Effect of 1,5-anhydroglucitol levels on culprit plaque rupture in diabetic patients with acute coronary syndrome

Abstract

Background: Postprandial hyperglycemia was reported to play a key role in established risk factors of coronary artery diseases (CAD) and cardiovascular events. Serum 1,5-anhydroglucitol (1,5-AG) levels are known to be a clinical marker of short-term postprandial glucose (PPG) excursions. Low serum 1,5-AG levels have been associated with occurrence of CAD. However, the relationship between 1,5-AG levels and coronary plaque rupture has not been fully elucidated. The aim of this study was to evaluate 1,5-AG as a predictor of coronary plaque rupture in diabetic patients with acute coronary syndrome (ACS).Methods: A total of 144 diabetic patients with ACS were included in this study. All patients underwent intravascular ultrasound examination, which revealed 49 patients with plaque rupture and 95 patients without plaque rupture in the culprit lesion. Fasting blood glucose (FBG), hemoglobin A 1c (HbA 1c ) and 1,5-AG levels were measured before coronary angiography. Fasting urinary 8-iso-prostaglandin F 2α (8-iso-PGF 2α ) level was measured and corrected by creatinine clearance.Results: Patients with ruptured plaque had significantly lower serum 1,5-AG levels, longer duration of diabetes, higher HbA 1c and FBG levels than patients without ruptured plaque in our study population. In multivariate analysis, low 1,5-AG levels were an independent predictor of plaque rupture (odds ratio 3.421; P = 0.005) in diabetic patients with ACS. The area under the receiver-operating characteristic curve for 1,5-AG (0.658, P = 0.002) to predict plaque rupture was superior to that for HbA 1c (0.587, P = 0.087). Levels of 1,5-AG were significantly correlated with urinary 8-iso-prostaglandin F 2α levels (r = − 0.234, P = 0.005).Conclusions: Serum 1,5-AG may identify high risk for coronary plaque rupture in diabetic patients with ACS, which suggests PPG excursions are related to the pathogenesis of plaque rupture in diabetes.

The clinical impact of serum 1,5-anhydro-D-glucitol levels on coronary artery calcification and adverse outcomes assessed by coronary optical coherence tomography in diabetic patients

“…During the follow-up period in the present study, serum 1,5-AG levels were associated with adverse clinical events, including all-cause death, CV death, and TVR. In addition to the recent report that 1,5-AG may be related to plaque rupture in diabetic patients with ACS ( 48 ), we hypothesized that the relationship between 1,5-AG and CAC in our study may be another important contributing factor supporting the hypothesis that low serum 1,5-AG levels could predict adverse outcomes. Interestingly, recent studies have reported that an intensive glucose-lowering intervention may increase serum 1,5-AG levels ( 49 ) and attenuate the progression of CAC in patients with DM ( 50 ).…”

Recent Developments in Biomarkers for Diagnosis and Screening of Type 2 Diabetes Mellitus

“…Blood 1,5-AHG quantification of at-risk individuals could provide a targeted screening strategy to prevent the development of T2DM or identify those with asymptomatic diabetes [102]. The glycemic biomarker 1,5-AHG not only has a diagnostic application for diabetes, but it has the potential to evaluate the risk of long-term complications, including the most documented association with cardiovascular diseases and mortality in people with T2DM [96,102,103]. There is also evidence of its prognostic value for microvascular complications such as retinopathy and CKD [97].…”

1,5-Anhydroglucitol as a Marker of Acute Hyperglycemia in Cardiovascular Events

“…It is worth noting that, in this study, coronary atheroma volume and plaque burden were not significantly associated with serum levels of 1,5-AG [ 37 ]. A recent study conducted by Su et al confirmed that 1,5-AG serum levels are associated with high risk of coronary plaque rupture in diabetic patients with ACS, which correlates with postprandial glycemia and is related to the pathogenesis of plaque rupture in diabetes [ 38 ].…”