Using Serum Advanced Glycation End Products-Peptides to Improve the Efficacy of World Health Organization Fasting Plasma Glucose Criterion in Screening for Diabetes in High-Risk Chinese Subjects

Sun, Zilin; He, Jia; Qiu, Shanhu; Lei, Cheng-Hao; Zhou, Yi; Xie, Zuolin; Zhang, Lin; Wang, Yanping; Jin, Hui

doi:10.1371/journal.pone.0137756

Cited by 6 publications

(6 citation statements)

References 43 publications

(49 reference statements)

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“…The sensitivity of using FPG alone for detecting diabetes was 56.1%, which is consistent with several other cross-sectional studies. [ 18 19 ] However, the efficacy of FPG for diabetes screening has been questioned. Therefore, some studies have attempted to improve the efficacy of FPG in diabetes screening by introducing new strategies.…”

Section: Discussionmentioning

confidence: 99%

“…However, HbA1c may not be suitable for mass screening of large populations because it is relatively expensive. Our previous study demonstrated that the use of serum advanced glycation end products-peptides substantially improved the efficacy of FPG in diabetes screening among high-risk Chinese individuals,[ 19 ] for which a sensitivity of 91.2% was found by combined utilization of advanced glycation end products-peptides and FPG. Nevertheless, the efficacy of advanced glycation end products-peptides in the general population for diabetes screening is unknown.…”

Section: Discussionmentioning

confidence: 99%

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Identification of Newly Diagnosed Diabetes and Prediabetes Using Fasting Plasma Glucose and Urinary Glucose in a Chinese Population

Chen

Guo

Qiu

et al. 2018

Chinese Medical Journal

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Background:Although fasting plasma glucose (FPG) has been highly recommended as the sole test for diabetes screening, the efficacy of FPG alone for diabetes screening is potentially limited due to its low sensitivity. The aim of this study was to improve the efficacy of FPG for diabetes screening using urinary glucose (UG).Methods:This study was initiated on November 12, 2015, and ended on June 28, 2016. A representative sample of individuals aged between 18 and 65 years, with no history of diabetes, from 6 cities in Jiangsu Province participated in this study. A 75-g oral glucose tolerance test was used to diagnose diabetes. All urine samples were collected within 2 h of oral glucose loading to measure UG. Partial correlation analyses were used to evaluate the associations between UG and other glycemic variables, including FPG, 2-h plasma glucose (2h-PG), and glycated hemoglobin A1c, after adjustment for age. The performance of UG was evaluated using a receiver operating characteristic (ROC) curve analysis.Results:Of the 7485 individuals included, 8% were newly diagnosed with diabetes and 48.7% had prediabetes. The areas under the ROC curves for UG were 0.75 for estimation of 2h-PG ≥7.8 mmol/L and 0.90 for 2h-PG ≥11.1 mmol/L, respectively. The sensitivity and specificity of UG were 52.3% and 87.8%, respectively, for 2h-PG ≥7.8 mmol/L (cutoff point ≥130 mg), and 83.5% and 87.5%, respectively, for 2h-PG ≥11.1 mmol/L (cutoff point ≥178.5 mg). The combination of FPG and UG demonstrated a significantly higher sensitivity than that of FPG alone for the identification of diabetes ([483/597] 80.9% vs. [335/597] 56.1%, χ2 = 85.0, P < 0.001) and glucose abnormalities ([2643/4242] 62.3% vs. [2365/4242] 55.8%, χ2 = 37.7, P < 0.001).Conclusions:The combination of UG and FPG substantially improves the efficacy of using FPG alone for diabetes screening; this combination might be a practical screening tool and is worth being recommended in the future.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Identification of Newly Diagnosed Diabetes and Prediabetes Using Fasting Plasma Glucose and Urinary Glucose in a Chinese Population

Chen

Guo

Qiu

et al. 2018

Chinese Medical Journal

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“…Our exclusion criteria should also minimize any vulnerability related to individual differences in systemic or ocular diseases and their treatment. Because protein carbonyls and AGEs have been found elevated in other patient groups, including those with diabetes mellitus, 43 , 44 such patients, as well as patients with other ocular diseases, were excluded from our study groups. In addition, our study participants did not have previous vitrectomy, endothelial keratoplasty, or cataract surgery, which have been suggested to increase oxidative stress in the anterior chamber.…”

Section: Discussionmentioning

confidence: 99%

“…It is similarly appealing to further determine as to whether the lack of correlation between blood and aqueous humor levels of protein carbonyls (different than AGEs that exhibited a positive correlation between blood and aqueous humor levels) may suggest a higher specificity as a glaucoma-related biomarker. Particularly respecting the relation of protein carbonyls or AGEs to other diseases, such as diabetes mellitus, 43 , 44 continued longitudinal analysis in larger and heterogeneous cohorts of patients, with or without glaucoma, should help proper calculation of biomarker sensitivity and specificity for clinical prediction of glaucoma and its progression.…”

Section: Discussionmentioning

confidence: 99%

Oxidative Stress–Related Molecular Biomarker Candidates for Glaucoma

Hondur

Göktaş

Yang

et al. 2017

Invest. Ophthalmol. Vis. Sci.

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PurposeGlaucoma-related molecular biomarkers can improve clinical testing to diagnose the disease early, predict its prognosis, and monitor treatment responses. Based on the evidence of increased oxidative stress in glaucomatous tissues, this study analyzed oxidative stress–related biomarker candidates in blood and aqueous humor samples with or without glaucoma.MethodsThe blood and aqueous humor samples collected from carefully selected groups of 96 patients with glaucoma and 64 healthy subjects without glaucoma were included in the study. The samples were analyzed for protein carbonyls and advanced glycation end products (AGEs) through ELISA-based quantification assays. To allow proper comparisons, the Goldmann-Witmer coefficient that reflects the ratio of aqueous humor to blood values corrected to total protein concentration in individual samples was calculated.ResultsBlood and aqueous humor levels of protein carbonyls and AGEs were found significantly higher in glaucomatous samples compared with age-matched nonglaucomatous controls (P < 0.001). The glaucoma-related increase in protein carbonyls and AGEs was more prominent in aqueous humor samples than blood samples (2.6-fold versus 1.9-fold for protein carbonyls, and 3.1-fold versus 1.9-fold for AGEs; P < 0.001). Comparison of the Goldmann-Witmer coefficients indicated greater values for protein carbonyls (1.37 ± 0.3 vs. 3.07 ± 0.8) and AGEs (1.2 ± 0.3 vs. 3.2 ± 1.1) in the glaucoma group (P < 0.001).ConclusionsFindings of this study encourage further validation studies of oxidative stress–related biomarkers in glaucoma. Analysis of protein carbonyls and AGEs in longitudinal studies of larger and heterogeneous patient cohorts should better assess the value of these promising candidates as molecular biomarkers of glaucoma for clinical predictions.

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“…Furthermore, AGE-P exhibits the same toxic activity as AGEs, and AGE-P has been recognized to be responsible for complications of diabetes such as diabetic nephropathy [ 11 , 12 ]. More importantly, a reliable and reproducible assay for determining the serum AGE-P concentrations has been successfully validated in previous studies [ 13 – 15 ].…”

Section: Introductionmentioning

confidence: 99%

RAGE and AGEs in Mild Cognitive Impairment of Diabetic Patients: A Cross-Sectional Study

Wang

Huang

et al. 2016

PLoS ONE

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ObjectiveReceptor for advanced glycation end products (AGEs; RAGE) binds to both AGEs and amyloid-beta peptides. RAGE is involved in chronic complications of type 2 diabetes and Alzheimer’s disease. We aimed to investigate the roles of RAGE, AGEs and the Gly82Ser polymorphism of RAGE in mild cognitive impairment (MCI) among type 2 diabetes patients.MethodsOf the 167 hospitalized type 2 diabetes patients recruited, 82 satisfied the diagnostic criteria for MCI, and 85 matched control individuals were classified as non-MCI. Demographic data were collected, and the soluble RAGE (sRAGE) concentrations, serum AGE-peptide (AGE-P) levels, RAGE Gly82Ser genotype and neuropsychological test results were examined.ResultsThe MCI group exhibited a decreased sRAGE level (0.87±0.35 vs. 1.05±0.52 ng/ml, p<0.01) and an increased serum AGE-P level (3.54±1.27 vs. 2.71±1.18 U/ml, p<0.01) compared with the control group. Logistic regression analysis indicated that each unit reduction in the sRAGE concentration increased the MCI risk by 54% (OR 0.46[95% CI 0.22–0.96], p = 0.04) and that each unit increase in the AGE-P level increased the MCI risk by 72% in the type 2 diabetes patients (OR 1.72[95% CI 1.31–2.28], p<0.01). The serum sRAGE level was negatively correlated with the score on the trail making test-B (TMT-B) (r = -0.344, p = 0.002), which indicates early cognitive deficits related to diabetes. Moreover, the AGE-P level was positively correlated with multiple cognitive domains (all p<0.05). No significant differences in the neuropsychological test results or serum RAGE concentrations between the different RAGE genotypes or in the RAGE genotype frequencies between the MCI and control groups were identified (all p>0.05).ConclusionsThe RAGE pathway partially mediates AGE-induced MCI in diabetic patients. The serum AGE-P level may serve as a serum biomarker of MCI in these individuals, and sRAGE represents a predictor and even a potential intervention target of early cognitive decline in type 2 diabetes patients.Trial registrationAdvanced Glycation End Products Induced Cognitive Impairment in Diabetes: BDNF Signal Meditated Hippocampal Neurogenesis ChiCTR-OCC-15006060

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Using Serum Advanced Glycation End Products-Peptides to Improve the Efficacy of World Health Organization Fasting Plasma Glucose Criterion in Screening for Diabetes in High-Risk Chinese Subjects

Cited by 6 publications

References 43 publications

Identification of Newly Diagnosed Diabetes and Prediabetes Using Fasting Plasma Glucose and Urinary Glucose in a Chinese Population

Identification of Newly Diagnosed Diabetes and Prediabetes Using Fasting Plasma Glucose and Urinary Glucose in a Chinese Population

Oxidative Stress–Related Molecular Biomarker Candidates for Glaucoma

RAGE and AGEs in Mild Cognitive Impairment of Diabetic Patients: A Cross-Sectional Study

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