1300-P: Visceral Adipose Tissue Volume Is Increased in Severe Insulin Resistant Diabetes

Introduction 1 y) of the prospective German Diabetes Study (GDS) underwent 1H magnetic resonance spectroscopy for quantifying intramyocellular lipids (IMCL) in tibialis anterior muscle, intrahepatic lipids (IHL), visceral (VAT) and subcutaneous adipose tissue (SAT) volumes. The validated clustering algorithm used age, sex, BMI, HOMA-IR, HOMA-B, islet-directed autoantibodies. Results: As expected, SIRD (n=40) had the highest IHL (11±5%) compared to mean IHL values of 2-6% in moderate obesity-related (MOD, n=215), moderate age-related (MARD, n=237) and severe autoimmune diabetes clusters (SAID, n=193; all p0.01). Interestingly, SIRD presented with higher VAT than MOD, MARD and SAID (6089±2705 vs 3260±2310, 3056±1963, 1524±1401 cm3) even after adjustment for BMI (all p0.05). Also, SAT was higher in SIRD than MARD (27879±6777 vs 17127±6218 cm3, p0.05), while differences to other subtypes lost statistical significance upon correction for BMI. There were no differences in IMCL between subtypes. Overall, VAT correlated with cardiovascular risk (Framingham, r=0.661, p0.05), whole-body insulin sensitivity derived from hyperinsulinemic euglycemic clamp (r=-0.537, p0.05) and with beta cell function during intravenous glucose tolerance test (r=0.379, p0.05). Within SIRD, VAT was further associated with fasting glycemia (r=0.121, p=0.05) and fasting insulin resistance (HOMA-IR; r=0.372, p0.05). Conclusion: The increases in IHL and VAT underline their key role in the pathophysiology and progression of severely insulin resistant diabetes and shall help to refine subtyping approaches for precision diabetology. Disclosure O.P. Zaharia: None. Y. Kupriyanova: None. P. Bobrov: None. M. Schön: None. C. Möser: None. N. Trinks: None. D.M. Mendez Cardenas: None. S. Trenkamp: None. K. Bódis: None. V. Schrauwen-Hinderling: None. R. Wagner: Speaker's Bureau; Sanofi. Advisory Panel; Lilly Diabetes. Speaker's Bureau; Boehringer-Ingelheim, Novo Nordisk. M. Roden: Advisory Panel; Eli Lilly and Company. Research Support; Boehringer-Ingelheim. Advisory Panel; Novo Nordisk. Research Support; Novo Nordisk. Advisory Panel; TARGET PharmaSolutions, Inc. Speaker's Bureau; AstraZeneca. Funding EFSD Rising Star Award