Association of reduced levels of serum 1,5-Anhydro-D-glucitol with carotid atherosclerosis in patients with type 2 diabetes

摘要

Background HbA1c level represents mean blood glycemic control. 1,5-Anhydro-d-glucitol (1,5-AG) level reflects glycemic fluctuations, a strong risk factor for the development of macroangiopathy. The present study investigated the relationship between serum 1,5-AG levels and macroangiopathy in patients with type 2 diabetes. Methods A total of 115 consecutive patients with type 2 diabetes, aged 45-79 years, were included. HbA1c, 1,5-AG, and lipid profile were measured. Carotid maximum intima-media thickness (IMT) and plaque score (PS) were determined by carotid sonography. An 1,5-AG level < 14.2 μg/mL was used as a predictor of a post-challenge 2-h blood glucose level > 200 mg/dL. Patients were divided into four groups: A (n = 32), HbA1c≥6.5% and 1,5-AG < 14.2 μg/mL; B (n = 23), HbA1c ≥ 6.5% and 1,5-AG ≥ 14.2 μg/mL; C (n = 24), HbA1c < 6.5% and 1,5-AG < 14.2 μg/mL; and D (n = 36), HbA1c < 6.5% and 1,5-AG ≥ 14.2 μg/mL. Results HbA1c level had significant positive correlation with IMT and PS. 1,5-AG level had a significant negative correlation with PS. PS was significantly higher in group C than in group D, but similar to that in group B. In multivariate analysis, HbA1c (β = 0.27, p = 0.03) and 1,5-AG (β = - 0.24, P = 0.04) were independent determinants of PS. Conclusions 1,5-AG level might provide additional information to identify macroangiopathy of patients with type 2 diabetes, especially in those with excellent HbA1c levels.