2型糖尿病患者血清1,5-脱水-d-葡萄糖醇水平降低与颈动脉粥样硬化的相关性

Association of reduced levels of serum 1,5-Anhydro-d-glucitol with carotid atherosclerosis in patients with type 2 diabetes.

作者信息

Sato Takao, Kameyama Tomoki, Inoue Hiroshi

机构信息

Itoigawa General Hospital, Niigata, Japan.

The Second Department of Internal Medicine, University of Toyama, Toyama, Japan.

出版信息

J Diabetes Complications. 2014 May-Jun;28(3):348-52. doi: 10.1016/j.jdiacomp.2014.01.004. Epub 2014 Jan 15.

DOI:10.1016/j.jdiacomp.2014.01.004

PMID:24560424

Abstract

BACKGROUND

HbA1c level represents mean blood glycemic control. 1,5-Anhydro-d-glucitol (1,5-AG) level reflects glycemic fluctuations, a strong risk factor for the development of macroangiopathy. The present study investigated the relationship between serum 1,5-AG levels and macroangiopathy in patients with type 2 diabetes.

METHODS

A total of 115 consecutive patients with type 2 diabetes, aged 45-79 years, were included. HbA1c, 1,5-AG, and lipid profile were measured. Carotid maximum intima-media thickness (IMT) and plaque score (PS) were determined by carotid sonography. An 1,5-AG level < 14.2 μg/mL was used as a predictor of a post-challenge 2-h blood glucose level > 200 mg/dL. Patients were divided into four groups: A (n=32), HbA1c ≥ 6.5% and 1,5-AG<14.2 μg/mL; B (n=23), HbA1c ≥ 6.5% and 1,5-AG ≥ 14.2 μg/mL; C (n=24), HbA1c < 6.5% and 1,5-AG <14.2 μg/mL; and D (n=36), HbA1c < 6.5% and 1,5-AG ≥ 14.2 μg/mL.

RESULTS

HbA1c level had significant positive correlation with IMT and PS. 1,5-AG level had a significant negative correlation with PS. PS was significantly higher in group C than in group D, but similar to that in group B. In multivariate analysis, HbA1c (β=0.27, p=0.03) and 1,5-AG (β=-0.24, P=0.04) were independent determinants of PS.

CONCLUSIONS

1,5-AG level might provide additional information to identify macroangiopathy of patients with type 2 diabetes, especially in those with excellent HbA1c levels.

摘要

背景

糖化血红蛋白（HbA1c）水平代表平均血糖控制情况。1,5-脱水-D-葡萄糖醇（1,5-AG）水平反映血糖波动，是大血管病变发生的一个重要危险因素。本研究调查了2型糖尿病患者血清1,5-AG水平与大血管病变之间的关系。

方法

纳入115例年龄在45至79岁之间的连续2型糖尿病患者。测量HbA1c、1,5-AG和血脂谱。通过颈动脉超声测定颈动脉最大内膜中层厚度（IMT）和斑块评分（PS）。1,5-AG水平<14.2μg/mL被用作挑战后2小时血糖水平>200mg/dL的预测指标。患者分为四组：A组（n = 32），HbA1c≥6.5%且1,5-AG<14.2μg/mL；B组（n = 23），HbA1c≥6.5%且1,5-AG≥14.2μg/mL；C组（n = 24），HbA1c<6.5%且1,5-AG<14.2μg/mL；D组（n = 36），HbA1c<6.5%且1,5-AG≥14.2μg/mL。