Diabetes Screening: Detection and Application of Saliva 1,5-Anhydroglucitol by Liquid Chromatography–Mass Spectrometry

Abstract

Context Unlike other commonly used invasive blood glucose monitoring methods, saliva detection prevents patients from suffering the physical uneasiness. However, there are few studies on saliva 1,5-anhydroglucitol (1,5-AG) in patients with diabetes mellitus (DM). Objective This study aimed to evaluate the effectiveness of saliva 1,5-AG in diabetes screening in a Chinese population. Design and Participants This was a population-based cross-sectional study. A total of 641 subjects without a valid diabetic history were recruited from September 2018 to June 2019. Saliva 1,5-AG was measured with liquid chromatography-mass spectrometry. Results Saliva 1,5-AG levels in DM subjects were lower than those in non-diabetes mellitus subjects (both P < 0.05). Saliva 1,5-AG was positively correlated with serum 1,5-AG and negatively correlated with blood glucose and glycated hemoglobin (HbA1c) (all P < 0.05). The optimal cutoff points of saliva 1,5-AG₀ and 1,5-AG₁₂₀ for diabetes screening were 0.436 μg/mL (sensitivity: 63.58%, specificity: 60.61%) and 0.438 μg/mL (sensitivity: 62.25%, specificity: 60.41%), respectively. Fasting plasma glucose (FPG) combined with fasting saliva 1,5-AG reduced the proportion of people who required an OGTT by 47.22% compared with FPG alone. Conclusion Saliva 1,5-AG combined with FPG or HbA1c improved the efficiency of diabetes screening. Saliva 1,5-AG is robust in nonfasting measurements and a noninvasive and convenient tool for diabetes screening.