Plasma 1,5-anhydroglucitol concentrations are influenced by variations in the renal threshold for glucose

Authors: Kilpatrick E.S.; Keevil B.G.; Richmond K.L.; Newland P.; Addison G.M.

Source: Diabetic Medicine, Volume 16, Number 6, June 1999 , pp. 496-499(4)

Publisher: Wiley-Blackwell

Abstract:

Aims Measurement of serum 1,5-anhydroglucitol (1,5AG) concentrations has been proposed as an alternative to HbA_1c as both a marker of diabetic glycaemic control and as a screening test for diabetes. The sugar competes with glucose for renal tubular reabsorption, so hyperglycaemia leads to reduced serum 1,5AG concentrations through increased urinary loss. This study has sought to establish whether plasma 1,5AG can be influenced by not only hyperglycaemia, but by variations in renal threshold for glucose.

Methods Thirty-eight pregnant women (median age 30 years, range 20–43) found to be normoglycaemic after a 75-g carbohydrate load had plasma 1,5AG and urine glucose measured.

Results Using multivariate analysis, the presence and degree of detectable glycosuria at 2 h post glucose load was strongly predictive of a low plasma 1,5AG concentration (P = 0.0012) independently of fasting plasma glucose (P = 0.96), 2 h glucose (P = 0.029), subject age (P = 0.97) and gestation (P = 0.36). Thus, when matched for plasma glucose areas under the glucose load curve, 16 glycosuric subjects had significantly lower 1,5AG concentrations compared to 16 nonglycosuric ones (median 1,5AG 46 mol/l (IQR 30–56) vs. 72 mol/l (IQR 55–79, P = 0.017).

Conclusions People with the same glucose tolerance may demonstrate variable plasma 1,5AG concentrations depending on their renal threshold for glucose. This inherent characteristic is likely to limit the usefulness of the test when monitoring or screening for diabetes.

Keywords: 1; 5-anhydroglucitol; renal threshold; screening

Language: English

Document Type: Research article

Publication date: 1999-06-01

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• In this Subject: Internal Medicine
• By this author: Kilpatrick E.S. ;  Keevil B.G. ;  Richmond K.L. ;  Newland P. ;  Addison G.M.

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