Enzymatic quantification of 1,5-anhydro-D-glucitol: evaluation and clinical application

We investigated an enzymatic colorimetric procedure for quantification of plasma 1,5-anhydro-D-glucitol (AG) with respect to its reproducibility and application for evaluation of diabetes mellitus. Assay specificity is critically dependent on the two-layer ion-exchange column chromatography procedure to remove glucose from the sample. For female nondiabetic subjects (n = 110, ages 22-36 years) the median plasma AG concentration was 143 mumol/L (range 70-209 mumol/L); there was no relation to body mass index (BMI), fasting plasma glucose, or insulin, but an inverse association was noted for age. For a group of older subjects (n = 69, 70-85 years), no association between AG concentrations and sex, age, BMI, or various medical conditions was found. In diabetic subjects (n = 170) a significant inverse nonlinear relation existed between plasma AG and glycohemoglobin (GHb) such that at GHb > 8.5%, AG concentrations were typically < 50 mumol/L. The findings confirm that plasma AG, in the presence of normal renal function, is a reliable marker for hyperglycemia.