Correlation between baseline serum 1,5-anhydroglucitol levels and 2-hour post-challenge glucose levels during oral glucose tolerance tests

Abstract

The resulTs of recent studies indicate that postprandial hyperglycemia may be an independent risk factor for the development of macrovascular complications [1,2]. Although tight glycemic control is important to prevent complications of diabetes [3][4][5], many patients who are well controlled based on their HbA1c values have post-challenge hyperglycemia in oral glucose tolerance tests (OGTTs) [6]. 1,5-Anhydroglucitol (1,5-AG), a major 6-carbon dietary monosaccharide, is thought to reflect daily glycemic excursions, especially in patients Endocrine Journal 2011, 58 (1), [13][14][15][16][17] Correlation between baseline serum 1,5-anhydroglucitol levels and 2-hour post-challenge glucose levels during oral glucose tolerance tests Abstract. Since there is increasing evidence that postprandial hyperglycemia is a risk factor for the development of macrovascular complications, it is important to predict postprandial hyperglycemia in the early stages of glucose intolerance, and routine medical checkups provide a good opportunity to do so. The aim of this study was to evaluate the usability of 1,5-anhydroglucitol (1,5-AG) in routine medical checkups. The subjects were 77 Japanese men who participated in a routine medical checkup. First, we performed 75 g oral glucose tolerance tests (OGTTs), and examined the changes in glucose and 1,5-AG levels measured at 0, 30, 60, 90, 120, and 180 minutes (min). 1,5-AG levels did not significantly change until 90 min after the glucose load. Second, a linear regression analysis showed an inverse correlation between the 2-hour postchallenge glucose (2h-PG) and baseline 1,5-AG levels during the OGTT (P = 0.001, r 2 = 0.13), and the correlation was still significant after adjustment for age (2h-PG = 170 + 0.83 × (age in years) -3.23 × (1,5-AG), P = 0.002, adjusted r 2 = 0.12).Finally, to investigate the test characteristics of 1,5-AG levels as a predictor of a 2h-PG level ≥200 mg/dL, we plotted a receiver operating characteristic (ROC) curve. The area under the ROC curve was 0.78, and the maximal sum of sensitivity and specificity (78% and 72%, respectively) was obtained at a 1,5-AG cutoff level of <14.2 μg/mL. We conclude that 1,5-AG values may provide an ancillary predictor of 2h-PG of 75 g OGTTs in routine medical checkups.

Association of 1,5-Anhydroglucitol with Diabetes and Microvascular Conditions

“…This suggests that while low concentrations of 1,5-AG are relatively insensitive for the identification of early hyperglycemic states and future diabetes, they may be useful in the setting of overt diabetes. Our findings are consistent with the physiology of 1,5-AG, where plasma concentrations of 1,5-AG are thought to show decreases only at the highest levels of blood glucose and reflect glucose excursions (31-33). …”

Excretion rates of 1,5-anhydro-D-glucitol, uric acid and microalbuminuria as glycemic control indexes in patients with type 2 diabetes

“…However, our derived cut-off value of 11.55 mg/L is similar to that previously reported (10.7 mg/L24; 12 mg/L, 12 14 mg/L2526. The sensitivity of 75.3% and specificity of 71.2% in our measurements with a cut-off value of 11.55 mg/L 1,5-AG concentrations is in a similar range reported (78% and 72%) for predicting blood glucose enhancements of 2-hour post-challenge glucose ≥200 mg/dL in 75 g oral glucose tolerance tests with a 1–5 AG cut-off value of 14.2 μg/mL27. In the present study, we found when comparing the ≤10 mg/L 1,5-AG serum concentration group with the >10 mg/L 1,5-AG serum concentration group, that in the low 1,5 AG diabetics the serum uric acid concentrations were significantly lower, which supports the hypothesis that reabsorption of uric acid in the proximal tubule is inhibited by hyperglycemia1718, because in the low 1,5-AG serum concentration group the HbA1c percentage was significantly higher.…”

Thresholds of various glycemic measures for diagnosing diabetes based on prevalence of retinopathy in community-dwelling Japanese subjects: the Hisayama Study

“…A Japanese population study showed that 14.0 μg/mL was the best value for detecting subjects with diabetes [24]. Similar findings were observed among Japanese male workers (14.2 μg/mL) [26]. In a Chinese study, the mean of 1,5-AG levels was 15.0 μg/mL in subjects with newly diagnosed diabetes and 11.8 μg/mL in subjects with known diabetes [25].…”

“…There have been a few studies investigating GA [21-23] and 1,5-AG levels [24-26] to detect subjects with glucose intolerance defined by glucose levels, but no study has examined the diagnostic thresholds of these glycemic measures for diabetes based on the presence of DR, and it is uncertain whether GA and 1,5-AG measurements are applicable as a diagnostic tool for diabetes [27,28]. In addition, in the general Asian community, there are limited data assessing FPG and 2-hour postload glucose (PG) levels associated with the prevalence of DR [14,17,29].…”