title: 1,5-Anhydroglucitol in saliva is a noninvasive marker of short-term glycemic control.
abstract: BACKGROUND
  In most ethnicities at least a quarter of all cases with diabetes is assumed to be undiagnosed. Screening for diabetes using saliva has been suggested as an effective approach to identify affected individuals.
  
  
  OBJECTIVE
  The objective of the study was to identify a noninvasive metabolic marker of type 2 diabetes in saliva.
  
  
  METHODS
  In a case-control study of type 2 diabetes, we used a clinical metabolomics discovery study to screen for diabetes-relevant metabolic readouts in saliva, using blood and urine as a reference. With a combination of three metabolomics platforms based on nontargeted mass spectrometry, we examined 2178 metabolites in saliva, blood plasma, and urine samples from 188 subjects with type 2 diabetes and 181 controls of Arab and Asian ethnicities.
  
  
  RESULTS
  We found a strong association of type 2 diabetes with 1,5-anhydroglucitol (1,5-AG) in saliva (P = 3.6 × 10(-13)). Levels of 1,5-AG in saliva highly correlated with 1,5-AG levels in blood and inversely correlated with blood glucose and glycosylated hemoglobin levels. These findings were robust across three different non-Caucasian ethnicities (Arabs, South Asians, and Filipinos), irrespective of body mass index, age, and gender.
  
  
  CONCLUSIONS
  Clinical studies have already established 1,5-AG in blood as a reliable marker of short-term glycemic control. Our study suggests that 1,5-AG in saliva can be used in national screening programs for undiagnosed diabetes, which are of particular interest for Middle Eastern countries with young populations and exceptionally high diabetes rates.
authors.affiliation: Department of Physiology and Biophysics (D.O.M.-K., J.R., N.A.Y., M.J.M.-K., W.A.A.M., K.S.) and Clinical Research Core (W.S.G., O.M.C., M.J.M.-K., S.A.K., C.M.), Weill Cornell Medical College, Qatar, Doha, Qatar; Department of Endocrinology (D.O.M.-K.), Leiden University Medical Centre, 2300 RC Leiden, The Netherlands; Departments of Dermatology (M.M.E.D.S., A.H.T., H.A.-H., K.A.S.A.-M., A.A.-O.) and Endocrinology (M.A.Z.), Hamad Medical Corporation, Doha, Qatar; Metabolon Inc (E.D.K.), Durham, North Carolina 27713; Unit of Periodontology (T.K.), Department of Restorative Dentistry, Periodontology, and Endodontology, University Medicine Greifswald, D-17487 Greifswald, Germany; and Institute of Bioinformatics and Systems Biology (K.S.), Helmholtz Zentrum München, German Research Center for Environmental Health, 85764 Neuherberg, Germany.
authors.forename: Dennis O
authors.initials: DO
authors.lastname: Mook-Kanamori
authors.forename: Mohammed M El-Din
authors.initials: MM
authors.lastname: Selim
authors.forename: Ahmed H
authors.initials: AH
authors.lastname: Takiddin
authors.forename: Hala
authors.initials: H
authors.lastname: Al-Homsi
authors.forename: Khoulood A S
authors.initials: KA
authors.lastname: Al-Mahmoud
authors.forename: Amina
authors.initials: A
authors.lastname: Al-Obaidli
authors.forename: Mahmoud A
authors.initials: MA
authors.lastname: Zirie
authors.forename: Jillian
authors.initials: J
authors.lastname: Rowe
authors.forename: Noha A
authors.initials: NA
authors.lastname: Yousri
authors.forename: Edward D
authors.initials: ED
authors.lastname: Karoly
authors.forename: Thomas
authors.initials: T
authors.lastname: Kocher
authors.forename: Wafaa
authors.initials: W
authors.lastname: Sekkal Gherbi
authors.forename: Omar M
authors.initials: OM
authors.lastname: Chidiac
authors.forename: Marjonneke J
authors.initials: MJ
authors.lastname: Mook-Kanamori
authors.forename: Sara
authors.initials: S
authors.lastname: Abdul Kader
authors.forename: Wadha A
authors.initials: WA
authors.lastname: Al Muftah
authors.forename: Cindy
authors.initials: C
authors.lastname: McKeon
authors.forename: Karsten
authors.initials: K
authors.lastname: Suhre
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000032:analysis / Q000378:metabolism; D001786:Blood Glucose / Q000378:metabolism*; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D003847:Deoxyglucose / Q000032:analysis / Q000378:metabolism*; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis* / Q000378:metabolism; D005260:Female; D006801:Humans; D008297:Male; D013058:Mass Spectrometry / Q000379:methods; D055432:Metabolomics / Q000379:methods; D008875:Middle Aged; D012463:Saliva / Q000737:chemistry / Q000378:metabolism*; D055815:Young Adult
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; C006584:1,5-anhydroglucitol; D003847:Deoxyglucose