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- Title
Clinical Application of 1,5-Anhydroglucitol Measurements in Patients with Hepatocyte Nuclear Factor-1α Maturity-Onset Diabetes of the Young.
- Authors
Skupien, Jan; Gorczynska-Kosiorz, Sylwia; Klupa, Tomasz; Wanic, Krzysztof; Button, Eric A.; Sieradzki, Jacek; Malecki, Maciej T.
- Abstract
OBJECTIVE -- 1,5-anhydroglucitol (1,5-AG) is a short-term marker of metabolic control in diabetes. Its renal loss is stimulated in hyperglycemic conditions by glycosuria, which results in a lowered plasma concentration. As a low renal threshold for glucose has been described in hepatocyte nuclear factor-1α (HNF-1α) maturity-onset diabetes of the young (MODY), the 1,5-AG level may be altered in these patients. The purpose of this study was to assess the 1,5-AG levels in patients with HNF-1α MODY and in type 2 diabetic subjects with a similar degree of metabolic control. In addition, we aimed to evaluate this particle as a biomarker for HNF-1α MODY. RESEARCH DESIGN AND METHODS -- We included 33 diabetic patients from the Polish Nationwide Registry of MODY. In addition, we examined 43 type 2 diabetic patients and 47 nondiabetic control subjects. The 1,5-AG concentration was measured with an enzymatic assay (GlycoMark). Receiver operating characteristic (ROC) curve analysis was used to evaluate 1,5-AG as a screening marker for HNF-1α MODY. RESULTS -- The mean 1,5-AG plasma concentration in diabetic HNF-1α mutation carriers was 5.9 µg/ml, and it was lower than that in type 2 diabetic patients (11.0 µg/ml, P = 0.003) and in nondiabetic control subjects (23.9 µg/ml, P < 0.00005). The ROC curve analysis revealed 85.7% sensitivity and 80.0% specificity of 1,5-AG in screening for HNF-1α MODY at the criterion of <6.5 µg/ml in patients with an A1C level between 6.5 and 9.0%. CONCLUSIONS -- 1,5-AG may be a useful biomarker for differential diagnosis of patients with HNF-1α MODY with a specific range of A1C, although this requires further investigation. However, the clinical use of this particle in diabetic HNF-1α mutation carriers for metabolic control has substantial limitations.
- Subjects
METABOLIC regulation; LIVER cells; DIABETES in children; PEOPLE with diabetes; GLYCOSURIA
- Publication
Diabetes Care, 2008, Vol 31, Issue 8, p1496
- ISSN
0149-5992
- Publication type
Article
- DOI
10.2337/dc07-2334