Elizabeth Selvin1, Andreea M Rawlings2, Morgan Grams3, Ronald Klein4, Michael Steffes5, Josef Coresh6. 1. 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. 2. Department of Epidemiology and the Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; 3. Department of Epidemiology and the Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Division of Nephrology, Department of Medicine, Johns Hopkins University, Baltimore, MD; 4. Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health; 5. Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MD. 6. 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;
Abstract
BACKGROUND: 1,5-Anhydroglucitol (1,5-AG) is inversely related to hyperglycemia and may be a useful indicator of short-term (1-2 weeks) hyperglycemia and glycemic excursions, but its prognostic value is unclear. We sought to evaluate the associations of 1,5-AG with risk of diabetes and microvascular disease. METHODS: We measured 1,5-AG in blood samples from over 10 000 participants in the ARIC (Atherosclerosis Risk in Communities) Study (baseline, 1990-1992) and characterized the independent associations with prevalent retinopathy and with incident chronic kidney disease and incident diabetes during approximately 20 years of follow-up. RESULTS: We found that 1,5-AG was associated with prevalent retinopathy, driven primarily by the strong association in persons with diagnosed diabetes: adjusted odds ratio (OR) 11.26 (95% CI, 6.17-20.53) for <6 μg/mL compared to 1,5-AG ≥10 μg/mL. This result remained significant after further adjustment for hemoglobin A(1c) (Hb A(1c)) (OR, 4.85; 95% CI, 2.42-9.74). In persons with diagnosed diabetes, low 1,5-AG (<6 μg/mL vs ≥10 μg/mL) was also associated with a >2-fold increased risk of incident chronic kidney disease [adjusted hazard ratio (HR), 2.83; 95% CI, 2.15-3.74] and remained significant after adjustment for Hb A(1c) (HR, 1.43; 95% CI, 1.02-2.00). Nondiabetic participants with high 1,5-AG (≥10 μg/mL) had the lowest prevalence of retinopathy and lowest risk of kidney disease. In persons without diagnosed diabetes at baseline, 1,5-AG <10 μg/mL was also associated with incident diabetes (adjusted HR, 2.29; 95% CI, 2.03-2.58). CONCLUSIONS: 1,5-AG was associated with long-term risk of important microvascular outcomes, particularly in persons with diagnosed diabetes and even after adjustment for Hb A(1c). Our results suggest 1,5-AG may capture risk information associated with hyperglycemic excursions.
BACKGROUND:1,5-Anhydroglucitol (1,5-AG) is inversely related to hyperglycemia and may be a useful indicator of short-term (1-2 weeks) hyperglycemia and glycemic excursions, but its prognostic value is unclear. We sought to evaluate the associations of 1,5-AG with risk of diabetes and microvascular disease. METHODS: We measured 1,5-AG in blood samples from over 10 000 participants in the ARIC (Atherosclerosis Risk in Communities) Study (baseline, 1990-1992) and characterized the independent associations with prevalent retinopathy and with incident chronic kidney disease and incident diabetes during approximately 20 years of follow-up. RESULTS: We found that 1,5-AG was associated with prevalent retinopathy, driven primarily by the strong association in persons with diagnosed diabetes: adjusted odds ratio (OR) 11.26 (95% CI, 6.17-20.53) for <6 μg/mL compared to 1,5-AG ≥10 μg/mL. This result remained significant after further adjustment for hemoglobin A(1c) (Hb A(1c)) (OR, 4.85; 95% CI, 2.42-9.74). In persons with diagnosed diabetes, low 1,5-AG (<6 μg/mL vs ≥10 μg/mL) was also associated with a >2-fold increased risk of incident chronic kidney disease [adjusted hazard ratio (HR), 2.83; 95% CI, 2.15-3.74] and remained significant after adjustment for Hb A(1c) (HR, 1.43; 95% CI, 1.02-2.00). Nondiabetic participants with high 1,5-AG (≥10 μg/mL) had the lowest prevalence of retinopathy and lowest risk of kidney disease. In persons without diagnosed diabetes at baseline, 1,5-AG <10 μg/mL was also associated with incident diabetes (adjusted HR, 2.29; 95% CI, 2.03-2.58). CONCLUSIONS:1,5-AG was associated with long-term risk of important microvascular outcomes, particularly in persons with diagnosed diabetes and even after adjustment for Hb A(1c). Our results suggest 1,5-AG may capture risk information associated with hyperglycemic excursions.
Authors: David J Couper; Ronald Klein; Larry D Hubbard; Tien Yin Wong; Paul D Sorlie; Lawton S Cooper; Rosemary J Brothers; F Javier Nieto Journal: Am J Ophthalmol Date: 2002-01 Impact factor: 5.258
Authors: L D Hubbard; R J Brothers; W N King; L X Clegg; R Klein; L S Cooper; A R Sharrett; M D Davis; J Cai Journal: Ophthalmology Date: 1999-12 Impact factor: 12.079
Authors: Antonio Ceriello; Claudio Taboga; Laura Tonutti; Lisa Quagliaro; Ludovica Piconi; Bruno Bais; Roberto Da Ros; Enrico Motz Journal: Circulation Date: 2002-09-03 Impact factor: 29.690
Authors: Morgan E Grams; Casey M Rebholz; Blaithin McMahon; Seamus Whelton; Shoshana H Ballew; Elizabeth Selvin; Lisa Wruck; Josef Coresh Journal: Am J Kidney Dis Date: 2014-04-13 Impact factor: 8.860
Authors: Bruce B Duncan; Maria Inês Schmidt; James S Pankow; Christie M Ballantyne; David Couper; Alvaro Vigo; Ron Hoogeveen; Aaron R Folsom; Gerardo Heiss Journal: Diabetes Date: 2003-07 Impact factor: 9.461
Authors: Elizabeth Selvin; Andreea M Rawlings; Morgan Grams; Ronald Klein; A Richey Sharrett; Michael Steffes; Josef Coresh Journal: Lancet Diabetes Endocrinol Date: 2014-01-15 Impact factor: 32.069
Authors: Bethany Warren; Alexandra K Lee; Christie M Ballantyne; Ron C Hoogeveen; James S Pankow; Morgan E Grams; Anna Köttgen; Elizabeth Selvin Journal: J Appl Lab Med Date: 2020-11-01
Authors: Christina M Parrinello; A Richey Sharrett; Nisa M Maruthur; Richard M Bergenstal; Morgan E Grams; Josef Coresh; Elizabeth Selvin Journal: Diabetes Care Date: 2015-12-17 Impact factor: 19.112
Authors: Gesiane Tavares; Gabriela Venturini; Kallyandra Padilha; Roberto Zatz; Alexandre C Pereira; Ravi I Thadhani; Eugene P Rhee; Silvia M O Titan Journal: Metabolomics Date: 2018-02-27 Impact factor: 4.290
Authors: Shengyuan Luo; Josef Coresh; Adrienne Tin; Casey M Rebholz; Lawrence J Appel; Jingsha Chen; Ramachandran S Vasan; Amanda H Anderson; Harold I Feldman; Paul L Kimmel; Sushrut S Waikar; Anna Köttgen; Anne M Evans; Andrew S Levey; Lesley A Inker; Mark J Sarnak; Morgan Erika Grams Journal: Clin J Am Soc Nephrol Date: 2019-02-07 Impact factor: 8.237
Authors: Morgan E Grams; Casey M Rebholz; Yuan Chen; Andreea M Rawlings; Michelle M Estrella; Elizabeth Selvin; Lawrence J Appel; Adrienne Tin; Josef Coresh Journal: J Am Soc Nephrol Date: 2016-03-10 Impact factor: 10.121
Authors: Menglu Liang; John William McEvoy; Yuan Chen; A Richey Sharrett; Elizabeth Selvin Journal: Diabetes Care Date: 2016-08-01 Impact factor: 19.112
Authors: Casey M Rebholz; Morgan E Grams; Yuan Chen; Alden L Gross; Yingying Sang; Josef Coresh; Elizabeth Selvin Journal: Am J Epidemiol Date: 2017-10-15 Impact factor: 4.897
Authors: Casey M Rebholz; Elizabeth Selvin; Menglu Liang; Christie M Ballantyne; Ron C Hoogeveen; David Aguilar; John W McEvoy; Morgan E Grams; Josef Coresh Journal: Kidney Int Date: 2017-08-31 Impact factor: 10.612