Combining serum 1,5-anhydroglucitol with fasting plasma glucose to detect diabetes mellitus in a community-based population with hypertension

Abstract

Background: The early diagnosis and treatment of diabetes mellitus has significant clinical benefits. However, the current diagnostic tools available for community-based populations are limited. This study sought to evaluate the clinical benefits of combining serum 1,5-anhydroglucitol (1,5-AG) with fasting plasma glucose (FPG) to detect diabetes in a community-based population with hypertension. Methods: A total of 359 subjects were enrolled in this diagnostic study, all of whom underwent a 75-g oral glucose tolerance test (OGTT). Venous blood samples were collected to measure FPG, 2 h postprandial plasma glucose (2h-PG), and hemoglobin A1c (HbA1c). Serum 1,5-AG levels were tested using the Glycomark assay, and a receiver operating characteristic (ROC) curve was used to assess the diagnostic value of this tool for diabetes and determine the optimal cut-point value to provide the maximum Youden’s index. A Spearman correlation analysis was performed to analyze the relationship between 1,5-AG and other indexes. Results: A total of 102 participants were diagnosed with diabetes, indicating a prevalence of 28.4% in the community-based population. The Spearman correlation analysis showed that 1,5-AG was negatively correlated with FPG and 2h-PG (r=−0.367 and −0.487, respectively; both P<0.05). For the estimation of 2h‐PG ≥11.1 mmol/L using 1,5-AG, the area under the curve (AUC) for the ROC analysis was 0.850 (95% confidence interval: 0.809–0.891). The corresponding optimal cut‐off for 1,5-AG was 13.23 μg/mL, which yielded a sensitivity of 89.7% and a specificity of 73.5%. Compared with FPG alone, FPG combined with 1,5-AG had a higher sensitivity for detecting diabetes (97.1% vs. 47.1%; P<0.001). Conclusions: FPG combined with 1,5-AG substantially improved the sensitivity in detecting diabetes relative to FPG alone in a community-based population with hypertension, and may be a simple and efficient tool for screening diabetes.