Effects of Sex and Age on Serum 1,5-anhydroglucitol in Nondiabetic Subjects

Abstract

Aims:

The aim of this study was to demonstrate the effects of sex and age on serum levels of 1,5-AG in nondiabetic subjects.

Methods:

A total of 1 134 nondiabetic subjects aged 16–96 years with HbA1c less than 6.8% were recruited and divided into 4 HbA1c groups (Q1: HbA1c≤5.3; Q2: 5.4–5.8; Q3: 5.9–6.3; and Q4: 6.4–6.8 [%]). 38 elderly subjects (65 years or older) in the Q3 and Q4 groups (13 men and 25 women) underwent a 75-g oral glucose tolerance test (OGTT).

Results:

The Q4 group had significantly lower 1,5-AG levels than did the Q1 group among nonelderly males, nonelderly females, and elderly men. In elderly women, 1,5-AG levels did not differ among the 4 HbA1c groups. In both nonelderly and elderly subjects, the 1,5-AG level of the Q1 group was significantly higher in males than in females. Stepwise multivariate regression analysis showed that age was significantly associated with 1,5-AG level in both sexes. HbA1c was significantly associated with the 1,5-AG level in males, while there was no significant association between HbA1c and the 1,5-AG level in females. In the elderly OGTT group, although the glucose levels of both sexes during OGTT were identical, the mean urinary glucose levels and the percentages of subjects with glucosuria were significantly higher in elderly men than in elderly women.

Conclusions:

Serum 1,5-AG levels were significantly associated with age and sex. The sensitivity of the 1,5-AG level for identifying postprandial hyperglycemia in elderly women with near-normoglycemia is less reliable because they have a higher renal threshold for glucose.

Key words

1,5-anhydroglucitol - renal threshold - glucosuria - age - sex - nondiabetics

• References

• 1 The DECODE study group on behalf of the European Diabetes Epidemiology Group . Glucose tolerance and mortality: comparison of WHO and American Diabetic Association diagnostic criteria. Lancet 1999; 354: 617-621
• 2 Ceriello A, Hanefeld M, Leiter L et al. for the International Prandial Glucose Regulation (PGR) Study group: Postprandial glucose regulation and diabetic complications. Arch Intern Med 2004; 164: 2090-2095
• 3 Tominaga M, Igarashi K, Eguchi H et al. Impaired glucose tolerance is a risk factor for cardiovascular disease, but not impaired fasting glucose. The Funagata Diabetes Study. Diabetes Care 1999; 22: 920-924
• 4 Watanabe K, Oba K, Suzuki T et al. Oral glucose loading attenuates endothelial function in normal individual. Eur J Clin Invest 2011; 41: 465-473
• 5 Weyer C, Bogardus C, Mott DM et al. The natural history of insulin secretory dysfunction and insulin resistance in the pathogenesis of type 2 diabetes mellitus. J Clin Invest 1999; 104: 787-794
• 6 Gerich JE. Pathogenesis and treatment of type 2 (noninsulin-dependent) diabetes mellitus (NIDDM). Horm Metab Res 1996; 28: 404-412
• 7 Stickle D, Turk J. A kinetic mass balance model for 1,5-anhydroglucitol: applications to monitoring of glycemic control. Am J Physiol 1997; 273: E821-E830
• 8 Yamanouchi T, Ogata N, Tagaya T et al. Clinical usefulness of serum 1,5-anhydroglucitol in monitoring glycaemic control. Lancet 1996; 347: 1514-1518
• 9 Yamanouchi T, Akanuma Y. Serum 1,5-anhydroglucitol (1,5-AG): new clinical marker for glycemic control. Diabetes Res Clin Pract 1994; 24: S261-S268
• 10 Yoshioka K, Azukari K, Yoshida T et al. Rapid improvement of serum 1,5-anhydroglucitol concentrations after administration of α-glucosidase inhibitor. Diabetes Care 1997; 20: 462
• 11 Matsumoto K, Yano M, Miyake S et al. Effects of voglibose on glycemic excursions, insulin secretion, and insulin sensitivity in non-insulin-treated NIDDM patients. Diabetes Care 1998; 21: 256-260
• 12 Yamanouchi T, Akanuma H, Nakamura T et al. Reduction of plasma 1,5-anhydroglucitol (1-deoxyglucose) concentration in diabetic patients. Diabetologia 1988; 31: 41-45
• 13 Funasako M, Taniji M, Fujimoto K et al. Effect of aging on plasma 1,5-anhydroglucitol levels in humans and rats. Diabetes Res Clin Pract 1994; 25: 35-41
• 14 Tsukui S, Fukumura Y, Kobayashi I. Decreased serum 1,5-anhydroglucitol in nondiabetic subjects with family history of NIDDM. Diabetes Care 1996; 19: 940-944
• 15 Watanabe M, Kokubo Y, Higashiyama A et al. Serum 1,5-anhydro-D-glucitol levels predict first-ever cardiovascular disease: an 11-year population-based cohort study in Japan, the Suita study. Atherosclerosis 2011; 216: 477-483
• 16 Fukumura Y, Tajima S, Oshitani S et al. Fully enzymatic method for detecting 1,5-anhydro-D-glucitol in serum. Clin Chem 1994; 40: 2013-2016
• 17 Committee on Diabetes Mellitus Indices, Japan Society of Clinical Chemistry . Japanese guideline for reporting HbA1c results reported in IFCC units and JDS units. Rinsho Kagaku 2008; 37: 393-409 (In Japanese)
• 18 Meguro S, Tomita M, Katsuki T et al. Plasma 25-hydroxyvitamin D is independently associated with hemoglobin concentration in male subjects with type 2 diabetes mellitus. Int J Endocrinol 2011; (International Journal of Endocrinology Advance Access published on Jun 6, 2011 DOI: 10.1155/2011/362981. )
• 19 The Committee of Japan Diabetes Society on the diagnostic criteria of diabetes mellitus . Report of the committee on the classification and diagnostic criteria of diabetes mellitus. J Jpn Diabetes Soc 2010; 53: 450-467
• 20 Matsuo S, Imai E, Horio M et al. Revised equations for estimated GFR from serum creatinine in Japan. Am J Kidney Dis 2009; 53: 982-992
• 21 Ohta M, Babazono T, Uchigata Y et al. Comparison of the prevalence of chronic kidney disease in Japanese patients with type 1 and type 2 diabetes. Diabet Med 2010; 27: 1017-1023
• 22 Monnier L, Lapinski H, Colette C. Contributions of fasting and postprandial plasma glucose increments to the overall diurnal hyperglycemia of type 2 diabetic patients: variations with increasing levels of HbA(1c). Diabetes Care 2003; 26: 881-885
• 23 Davidson MB. The effect of aging on carbohydrate metabolism: a review of the English literature and a practical approach to the diagnosis of diabetes mellitus in the elderly. Metabolism 1979; 28: 688-705
• 24 Servo C, Palo J, Pitkänen E. Polyols in the cerebrospinal fluid and plasma of neurological, diabetic and uraemic patients. Acta Neurol Scand 1977; 56: 111-116
• 25 Emoto M, Tabata T, Inoue T et al. Plasma 1,5-anhydroglucitol concentration in patients with end-stage renal disease with and without diabetes mellitus. Nephron 1992; 61: 181-186
• 26 Yamanouchi T, Tachibana Y, Akanuma H et al. Origin and disposal of 1,5-anhydroglucitol, a major polyol in the human body. Am J Physiol 1992; 263: E268-E273
• 27 Anonymous . Daily fat and total food energy intakes. Third National Health and Nutrition Examination Survey. phase 1. 1988–1991. MMWR Morb Mortal Wkly Rep 1994; 43: 116-125
• 28 National Institute of Health and Nutrition, Japan. Outline for the Results of the National Health and Nutrition Survey Japan. 2007 Available from http://www.nih.go.jp/eiken/english/research/pdf/nhns2007.pdf
• 29 Steinberg AG. Genetics and diabetes. In: Leibel BS, Wrenshall GA. 4^th eds. On the nature and treatment of diabetes. Amsterdam: Excerpta Medica Foundation; 1965: 601-611
• 30 Butterfield WJH, Keen H, Whichelow MJ. Renal glucose threshold variations with age. Br Med J 1967; 4: 505-507
• 31 Sandhu S, Wiebe N, Fried LF et al. Statins for improving renal outcomes: a meta-analysis. J Am Soc Nephrol 2006; 17: 2006-2016
• 32 Sattar N, Preiss D, Murray H et al. Statins and risk of incident diabetes: a collaborative meta-analysis of randomised statin trials. Lancet 2010; 375: 735-742
• 33 Koga M, Murai J, Saito H et al. Close relationship between serum concentrations of 1,5-anhydroglucitol and uric acid in non-diabetic male subjects implies common renal transport system. Clin Chim Acta 2009; 410: 70-73
• 34 Gotoh M, Li C, Yatoh M et al. Serum uric acid concentrations in type 2 diabetes: its significant relationship to serum 1,5-anhydroglucitol concentrations. Endocr Regul 2005; 39: 119-125
• 35 Rafey MA, Lipkowitz MS, Leal-Pinto E et al. Uric acid transport. Curr Opin Nephrol Hypertens 2003; 12: 511-516