1,5-Anhydroglucitol and Neonatal Complications in Pregnancy Complicated by Diabetes

Wright, Lorena; Hirsch, Irl B.; Gooley, Ted; Brown, Zane A.

doi:10.4158/ep14437.or

Cited by 17 publications

(22 citation statements)

References 28 publications

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“…It is also a good biomarker for screening gestational diabetes in the early pregnancy 20. 1,5-AG was found to be well associated with neonatal birth weight in diabetic pregnancies 21. Our results also found a consistent inverse association of 1,5-AG with adverse pregnancy outcomes.…”

Section: Discussionsupporting

confidence: 79%

Maternal glycemic parameters and adverse pregnancy outcomes among high-risk pregnant women

Zheng

Shen

Jiang

et al. 2019

BMJ Open Diab Res Care

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ObjectiveWe aimed to investigate the association between maternal glycemic parameters and adverse pregnancy outcomes among high-risk pregnant women.Research design and methodsA total of 1976 high-risk pregnant women were enrolled between 2015 and 2017. All participants received a 75 g oral glucose tolerance test during the 24–30 gestational weeks and complete birth and delivery information was collected. Adverse pregnancy outcomes were defined as premature birth, birth weight >90th percentile, primary cesarean section, and pre-eclampsia. Logistic regression models were used to assess the association between five maternal glycemic parameters during pregnancy (fasting glucose, 1-hour glucose, 2-hour glucose, HbA1c, and serum 1,5-anhydroglucitol (1,5-AG)) and adverse pregnancy outcomes.ResultsOf 1976 participants, 498 were diagnosed with gestational diabetes. The multivariable-adjusted ORs of adverse pregnancy outcomes for each one unit increase (1 mmol/L, 1%, or 1 µg/mL) were 2.32 (95% CI 1.85 to 2.92) for fasting glucose, 1.07 (95% CI 1.01 to 1.15) for 1-hour glucose, 1.03 (95% CI 0.96 to 1.10) for 2-hour glucose, 1.77 (95% CI 1.34 to 2.33) for HbA1c, and 0.96 (95% CI 0.94 to 0.98) for 1,5-AG, respectively. When all five glycemic parameters were simultaneously entered into the multivariable-adjusted model, only fasting glucose was significantly associated with total and individual adverse pregnancy outcomes. Receiver operating characteristic curve showed that fasting glucose plus any one of other four glycemic parameters had significantly enhanced the sensitivity of detecting adverse pregnancy outcomes.ConclusionsFasting glucose at 24–30 gestational weeks was strongly associated with adverse pregnancy outcomes. Fasting glucose combined with one additional glycemic measurement showed non-inferiority indicating that post-load glycemic measurement was not necessary in detecting adverse pregnancy outcomes among high-risk pregnant women.

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Section: Discussionsupporting

confidence: 79%

Maternal glycemic parameters and adverse pregnancy outcomes among high-risk pregnant women

Zheng

Shen

Jiang

et al. 2019

BMJ Open Diab Res Care

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“…1,5-AG is structurally similar to glucose and, therefore, high serum glucose prevents 1,5-AG reabsorption in renal tubules, thus leading to 1,5-AG excretion in urine and lower serum levels. Decreased maternal serum levels of 1,5-AG indicates poor short-term glycemic control in both pregestational diabetes and GDM [ 24 ], and is associated with complications of diabetes in pregnancy, specifically neonatal hypoglycemia [ 24 ]. Although it is not known whether 1,5-AG crosses the placenta, if the inverse relationship between blood glucose and 1,5-AG persists in AF, decreased concentrations of 1,5-AG provide additional evidence for early AF glucose elevations in our GDM cohort.…”

Section: Resultsmentioning

confidence: 99%

Gestational Diabetes Alters the Metabolomic Profile in 2nd Trimester Amniotic Fluid in a Sex-Specific Manner

O’Neill

Alexander

Azuma

et al. 2018

IJMS

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Maternal diabetes and obesity induce marked abnormalities in glucose homeostasis and insulin secretion in the fetus, and are linked to obesity, diabetes, and metabolic disease in the offspring, with specific metabolic characterization based on offspring sex. Gestational diabetes (GDM) has profound effects on the intrauterine milieu, which may reflect and/or modulate the function of the maternal–fetal unit. In order to characterize metabolic factors that affect offspring development, we profiled the metabolome of second trimester amniotic fluid (AF) from women who were subsequently diagnosed with gestational diabetes (GDM) using a targeted metabolomics approach, profiling 459 known biochemicals through gas chromatography/mass spectrometry (GC/MS) and liquid chromatography/mass spectrometry (LC/MS) assays. Using a nested case-control study design, we identified 69 total biochemicals altered by GDM exposure, while sex-specific analysis identified 44 and 58 metabolites in male and female offspring, respectively. The most significant changes were in glucose, amino acid, glutathione, fatty acid, sphingolipid, and bile acid metabolism with specific changes identified based on the offspring sex. Targeted isotope dilution LC/MS confirmatory assays measured significant changes in docosahexaenoic acid and arachidonic acid. We conclude that the sex-specific alterations in GDM maternal–fetal metabolism may begin to explain the sex-specific metabolic outcomes seen in offspring exposed to GDM in utero.

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“…56 Low levels are negatively associated with neonatal birth weight. [56][57][58] The limitation of this biomarker derives mainly from renal function and factors that influence the renal threshold to glucose. 59 1,5-AG has not been adequately studied in severe hyperglycemia and marked glycosuria (A1C >10%).…”

Section: Glycated Proteinsmentioning

confidence: 99%

Metrics Beyond Hemoglobin A1C in Diabetes Management: Time in Range, Hypoglycemia, and Other Parameters

Wright

Hirsch

2017

Diabetes Technology & Therapeutics

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146

114

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1,5-Anhydroglucitol and Neonatal Complications in Pregnancy Complicated by Diabetes

Cited by 17 publications

References 28 publications

Maternal glycemic parameters and adverse pregnancy outcomes among high-risk pregnant women

Maternal glycemic parameters and adverse pregnancy outcomes among high-risk pregnant women

Gestational Diabetes Alters the Metabolomic Profile in 2nd Trimester Amniotic Fluid in a Sex-Specific Manner

Metrics Beyond Hemoglobin A1C in Diabetes Management: Time in Range, Hypoglycemia, and Other Parameters

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