Department of Endocrinology and Metabolism, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
Diabet Med. 2012 Sep;29(9):1184-90. doi: 10.1111/j.1464-5491.2012.03613.x.
To determine whether there is a relationship between 1,5-anhydroglucitol (1,5-AG), a marker of postprandial hyperglycaemia and glycaemic variability, and the presence of diabetic retinopathy and albuminuria in patients with Type 2 diabetes.
Five hundred and sixty-seven patients with Type 2 diabetes (serum creatinine < 133 μmol/l), who were enrolled in the Seoul Metro-City Diabetes Prevention Program (SMC-DPP), were cross-sectionally assessed by multivariate logistic regression analysis.
After controlling for age, sex, binary HbA(1c) levels, duration of diabetes, triglyceride, systolic blood pressure, smoking status, history of hypertension and dyslipidaemia, and the use of angiotensin-converting enzyme inhibitor/angiotensin receptor blocker medication, the odds ratios (95% CI) of diabetic retinopathy were 2.86 (1.12-7.25) for the first (lowest) quartile of 1,5-anhydroglucitol, 2.87 (1.25-6.61) for the second quartile and 0.88 (0.35-2.22) for the third quartile compared with the fourth quartile (P for trend = 0.010). Conversely, the associations between 1,5-anhydroglucitol and clinical albuminuria were non-significant after adjustment. Subjects with low 1,5-anhydroglucitol (< 10.0 μg/ml) were more likely to experience diabetic retinopathy than those with high 1,5-anhydroglucitol (≥ 10.0 μg/ml) under moderate glucose control (HbA(1c) < 8%, 64 mmol/mol) and there were no significant differences in the prevalence of diabetic retinopathy between the subgroup with HbA(1c) < 8% (64 mmol/mol) and low 1,5-anhydroglucitol and the subgroup with HbA(1c) ≥ 8% (64 mmol/mol).
1,5-Anhydroglucitol levels show close associations with diabetic retinopathy, especially among patients under moderate glucose control, but not with albuminuria. These results suggest that 1,5-anhydroglucitol might be a complementary marker for targeting higher risk group.
确定 1,5-脱水葡萄糖醇（1,5-AG），一种餐后高血糖和血糖变异性的标志物，与 2 型糖尿病患者的糖尿病视网膜病变和白蛋白尿的发生是否有关。
通过多变量 logistic 回归分析，对参加首尔大都市糖尿病预防计划（SMC-DPP）的 567 例 2 型糖尿病患者（血清肌酐<133 μmol/l）进行了横断面评估。
在校正年龄、性别、二元糖化血红蛋白（HbA1c）水平、糖尿病病程、甘油三酯、收缩压、吸烟状况、高血压和血脂异常病史以及血管紧张素转换酶抑制剂/血管紧张素受体阻滞剂的使用后，1,5-脱水葡萄糖醇的第 1（最低）四分位数的比值比（95%CI）分别为糖尿病视网膜病变的 2.86（1.12-7.25）、第 2 四分位数的 2.87（1.25-6.61）和第 3 四分位数的 0.88（0.35-2.22）与第 4 四分位数相比（P 趋势=0.010）。相反，调整后，1,5-脱水葡萄糖醇与临床白蛋白尿之间的关联无统计学意义。在中等血糖控制（HbA1c<8%，64 mmol/mol）下，1,5-脱水葡萄糖醇水平低（<10.0 μg/ml）的患者比 1,5-脱水葡萄糖醇水平高（≥10.0 μg/ml）的患者更易发生糖尿病视网膜病变，并且在 HbA1c<8%（64 mmol/mol）和低 1,5-脱水葡萄糖醇亚组与 HbA1c≥8%（64 mmol/mol）的亚组之间，糖尿病视网膜病变的患病率无显著差异。
1,5-脱水葡萄糖醇水平与糖尿病视网膜病变密切相关，尤其是在中等血糖控制的患者中，但与白蛋白尿无关。这些结果表明，1,5-脱水葡萄糖醇可能是一个针对更高风险人群的补充标志物。
