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Published on: May 10, 2013
Relationship Between 1,5-Anhydroglucitol and Renal Function Assessed by Dynamic Renal Scintigraphy in Type 2 Diabetes
Jiaying Ni1, Hang Su1,2, Yaxin Wang1
1Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai 200233, China.
Context:
The reliability of serum 1,5-anhydroglucitol (1,5-AG) in patients with type 2 diabetes and renal insufficiency remains controversial.
Objective:
To evaluate the relationship between renal function and serum 1,5-AG and to assess the extent to which renal function influences 1,5-AG.
Methods:
A total of 5337 participants with type 2 diabetes were enrolled. The measured glomerular filtration rate (mGFR) was assayed using 99mTc-DTPA dynamic renal scintigraphy. All subjects were stratified into 5 groups based on mGFR (≥120 [n = 507], 90-120 [n = 2015], 60-90 [n = 2178], 30-60 [n = 604], and <30 mL/min/1.73 m2 [n = 33]).
Results:
Overall, the serum 1,5-AG and mGFR levels were 3.3 (1.7-7.0) μg/mL and 88.6 ± 24.1 mL/min/1.73 m2, respectively. mGFR was found to be negatively correlated with 1,5-AG levels (r = -0.189, P < .001). Multiple linear regression revealed that mGFR was independently and negatively related to serum 1,5-AG after adjusting for covariates including hemoglobin A1c (HbA1c; P < .001). In subgroups with mGFR ≥ 30 mL/min/1.73 m2, the correlation coefficients between 1,5-AG and HbA1c, fasting plasma glucose, postprandial plasma glucose, and the differences between postprandial and fasting plasma glucose remained significant (range, -0.126 to -0.743, all P < .01). However, the link between 1,5-AG and traditional glycemic markers was attenuated in individuals with mGFR < 30 mL/min/1.73 m2. Sensitivity analysis after excluding anemic patients showed similar results regarding the relationship between serum 1,5-AG and HbA1c across the mGFR subgroups.
Conclusion:
Although we observed a weak inverse correlation (r = -0.189) between mGFR and serum 1,5-AG in type 2 diabetes, 1,5-AG remains a valid marker for assessing glucose control in subjects with mild or moderate renal dysfunction.
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