic subjects, 33 (34%) had nephropathy, subjects with kidney disease had more advanced age (p=0.03)
as well as older diabetes (p=0.049). Arterial hypertension p=0.038), cardiovascular diseases (p=0.018) as well as a high
level of glycated hemoglobin (p=0.048) were associated with an increased risk of development of nephropathy. While
elevated fasting blood glucose and glycated hemoglobin levels were identified as progression factors of kidney disease
when comparing the three stages of kidney disease
CONCLUSIONS
Early diagnosis and control of risk factors such as hypertension arterial blood pressure as well as monitoring of HbA1c
and blood sugar levels are the best ways to prevent this complication

P0871
A STEP TOWARDS PRECISION MEDICINE: REMOTE PATIENT MONITORING OF TYPE II DIABETES
S. Golstein 3, W. Zhao 3, A. Unger 2, D. Gruson 1, B. Macq 3

1
Department of laboratory medicine, Cliniques Universitaires Saint-Luc
2
Erasme, HUB
3
ICTeam, UCLouvain
BACKGROUND-AIM
Remote diagnosis and digital management of diabetes is a reality and the use of real-world data (RWD) will
considerably improve health via preventive, personalized, and precision medicine. In Belgium, health data exchange
is performed via a hub-metahub system, i.e., via four health networks. In Belgium, 7% of the population suffers from
type II diabetes but RWD from glucometers are not integrated into clinician’s workflow with currently no possibility for
a specialist or a general practitioner (GP) to access glucometers data when connecting to the one of the four Belgian
hubs. To improve patient’s care, it is of prime importance to make these data available via the hubs. The team’s solution
aims to improve monitoring of type II diabetes using the glucometer “GlucoMen Areo” from Menarini by storing data
into the Brussels Health Network (BHN).
METHODS
First, the patient authenticates to the BHN via a mobile application. Row measurements are then transmitted from
the device to the application via near-field communication. After, data is mapped using the Belgian FHIR standard
to achieve interoperability, which is key to allow integration and data exchange between healthcare services. Finally,
a FHIR dashboard is implemented to display measurements from the BHN. The dashboard must be integrated into
electronic health records (EHRs), allowing GPs and specialists to easily access, visualize and interpret the data, and
therefore optimize their patient’s treatments.
RESULTS
A prototype was implemented by the team, which captures blood glucose measurements from Menarini’s glucometer
to a mobile application, maps them to FHIR standard and stores them into the BHN. A dashboard, currently not
integrated within EHRs, is accessible for clinicians, and presents the evolution of the measurements as a function of
time.
An extension is to integrate other point of care testing’s devices into EHRs.
CONCLUSIONS
Type II diabetes affects around 900k persons in Belgium and our solution allows remote monitoring of patients thanks
to the integration of blood glucose level measurements via the hub-metahub system. In doing so, data is accessible
by GPs and specialists, leading to improved patient care.

P0872
CORRELATION BETWEEN HBA1C AND FRUCTOSAMINE AND THE GLYCOSYLATION GAP EVIDENCE
A. Slimoune 1, M. Boutebba 1, B. Aissaoui 1, A. Benatallah 1, S. Hanachi 2, K. Sifi 2, N. Abadi 2, K. Benemebarek 2

1
University Hospital of Constantine, Laboratory of biochemistry
2
University Hospital of Constantine, Laboratory of biochemistry/ Research laboratory of biology and molecular genetics,
Faculty of medecine, University 3 of Consantine
BACKGROUND-AIM
The discordance between glycated hemoglobin (HbA1C) and fructosamine (FA) estimations in the assessment of
glycemia is often encountered. The purpose of this study is to point out the correlation between HbA1c and
Fructosamine levels and to evaluate the GG (Glycation gap) which is defined as the difference between the measured
HbA1C and the estimated one. GG has improved the quality of the monitoring of glycemic control, especially for those
patients whose HbA1C levels do not truly reflect the mean blood glucose levels.
METHODS
The study population consisted of 100 diabetics with a sex ratio of 1:1. Blood samples were collected for the
estimation of the levels of HbA1c (on D-10 bio-rad) and fructosamine (on Architect ci8200). The results were compared
by correlation analysis and the glycation gap (GG) was calculated based on the HbA1c-FA regression equation.The
statistical analyses were performed with the IBM SPSS statistics 20.
RESULTS
The mean value of measured HbA1c is 7,2% ± 3%. Thus, the mean value of Fructosamine is 210 ± 100 µmol/l. The study
has shown a good correlation between Fructosamine levels and HbA1c (r=0.61, p<0.05). GG had a broad distribution
(range from -0,6% to 5.5%).
CONCLUSIONS
Fructosamine can be used in the evaluation of glycemic status in a short period of time. The glycosylation gap may
be a useful tool for estimating the physiologic and pathologic sources of variation in diabetic complications beyond
glycemic control.

P0873
ASSOCIATION OF PCSK9 AND LOW-GRADE INFLAMMATION IN CHILDREN AND ADOLESCENTS WITH TYPE 1 DIABETES
MELLITUS
D. Bojanin 1, J. Vekić 2, A. Stefanović 2, M. Miljković 2, V. Spasojević-Kalimanovska 2

1
Biochemical Laboratory, Department for Clinical Chemistry and Hematology, Mother and Child Health Care Institute of
Serbia "Dr Vukan Čupić", Belgrade, Serbia
2
Department of Medical Biochemisty, Faculty of Pharmacy, University of Belgrade, Belgrade, Serbia.
BACKGROUND-AIM
Proprotein convertase subtilisin/kexin type 9 (PCSK9), beside pivotal role in low-density lipoprotein (LDL) homeostasis,
could be involved in the inflammatory pathway of atherosclerosis. Type 1 diabetes mellitus (T1DM) is well established
risk factor for atherosclerotic cardiovascular disease (ASCVD). The aim of this study was to evaluate the link between
PCSK9 and low-grade inflammation in children and adolescents with T1DM.
METHODS
Blood samples were obtained from 151 T1DM patients, without any micro- or macrovascular complications. All patients
were treated with intensive insulin therapy. Standard lipid profile, glycohemoglobin and high-sensitivity CRP (hsCRP)
were determined by routine laboratory methods, while PCSK9 was measured by ELISA.
RESULTS
The patients in the highest tertile of PCSK9 concentrations (>253.86 ng/mL) had significantly higher (P<0.05) levels
of hsCRP (median: 1.20 mg/L; 25th-75th percentile: 0.60-2.50 mg/L) than the patients in first (median: 0.60 mg/
L; 25th-75th percentile: 0.20-1.40 mg/L) and second tertile (median: 0.5 mg/L; 25th-75th percentile: 0.30-1,30
mg/L). These patients also had significantly higher levels of total cholesterol (P<0.001), triglycerides (P<0.001),
LDL-cholesterol (P<0.01) and glycohemoglobin (P<0.001), as compared to patients in lower tertiles. Increased
concentrations of PCSK9 were associated with approximately 2 times higher risk for low-grade inflammation (OR: 2.14;
95% CI: 1.07-4.25; P<0.05). This association remained significant after adjustment for age, gender, body mass index,
diabetes duration, insulin dose and concentrations of triglycerides and LDL-cholesterol.
CONCLUSIONS
Our results suggest a proinflammatory effect of PCSK9 in children and adolescents with T1DM. However, contribution
of PCSK9-related inflammation to ASCVD risk, beyond PCSK9 involvement in LDL-cholesterol metabolism, should be
further investigated.

P0874
GLUCOSE HOMEOSTASIS IN THE FIRST AND THIRD TRIMESTERS OF HEALTHY PREGNANCIES
J. Omazić 1, M. Horvat 1, J. Wagner Kostadinović 2

1
Department of Laboratory and Transfusion Medicine, "Dr Juraj Njavro" National Memorial Hospital, Vukovar, Croatia
2
Department of Medical Biology and Genetics, Faculty of Medicine, J.J. Strossmayer University, Osijek, Croatia
BACKGROUND-AIM
Pregnancy can be associated with many metabolic, biochemical, physiological, hematological and immunological
changes. The aim of our study was to compare the values of hemoglobin (Hgb), fasting serum glucose (GLUC), insulin,
c-peptide, insulin resistance (HOMA-IR) and hemoglobin A1c (HbA1c) in the first and third trimester of pregnancy of
37 healthy pregnant women.
METHODS
Healthy pregnant women (ages 20 to 40) had their blood sampled in the first and third trimesters of pregnancy, and
a complete blood count (Advia, Siemens Healthineers), GLUC, insulin, c-peptide and HbA1c (cobaspro, Roche) were
determined. HOMA-IR was calculated from GLUC and insulin values. The comparison of the obtained values in the first
and third trimester was done with the Wilcoxon test in the MedCalc 12.4.0.0 program (MedCalc, Mariakerke, Belgium)
and the Spearman correlation coefficient between changes in HbA1c and Hgb values, and changes in HbA1c and HOMA-
IR, was determined in the same program.
RESULTS
There was no statistically significant difference between the glucose values in the first and third trimesters (p=0,17),
while for insulin (p=0,003), c-peptide (p<0,001), HOMA-IR (p=0,02) and HbA1c (p=0,001) there were statistically
significant differences between the two trimesters of pregnancy. The correlation coefficient between changes in HbA1c
and Hgb values was 0,0366, and the correlation coefficient between changes in HbA1c and HOMA-IR was 0,2056 which
indicates that there is no connection between changes in HbA1c and Hgb or HOMA-IR.
CONCLUSIONS
Pregnancy of healthy women can be associated with resistance to the action of insulin on glucose uptake and
utilization. Maternal insulin resistance leads to more use of fats than carbohydrates for energy by mother and spares
carbohydrates for fetus, and because of this, there is a difference in the values of insulin, c-peptide and HOMA-IR
between the first and third trimester. HbA1c levels fall in most women in early pregnancy, which is related to increased
red cell production and a decrease in fasting blood glucose levels. Iron deficiency may prolong red cell survival and
increase HbA1c levels. Nevertheless, we did not find connection between the change in HbA1c and the change in Hgb
or HOMA-IR, which proves the complexity of metabolism in pregnancy.

P0875
EFFECTS OF A LOW-CARBOHYDRATE DIET ACCORDING TO THE INTERMITTENT FASTING REGIMEN IN OBESE PATIENTS
WITH TYPE 2 DIABETES
D. Sopa 1
1
Clinic of medical biochemistry,University Clinical Center of KOSOVA.
BACKGROUND-AIM
Treatment of DM2(diabetes mellitus type2) through Nutritional Intervention (NI) is main pillars for an alternative
approach to standard drugs treatment. If obesity is a strong antecedent factor in DM2, then natural approach would be
weight loss by NI. Modification of risk factors such as visceral obesity, reduction of insulin resistance, and alleviation
of metabolic syndrome are among the key factors for the control or remission of DM2. Based on this, an observational
perspective study was carried out on subjects with DM2. The NI applied was according to the Intermittent fasting low
carbihidrate diet, with 6 hours feeding window of 24 hours (IF 6/24-LCD).
METHODS
NI applied to 20 patients with DM2 non-insulin-dependent, BMI > 25 kg/m2, DM2 morbidity < 6 years, without other
secondary diseases.
Three check points were applied: phase T0-before NI, phase T1- four weeks after NI, and phase T2-8 weeks after NI.
RESULTS
Anthropometric and metabolic parameters applied generally resulted in a fairly high statistical significance (p > 0.05).
In T0 , BMI=32.66± 4.83,W/H ratio(Waist/Hip)0.98± 0.04, Glycemia 9.02± 1.78, HbA1c 8.19± 1.21, Homa-IR 6.99± 3.07,
and TG/ HDL ratio 3.23 ± 1.19, shows of visceral obesity with high metabolic/atherogjenic risk and poorly controlled
of the disease.
In T2, weight loss resulted by decreased BMI to 29.60±3.8 (p > 0.032) or-9.4 ∆% compared to T0. W/H-ratio from
0.98±0.04 to 0.957±0.02 (p > 0.005). Tg/HDL-ratio from 3.23±1.19 to 1.20±0.36 (p > 0.001). HbA1c from 8.19± 1.21 to
6.99± 1.23 (P0,036).
In the T0 phase, ketonuria 0,195± 0.028 mmol/L while in both control phases T1 and T2, increased to1.84± 0.8 mmol/
L and 1.75± 0.7 respectively.
CONCLUSIONS
Application of IF6/24-LCD results in weight loss and decrease of insulin resistance,expressed by positive correlation
of BMI / Homa-IR- ratio.
Metabolic shift throughout lipolysis and nutritional ketosis, at the expense of fat mass, is expressed by negative
correlation between BMI/ketones.
Improved atherogenic patterns (decreased TG/HDL-ratio) is closely related with an improvement of body shape
(decreased W/H-ratio) which is expressed by positive correlation of TG/HDL-ratio:W/H-ratio.

P0876
CORRELATES OF HIGH BLOOD PRESSURE AMONG ADULTS PRESENTING AT A LARGE REFERRAL HOSPITAL IN ZAMBIA
K. Kamvuma 2, B.M. Hamooya 2, H. Mutengo 1, J. Mulemena 2, W. Chanda 2

1
Livingstone Teaching Hospital
2
Mulungushi University
BACKGROUND-AIM
Hypertension is a silent epidemic and a major source of increasing health costs, morbidity and mortality and is
associated with increased risk of type 2 diabetes mellitus, dyslipidaemia, and cardiovascular diseases. Hypertension
itself is a condition that can be controlled, and early detection can prevent its complications. Our study has been
designed to determine the prevalence and correlates of blood pressure in adults who present to the adult outpatient
clinic at the University Teaching Hospital which is the largest referral hospital in Zambia.
METHODS
This was a cross-sectional study among adult’s clients attending Outpatient Clinic (OC) at the Lusaka Adult Hospital of
the University Teaching Hospitals between January to June 2017. We collected socio-demographic, anthropometric,
blood pressure (BP), lifestyle and fasting lipid profile data. All participants were in an 8-12 hour overnight fasting state.
RESULTS
The overall prevalence of hypertension was 51% among the study participants. At multivariate analysis, age (aOR:
1.064, 95% CI 1.018-1.112; p=0.006) was associated with increased risk of hypertension while aspirin use (aOR: 0.025,
95% CI 0.002-0.322; p=0.005, having a secondary education (aOR: 0.211 95% CI-0.049-0.909; p=0.037) and tertiary
education (aOR: 0.251 95% CI 0.063-1; p=0.05) were associated with reduced odds of developing blood pressure.
CONCLUSIONS
The study revealed a higher prevalence of hypertension among clients attending outpatient clinic in Lusaka and it
was significantly associated with age, education level and use of aspirin. These evidences may suggest the need for
mandatory screening of blood pressure among and urgent interventions.

P0877
CORRELATION OF ADIPOSE TISSUE CYTOKINES WITH ATHEROGENIC MARKERS IN ADOLESCENT WOMEN WITH
POLYCYSTIC OVARY SYNDROME
A. Atanasova Boshku 2, D. Ivanova Panova 1

1
niversity Clinic of Gynecology and Obstetrics, Faculty of Medicine, Ss. Cyril and Methodius UniversitySkopje, Skopje, North
Macedonia
2
University Clinic of Gynecology and Obstetrics, Faculty of Medicine, Ss. Cyril and Methodius University Skopje, Skopje, North
Macedonia
BACKGROUND-AIM
To evaluate levels of adipose tissue cytokines such as adiponectin and resistin and and to investigate their
relationship with various biochemical and metabolic and atherogenic parameters markers, as well as its contribution
in pathogenesis of insulin resistance in women with PCOS with and without insulin resistance.
METHODS
This study was designed as a cross-sectional and involves 80 premenopausal women. Of these patients, 63 females
have met the criteria for PCOS (59 insulin resistant, 28 non-insulin resistant). We assessed anthropometric indices
of obesity: waist and hip circumference, waist to hip ratio, serum glucose, insulin, total cholesterol, HDL-cholesterol,
triglycerides, FSH, LH, E2, testosterone, adiponectin and resistin. Body mass index, waist to hip ratio, HOMA-IR, LDL-
cholesterol, and adiponectin to resistin ratio were calculated.
RESULTS
Insulin resistant PCOS woman had significantly lower levels of adiponectin compared to non-insulin resistant PCOS
women, and controls. Resistin levels were higher in IR-PCOS, but without statistical significance. Adiponectin showed
significant positive correlation with LH, HDL-C, and negative correlation with BMI, insulin, HOMA-IR and triglycerides.
Resistin correlated positively with BMI and WC. A/R was significantly higher in insulin resistant PCOS women compared
to non-insulin resistant and control women.
CONCLUSIONS
Results from this study suggest that PCOS women were at higher metabolic and atherogenic risk as compared to the
healthy women, and this was more pronounced in the insulin-resistant group. Correlations between adipose tissue
cytokines with the degree of insulin resistance suggest their involvement in modulation of insulin action in PCOS
women.

P0878
LIMITATION OF HAEMOGLOBIN A1C UTILITY IN DIAGNOSIS AND MONITORING OF PATIENTS WITH DIABETES
MELLITUS
A. Lopez Martos 1, A. Escobar Medina 1, E. Martin Torres 2, R. Palma Fernandez 2, N. Romero Sanchez 1, R. Lahoz Alonso
1
, R. Gonzalez Sanchez 1, P. Esteve Alcalde 1
1
Ernest Lluch Hospital, Calatayud
2
Hospital General Universitario of Toledo, Toledo
BACKGROUND-AIM
Glycated haemoglobin (HbA1c) is used as a useful tool in the diagnosis and monitoring of patients with diabetes
mellitus. The latest ADA recommendations had included HbA1c ≥ 6.5% as diagnostic criterio.
However, there are patients that HbA1c determination is not useful.
METHODS
A 78-years-old man was diagnosed with diabetes mellitus in 2004. Henceforth, HbA1c test was carried out and it was
reported with estimated average of glucose levels (mg/dL) over a period of 2 to 3 months based on HbA1c (%) results.
In addition, fasting plasma glucose (mg/dL) and total haemoglobin (g/dL) are also requested at same analysis.
RESULTS
The following analysis results were obtained:
22/09/2020
- Fasting plasma glucose: 195
- HbA1c: 5.6
- Estimated average of glucose: 114
- Total haemoglobin: 13.5.
11/03/2021
- HbA1c: 5.6
- Total haemoglobin: 13.6
20/07/2021
- HbA1c: 5.1
05/04/2022
- HbA1c: 5.3
08/11/2022
- HbA1c: 4.7
- Total haemoglobin: 12
The results showed much lower HbA1c values than expected. Anemia could justify its reduction occasionally, but it
was observed constantly.
Sample from 08/11/2022 was decided to process using boronate affinity. It was obtained a very similar result (4.9%),
ruling out methodological interference.
In addition, the haemoglobinopathies study obtained normal results, thence no abnormal structural variants were
observed that HbA1c determination could be modified.
Also other factors were considered, including chronic liver disease, antiretroviral therapy, iron deficiency or B12
deficiency.
The complete study showed this patient could present a low glycator metabolism of haemoglobin.
CONCLUSIONS
The HbA1c determination is useful for the diagnosis and monitoring of patients with diabetes mellitus. However, it
could not be used in all of them, particularly those considered as low glycators.

P0879
NON-ALCOHOLIC FATTY LIVER DISEASE AND CARDIOVASCULAR RISK IN TYPE 2 DIABETES MELLITUS: ANALYSIS OF
CASE SERIES FROM AN ACADEMIC CENTER.
K. Boudaoud 1, N. Nouri 2
1
Faculty of Medicine, Genetics and Molecular Biology Laboratory University Constantine 3, Department of Endocrinology-
Diabetology, of academic center of Constatine
2
Faculty of Medicine, University Constantine 3, Department of Endocrinology-Diabetology, of academic center of Constatine
BACKGROUND-AIM
Non-alcoholic fatty liver disease (NAFLD) is a spectrum of pathologies ranging from fatty liver to NASH to cirrhosis.
Long-term follow-up studies demonstrate cardiovascular mortality to be the most important cause of death in NAFLD
patients; the mechanisms by which NAFLD causally contributes to cardiovascular risk (CVR) are not fully elucidated.
AIM To evaluate cardiovascular risk in type 2 diabetic (MDT2) patients with NAFLD.
METHODS
Retrospective study including 20 diabetics subjects with NAFLD hospitalized in Endocrinology-Diabetology-
Department-CHU-Constantine from January 2021 to December 2022. The diagnosis of NAFLD is retained on the data of
the hepatic ultrasonography with absence of serology viral positive and alcoholism. We followed the European society
of cardiology (ESC) 2021 guidelines to stratify the CVR. We studied for each patient the presence of target organ damage
(proteinuria or eGFR <30 mL/min/1.73 m2) and the presence of a major risk factors (Age >50 years, Hypertension,
Dyslipidemia, Smoking, Obesity).
RESULTS
Of all patients 67% are women (sex ratio F/H=1.5), the median age is 52.4±8.2 years, mean duration of diabetes
is 13.55±7.26 years, mean BMI is 29.87±4.28 Kg/m2. Dyslipidemia is noted in 70% of cases with 50% of
hypertriglycidemia, 50% of LDL level >1g/l and 100% of HDL level < 0.4g/l. CVD risk is very high in 80% of cases, high
in 20% and absence of moderate risk.
CONCLUSIONS
NAFLD is often associated with insulin resistance and strongly associated with DMT2. In addition to being at risk of
advanced fibrosis and cirrhosis, NAFLD patients are also at higher risk of cardiovascular disease which is consistent with
our results. Close follow-up diabetics with NAFLD may be indicated to prevent major vascular events. Risk stratification
scores are needed that address both the risk for advanced liver disease and CV disease.

P0880
IS DETECTION OF ISLET CELL ANTIBODIES (ICA) BY A NOVEL TOOLS: RSR 3 SCREEN ICATM MORE SENSITIVE IN
COMPARISON WITH MEDIZYM® ICASCREEN IN TYPE 1 DIABETES (T1D) DIAGNOSTICS?
A. Ochocińska 2, I. Podstawka 2, L. Ponikowska 2, J. Świderska 1, Z. Woźniak 3, W. Laprus 4

1
2
Warsaw, Poland
3
Faculty of Chemistry, University of Warsaw, Poland
4
Intercollegiate Faculty of Biotechnology of the University of Gdańsk and the Medical University of Gdańsk, Poland
BACKGROUND-AIM
Islet-cell antibodies (ICA) to glutamic acid decarboxylase 65 (GADA), islet antigen-2 (IA-2A), zinc transporter 8 (ZnT8A)
and insulin autoantibodies (IAA) are specific serological markers of type 1 diabetes (T1D) and serve as important tools
for clinicians to determine the clinical classification, prediction of the need of insulin treatment, to identify subjects
at risk for developing T1D and as end-points in observational studies. There are two types of tests available on the
market for laboratory assessment of ICA: 2 Screen - for combined measurements of GADA and IA-2A and 3 Screen
- for combined measurement of GADA, IA-2A and ZnT8A. The study aim was to evaluate the RSR 3 Screen ICA™ and
Medizym® ICAscreen for detection of islet cell autoimmunity in patients with suspected T1D.
METHODS
A total of 87 subjects (age 1–18 years) were recruited from Clinic of Endocrinology and Diabetology. Serum samples
were tested by 3-Screen (RSR Ltd (Cardiff, UK), 2-Screen (MEDIPAN, Germany) and positive by tests for individual
autoantibodies (GADA, IA2-A, ZnT8A, IAA - MEDIPAN, Germany).
RESULTS
Of the 87 samples, n=25 (28.7%) gave 3 positive screening results, n=17 (19.5%) 2 positive screening results. Testing
of individual autoantibodies identified 15 children (17.2%) with multiple autoantibodies who were diagnosed with
clinical diabetes. All 25 3-Screen positive samples were from subjects with symptoms of diabetes (i.e., hyperglycemia,
decreased C-peptide, clinical signs). 3 Screen achieved 96% assay sensitivity and 97.5% specificity, while 2 Screen
achieved 90% assay sensitivity and 94.5% specificity.
CONCLUSIONS
In conclusion, this study showed excellent performance for 3 Screen with high assay sensitivity and specificity better
than the 2-Screen test used so far. Comparison of the results of the screening tests with the assessment of individual
antibodies highlighted that there must probably be other unidentified antibodies specific to T1D.

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Poster Abstracts – WorldLab • EuroMedLab Roma 2023 – Rome, Italy, May 21-25, 2023 • DOI 10.

Diabetes, obesity, metabolic syndrome

Diabetes, obesity, metabolic syndrome

P. Singh 2, A. Rawat 2, M. Alwakeel 1, E. Sharif 1, S. Al Khodor 2

Diabetes, obesity, metabolic syndrome

E. Sharif 1, M. Alwakeel 1, A. Mohamed 1, A. Kerkadi 1, N. Rizk 1

Diabetes, obesity, metabolic syndrome

A. Mathew 1, P. Chauhan 1, E. Debnath 2, S. Sharma 1

Diabetes, obesity, metabolic syndrome

S. Pokhrel 2, B.R. Bhattarai 3, S. Aryal 3, K. Acharya 3, R. Pokhrel 1

Diabetes, obesity, metabolic syndrome

H. M Demerdash 1, M. Hany 3, A. Agayby 3, M. Ibrahim 3, B. Torensma 2

Diabetes, obesity, metabolic syndrome

A. Anbhule 1, A. Ramteke 1, M. Arora 1, S. Yadav 1, Y. Porwal 1, A. Yadav 1, C. Kaur 1

Diabetes, obesity, metabolic syndrome

M. Sultan 2, H. Abu-Toamih Atamni 2, T. Tohami 4, O. Twito 3, E. Neumark 1, G. Rashid 2

Diabetes, obesity, metabolic syndrome

A. Amol 1, R. Alka 1, A. Megha 1, Y. Surabhi 1, Y. Porwal 1, Y. Amita 1, K. Charanjeet 1

Diabetes, obesity, metabolic syndrome

O. Ciepiela 1, M. Małecka-Giełdowska 1, M. Paskudzka 1

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S. Darmayanti 3, R. Lesmana 2, A. Meiliana 3, R. Abdulah 1

Diabetes, obesity, metabolic syndrome

K. Mehta 3, R. Maskey 3, P. Devkumar 2, S.P. Ramachandrarao 1

Diabetes, obesity, metabolic syndrome

J.C. Nnamdi 1, U.K. Amah 1, J.A. Onuegbu 1, H.C. Okpara 1

Diabetes, obesity, metabolic syndrome

C. Kao 1, J. Lin 1, Y. Hsu 1

Diabetes, obesity, metabolic syndrome

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Diabetes, obesity, metabolic syndrome

A. Stefanska 1, P. Cembrowska 1, M. Krintus 1, G. Sypniewska 1

Diabetes, obesity, metabolic syndrome

R.K. Chaudhari 1, B. Gelal 1, N. Baral 1, B. Pradhan 2, M. Lamsal 1

Diabetes, obesity, metabolic syndrome

I. Cebreiros-López 1, R. Sansano-Galiano 1, D. Calvo-Sánz 1, M.D. Frutos-Bernal 4, F. Guzmán-Aroca 3, A.J. Ruiz-Alcaraz

Diabetes, obesity, metabolic syndrome

P. Pontrelli 2, F. Conserva 2, M. Fiume 2, C. Cinefra 2, A. Schirinzi 1, F. Di Serio 1, F. Pesce 2, L. Gesualdo 2

Diabetes, obesity, metabolic syndrome

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Diabetes, obesity, metabolic syndrome

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A. Valle Rodríguez 1, A. Navarro Murillo 1, J. Rodríguez Garcia 1, S. Rodriguez-Segade Villamarin 1

Diabetes, obesity, metabolic syndrome

G.G. Aliyu 3, A.B. Okesina 1, I.M. Abudulazeez 1, S.A. Biliaminu 1, A. Muhammed 2

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N. Kacimi 1, G. Kacimi 1, S. Hatri 1

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G. Kacimi 1, N. Kacimi 1, S. Hatri 1

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Diabetes, obesity, metabolic syndrome

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D. Janicevic Ivanovska 1, N. Manuseva 3, A. Spasovska Trajanovska 3, S. Domazetovska 2, B. Stefanovski 3

Diabetes, obesity, metabolic syndrome

K. Siﬁ 2, S. Hanachi 2, K. Boudaoud 1, S. Zekri 2, S. Houche 2, h. Houamel 2, S. Hassini 2, K. Benembarek 2, n. Abadi 2

Diabetes, obesity, metabolic syndrome

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