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Introduction: A recent in-vitro and in-vivo experimental study has revealed that family with sequence similarity 19 [chemokine (C-C motif)-like] member A5 (FAM19A5), a novel secreted adipokine has inhibitory effects on proliferation and migration of vascular smooth muscle cells, and neointima formation of injured arteries. However, the relationship between serum FAM19A5 level and cardio-metabolic risks has not been evaluated in humans. For the first time, we investigated the association between serum FAM19A5 concentration with various metabolic and vascular risk factors in human subjects with or without type 2 diabetes. Methods: Circulating FAM19A5 concentration was measured in 223 individuals (45 without diabetes and 178 with type 2 diabetes), and the association of FAM19A5 level with cardio-metabolic risk factors including body composition, plasma glucose, glycated hemoglobin (HbA1c), and atherosclerosis was explored. Results: Serum FAM19A5 (pg/ml) was higher in patients with type 2 diabetes [172.70 (116.19, 286.42)] compared with that in individuals without diabetes [92.09 (70.32, 147.24)] (p Discussion: A novel adipokine FAM19A5 was closely related to various metabolic and vascular risk factors in human subjects, suggesting its potential as a biomarker of cardio-metabolic disease in humans. Disclosure Y. Lee: None. J.A. Kim: None. E. Roh: None. S. Hong: None. K. Choi: None. S. Baik: None. H. Yoo: None.

Objective: Previous in vitro and in vivo experimental studies have shown that Sestrin2 attenuates oxidative stress and the pro-inflammatory pathway, resulting in improving metabolic homeostasis. However, the relationship between circulating Sestrin2 concentration and cardiometabolic risks in humans has not been explored. Methods: Sestrin2 concentration was measured in 240 subjects (46 nondiabetics and 194 diabetics) using an enzyme-linked immunosorbent assay, and the associations between Sestrin2 level and various cardiometabolic risk factors including body composition, insulin resistance, and atherosclerosis was assessed. Results: Sestrin2 concentration showed a trend of increasing in subjects with metabolic syndrome. After adjustment for age and gender, Sestrin2 level had a positive relationship with serum triglyceride, alanine aminotransferase (ALT), and creatinine levels, but no association with carotid atherosclerosis. Especially, in subjects with type 2 diabetes Sestrin2 concentration exhibited a significant positive correlation with body mass index (P =0.015), waist circumference (P =0.020), high-sensitivity C-reactive protein (P =0.008), Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) (P =0.041), percentage body fat (P =0.001), and truncal fat mass (P =0.005) after adjusting age and gender. Multiple stepwise regression analysis identified age, serum ALT and creatinine levels, and percentage body fat as independent determining factors for Sestrin2 concentration in patients with type 2 diabetes (R2 = 0.173). Conclusions: This study is the first to demonstrate a trend for increased Sestrin2 level in subjects with metabolic syndrome. In particular, in subjects with type 2 diabetes, Sestrin2 was significantly related to insulin resistance and percentage body fat, suggesting its potential as a novel modulatory factor for metabolic disorders in humans. Disclosure H. Chung: None. E. Roh: None. S. Hong: None. J.A. Kim: None. Y. Lee: None. S. Baik: None. K. Choi: None. H. Yoo: None.

Introduction: We investigated the annual incidence rate and risk factors for progression of diabetic retinopathy in The Korea National Diabetes Program. Method: The Korean national Diabetes Program (KNDP) is a prospective, multicenter, and observational cohort study performed on type 2 diabetic patients in Korea. The study started in May 20and continued to follow-up until March 2014. Of the 3,949 patients enrolled in the KNDP, we analyzed 2962 patients who had both eyes photographed and assessed at baseline and further follow-up. An ophthalmologist evaluated and graded the funduscopic findings. Diabetic reinopathy (DR) was classified as 4 stages which were no DR, NPDR, PDR and blindness. We calculated the annual incidence rate from stage to stage. We analyzed the risk factor for progression of diabetic retinopathy. Results: The mean follow-up time (SD) was 4.1 (1.7) years. The mean age and DM duration were 54.6 (9.8) years and 6.7 (6.5) years, respectively. The mean level of fasting glucose and HbA1c was 144 (50) mg/dl and 7.7 (1.7), respectively. Of those, patients with diabetic retinopathy was 691 (23.4%). The annual progression rate from no retinopathy to NPDR was 3.28% (295/2271). Patients progressed directly from NPDR to PDR at a rate of 3.13% (85/871). Three of 200 patients with PDR progressed to blindness, at an annual rate of 0.57%. Patients who further progressed retinopathy had older age, longer DM duration, higher levels of HbA1c, higher systolic blood pressure, and more history of cerebrovascular disease than those who didn’t progress retinopathy. Conclusion: We reported the results of larger scale on DR progression than previous study of Korea. When compared to previous studies, the disease progression has improved over the 2 decades in Korean patients with type 2 diabetes. Our findings are consistent with other recent small studies from Korea. This study also confirmed risk factors for DR progression. Disclosure H. Moon: None. J. Jeon: None. S. Lee: None. S. Han: None. H. Kim: None. K. Chun: None. T. Kim: None. Y. Kim: None. J. Woo: None. K. Ahn: None. M. Nam: None. S. Baik: None. Y. Park: None. K. Lee: None.

Background: Recent clinical evidences indicate that early rapid renal function decline is closely associated with the development of diabetic kidney disease. We have investigated the incidence and baseline clinical predictors of rapid renal function decline in patients with type 2 diabetes and normal baseline renal function. Methods: A total of 967 type 2 diabetic patients from the Korean National Diabetes Program (KNDP), a prospective, multicenter, observational cohort study, with serial GFR measurement for 5 years and normal renal function were included for the analysis. Rapid renal function decline was defined as an eGFR decline >3.3% per year. Carotid ultrasonography was used to assess carotid intima-media thickness (IMT) and the presence of plaque. Results: The mean age was 53.7 years with body mass index of 25.4 kg/m2. Rapid renal function decline developed in 158 participants (16.3%) and average GFR decline was -5.2 ± 1.9% /year in rapid decliners and -0.4 ± 1.9% /year in non-decliners. There were no differences in the presence of albuminuria or retinopathy between the rapid decliners and non-decliners at baseline. Multivariable logistic regression analyses revealed that female sex (odds ratio (OR) 4.80 [95% CI 2.69-8.56], p Conclusions: Our study suggests the need for close monitoring of renal function and early intensive management in patients with type 2 diabetes and carotid atherosclerosis. Disclosure D. Seo: None. S. Kim: None. S. Ahn: None. S. Hong: None. M. Nam: None. J. Woo: None. S. Baik: None. K. Lee: None. Y. Kim: None. Y. Park: None.

Recent studies have suggested that a novel adipokine, C1q/tumor necrosis factor-related protein-3 (CTRP-3), a paralog of adiponectin, may play an important role in the regulation of glucose metabolism and innate immunity. Pigment epithelium-derived factor (PEDF), a multifunctional protein with antioxidant and anti-inflammatory properties, is associated with insulin resistance and metabolic syndrome. We examined circulating CTRP-3 and PEDF concentrations in 345 subjects with diverse glucose tolerance statuses. Furthermore, we evaluated the involvement of CTRP-3 and PEDF with cardiometabolic risk factors including insulin resistance, high-sensitivity C-reactive protein (hsCRP), estimated glomerular filtration rate (eGFR), and brachial-ankle pulse wave velocity (baPWV). CTRP-3 concentrations were significantly higher in patients with type 2 diabetes or prediabetes than the normal glucose tolerance group, whereas PEDF levels were not different. Subjects with metabolic syndrome showed significantly higher levels of both CTRP-3 and PEDF compared with subjects without metabolic syndrome. Both CTRP-3 and PEDF were significantly associated with cardiometabolic parameters, including waist-to-hip ratio, triglycerides, HDL-cholesterol, alanine aminotransferase, eGFR, hsCRP, and baPWV. In conclusion, circulating CTRP-3 concentrations were elevated in patients with glucose metabolism dysregulation. Both CTRP-3 and PEDF concentrations were increased in subjects with metabolic syndrome and associated with various cardiometabolic risk factors.