title: Association of 1,5-Anhydroglucitol With Cardiovascular Disease and Mortality.
abstract: In diabetes, low concentrations of the biomarker 1,5-anhydroglucitol (1,5-AG) reflect hyperglycemic excursions over the prior 1-2 weeks. To the extent that hyperglycemic excursions are important in atherogenesis, 1,5-AG may provide independent information regarding cardiovascular risk. Nonetheless, few studies have evaluated associations of 1,5-AG with long-term cardiovascular outcomes in a population-based setting. We measured 1,5-AG in 11,106 participants in the Atherosclerosis Risk in Communities (ARIC) study without cardiovascular disease at baseline (1990-1992) and examined prospective associations with coronary heart disease (n = 1,159 events), ischemic stroke (n = 637), heart failure (n = 1,553), and death (n = 3,120) over 20 years of follow-up. Cox proportional hazards models were adjusted for demographic and cardiovascular risk factors. Compared with persons with 1,5-AG ≥6 μg/mL and no history of diabetes, persons with diabetes and 1,5-AG <6.0 μg/mL had an increased risk of coronary heart disease (HR 3.85, 95% CI 3.11-4.78), stroke (HR 3.48, 95% CI 2.66-4.55), heart failure (HR 3.50, 95% CI 2.93-4.17), and death (HR 2.44, 95% CI 2.11-2.83). There was a threshold effect, with little evidence for associations at "nondiabetic" concentrations of 1,5-AG (e.g., >10 μg/mL). Associations remained but were attenuated with additional adjustment for fasting glucose or HbA1c. These data add to the growing evidence for the prognostic value of 1,5-AG for long-term complications in the setting of diabetes.
authors.affiliation: Department of Epidemiology and the Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD Division of General Internal Medicine, Department of Medicine, Johns Hopkins University, Baltimore, MD eselvin@jhu.edu.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Selvin
authors.affiliation: Department of Epidemiology and the Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
authors.forename: Andreea
authors.initials: A
authors.lastname: Rawlings
authors.affiliation: Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN.
authors.forename: Pamela
authors.initials: P
authors.lastname: Lutsey
authors.affiliation: Department of Epidemiology and the Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD Division of General Internal Medicine, Department of Medicine, Johns Hopkins University, Baltimore, MD.
authors.forename: Nisa
authors.initials: N
authors.lastname: Maruthur
authors.affiliation: Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN.
authors.forename: James S
authors.initials: JS
authors.lastname: Pankow
authors.affiliation: Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN.
authors.forename: Michael
authors.initials: M
authors.lastname: Steffes
authors.affiliation: Department of Epidemiology and the Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD Division of General Internal Medicine, Department of Medicine, Johns Hopkins University, Baltimore, MD.
authors.forename: Josef
authors.initials: J
authors.lastname: Coresh
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases / Q000097:blood / Q000453:epidemiology; D003327:Coronary Disease / Q000097:blood* / Q000453:epidemiology; D003847:Deoxyglucose / Q000097:blood*; D003920:Diabetes Mellitus / Q000097:blood* / Q000453:epidemiology; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006333:Heart Failure / Q000097:blood* / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009026:Mortality; D016016:Proportional Hazards Models; D011446:Prospective Studies; D020521:Stroke / Q000097:blood* / Q000453:epidemiology; D014481:United States / Q000453:epidemiology
chemical_list: D003847:Deoxyglucose; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human; C006584:1,5-anhydroglucitol