Clinical application of 1,5-anhydroglucitol measurements in patients with hepatocyte nuclear factor-1alpha maturity-onset diabetes of the young.

Abstract

OBJECTIVE:

1,5-anhydroglucitol (1,5-AG) is a short-term marker of metabolic control in diabetes. Its renal loss is stimulated in hyperglycemic conditions by glycosuria, which results in a lowered plasma concentration. As a low renal threshold for glucose has been described in hepatocyte nuclear factor-1alpha (HNF-1alpha) maturity-onset diabetes of the young (MODY), the 1,5-AG level may be altered in these patients. The purpose of this study was to assess the 1,5-AG levels in patients with HNF-1alpha MODY and in type 2 diabetic subjects with a similar degree of metabolic control. In addition, we aimed to evaluate this particle as a biomarker for HNF-1alpha MODY.

RESEARCH DESIGN AND METHODS:

We included 33 diabetic patients from the Polish Nationwide Registry of MODY. In addition, we examined 43 type 2 diabetic patients and 47 nondiabetic control subjects. The 1,5-AG concentration was measured with an enzymatic assay (GlycoMark). Receiver operating characteristic (ROC) curve analysis was used to evaluate 1,5-AG as a screening marker for HNF-1alpha MODY.

RESULTS:

The mean 1,5-AG plasma concentration in diabetic HNF-1alpha mutation carriers was 5.9 microg/ml, and it was lower than that in type 2 diabetic patients (11.0 microg/ml, P = 0.003) and in nondiabetic control subjects (23.9 microg/ml, P < 0.00005). The ROC curve analysis revealed 85.7% sensitivity and 80.0% specificity of 1,5-AG in screening for HNF-1alpha MODY at the criterion of <6.5 microg/ml in patients with an A1C level between 6.5 and 9.0%.

CONCLUSIONS:

1,5-AG may be a useful biomarker for differential diagnosis of patients with HNF-1alpha MODY with a specific range of A1C, although this requires further investigation. However, the clinical use of this particle in diabetic HNF-1alpha mutation carriers for metabolic control has substantial limitations.

• Authors: Jan Skupien, Sylwia Gorczynska-Kosiorz, Tomasz Klupa, Krzysztof Wanic, Eric A Button, Jacek Sieradzki, Maciej T Malecki
• Journal: Diabetes care (Diabetes Care) Vol. 31 Issue 8 Pg. 1496-501 (Aug 2008) ISSN: 1935-5548 [Electronic] United States
• PMID: 18492944 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• HNF1A protein, human
• Hepatocyte Nuclear Factor 1-alpha
• 1,5-anhydroglucitol
• Deoxyglucose

Topics

• Adult
• Deoxyglucose (blood)
• Diabetes Mellitus, Type 2 (blood, genetics)
• Female
• Hepatocyte Nuclear Factor 1-alpha (genetics)
• Humans
• Male
• Middle Aged
• Mutation
• Poland
• Reference Values
• Registries
• Sex Characteristics