1
could reduce oxidative burst capacity of macrophages during hyperglycemia and inammation or infection. This mechanism could contribute to augmented infection rates among diabetic patients in Canada. 233 Protection Against Diet-Induced Obesity Afforded by Reduced Circulating Insulin Levels is Linked to Increased Energy Expenditure and Browning of White Adipose NICOLE M. TEMPLEMAN * , ARYA E. MEHRAN, XIAOKE HU, SUSANNE M. CLEE, JAMES D. JOHNSON Vancouver, BC Despite a widely held paradigm that obesity, with its elevated lipids and low-grade inammation, leads to peripheral insulin resistance which subsequently causes compensatory hypersecre- tion of insulin, there is also clinical evidence that fasting hyper- insulinemia itself can precede and induce obesity. Mice have two insulin genes with distinct tissue distribution patterns: Insulin 1 (Ins1) and insulin 2 (Ins2). We have shown that when the Ins2 gene is removed (eliminating extra-pancreatic insulin), mice heterozygous for Ins1 (Ins1+/-:Ins2-/-) have reduced fasting circulating insulin and glucose-induced insulin secretion, compared to Ins1+/+:Ins2-/- mice. Remarkably, the genetic prevention of hyperinsulinemia also leads to protection from diet-induced obesity in Ins1+/-:Ins2-/- mice. Our results indicate that this is partially due to increased whole-body energy expen- diture, and using Taqman RT-qPCR and immunoblotting we demonstrate that reductions in circulating insulin levels correlate to elevated uncoupling protein expression in white adipose tissue (but no detected changes in brown adipose tissue or skeletal muscle) on a high fat diet. We propose that the protection from diet-induced obesity afforded to mice with reduced circulating insulin (Ins1+/-:Ins2-/-) is partially due to the promotion of browningand increased energy uncoupling in white adipose tissue. Conversely, our data indicate that increased circulating insulin promotes white adipocyte formation and hypertrophy when mice are on a high fat diet. Together, these experiments suggest that increased circulating insulin is required for diet- induced obesity in mammals. 234 Withdrawn 235 One Year Evaluation of Metabolic Syndrome in the Helping Evaluate Reduction in Obesity (HERO) Study JOHN B. DIXON, TED E. OKERSON * , CAROLINE T. BURK, RUI SHI, DAISY S. NG-MAK, DENISE GLOBE, NANCY A. DREYER Melbourne, Australia; Irvine, CA; Laguna Beach, CA; Cambrige, MA Introduction: Metabolic syndrome (MeS) is associated with a signicantly increased risk of cardiovascular disease and type 2 diabetes1. Few studies have assessed the effect of weight loss following LAP-BAND AP Ò adjustable gastric banding (LAGB) on prevalence of MeS. No study has compared gender and regional differences in MeS after banding. Methods: Subjects enrolled in the HERO 5-year prospective study, who had baseline (BL) and 1yr waist circumference, were included in this analysis (834/1,123). BL and 1yr rates of MeS were assessed and compared by gender and regions using the NCEP ATP III MeS denition using Chi-square. Results: 599/834 patients (71.8%) had MeS at BL with more patients from United States (US) and Canada (CA)/ Australia (AU) than Europe (EU): 74.6% and 73.6% vs. 61.8% respectively (p<0.05). At 1 yr, median weight change was -16.5% (p<0.001), there were fewer patients with MeS compared to BL for all regions 356 (42.7%) as well as within each region (43.0% in US, 47.2% in CA/AU and 38.2% in EU) (p<0.0001). More men had MeS at BL (Overall 82.2% vs. 69.2%, US 82.4% vs. 72.8%, CA/AU 92.6% vs. 68.4%, EU 75.0% vs. 57.7%) and at 1yr (Overall 55.6% vs. 39.4%, US 55.9% vs. 40.0%, CA/AU 59.3% vs. 43.9%, EU 52.5% vs. 33.8%) (all but CA/AU p<0.05). Conclusions: LAGB was associated with signicant weight loss and decrease in MeS at 1yr across all regions and for both men and women. Further analyses are needed to identify factors associated with the observed differences. 236 Do Canadian Obese Adolescents who Meet the Screen Time Guidelines Have a Better Metabolic Prole than those who Do Not Meet the Guidelines? ANGELA S. ALBERGA * , DENIS PRUD'HOMME, GLEN P. KENNY, GARY S. GOLDFIELD, STASIA HADJIYANNAKIS, JANINE MALCOLM, RONALD J. SIGAL Ottawa, ON; Calgary, AB Introduction: Sedentary behavior has been associated with an adverse metabolic prole in obese youth. The purpose of this study was to compare body anthropometrics and plasma lipids, glucose and insulin of overweight and obese adolescents who meet the Canadian screen time recommendations (2 hours/day) (n¼37) to those who exceed the guidelines (>2 hours/day) (n¼274). Methods: Overweight and obese adolescents aged 14-17 years (N¼ 312; 89 males, 223 females, BMI 34.5 4.5 kg/m 2 ) who volunteered for the HEARTY trial (Healthy Eating Aerobic and Resistance Training in Youth) were assessed. Time spent in screen time behaviors (hours/day spent watching TV + recreational computer use + seated inactive video games) was assessed by a self-report questionnaire and fasting blood samples were taken at baseline. Results: The group who exceeded the guidelines had a greater body weight (98 17 vs. 91 11 kg), BMI (34.7 4.6 vs. 33.0 3.0 kg/m 2 ), waist circumference (97 11 vs. 92 7 cm) and systolic blood pressure (113 12 vs. 109 10 mmHg) compared to the group who met the guidelines (p<0.05). The group who exceeded the guidelines did not differ in fasting glucose, insulin, LDL, HDL, or triglycerides (p>0.05). Discussion: Obese adolescents who accumulate 2 hrs of screen time have lower weight, BMI and waist circumference than those accumulating >2 hours of screen time daily, although their car- diometabolic prole is similar to those who exceed the guidelines. 237 Adiposity, Self-Concept and Body Size Dissatisfaction Among Cree Schoolchildren NOREEN D. WILLOWS * , KATERINA MAXIMOVA Edmonton, AB Virtually no data exists about the psychosocial aspects of obesity in First Nations children. In this study, 203 school children from Quebec Cree communities had measured weight status determined using World Health Organization references. Multivariate regres- sion models that included child's age and sex were used to assess the association between (a) child's weight status and physical appearance dissatisfaction using pictorial and verbal body rating measures, and (b) BMI z-score and self-concept using Piers-Harris Children's Self-Concept Scale. Most (73%) children were overweight or obese. Based on the pictorial gures children chose to represent their perceived and ideal body sizes, 63% of children desired to be smaller, with overweight and obese children more likely desiring to be smaller than normal weight children (OR¼4.3 and 19.8, respectively). In response to What do you think of your body size?Abstracts / Can J Diabetes 36 (2012) S24eS76 S68

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Abstracts / Can J Diabetes 36 (2012) S24eS76S68

could reduce oxidative burst capacity of macrophages duringhyperglycemia and inflammation or infection. This mechanismcould contribute to augmented infection rates among diabeticpatients in Canada.

233

Protection Against Diet-Induced Obesity Afforded by ReducedCirculating Insulin Levels is Linked to Increased EnergyExpenditure and Browning of White AdiposeNICOLE M. TEMPLEMAN*, ARYA E. MEHRAN, XIAOKE HU,SUSANNE M. CLEE, JAMES D. JOHNSONVancouver, BC

Despite a widely held paradigm that obesity, with its elevatedlipids and low-grade inflammation, leads to peripheral insulinresistance which subsequently causes compensatory hypersecre-tion of insulin, there is also clinical evidence that fasting hyper-insulinemia itself can precede and induce obesity. Mice have twoinsulin genes with distinct tissue distribution patterns: Insulin 1(Ins1) and insulin 2 (Ins2). We have shown that when the Ins2gene is removed (eliminating extra-pancreatic insulin), miceheterozygous for Ins1 (Ins1+/-:Ins2-/-) have reduced fastingcirculating insulin and glucose-induced insulin secretion,compared to Ins1+/+:Ins2-/- mice. Remarkably, the geneticprevention of hyperinsulinemia also leads to protection fromdiet-induced obesity in Ins1+/-:Ins2-/- mice. Our results indicatethat this is partially due to increased whole-body energy expen-diture, and using Taqman RT-qPCR and immunoblotting wedemonstrate that reductions in circulating insulin levels correlateto elevated uncoupling protein expression in white adipose tissue(but no detected changes in brown adipose tissue or skeletalmuscle) on a high fat diet. We propose that the protection fromdiet-induced obesity afforded to mice with reduced circulatinginsulin (Ins1+/-:Ins2-/-) is partially due to the promotion of“browning” and increased energy uncoupling in white adiposetissue. Conversely, our data indicate that increased circulatinginsulin promotes white adipocyte formation and hypertrophywhen mice are on a high fat diet. Together, these experimentssuggest that increased circulating insulin is required for diet-induced obesity in mammals.

234

Withdrawn

235

One Year Evaluation of Metabolic Syndrome in the HelpingEvaluate Reduction in Obesity (HERO) StudyJOHN B. DIXON, TED E. OKERSON*, CAROLINE T. BURK, RUI SHI,DAISY S. NG-MAK, DENISE GLOBE, NANCY A. DREYERMelbourne, Australia; Irvine, CA; Laguna Beach, CA; Cambrige,MA

Introduction: Metabolic syndrome (MeS) is associated witha significantly increased risk of cardiovascular disease and type 2diabetes1. Few studies have assessed the effect of weight lossfollowing LAP-BAND AP� adjustable gastric banding (LAGB) onprevalence of MeS. No study has compared gender and regionaldifferences in MeS after banding.Methods: Subjects enrolled in the HERO 5-year prospective study,who had baseline (BL) and 1yr waist circumference, were includedin this analysis (834/1,123). BL and 1yr rates of MeS were assessedand compared by gender and regions using the NCEP ATP III MeSdefinition using Chi-square.Results: 599/834 patients (71.8%) had MeS at BL with morepatients from United States (US) and Canada (CA)/ Australia (AU)than Europe (EU): 74.6% and 73.6% vs. 61.8% respectively (p<0.05).

At 1 yr, median weight change was -16.5% (p<0.001), there werefewer patients with MeS compared to BL for all regions 356(42.7%) as well as within each region (43.0% in US, 47.2% in CA/AUand 38.2% in EU) (p<0.0001). More men had MeS at BL (Overall82.2% vs. 69.2%, US 82.4% vs. 72.8%, CA/AU 92.6% vs. 68.4%, EU75.0% vs. 57.7%) and at 1yr (Overall 55.6% vs. 39.4%, US 55.9% vs.40.0%, CA/AU 59.3% vs. 43.9%, EU 52.5% vs. 33.8%) (all but CA/AUp<0.05).Conclusions: LAGBwas associatedwith significant weight loss anddecrease in MeS at 1yr across all regions and for both men andwomen. Further analyses are needed to identify factors associatedwith the observed differences.

236

Do Canadian Obese Adolescents who Meet the Screen TimeGuidelines Have a Better Metabolic Profile than those who DoNot Meet the Guidelines?ANGELA S. ALBERGA*, DENIS PRUD'HOMME, GLEN P. KENNY,GARY S. GOLDFIELD, STASIA HADJIYANNAKIS, JANINE MALCOLM,RONALD J. SIGALOttawa, ON; Calgary, AB

Introduction: Sedentary behavior has been associated with anadverse metabolic profile in obese youth. The purpose of this studywas to compare body anthropometrics and plasma lipids, glucoseand insulin of overweight and obese adolescents who meet theCanadian screen time recommendations (�2 hours/day) (n¼37) tothose who exceed the guidelines (>2 hours/day) (n¼274).Methods: Overweight and obese adolescents aged 14-17 years (N¼312; 89males, 223 females, BMI 34.5� 4.5 kg/m2) who volunteeredfor the HEARTY trial (Healthy Eating Aerobic and ResistanceTraining in Youth) were assessed. Time spent in screen timebehaviors (hours/day spent watching TV + recreational computeruse + seated inactive video games) was assessed by a self-reportquestionnaire and fasting blood samples were taken at baseline.Results: The group who exceeded the guidelines had a greaterbody weight (98 � 17 vs. 91 �11 kg), BMI (34.7 � 4.6 vs. 33.0 � 3.0kg/m2), waist circumference (97 � 11 vs. 92 � 7 cm) and systolicblood pressure (113 � 12 vs. 109 � 10 mmHg) compared to thegroup who met the guidelines (p<0.05). The group who exceededthe guidelines did not differ in fasting glucose, insulin, LDL, HDL, ortriglycerides (p>0.05).Discussion: Obese adolescents who accumulate �2 hrs of screentime have lower weight, BMI and waist circumference than thoseaccumulating >2 hours of screen time daily, although their car-diometabolic profile is similar to those who exceed the guidelines.

237

Adiposity, Self-Concept and Body Size Dissatisfaction AmongCree SchoolchildrenNOREEN D. WILLOWS*, KATERINA MAXIMOVAEdmonton, AB

Virtually no data exists about the psychosocial aspects of obesityin First Nations children. In this study, 203 school children fromQuebec Cree communities had measured weight status determinedusing World Health Organization references. Multivariate regres-sion models that included child's age and sex were used to assessthe association between (a) child's weight status and physicalappearance dissatisfaction using pictorial and verbal body ratingmeasures, and (b) BMI z-score and self-concept using Piers-HarrisChildren's Self-Concept Scale. Most (73%) childrenwere overweightor obese. Based on the pictorial figures children chose to representtheir perceived and ideal body sizes, 63% of children desired to besmaller, with overweight and obese childrenmore likely desiring tobe smaller than normal weight children (OR¼4.3 and 19.8,respectively). In response to ‘What do you think of your body size?’