Objective: To detect the level of serum 1,5-anhydroglucitol(1,5-AG) in patients with prediabetes(p-T2DM) and type 2 diabetes(T2DM), and to explore its application value as an early diagnostic indicator of T2DM.Methods: From May 2022 to September 2022,55 hospitalized patients with T2DM in the department of endocrinology and nephrology of Xiangya Hospital of Central South University were collected as T2DM group, including 38 males and 17 females, with an average age of(55.13±8.44) years old;51 patients with p-T2DM in the department of endocrinology were collected as p-T2DM group, including 30 males and 21 females, with an average age of(55.18±10.02) years old. After matching according to age and sex, 51 healthy subjects were collected as the control group, including 33 males and 18 females, with an average age of(52.00±6.49) years old. The clinical data of each group were collected, and the serum 1,5-AG levels of each group were measured for statistical analysis.Results: The levels of 1,5-AG in the control group [(142.73±53.51) mmol·L-1], p-T2DM group[(113.48±65.48) mmol·L-1] and T2DM group [(49.88±56.31) mmol·L-1] decreased gradually, and the differences between the groups were statistically significant(all P<0.05). The results of correlation analysis show that 1,5-AG was negatively correlated with body mass index(r=-0.184, P= 0.021),urea(r=-0.177,P=0.028),triglyceride(r=-0.303,P<0.001), non-high-density lipoprotein cholesterol(r=-0.185,P=0.025), fasting blood glucose(r=-0.529,P<0.001) and glycosylated hemoglobin(HbA1C)(r=-0.565, P<0.001), and positively correlated with high-density lipoprotein cholesterol(HDL-C)(r=0.227,P=0.006) and HDL-C to total cholesterol ratio(r=0.244, P=0.003). Multiple linear regression showed that total bilirubin(TB), direct bilirubin(DB), uric acid(UA), HDL-C, and 2-hour post-meal blood glucose(2h-BG) were the main influencing factors for serum 1,5-AG.The linear regression equation was Y=-5.16X1+14.66X2+0.2X3+82.37X4-6.63X5(Y=1,5-AG；X1=TB；X2=DB；X3=UA；X4=HDL-C；X5=2h-BG), which explained 58.2% of the change in serum 1,5-AG level. Logistic regression analysis revealed that the decrease of 1,5-AG level, the increase of systolic blood pressure and HbA1C level were independent risk factors for the progression of p-T2DM to T2DM(P<0.05). Area under the curve(AUC) of serum 1, 5-AG to distinguish p-T2DM from T2DM was 0.821(95% CI 0.727-0.915), the cut-off value was 93.15 mmol·L-1, the sensitivity was 0.852, and the specificity was 0.815. Conclusion: The decrease of serum 1,5-AG level is a risk factor for the progression of p-T2DM to T2DM, which has important clinical significance for the early diagnosis of T2DM.
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