The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology of National Health Commission, Beijing, China.
Department of Cardiology, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China.
Front Endocrinol (Lausanne). 2022 Sep 5;13:978520. doi: 10.3389/fendo.2022.978520. eCollection 2022.
Postprandial hyperglycemia plays an important role in the pathogenesis of coronary artery disease (CAD). The aim of this study is to determine the associations of 1,5-Anhydroglucitol (1,5-AG), which reflects circulating glucose fluctuations, with the prevalence of CAD and CAD severity in coronary angiography defined Chinese patients.
2970 Chinese patients undergoing coronary angiography were enrolled. Baseline demographics and medical history data was recorded. Serum 1,5-AG levels and biochemical parameters were measured. Baseline characteristics were compared across 1,5-AG categories in diabetes (DM) and non-DM groups. Logistic regression analysis was performed to evaluate the associations of 1,5-AG with the prevalence and severity of CAD.
Lower 1,5-AG was significantly associated with higher Gensini scores in both DM and non-DM groups. Logistic regression analysis demonstrated that the associations of low 1,5-AG with the prevalence of CAD, elevated Gensini score and severe CAD robustly dose-response increased from undiagnosed DM with 1,5-AG ≥ 14µg/mL to DM with 1,5-AG < 14µg/mL even after adjusting for fasting blood glucose (FBG) or Hemoglobin A1c (HbA). The associations were more significant in persons with DM. Significant modification effect of DM on the relationship of 1,5-AG with elevated Gensini score was found. In addition, nonlinear relationship and threshold effects of 1,5-AG with CAD and severity were observed.
Low 1,5-AG is significantly and independently associated with CAD and CAD severity in Chinese patients undergoing coronary angiography. Measurement of 1,5-AG is useful to differentiate subjects with extensive glucose fluctuations and high CAD risks, especially in DM patients.
ClinicalTrials.gov, identifier NCT03072797.
餐后高血糖在冠状动脉疾病（CAD）的发病机制中起重要作用。本研究旨在确定反映循环血糖波动的 1,5-脱水葡萄糖醇（1,5-AG）与冠状动脉造影定义的中国患者 CAD 的患病率和 CAD 严重程度的相关性。
纳入 2970 名接受冠状动脉造影的中国患者。记录基线人口统计学和病史数据。测量血清 1,5-AG 水平和生化参数。在糖尿病（DM）和非 DM 组中，根据 1,5-AG 类别比较基线特征。使用逻辑回归分析评估 1,5-AG 与 CAD 患病率和严重程度的相关性。
在 DM 和非 DM 组中，较低的 1,5-AG 与更高的 Gensini 评分显著相关。逻辑回归分析表明，低 1,5-AG 与 CAD 的患病率、升高的 Gensini 评分和严重 CAD 的关联随着从 1,5-AG≥14μg/mL 的未确诊 DM 到 1,5-AG<14μg/mL 的 DM 呈剂量反应性增加，即使在调整空腹血糖（FBG）或糖化血红蛋白（HbA）后也是如此。在 DM 患者中，这种关联更为显著。发现 DM 对 1,5-AG 与升高的 Gensini 评分之间关系的显著修饰作用。此外，观察到 1,5-AG 与 CAD 和严重程度之间存在非线性关系和阈值效应。
在中国接受冠状动脉造影的患者中，低 1,5-AG 与 CAD 和 CAD 严重程度显著独立相关。1,5-AG 的测量有助于区分广泛血糖波动和高 CAD 风险的患者，特别是在 DM 患者中。
ClinicalTrials.gov，标识符 NCT03072797。
