Serum 1,5-Anhydroglucitol Concentrations Remain Valid as a Glycemic Control Marker In Diabetes with Earlier Chronic Kidney Disease Stages

Abstract

Purpose To investigate the reliability of 1,5-anhydroglucitol (1,5-AG) in diabetes with mild or moderate renal dysfunction.

Methods 668 patients diagnosed with diabetes as DM group and 336 healthy controls as non-DM group were enrolled in this study. DM group was divided into four groups according to estimated glomerular filtration rate (eGFR). Serum concentrations of 1,5-AG, fructosamine (FMN) and glycated hemoglobin (HbA1c) were assayed via the enzymatic method, the nitro reduction four nitrogen thiazole blue test,high performance liquid chromatography respectively.

Results In diabetic Patients with eGFR≥30 mL/min, significant negative association still existed between logarithmic transformed 1,5-AG values (ln1,5-AG) and HbA1c (all P<0.001) as well as fasting plasma glucose (FPG) (all P<0.05). Besides, eGFR was not one of the determinants of 1,5-AG levels in both DM group (standard β=−0.049, P=0.383 ) and healthy controls (r=-0.095, P=0.084 ). Stepwise multiple linear regression showed that serum uric acid (UA) is one of the influencing factors of 1,5-AG (standard β=0.119, P=0.015) and among the three glycemic markers, only HbA1c was found to be correlated with the homeostasis model assessment for b-cell function (HOMA-β) (standard β=0.097, P=0.012).

Conclusions 1,5-AG values remain reliable as a glycemic control marker In diabetes with mild or moderate dysfunction. Serum UA was significantly and positively correlated with 1,5-AG levels. HbA1c may be a good biomarker for insulin resistance compared with 1,5-AG and FMN.

Key words

1,5-Anhydroglucitol - Diabetes - Fructosamine - Glycated hemoglobin - Renal dysfunction

• References

• 1 Kim WJ, Park CY, Lee KB. et al. Serum 1,5-anhydroglucitol concentrations are a reliable index of glycemic control in type 2 diabetes with mild or moderate renal dysfunction. Diabetes Care. 2012; 35: 281
• 2 Hasslacher C, Kulozik F. Influence of renal function on serum concentration of 1,5-anhydroglucitol in type 2 diabetic patients in CKD stages I-III: A comparative study with HbA1c and glycated albumin. Journal of Diabetes 2015; 8: 712-719
• 3 Ruggenenti P, Porrini EL, Gaspari F. et al. Glomerular hyperfiltration and renal disease progression in type 2 diabetes. Diabetes Care. 2012; 35: 2061-2068
• 4 Jerums G, Premaratne E, Panagiotopoulos S. et al. The clinical significance of hyperfiltration in diabetes. Diabetologia 2010; 53: 2093-2104
• 5 Yamanouchi T, Tachibana Y, Akanuma H. et al. Origin and disposal of 1,5-anhydroglucitol, a major polyol in the human body. American Journal of Physiology 1992; 263: 268-273
• 6 Yamanouchi T, Akanuma Y. Serum 1,5-anhydroglucitol (1,5 AG): new clinical marker for glycemic control. Diabetes Research & Clinical Practice 1994; 24 Suppl S261
• 7 Yamanouchi T, Shinohara T, Ogata N. et al. Common reabsorption system of 1,5-anhydro-D-glucitol, fructose, and mannose in rat renal tubule. Biochimica Et Biophysica Acta 1996; 1291: 89-95
• 8 Tazawa S, Yamato T, Fujikura H. et al. SLC5A9/SGLT4, a new Na+-dependent glucose transporter, is an essential transporter for mannose, 1,5-anhydro-D-glucitol, and fructose. Life Sciences. 2005; 76: 1039-1050
• 9 Akanuma Y, Morita M, Fukuzawa N. et al. Urinary excretion of 1,5-anhydro-D-glucitol accompanying glucose excretion in diabetic patients. Diabetologia 1988; 31: 831
• 10 Dungan KM, Buse JB, Largay J. et al. 1,5-anhydroglucitol and postprandial hyperglycemia as measured by continuous glucose monitoring system in moderately controlled patients with diabetes. Diabetes Care. 2006; 29: 1214
• 11 Mannucci E, Monami M, Lamanna C. et al. Post-prandial glucose and diabetic complications: systematic review of observational studies. Acta Diabetologica. 2012; 49: 307-314
• 12 Niwa T, Dewald L, Sone J. et al. Quantification of serum 1,5-anhydroglucitol in uremic and diabetic patients by liquid chromatography/mass spectrometry. Clinical Chemistry. 1994; 40: 260-264
• 13 Shimizu H, Shouzu A, Nishikawa M. et al. Serum concentration and renal handling of 1,5-anhydro-D-glucitol in patients with chronic renal failure. Annals of Clinical Biochemistry 1999; 36 (Pt 6) 749
• 14 Emoto M, Tabata T, Inoue T. et al. Plasma 1,5-anhydroglucitol concentration in patients with end-stage renal disease with and without diabetes mellitus. Nephron 1992; 61: 181-186
• 15 Yamanouchi T, Akanuma H, Nakamura T. et al. Reduction of plasma 1,5-anhydroglucitol (1-deoxyglucose) concentration in diabetic patients. Diabetologia 1988; 31: 41-45
• 16 Ichikawa H, Nagake Y, Takahashi M. et al. What is the best index of glycemic control in patients with diabetes mellitus on hemodialysis?. Nihon Jinzo Gakkai Shi 1996; 38: 305-308
• 17 Ouchi M, Oba K, Aoyama J. et al. Serum uric acid in relation to serum 1,5-anhydroglucitol levels in patients with and without type 2 diabetes mellitus. Clinical Biochemistry. 2013; 46: 1436-1441
• 18 Koga M, Murai J, Saito H. et al. Close relationship between serum concentrations of 1,5-anhydroglucitol and uric acid in non-diabetic male subjects implies common renal transport system. Clinica chimica acta; international journal of clinical chemistry 2009; 410: 70
• 19 Gotoh M, Li C, Yatoh M. et al. Serum uric acid concentrations in type 2 diabetes: its significant relationship to serum 1,5-anhydroglucitol concentrations. Endocrine Regulations. 2005; 39: 119