Department of Internal Medicine, Seoul National University College of Medicine, 28 Yongon-dong, Jongno-gu, Seoul, 110-744, Republic of Korea.
Acta Diabetol. 2013 Aug;50(4):505-10. doi: 10.1007/s00592-011-0302-0. Epub 2011 Jun 18.
1,5-anhydroglucitol (1,5-AG) has been suggested as a marker for short-term glycemic control and postprandial hyperglycemia. However, the role of 1,5-AG in glycemic variability has not been established. The aim of this study was to demonstrate the usefulness of 1,5-AG as a marker for glycemic variability in patients with type 2 diabetes. Sixty patients with type 2 diabetes were enrolled, and a continuous glucose monitoring system (CGMS) was applied for 72 h. Continuous overlapping net glycemic action (CONGA), mean amplitude of glycemic excursion (MAGE), and mean of the daily differences (MODD) were calculated for the assessment of glycemic variability and compared with 1,5-AG. Urinary 8-iso prostaglandin F2α (8-isoPGF2α) was measured to assess oxidative stress. 1,5-AG was correlated with fasting blood glucose, HbA1c, postprandial area under the curve for glucose above 180 mg/dL (AUC-180), and mean post-meal maximum glucose (MPMG). However, 1,5-AG did not show significant correlation with CONGA-1, MAGE, and MODD (R = -0.053, P = 0.689; R = -0.148, P = 0.259; R = -0.123, P = 0.350). In patients with HbA1c ≤ 8.0% (n = 35), 1,5-AG was significantly correlated with HbA1c, mean glucose, postprandial AUC-180, and MPMG. However, in patients with HbA1c > 8.0% (n = 25), 1,5-AG did not show correlation with any glycemic markers. Oxidative stress measured as urine 8-isoPGF2α showed positive correlations with CONGA-1, MAGE, AUC-180, postprandial AUC-180, and MPMG only in men. However, 1,5-AG did not correlate with oxidative stress. Our data suggested a limited usefulness of 1,5-AG in estimating glycemic variability and oxidative stress. 1,5-AG was able to represent mean glucose and postprandial hyperglycemia only in well-controlled diabetic patients.
1,5-脱水山梨醇（1,5-AG）已被提议作为短期血糖控制和餐后高血糖的标志物。然而，1,5-AG 在血糖变异性中的作用尚未确定。本研究旨在证明 1,5-AG 作为 2 型糖尿病患者血糖变异性标志物的有用性。纳入 60 例 2 型糖尿病患者，应用连续血糖监测系统（CGMS）进行 72 h 监测。计算连续重叠净血糖作用（CONGA）、血糖波动幅度（MAGE）和日间血糖差异平均值（MODD），评估血糖变异性，并与 1,5-AG 进行比较。测量尿 8-异前列腺素 F2α（8-isoPGF2α）以评估氧化应激。1,5-AG 与空腹血糖、HbA1c、餐后血糖 180mg/dL 以上曲线下面积（AUC-180）和餐后最大血糖均值（MPMG）相关。然而，1,5-AG 与 CONGA-1、MAGE 和 MODD 无显著相关性（R = -0.053，P = 0.689；R = -0.148，P = 0.259；R = -0.123，P = 0.350）。在 HbA1c≤8.0%（n = 35）的患者中，1,5-AG 与 HbA1c、平均血糖、餐后 AUC-180 和 MPMG 显著相关。然而，在 HbA1c＞8.0%（n = 25）的患者中，1,5-AG 与任何血糖标志物均无相关性。作为氧化应激标志物的尿 8-isoPGF2α 仅在男性中与 CONGA-1、MAGE、AUC-180、餐后 AUC-180 和 MPMG 呈正相关。然而，1,5-AG 与氧化应激无相关性。我们的数据表明，1,5-AG 在估计血糖变异性和氧化应激方面的作用有限。1,5-AG 仅在血糖控制良好的糖尿病患者中能够反映平均血糖和餐后高血糖。
