Skip to main content

Advertisement

SpringerLink
Log in

Serum 1,5-anhydroglucitol level as a screening tool for diabetes mellitus in a community-based population at high risk of diabetes

  • Original Article
  • Published:
Acta Diabetologica Aims and scope Submit manuscript

Abstract

Aims

Early diagnosis of diabetes yields significant clinical benefits; however, currently available diagnostic tools for community-based population are limited. This study aimed to assess the value of serum 1,5-anhydroglucitol (1,5-AG) for the diagnosis and screening of diabetes mellitus in a community-based population at high risk of diabetes.

Methods

In this diagnostic test, 1170 participants underwent a 75-g oral glucose tolerance test. Venous blood samples were collected for fasting blood glucose (FBG), 2-h postprandial blood glucose (PBG), and glycosylated hemoglobin A1c (HbA1c) measurements. Serum 1,5-AG levels were detected by the GlycoMark assay, and a receiver operating characteristic (ROC) curve was generated to assess their diagnostic value for diabetes.

Results

A total of 298 adults were diagnosed with diabetes, indicating a prevalence of 25.47%. Partial Pearson correlation analysis adjusted for age and body mass index showed that serum 1,5-AG level was negatively correlated with FBG, PBG, and HbA1c (all P < 0.01). Areas under the curves (AUCs) for serum 1,5-AG, FBG, PBG, and HbA1c in identifying diabetes were 0.920, 0.874, 0.933, and 0.887, respectively. According to the ROC curve, the optimal cutoff value of serum 1,5-AG for diagnosing diabetes was 11.18 μg/ml, which yielded a sensitivity of 92.6% and a specificity of 82.3%, respectively. Comparisons between 1,5-AG and HbA1c showed that both the AUC and sensitivity of 1,5-AG were higher than those of HbA1c (both P < 0.01).

Conclusions

Serum 1,5-AG is a simple and effective marker with high sensitivity and specificity for identifying diabetes in populations at high risk of diabetes.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Yang W, Lu J, Weng J et al (2010) Prevalence of diabetes among men and women in China. N Engl J Med 362:1090–1101

    Article  CAS  PubMed  Google Scholar 

  2. Xu Y, Wang L, He J et al (2013) Prevalence and control of diabetes in Chinese adults. JAMA 310:948–959

    Article  CAS  PubMed  Google Scholar 

  3. Saudek CD, Herman WH, Sacks DB, Bergenstal RM, Edelman D, Davidson MB (2008) A new look at screening and diagnosing diabetes mellitus. J Clin Endocrinol Metab 93:2447–2453

    Article  CAS  PubMed  Google Scholar 

  4. Jia WP, Pang C, Chen L et al (2007) Epidemiological characteristics of diabetes mellitus and impaired glucose regulation in a Chinese adult population: the Shanghai diabetes studies, a cross-sectional 3-year follow-up study in Shanghai urban communities. Diabetologia 50:286–292

    Article  CAS  PubMed  Google Scholar 

  5. King H, Aubert RE, Herman WH (1998) Global burden of diabetes, 1995–2025: prevalence, numerical estimates, and projections. Diabetes Care 21:1414–1431

    Article  CAS  PubMed  Google Scholar 

  6. Wong KC, Wang Z (2006) Prevalence of type 2 diabetes mellitus of Chinese populations in Mainland China, Hong Kong, and Taiwan. Diabetes Res Clin Pract 73(2):126–134

    Article  PubMed  Google Scholar 

  7. Nguyen TT, Wang JJ, Wong TY (2007) Retinal vascular changes in pre-diabetes and prehypertension: new findings and their research and clinical implications. Diabetes Care 30:2708–2715

    Article  PubMed  Google Scholar 

  8. Herman WH (2007) Diabetes epidemiology: guiding clinical and public health practice: the Kelly West Award Lecture, 2006. Diabetes Care 30:1912–1919

    Article  PubMed  Google Scholar 

  9. Sumner CJ, Sheth S, Griffin JW, Cornblath DR, Polydefkis M (2003) The spectrum of neuropathy in diabetes and impaired glucose tolerance. Neurology 60:108–111

    Article  CAS  PubMed  Google Scholar 

  10. Barr EL, Zimmet PZ, Welborn TA et al (2007) Risk of cardiovascular and all-cause mortality in individuals with diabetes mellitus, impaired fasting glucose, and impaired glucose tolerance: the Australian Diabetes, Obesity, and Lifestyle Study (AusDiab). Circulation 116:151–157

    Article  CAS  PubMed  Google Scholar 

  11. Gaede P, Lund-Andersen H, Parving HH, Pedersen O (2008) Effect of a multifactorial intervention on mortality in type 2 diabetes. N Engl J Med 358:580–591

    Article  CAS  PubMed  Google Scholar 

  12. Lee H, Oh JY, Sung YA et al (2013) Optimal hemoglobin A1C cutoff value for diagnosing type 2 diabetes mellitus in Korean adults. Diabetes Res Clin Pract 99:231–236

    Article  CAS  PubMed  Google Scholar 

  13. Mooy JM, Grootenhuis PA, de Vries H et al (1996) Intra-individual variation of glucose, specific insulin and proinsulin concentrations measured by two oral glucose tolerance tests in a general Caucasian population: the Hoorn Study. Diabetologia 39:298–305

    Article  CAS  PubMed  Google Scholar 

  14. Adams OP (2013) The impact of brief high-intensity exercise on blood glucose levels. Diabetes Metab Syndr Obes 6:113–122

    Article  PubMed  PubMed Central  Google Scholar 

  15. Asif M (2014) The prevention and control the type-2 diabetes by changing lifestyle and dietary pattern. J Educ Health Promot 3:1

    Article  PubMed  PubMed Central  Google Scholar 

  16. Sung KC, Rhee EJ (2007) Glycated haemoglobin as a predictor for metabolic syndrome in non-diabetic Korean adults. Diabet Med 24:848–854

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Jagannathan R, Sevick MA, Fink D et al (2016) The 1-hour post-load glucose level is more effective than HbA1c for screening dysglycemia. Acta Diabetol 53(4):543–550

    Article  CAS  PubMed  Google Scholar 

  18. Kim WJ, Park CY (2013) 1,5-Anhydroglucitol in diabetes mellitus. Endocrine 43:33–40

    Article  CAS  PubMed  Google Scholar 

  19. Shipman KE, Jawad M, Sullivan KM, Ford C, Gama R (2015) Ethnic/racial determinants of glycemic markers in a UK sample. Acta Diabetol 52(4):687–692

    Article  CAS  PubMed  Google Scholar 

  20. American Diabetes Association (2013) Diagnosis and classification of diabetes mellitus. Diabetes Care 36(Suppl 1):S67–S74

    Article  Google Scholar 

  21. Bao Y, Ma X, Li H et al (2010) Glycated haemoglobin A1c for diagnosing diabetes in Chinese population: cross sectional epidemiological survey. BMJ 340:c2249

    Article  PubMed  PubMed Central  Google Scholar 

  22. Alberti KG, Zimmet PZ (1998) Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus provisional report of a WHO consultation. Diabet Med 15:539–553

    Article  CAS  PubMed  Google Scholar 

  23. Ma X, Hao Y, Hu X et al (2015) 1,5-Anhydroglucitol is associated with early-phase insulin secretion in chinese patients with newly diagnosed type 2 diabetes mellitus. Diabetes Technol Ther 17:320–326

    Article  CAS  PubMed  Google Scholar 

  24. Wright LA, Hirsch IB, Gooley TA, Brown Z (2015) 1,5-Anhydroglucitol and neonatal complications in pregnancy complicated by diabetes. Endocr Pract 21:725–733

    Article  PubMed  Google Scholar 

  25. Lee JE (2015) Alternative biomarkers for assessing glycemic control in diabetes: fructosamine, glycated albumin, and 1,5-anhydroglucitol. Ann Pediatr Endocrinol Metab 20:74–78

    Article  PubMed  PubMed Central  Google Scholar 

  26. Malkan UY, Gunes G, Corakci A (2015) Rational diagnoses of diabetes: the comparison of 1,5-anhydroglucitol with other glycemic markers. Springerplus 4:587

    Article  PubMed  PubMed Central  Google Scholar 

  27. Weng J, Ji L, Jia W et al (2016) Standards of care for type 2 diabetes in China. Diabetes Metab Res Rev 32(5):442–458

    Article  PubMed  PubMed Central  Google Scholar 

  28. Tanaka A, Yamada N, Saito Y, Kawakami M, Ohashi Y, Akanuma Y (2001) A double-blind trial on the effects of atorvastatin on glycemic control in Japanese diabetic patients with hypercholesterolemia. Clin Chim Acta 312:41–47

    Article  CAS  PubMed  Google Scholar 

  29. Altman DG, Bland JM (2009) Parametric v non-parametric methods for data analysis. BMJ 338:a3167

    Article  PubMed  Google Scholar 

  30. Bland JM, Altman DG (2009) Analysis of continuous data from small samples. BMJ 338:a3166

    Article  PubMed  Google Scholar 

  31. DeLong ER, DeLong DM, Clarke-Pearson DL (1988) Comparing the areas under two or more correlated receiver operating characteristic curves: a nonparametric approach. Biometrics 44:837–845

    Article  CAS  PubMed  Google Scholar 

  32. Diagnosis ECot, Classification of Diabetes Mellitus (2003) Report of the expert committee on the diagnosis and classification of diabetes mellitus. Diabetes Care 26(Suppl 1):S5–S20

    Google Scholar 

  33. Goto M, Yamamoto-Honda R, Shimbo T et al (2011) Correlation between baseline serum 1,5-anhydroglucitol levels and 2-hour post-challenge glucose levels during oral glucose tolerance tests. Endocr J 58(1):13–17

    Article  CAS  PubMed  Google Scholar 

  34. Yamanouchi T, Akanuma H, Nakamura T, Akaoka I, Akanuma Y (1988) Reduction of plasma 1,5-anhydroglucitol (1-deoxyglucose) concentration in diabetic patients. Diabetologia 31:41–45

    CAS  PubMed  Google Scholar 

  35. Buse JB, Freeman JL, Edelman SV, Jovanovic L, McGill JB (2003) Serum 1,5-anhydroglucitol (GlycoMark): a short-term glycemic marker. Diabetes Technol Ther 5:355–363

    Article  CAS  PubMed  Google Scholar 

  36. Wang Y, Zhang YL, Wang YP, Lei CH, Sun ZL (2012) A study on the association of serum 1,5-anhydroglucitol levels and the hyperglycaemic excursions as measured by continuous glucose monitoring system among people with type 2 diabetes in China. Diabetes Metab Res Rev 28:357–362

    Article  PubMed  PubMed Central  Google Scholar 

  37. Hasslacher C, Kulozik F (2016) Effect of renal function on serum concentration of 1,5-anhydroglucitol in type 2 diabetic patients in chronic kidney disease stages I-III: a comparative study with HbA1c and glycated albumin. J Diabetes 8(5):712–719

    Article  CAS  PubMed  Google Scholar 

  38. Yamanouchi T, Ogata N, Tagaya T et al (1996) Clinical usefulness of serum 1,5-anhydroglucitol in monitoring glycaemic control. Lancet 347:1514–1518

    Article  CAS  PubMed  Google Scholar 

  39. Kim WJ, Park CY, Lee KB et al (2012) Serum 1,5-anhydroglucitol concentrations are a reliable index of glycemic control in type 2 diabetes with mild or moderate renal dysfunction. Diabetes Care 35(2):281–286

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  40. Ko GT, Chan JC, Yeung VT et al (1998) Combined use of a fasting plasma glucose concentration and HbA1c or fructosamine predicts the likelihood of having diabetes in high-risk subjects. Diabetes Care 21(8):1221–1225

    Article  CAS  PubMed  Google Scholar 

  41. Sumner AE, Duong MT, Bingham BA et al (2016) Glycated albumin identifies prediabetes not detected by hemoglobin A1c: the Africans in America Study. Clin Chem 62(11):1524-1532

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Endocrinology, Zhongda Hospital Southeast University, Nanjing, China

    Yao Wang, Yuexing Yuan & Zilin Sun

  2. Department of Endocrinology, Zhongda Hospital, Institute of Diabetes, Medical School, Southeast University, No. 87 Dingjiaqiao Road, Nanjing, 210009, Jiangsu Province, China

    Yanli Zhang, Chenghao Lei, Yi Zhou, Jiajia He & Zilin Sun

Authors
  1. Yao Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yuexing Yuan
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yanli Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Chenghao Lei
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Yi Zhou
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Jiajia He
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Zilin Sun
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Zilin Sun.

Ethics declarations

Conflict of interest

The authors declared that they have no conflict of interest.

Ethical standard

This study was approved by the Research Ethics Committee of Zhongda Hospital.

Human and animal rights

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Managed by Antonio Secchi.

Electronic supplementary material

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Wang, Y., Yuan, Y., Zhang, Y. et al. Serum 1,5-anhydroglucitol level as a screening tool for diabetes mellitus in a community-based population at high risk of diabetes. Acta Diabetol 54, 425–431 (2017). https://doi.org/10.1007/s00592-016-0944-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00592-016-0944-z

Keywords

Search

Navigation