Abstract | BACKGROUND:
1,5-Anhydroglucitol (1,5-AG) is inversely related to hyperglycemia and may be a useful indicator of short-term (1-2 weeks) hyperglycemia and glycemic excursions, but its prognostic value is unclear. We sought to evaluate the associations of 1,5-AG with risk of diabetes and microvascular disease. METHODS: We measured 1,5-AG in blood samples from over 10 000 participants in the ARIC ( Atherosclerosis Risk in Communities) Study (baseline, 1990-1992) and characterized the independent associations with prevalent retinopathy and with incident chronic kidney disease and incident diabetes during approximately 20 years of follow-up. RESULTS: We found that 1,5-AG was associated with prevalent retinopathy, driven primarily by the strong association in persons with diagnosed diabetes: adjusted odds ratio (OR) 11.26 (95% CI, 6.17-20.53) for <6 μg/mL compared to 1,5-AG ≥10 μg/mL. This result remained significant after further adjustment for hemoglobin A(1c) (Hb A(1c)) (OR, 4.85; 95% CI, 2.42-9.74). In persons with diagnosed diabetes, low 1,5-AG (<6 μg/mL vs ≥10 μg/mL) was also associated with a >2-fold increased risk of incident chronic kidney disease [adjusted hazard ratio (HR), 2.83; 95% CI, 2.15-3.74] and remained significant after adjustment for Hb A(1c) (HR, 1.43; 95% CI, 1.02-2.00). Nondiabetic participants with high 1,5-AG (≥10 μg/mL) had the lowest prevalence of retinopathy and lowest risk of kidney disease. In persons without diagnosed diabetes at baseline, 1,5-AG <10 μg/mL was also associated with incident diabetes (adjusted HR, 2.29; 95% CI, 2.03-2.58). CONCLUSIONS: 1,5-AG was associated with long-term risk of important microvascular outcomes, particularly in persons with diagnosed diabetes and even after adjustment for Hb A(1c). Our results suggest 1,5-AG may capture risk information associated with hyperglycemic excursions.
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Authors | Elizabeth Selvin, Andreea M Rawlings, Morgan Grams, Ronald Klein, Michael Steffes, Josef Coresh |
Journal | Clinical chemistry
(Clin Chem)
Vol. 60
Issue 11
Pg. 1409-18
(Nov 2014)
ISSN: 1530-8561 [Electronic] England |
PMID | 25200356
(Publication Type: Journal Article, Research Support, N.I.H., Extramural)
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Copyright | © 2014 American Association for Clinical Chemistry. |
Chemical References |
- Glycated Hemoglobin A
- 1,5-anhydroglucitol
- Deoxyglucose
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Topics |
- Cohort Studies
- Deoxyglucose
(blood)
- Diabetes Mellitus
(blood)
- Diabetic Retinopathy
(blood)
- Female
- Glycated Hemoglobin
(metabolism)
- Humans
- Hyperglycemia
(blood)
- Male
- Middle Aged
- Proportional Hazards Models
- Prospective Studies
- ROC Curve
- Renal Insufficiency, Chronic
(blood)
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