The Relationship Between Serum 1,5-anhydroglucitol And Serum Uric Acid In Type 2 Diabete Mellitus.

Objective:Serum 1,5-anhydroglucitol(1,5-AG)have been indicated to decrease sensitively and specifically in diabetes mellitus,and to be used as a clinical marker for blood glucose excursion and postprandial hyperglycaemia.When the blood glucose level is above the renal threshold,1,5-AG is excreted in the urine and the serum concentrations decrease.Serum uric acid(SUA)is the final product of purine metabolism,which is a strong predictor of cardiovascular diseases in patients with noninsulin-dependent diabetes mellitus.A correlation between uric acid and glucose metabolism have been found in a large number of researchers.In diabetic patients serum uric acid concentrations have been demonstrated to be significantly lower than those in non-diabetic subjects.However,changes in serum uric acid and blood glucose do not exhibit a linear relationship in diabetes patients.The relationship between HbA1c and serum uric acid presents more of a bell curve.Now there are very few researches about the association between serum uric acid and 1,5-AG concentrations in T2DM.In order to get an insight to this,we investigated 405 inpatients to analyses medical tests.Method:Participants:A total of 405 patients definitively diagnosed with type 2 diabetes were recruited from the Endocrinology and Metabolism Department of Zhongda Hospital in Nanjing and Jiangbei People’s Hospital,which are affiliated to Southeast University during January 2013 to December 2015.Clinical measurements:Body height;body weight;body mass index(BMI);blood pressure;duration of diabetes;smoking status;the use of angiotensin-converting enzyme inhibitor(ACEI);serum uric acid,creatinine,triglyceride,total cholesterol,low-density lipoprotein cholesterol(LDL-c),high-density lipoprotein cholesterol(HDL-c)and creatinine levels,eGFR was calculated using the urine volume and serum creatinine.Statistical analysis:Continues data are expressed as means ± standard deviations(SDs)if possible.1,5-AG was stratified into four groups by quartiles and the comparisons between groups were performed with one-way analysis of variance(ANOVA).Spearman’s correlation coefficients were analyzed between 1,5-AG and SUA.We used an extended-model approach for covariate adjustment:Model 1 = age and duration of diabetes;Model 2 = Model 1+ BMI,systolic blood pressure(SBP),diastolic blood pressure(DBP),TG,LDL-C,HDL-C;and Model 3 = Model 2 + HbA1c,FBG;Model 4 = Model 3 + eGFR,ACR.Both univariable and multivariable analyses were performed with adjusting for demographic and clinical factors in the multivariable analysis.Two-sided P<0.05 was considered statistically significant.Result:1.In this study 192 female and 213male have been included.Compared with male,female have lower SUA and creatinine but their age and duration of diabetes is much longer than male.2.After stratification by quartiles of the 1,5-AG level,an increased 1,5-AG level was associated with rising trends in age,SUA and Cr(for all trends,P<0.05).Conversely,the FBG and HbA1c exhibited downward trends(for all trends,P<0.05).3.For further investigation the positive correlation between 1,5-AG and SUA,we use Pearson’s correlation coefficient taking clinical charactors into covariention.In Model 1(age,course);Model 2(Model 1plus blood pressure,lipids,BMI);Model 3(Model 2 plus HbA1c and FBG),the correlation coefficients gradually declined with more variables put into covariation,but the positive significance remained.But in Model 4(Model 3 plus eGFR and ACR)the relationship between 1,5-AG and SUA had no statistic significance(female:r=0.146,male:r=0.110,P>0.05).4.In T2DM with different SUA level Pearson’s correlation coefficient was used.In NUA group(n=377)SUA is significantly positively associated with 1,5-AG(r=-0.617,P<0.001);in HUA group(n=28)the relationship between 1,5-AG and SUA had no statistic significance(r=-0.439,P=0.098).5.Multiple linear regression analysis with serum 1,5-anhydroglucitol levels as the dependent variable and clinical characteristics as independent variables shows that course of diabetes,HbA1c and SUA(female:β=0.143,male:P=0.148,P<0.05)is significantly positively associated with 1,5-AG.6.The relationship by the simple linear regression between serum 1,5-AG and SUA levels in all patients with different eGFR.In our study in patients with advanced renal failure(eGFR<60mL/min)1,5-AG can still reflect the glucose metabolic situation(β=-0.639,P<0.001*),but had no statistic significance with SUA(p=0.143,P=0.458).7.The relationship by the Pearson’s correlation coefficient,between serum 1,5-AG and SUA levels in all patients with different ACR:In patients with non-proteinuria and mrioproteinuria,1,5-AG is positively associated with SUA,but when it comes to macroproteinuria the association between 1,5-AG and SUA loss significance(r=0.122,P=0.878).Conclusion:In conclusion,the results of this study suggest that the serum 1,5-AG level is an independent factor associated with serum UA levels in T2DM.