Yoo Ha Yeong, Kwak Byung Ok, Son Jae Sung, Kim Kyo Sun, Chung Sochung
Department of Pediatrics, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea.
Ann Pediatr Endocrinol Metab. 2015 Dec;20(4):192-7. doi: 10.6065/apem.2015.20.4.192. Epub 2015 Dec 31.
The prevalence of type 2 diabetes mellitus (T2DM) and obesity are currently increasing. Accordingly, the concept of "preventing diabetes" in high-risk groups has become more important in diabetic care, but the use of glycated hemoglobin (HbA1c) as a measure has limitations in this field. The aim of this study was to investigate the utility of 1,5-anhydroglucitol (1,5-AG) in assessing prediabetes status in obese children.
The medical records of 74 subjects aged 6-19 years (of which 27 were overweight/obese and 47 had diabetes) who had 1,5-AG data were reviewed retrospectively. We compared 1,5-AG with HbA1c using the Pearson correlation test to assess the clinical utility of 1,5-AG.
1,5-AG levels were higher (31.1±10.1 µg/mL vs. 7.4±7.3 µg/mL) and HbA1c levels were lower (5.5%±0.3% vs. 8.9%±2.7%) in the overweight/obese group than in the diabetics group. The range of 1,5-AG levels in obese children was wide (16.8-59.3 µg/mL), and did not have significance with HbA1c. A negative correlation between 1,5-AG and HbA1c was significant in the entire subject (r=-0.822, P<0.001), and also in the HbA1c range of 5.5% to 8% (r=-0.736, P<0.001).
1,5-AG is a valuable index in the HbA1c range of 5.5%-8% and it might be considered an early glycemic control index in insulin-resistant obese children with an HbA1c level above 5.5%. Moreover, the 1,5-AG level assessment should be presented as a supplementary tool for better compliance, as well as being an improvement in diabetes management for the short-term glucose control in relatively well-controlled diabetes patients with an HbA1c level below 8%.
2型糖尿病（T2DM）和肥胖症的患病率目前正在上升。因此，在糖尿病护理中，高危人群“预防糖尿病”的概念变得更加重要，但使用糖化血红蛋白（HbA1c）作为衡量指标在该领域存在局限性。本研究的目的是调查1,5-脱水葡萄糖醇（1,5-AG）在评估肥胖儿童糖尿病前期状态中的效用。
回顾性分析74名年龄在6至19岁（其中27名超重/肥胖，47名患有糖尿病）且有1,5-AG数据的受试者的病历。我们使用Pearson相关检验比较1,5-AG与HbA1c，以评估1,5-AG的临床效用。
超重/肥胖组的1,5-AG水平较高（31.1±10.1μg/mL对7.4±7.3μg/mL），HbA1c水平较低（5.5%±0.3%对8.9%±2.7%）。肥胖儿童的1,5-AG水平范围较宽（16.8 - 59.3μg/mL），与HbA1c无显著相关性。1,5-AG与HbA1c之间的负相关性在整个受试者中显著（r = -0.822，P < 0.001），在HbA1c范围为5.5%至8%时也显著（r = -0.736，P < 0.001）。
1,5-AG在HbA1c范围为5.5% - 8%时是一个有价值指标，对于HbA1c水平高于5.5%的胰岛素抵抗肥胖儿童，它可能被视为早期血糖控制指标。此外，1,5-AG水平评估应作为一种补充工具，以提高依从性，同时也是对HbA1c水平低于8%的相对血糖控制良好的糖尿病患者进行短期血糖控制的糖尿病管理的一种改进。
