Clinical Application of 1,5-Anhydroglucitol Measurements in Patients with Hepatocyte Nuclear Factor-1α Maturity-Onset Diabetes of the Young

  1. Jan Skupien, MD, PHD1,
  2. Sylwia Gorczynska-Kosiorz, PHD2,
  3. Tomasz Klupa, MD, PHD1,
  4. Krzysztof Wanic, MD, PHD1,
  5. Eric A. Button, MS, MBA3,
  6. Jacek Sieradzki, MD, PHD1 and
  7. Maciej T. Malecki, MD, PHD1
  1. 1Department of Metabolic Diseases, Jagiellonian University, Medical College, Krakow, Poland
  2. 2Department of Internal Medicine, Diabetology and Nephrology, Silesian School of Medicine, Zabrze, Poland
  3. 3BioMarker Group, Kannapolis, North Carolina
  1. Corresponding author: Maciej T. Malecki, malecki_malecki{at}yahoo.com

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.

Footnotes

  • Published ahead of print at http://care.diabetesjournals.org on 20 May 2008.

    E.B. is the president and managing director of BioMarker Group, which distributes 1,5-anhydroglucitol in the U.S.

    Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details.

    The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C Section 1734 solely to indicate this fact.

    • Received December 8, 2007.
    • Accepted May 7, 2008.
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  1. Published online before print May 20, 2008, doi: 10.2337/dc07-2334 Diabetes Care August 2008 vol. 31 no. 8 1496-1501
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