1728-P: Identifying Presurgery Urine Biomarkers for Type 2 Diabetes Mellitus Improvement with Bariatric Surgery

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Introduction and Objective: Bariatric surgery can result in significant weight loss and type 2 diabetes (T2DM) remission, however such remission varies by 40-80%. Current pre-surgery methods to predict successful outcomes are limited. We aimed to investigate pre-surgery urine biomarkers as a non-invasive method to predict T2DM improvement, allowing stratification of patients to improve bariatric outcomes. Methods: Fasted urine and blood samples were collected from female Caucasian participants (age=52.7 (SEM)±1.39yr; body mass index=41.6 (SEM)±1.09Kg/m2; n=40) undergoing bariatric surgery at baseline (0m) and 6-months post-surgery (6m). Mass spectrometry (MS) of pre-surgery urine was used to determine proteins associated with improved T2DM status (HbA1c: <42mmol/mol no T2DM; 42-47mmol/mol pre-T2DM; >47mmol/mol T2DM). Neural networking models mapped protein interactions to identify pre-surgery proteins with most influence on T2DM improvement. Results: MS identified 57 differential proteins in pre-surgery urine associated with improved T2DM status (p value range 2.26x10-5 to 0.05), out of 2557 detected proteins. Post-surgery HbA1c (0m=55.32mmol/mol vs 6m=45.26mmol/mol, p<0.0001), BMI (p<0.0001), triglycerides (p<0.01) and cholesterol (p<0.001) were significantly improved. Neural network bioinformatics analysis identified immunoglobulin-like cell surface receptor for CD47 as most influential for improved T2DM status, with the chance of this being false < 3.25x10-38. Conclusion: These analyses indicate that pre-surgery urine samples exhibit a different protein profile based on post-bariatric T2DM outcomes, and include potential biomarkers to predict T2DM remission. This offers an innovative opportunity for surgeon and patient to personalize pre-surgery approaches to enhance bariatric outcomes. Disclosure A. Murphy: None. G.R. Ball: None. I. Kyrou: None. J. Vrbikova: None. M. Fried: None. V. Hainer: None. G. Tripathi: None. P.G. McTernan: None. Funding European Foundation for the Study of Diabetes (1113 09); Society for Endocrinology

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