Abstract MP23: The Prognostic Value of 1,5-anhydroglucitol
Background: 1,5-anhydroglucitol (1,5-AG) is inversely related to glucose excursions and is thought to be a useful indicator of short-term (1-2 week) hyperglycemia. A commercial assay for 1,5-AG is approved for use in the USA but the relationship of 1,5-AG to long-term outcomes is unclear.
Methods: We measured 1,5-AG in stored serum samples from 11,106 participants in the ARIC Study without cardiovascular disease at baseline (1990-1992) and examined prospective associations with clinical outcomes. Cox models were adjusted for demographic, lifestyle, and clinical variables.
Results: During 20 years of follow-up, there were 2,601 incident cases of diabetes (among the 10,344 persons without diabetes at baseline), 2,928 incident cases of cardiovascular disease, 1,328 incident cases of chronic kidney disease (among the 10,951 persons with normal kidney function at baseline) and 2,595 deaths. There were 137 prevalent cases of retinopathy (among 516 persons with diabetes) identified in 1993-1996 when retinal photographs were taken. Compared to persons with 1,5-AG concentrations ≥10 ug/mL and no history of diabetes, persons with diabetes and 1,5-AG <6.0 ug/mL had significantly higher risks of chronic kidney disease (HR 4.45, 3.69-5.37), coronary heart disease (HR 3.81, 3.04-4.78), ischemic stroke (HR 3.84, 2.91-5.06), heart failure (HR 3.63, 3.01-4.38), and total mortality (HR 2.48, 2.12-2.91). Associations in persons with diabetes were attenuated but remained significant after adjustment for HbA1c. In persons with diabetes, 1,5-AG <6.0 ug/mL was associated with a higher prevalence of retinopathy compared to persons with 1,5-AG ≥10 ug/mL (OR 12.90, 6.74-24.69). In persons without diabetes at baseline, 1,5-AG <10 ug/mL was also associated with incident diabetes (HR 2.24, 1.97-2.54). Multivariable-adjusted spline models show the continuous associations of 1,5-AG with the prospective outcomes (Figure).
Conclusions: 1,5-AG provides prognostic information regarding long-term risk of important clinical outcomes.
Author Disclosures: E. Selvin: None. A.M. Rawlings: None. M. Grams: None. J.S. Pankow: None. A. Sharrett: None. M. Steffes: None. J. Coresh: None.
- © 2014 by American Heart Association, Inc.