1,5-Anhydroglucitol levels are low irrespective of plasma glucose levels in patients with chronic liver disease

Abstract

Backgound: Serum 1,5-anhydroglucitol (1,5-AG) is a known marker reflecting recent glycaemic control. In this study, we examined serum 1,5-AG levels in chronic liver disease (CLD) patients with and without diabetes mellitus. Methods: Eighty patients with CLD were compared with 667 subjects without CLD. Glycaemic control of the CLD patients was evaluated by estimated glycated haemoglobin (HbA 1C ) calculated using the equation by Rohlfing et al. from mean plasma glucose because CLD patients have apparently low HbA 1C .Results: When the study participants were divided into subgroups stratified by HbA 1C levels, the CLD patients whose estimated HbA 1C levels were less than 7.0% showed significantly lower 1,5-AG than their counterparts of the control subjects.Stepwise multivariable analysis revealed that estimated HbA 1C was the significant explanatory variable for 1,5-AG in the CLD patients. However, in the CLD patients with estimated HbA 1C less than 5.8%, only hepaplastin test was the significant explanatory variable for 1,5-AG. Conclusions: Serum 1,5-AG levels are low irrespective of plasma glucose levels in the CLD patients with and without diabetes. The CLD patients who had low serum 1,5-AG levels were associated with deteriorated liver function.

Beyond HbA1c and Glucose: the Role of Nontraditional Glycemic Markers in Diabetes Diagnosis, Prognosis, and Management

“…105–108 There is also interest in whether fructosamine, glycated albumin, or 1,5-AG testing may play a role in the management of diabetes in patients with liver disease, but evidence for their performance in this setting is inconsistent. 109–111 Furthermore, during pregnancy, glycated albumin may better reflect average glucose compared to HbA1c, which may be artificially elevated due to iron deficiency. 112,113 Furthermore, measures of shorter-term glycemia may be especially important in gestational diabetes given the importance of frequent monitoring and strong associations between diabetes control in pregnancy and maternal and fetal outcomes.…”

Glycemic control indicators in patients with neonatal diabetes mellitus

“…Serum 1,5-AG is also affected by the threshold for urinary glucose excretion, and therefore shows a low level in renal glycosuria in which the threshold decreases. In addition, serum 1,5-AG shows an abnormally low level in conditions such as chronic renal failure in which reabsorption of 1,5-AG decreases [38][39][40] , pregnancy [41] , oxyhyperglycemia in which urinary glucose is observed transiently [42] , patients receiving long-term hyperalimentation [43] , and liver cirrhosis [44,45] . One of the causes of an abnormally high level of 1,5-AG is oral administration of a kind of Chinese medicines such as Ninjin-yoei-to and Kami-kihi-to which contain large amounts of 1,5-AG [46] .…”

Diagnostic Usefulness of 1, 5 Anhyroglucitol in Diabetes Mellitus: A Review

“…Hence, serum 1,5AG levels were found to be low in CLD patients with and without DM. The CLD patients with low 1,5AG were associated with a deteriorated liver function (Koga M et al, 2011).…”