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

Abstract

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.