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We evaluated the associations between metabolic parameters with visceral adipose tissue (VAT) volume in women with prediabetes or type 2 diabetes (T2DM), and we compared the VAT volume with the VAT area. We enrolled women aged > 20 years with prediabetes or T2DM, who underwent oral glucose tolerance test and whose VAT was evaluated using computed tomography (CT) at our institution between 2017 and 2019. All participants underwent unenhanced spiral CT with a 3-mm slice thickness from the level of the diaphragm to the level of the mid-thigh. The two VAT areas were defined as the free drawn area on the levels of the umbilicus and L2 vertebra. The VAT areas were also manually drawn from the level of the diaphragm to the level of the pelvic floor and were used to calculate the VAT volumes by summing all areas with a slice thickness of 3 mm after setting the attenuation values from −45 to −195 Hounsfield Unit. All metabolic characteristics, except blood pressure, were significantly correlated with the VAT volume. The VAT areas measured at the level of the L2 vertebra and umbilicus were correlated with serum triglyceride, high-density lipoprotein cholesterol, and Framingham steatosis index alone. Multivariable regression analyses revealed that the VAT volume was significantly associated with several metabolic parameters. In conclusion, in women with prediabetes and T2DM, the VAT volume acquired from CT-based calculation has more significant correlations with metabolic risk factors compared with the VAT area.

Mature cystic teratomas (MCTs) of the ovary can occur at any age; however, the most common period is childbearing age, accounting for 10-20% of ovarian tumors and 85-97% of germ cell tumors. Differentiated thyroid cancers from MCTs in pregnant women are rare. A 32-year-old pregnant women presented with left ovarian mass revealed following a transabdominal ultrasonography performed to confirm pregnancy. After delivery, left ovarian cystectomy was performed and mass was examined by pathologists. The result of pathological examination was a combined papillary thyroid carcinoma (PTC) and stromal carcinoid from a mature teratoma. Thyroid ultrasonography was performed to check for accompanying thyroid cancer. Two nodules with no suspected malignancy were observed in both lobes and no other adjuvant therapy was administered. We would like to report this extremely rare case along with a literature review.

One-hour glucose to predict prediabetes (PreDM=155mg/dL) and type 2 diabetes (T2D= 209 mg/dl) could improve detection with a shorter 1-hour OGTT, but thresholds need validation in longitudinal cohorts. We determined the risk of incident diabetes using the proposed thresholds with a 16-year longitudinal Korean data set (N=6381, BMI=24±4.0 kg/m2; Age 51.2±8.6 y). OGTT was conducted every 2 y, and 3 groups were assigned at baseline: low one-hour plasma glucose (1h-PG) with normal glucose tolerance (NGT) (low 1h-PG: FPG<100, 2h-PG<140, 1h-PG<155), high 1h-PG with NGT (high 1h-PG: FPG<100, 2h-PG<140, 1h-PG≥155), and PreDM (100≤FPG<126 or 140≤2h-PG<200). Time to T2D was compared by the group in a subset (N=230). T2D risk was higher in high 1h-PG and PreDM than low 1h-PG group (HR:4.9 [3.5, 6.8] and 8.8 [6.5, 11.8]). With the subset of progressors, a linear mixed effect model showed that times to T2D from low and high 1h-PG were 24.8±18.5 y and 19.5±12.4 y (P<0.05). The 1h-PG threshold for T2D, 209 mg/dl, was reached 7.5±14.5 y earlier than the 2h-PG threshold, 200 mg/dl. Conclusion: NGT with high 1h-PG is an intermediate state between low 1h-PG NGT and PreDM, and the 1h-PG threshold for T2D allows earlier diagnosis than the current 2h-PG threshold. Disclosure M.Im: None. I.Kim: None. S.T.Chung: None. A.Sherman: None. J.Ha: None. S.Kim: None. S.Ryang: None. D.Kim: None. W.Yi: None. J.Kim: None. H.Kang: None. Y.Kim: None. Y.Kim: None. M.Kim: None. Funding Busan Economic Promotion Agency; National Research Foundation of Korea (2022H1D3A2A01063552); Korea Health Industry Development Institute (HI18C2383); dkNET New Investigator Pilot Program in Bioinformatics; National Institute of Diabetes and Digestive and Kidney Diseases

Insulin resistance (IR) is a modest but important pathophysiological factor in the development of type 2 diabetes (T2D) in East Asians and manageable through lifestyle intervention. The degree to which worsening insulin resistance independent of beta cell dysfunction, contributes to diabetes progression in lean Koreans is unknown. With a 10-year longitudinal study from a Korean cohort, we investigated whether worsening insulin resistance contributes to disease progression in individuals who had normal glucose tolerance at baseline (N=3700, Age=50.1±8.3 y, BMI= 24.1±2.9 kg/m2). We identified metabolic characteristics of progressors and non-progressors to prediabetes (PreDM) or T2D at baseline and 10 year-longitudinal changes in IR and BMI. To assess whether longitudinal changes of IR, independent of beta-cell function (BCF), contributed to progression, the cohort was divided into low and high BCF groups, using group median at baseline. Progressors to PreDM or T2D had weaker BCF and more insulin resistance, compared to non-progressors (Panel A) at baseline. Insulin sensitivity declined more, 30.7 vs 46.5 vs 16.7% and BMI increased in progressors to PreDM or T2D, but not in nonprogressor (Panels A and B). Conclusion: Worsening insulin resistance even for lean people is a key pathological factor to PreDM and T2D progression. Disclosure D.Kim: None. H.Kang: None. A.Sherman: None. S.T.Chung: None. S.Kim: None. J.Ha: None. J.Kim: None. M.Im: None. S.Ryang: None. W.Yi: None. M.Kim: None. Y.Kim: None. I.Kim: None. Y.Kim: None. Funding Busan Economic Promotion Agency; National Research Foundation of Korea (2022H1D3A2A01063552); Korea Health Industry Development Institute (HI18C2383); dkNET New Investigator Pilot Program in Bioinformatics; National Institute of Diabetes and Digestive and Kidney Diseases