Department of Epidemiology , The Welch Center for Prevention, Epidemiology, and Clinical Research, The Johns Hopkins Bloomberg School of Public Health , Baltimore, Maryland , USA.
Department of Epidemiology , The Welch Center for Prevention, Epidemiology, and Clinical Research, The Johns Hopkins Bloomberg School of Public Health , Baltimore, Maryland , USA ; Department of Medicine , The Johns Hopkins School of Medicine , Baltimore, Maryland , USA.
BMJ Open Diabetes Res Care. 2014 Apr 8;2(1):e000002. doi: 10.1136/bmjdrc-2013-000002. eCollection 2014.
To compare the associations of diabetes mellitus risk factors with nontraditional markers of hyperglycemia (glycated albumin, fructosamine, 1,5-anhydroglucitol (1,5-AG)) to those observed with traditional markers (fasting glucose, hemoglobin A1c (HbA1c)).
Cross-sectional study.
The community-based Atherosclerosis Risk in Communities (ARIC) Study cohort.
A subsample of 1764 participants (309 with diagnosed diabetes and 1455 without diagnosed diabetes) from the ARIC Study who attended a clinic visit in 2005-2006.
Elevated levels of glycated albumin, fructosamine, 1,5-AG, fasting glucose, and HbA1c in persons with and without a diagnosis of diabetes.
The mean age of participants was 70 years (SD, 6), 43% were men, and 20% were African-American. Black race and family history of diabetes were generally positively associated with elevated levels of all biomarkers of hyperglycemia except 1,5-AG, which showed inverse but weaker associations with the risk factors examined. In general, patterns of risk factor associations observed for fasting glucose and HbA1c were similar to those observed for the nontraditional biomarkers of hyperglycemia but with one clear exception: body mass index (BMI). In persons without a diagnosis of diabetes, BMI was positively associated with fasting glucose and HbA1c, but the associations of BMI with glycated albumin and fructosamine were inverse, with high values of these markers at low levels of BMI. 1,5-AG, which is lowered in the setting of hyperglycemia, was positively associated with BMI.
Traditional diabetes risk factors have similar associations with glycated albumin and fructosamine as those for fasting glucose and HbA1c, with the exception of BMI. Risk factor associations with 1,5-AG were mostly inverse. The inverse associations of BMI with glycated albumin and fructosamine, and positive associations with 1,5-AG, may reflect pathways independent of glucose metabolism and merit further examination.
比较糖尿病风险因素与非传统高血糖标志物（糖化白蛋白、果糖胺、1,5-脱水葡萄糖醇（1,5-AG））的关联，与传统标志物（空腹血糖、糖化血红蛋白（HbA1c））的关联。
横断面研究。
基于社区的动脉粥样硬化风险研究（ARIC）研究队列。
ARIC 研究中的一个亚组，1764 名参与者（309 名确诊糖尿病患者和 1455 名无确诊糖尿病患者），他们于 2005-2006 年参加了一次临床就诊。
患有和未患糖尿病的个体中糖化白蛋白、果糖胺、1,5-AG、空腹血糖和 HbA1c 水平升高。
参与者的平均年龄为 70 岁（标准差，6），43%为男性，20%为非裔美国人。黑种人和糖尿病家族史通常与除 1,5-AG 外的所有高血糖生物标志物的升高水平呈正相关，而 1,5-AG 与所检查的危险因素呈负相关但较弱。一般来说，空腹血糖和 HbA1c 的危险因素关联模式与高血糖的非传统生物标志物相似，但有一个明显的例外：体重指数（BMI）。在未诊断为糖尿病的人群中，BMI 与空腹血糖和 HbA1c 呈正相关，但 BMI 与糖化白蛋白和果糖胺的关联呈负相关，这些标志物的高值出现在 BMI 较低的水平。1,5-AG 在高血糖的情况下降低，与 BMI 呈正相关。
传统的糖尿病危险因素与糖化白蛋白和果糖胺的关联与空腹血糖和 HbA1c 的关联相似，除了 BMI。1,5-AG 的危险因素关联大多呈负相关。BMI 与糖化白蛋白和果糖胺呈负相关，与 1,5-AG 呈正相关，可能反映了与葡萄糖代谢无关的途径，值得进一步研究。
