Fujiwara Takayuki, Yoshida Masashi, Yamada Hodaka, Tsukui Takunori, Nakamura Tomohiro, Sakakura Kenichi, Wada Hiroshi, Arao Kenshiro, Katayama Takuji, Funayama Hiroshi, Sugawara Yoshitaka, Mitsuhashi Takeshi, Kakei Masafumi, Momomura Shin-Ichi, Ako Junya
Department of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma, Omiya Ward, Saitama, Saitama, 330-8503, Japan.
Heart Vessels. 2015 Jul;30(4):469-76. doi: 10.1007/s00380-014-0502-y. Epub 2014 Apr 2.
Postprandial hyperglycemia is a risk factor for cardiovascular disease and mortality. Serum 1,5-anhydroglucitol (1,5-AG) level is an useful clinical marker of glucose metabolism which reflects postprandial hyperglycemia more robustly compared to hemoglobin A1c (HbA1c). Relationship between serum 1,5-AG level and cardiovascular disease has been reported; however, comparison between HbA1c and 1,5-AG as markers of cardiovascular disease was not performed. We included 227 consecutive patients who underwent coronary angiography meeting the following inclusion criteria: (1) patients who had no history of coronary artery disease (CAD); (2) patients without acute coronary syndrome; (3) patients without poorly controlled diabetes mellitus; (4) patients without anemia, liver dysfunction, acute, and chronic renal failure and malnutrition; and (5) patients without adhibition of acarbose or Chinese herbal medicine. We measured HbA1c, glycoalbumin, and 1,5-AG. Serum 1,5-AG was significantly lower in patients with CAD (16.6 ± 8.50 vs. 21.1 ± 7.97 μg/ml, P < 0.001). Multivariable logistic regression analysis showed decrease in serum 1,5-AG was independently associated with the presence of denovo CAD (0.93, 95% CI 0.88-0.98, P = 0.006). Serum 1,5-AG was also independently associated with the presence of denovo CAD in patients without diabetes mellitus (0.94, 95% CI 0.88-0.99, P = 0.046). In conclusion, lower serum 1,5-AG was associated with the presence of denovo CAD. Serum 1,5-AG may identify high cardiovascular risk patients for denovo CAD in both diabetic and non-diabetic patients.
餐后高血糖是心血管疾病和死亡的危险因素。血清1,5-脱水葡萄糖醇（1,5-AG）水平是葡萄糖代谢的一个有用的临床标志物，与糖化血红蛋白（HbA1c）相比，它能更有力地反映餐后高血糖。血清1,5-AG水平与心血管疾病之间的关系已有报道；然而，尚未对作为心血管疾病标志物的HbA1c和1,5-AG进行比较。我们纳入了227例连续接受冠状动脉造影且符合以下纳入标准的患者：（1）无冠状动脉疾病（CAD）病史的患者；（2）无急性冠状动脉综合征的患者；（3）糖尿病控制不佳的患者；（4）无贫血、肝功能不全、急性和慢性肾功能衰竭及营养不良的患者；（5）未服用阿卡波糖或中药的患者。我们检测了HbA1c、糖化白蛋白和1,5-AG。CAD患者的血清1,5-AG显著降低（16.6±8.50 vs. 21.1±7.97μg/ml，P<0.001）。多变量逻辑回归分析显示，血清1,5-AG降低与新发CAD独立相关（0.93，95%CI 0.88-0.98，P=0.006）。血清1,5-AG在无糖尿病患者中也与新发CAD独立相关（0.94，95%CI 0.88-0.99，P=0.046）。总之，较低的血清1,5-AG与新发CAD相关。血清1,5-AG可能在糖尿病和非糖尿病患者中识别出心血管疾病高风险的新发CAD患者。
