1,5-anhydroglucitol: a better marker for short-term glycemic control

Abstract

Objective To establish the reference range of serum 1, 5-anhydroglucitol(1, 5-AG) in healthy people and analyze its correlation with short-term glycemic control. Methods From March to July in 2010, 281 individuals with normal glucose regulation, 143 men and 138 women aged from 20 to 87 years, were recruited from Gucheng and Pingguoyuan community in Beijing and outpatients of General Hospital of People's Liberation Army(PLA). Serum 1, 5-AG levels were measured with glucose kinase-pyranoid sugars oxidase (GK-PROD) methods in these individuals. Thirty-eight outpatients with type 2 diabetes, 19 men and 19 women aged 37 to 74 years, were selected from General Hospital of PLA and received mixed protamine zinc recombinant human insulin lispro injection (25R) interventions for 12 weeks. The blood glucose levels in the patients were regularly monitored before and 2h after main meals in order to obtain mean blood glucose(MBG); and 1, 5-AG, glycosylated hemoglobin (HbA1c)and serum glycated albumin(GA) were measured at week 0, 2, 4, 8 and 12 with clinic visits. Pearson correlation coefficient was used to measure the relation between 1, 5-AG, HbA1c , GA and MBG. Results The normal range of serum 1, 5-AG for healthy population could be suggested at 68-251 μmol/L overall, 80-267 μmol/L for man and 66-206 μmol/L for woman. The level of 1, 5-AG in man was higher than that in woman, but there was no difference in the whole range of age and body mass index(BMI) in subjects. There were significant correlation between 1, 5-AG, HbA1c, GA and MBG(r=-0.491, 0.563, 0.422, all P<0.01). 1, 5-AG was most closely associated with 2-week MBG level(r=-0.675, P<0.01), while the correlation between HbA1c and MBG maintained longer than others. After treatment of 2 weeks, 1, 5-AG increased by 18.8%, but HbA1c and GA decreased by 3.2% and 6.2%. By week 12, 1, 5-AG increased by 65.2%, while the HbA1c and GA decreased by 16.1% and 21.1%. In general, there was satisfactory concordance between longitudinal changes of 1, 5-AG, HbA1c, GA and MBG in patients with type 2 diabetes. Conclusions The normal range of serum 1, 5-AG for normal population could be suggested at 68-251 μmol/L overall, 80-267 μmol/L for man and 66-206 μmol/L for woman. 1, 5-AG was a probably better marker than HbA1c and GA in evaluating short-term glycemic control. Key words: Diabetes mellitus, type 2; 1, 5-anhydroglucitol; Hemoglobin A, glycosylated