title: Association of reduced levels of serum 1,5-Anhydro-d-glucitol with carotid atherosclerosis in patients with type 2 diabetes.
abstract: BACKGROUND
  HbA1c level represents mean blood glycemic control. 1,5-Anhydro-d-glucitol (1,5-AG) level reflects glycemic fluctuations, a strong risk factor for the development of macroangiopathy. The present study investigated the relationship between serum 1,5-AG levels and macroangiopathy in patients with type 2 diabetes.
  
  
  METHODS
  A total of 115 consecutive patients with type 2 diabetes, aged 45-79 years, were included. HbA1c, 1,5-AG, and lipid profile were measured. Carotid maximum intima-media thickness (IMT) and plaque score (PS) were determined by carotid sonography. An 1,5-AG level < 14.2 μg/mL was used as a predictor of a post-challenge 2-h blood glucose level > 200 mg/dL. Patients were divided into four groups: A (n=32), HbA1c ≥ 6.5% and 1,5-AG<14.2 μg/mL; B (n=23), HbA1c ≥ 6.5% and 1,5-AG ≥ 14.2 μg/mL; C (n=24), HbA1c < 6.5% and 1,5-AG <14.2 μg/mL; and D (n=36), HbA1c < 6.5% and 1,5-AG ≥ 14.2 μg/mL.
  
  
  RESULTS
  HbA1c level had significant positive correlation with IMT and PS. 1,5-AG level had a significant negative correlation with PS. PS was significantly higher in group C than in group D, but similar to that in group B. In multivariate analysis, HbA1c (β=0.27, p=0.03) and 1,5-AG (β=-0.24, P=0.04) were independent determinants of PS.
  
  
  CONCLUSIONS
  1,5-AG level might provide additional information to identify macroangiopathy of patients with type 2 diabetes, especially in those with excellent HbA1c levels.
authors.affiliation: Itoigawa General Hospital, Niigata, Japan. Electronic address: kirotaro19731013@yahoo.co.jp.
authors.forename: Takao
authors.initials: T
authors.lastname: Sato
authors.affiliation: The Second Department of Internal Medicine, University of Toyama, Toyama, Japan.
authors.forename: Tomoki
authors.initials: T
authors.lastname: Kameyama
authors.affiliation: The Second Department of Internal Medicine, University of Toyama, Toyama, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Inoue
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D002339:Carotid Arteries / Q000000981:diagnostic imaging; D002340:Carotid Artery Diseases / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology*; D003847:Deoxyglucose / Q000097:blood*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications*; D003925:Diabetic Angiopathies / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D012307:Risk Factors; D012720:Severity of Illness Index; D014463:Ultrasonography
chemical_list: D015415:Biomarkers; D003847:Deoxyglucose; D006442:Glycated Hemoglobin; C006584:1,5-anhydroglucitol
keywords: 1,5-anhydro-d-glucitol; Atherosclerosis; Maximum intima–media thickness; Plaque score; Type 2 diabetes