Ability of 1,5-Anhydro-d-glucitol Values to Predict Coronary Artery Disease in a Non-Diabetic Population

Increasing evidence has indicated that postprandial hyperglycemia affects coronary artery disease (CAD). The serum 1,5-anhydro-d-glucitol (1,5-AG) value is a useful clinical marker to evaluate short-term glycemic status and reflects glycemic excursions with greater sensitivity when compared with hemoglobinA1c (HbA1c), especially for patients in the postprandial state. The aim of this study was to evaluate the predictive value of 1,5-AG for CAD in patients without diabetes mellitus.This study included 729 consecutive patients who had undergone their first coronary angiography. A total of 284 patients (246 diabetic patients and 38 patients with stage 4 or 5 chronic kidney disease) were excluded. The predictive values of 1,5-AG and HbA1c for CAD were evaluated by multivariable logistic regression analysis.Patients with CAD demonstrated significantly lower 1,5-AG values and higher HbA1c values than did patients without CAD (18.6 μg/mL [12.0, 23.3] versus 19.2 μg/mL [14.4, 25.2], P = 0.036, and 5.7% [5.5, 5.9] versus 5.6% [5.4, 5.8], P = 0.016, respectively). In multivariable logistic regression analysis, the HbA1c values did not indicate a predictive value for the prevalence of CAD. In contrast, the 1,5-AG levels were still an independent predictor of CAD (adjusted odds ratio 0.96, 95% confidence interval 0.93-0.99, P = 0.0097).Serum 1,5-AG is superior to HbA1c for predicting CAD prevalence in patients without diabetes mellitus.