Clinical Application of 1,5-Anhydroglucitol Measurements in Patients with Hepatocyte Nuclear Factor-1α Maturity-Onset Diabetes of the Young
Open Access
- 1 August 2008
- journal article
- Published by American Diabetes Association in Diabetes Care
- Vol. 31 (8), 1496-1501
- https://doi.org/10.2337/dc07-2334
Abstract
OBJECTIVE—1,5-anhydroglucitol (1,5-AG) is a short-term marker of metabolic control in diabetes. Its renal loss is stimulated in hyperglycemic conditions by glycosuria, which results in a lowered plasma concentration. As a low renal threshold for glucose has been described in hepatocyte nuclear factor-1α (HNF-1α) maturity-onset diabetes of the young (MODY), the 1,5-AG level may be altered in these patients. The purpose of this study was to assess the 1,5-AG levels in patients with HNF-1α MODY and in type 2 diabetic subjects with a similar degree of metabolic control. In addition, we aimed to evaluate this particle as a biomarker for HNF-1α MODY. RESEARCH DESIGN AND METHODS—We included 33 diabetic patients from the Polish Nationwide Registry of MODY. In addition, we examined 43 type 2 diabetic patients and 47 nondiabetic control subjects. The 1,5-AG concentration was measured with an enzymatic assay (GlycoMark). Receiver operating characteristic (ROC) curve analysis was used to evaluate 1,5-AG as a screening marker for HNF-1α MODY. RESULTS—The mean 1,5-AG plasma concentration in diabetic HNF-1α mutation carriers was 5.9 μg/ml, and it was lower than that in type 2 diabetic patients (11.0 μg/ml, P = 0.003) and in nondiabetic control subjects (23.9 μg/ml, P < 0.00005). The ROC curve analysis revealed 85.7% sensitivity and 80.0% specificity of 1,5-AG in screening for HNF-1α MODY at the criterion of <6.5 μg/ml in patients with an A1C level between 6.5 and 9.0%. CONCLUSIONS—1,5-AG may be a useful biomarker for differential diagnosis of patients with HNF-1α MODY with a specific range of A1C, although this requires further investigation. However, the clinical use of this particle in diabetic HNF-1α mutation carriers for metabolic control has substantial limitations.Keywords
This publication has 26 references indexed in Scilit:
- New Polymorphism of ENPP1 (PC-1) Is Associated With Increased Risk of Type 2 Diabetes Among Obese IndividualsDiabetes, 2006
- 1,5-Anhydroglucitol and Postprandial Hyperglycemia as Measured by Continuous Glucose Monitoring System in Moderately Controlled Patients With DiabetesDiabetes Care, 2006
- Renal Malformations May Be Linked to Mutations in the Hepatocyte Nuclear Factor-1α (MODY3) GeneDiabetes Care, 2005
- Plasma anhydro‐d‐glucitol (1,5‐AG) as an indicator of hyperglycaemic excursions in pregnant women with diabetesDiabetic Medicine, 2005
- β-Cell Dysfunction, Insulin Sensitivity, and Glycosuria Precede Diabetes in Hepatocyte Nuclear Factor-1α Mutation CarriersDiabetes Care, 2005
- Different genes, different diabetes: lessons from maturity-onset diabetes of the youngAnnals of Medicine, 2002
- Plasma 1,5-anhydroglucitol concentrations are influenced by variations in the renal threshold for glucoseDiabetic Medicine, 1999
- Common reabsorption system of 1,5-anhydro-d-glucitol, fructose, and mannose in rat renal tubuleBiochimica et Biophysica Acta (BBA) - General Subjects, 1996
- Is Serum Anhydroglucitol an Alternative to the Oral Glucose Tolerance Test for Diabetes Screening?Diabetic Medicine, 1993
- Plasma 1,5-Anhydroglucitol Concentration in Patients with End-Stage Renal Disease with and without Diabetes MellitusNephron, 1992