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Journal article
Response of 1,5-anhydroglucitol level to intensive glucose- and blood-pressure lowering interventions, and its associations with clinical outcomes in the ADVANCE trial
Diabetes, obesity & metabolism, v 21(8), pp 2017-2023
01 Aug 2019
PMID: 31050156
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Aims To evaluate 1,5-anhydroglucitol (1,5-AG) according to clinical outcomes and assess the effects of glucose- and blood pressure-lowering interventions on change in 1,5-AG levels in people with type 2 diabetes. Methods We measured 1,5-AG in 6826 stored samples at baseline and in a random subsample of 684 participants at the 1-year follow-up visit in the ADVANCE trial. We examined baseline 1,5-AG [< 39.7, 39.7-66.2, >= 66.2 mu mol/L (<6, 6-10, >= 10 mu g/mL)] and microvascular and macrovascular events and mortality using Cox regression models during 5 years of follow-up. Using an intention-to-treat approach, we examined 1-year change in 1,5-AG (mean and percent) in response to the glucose- and blood pressure-lowering interventions in the subsample. Results Low 1,5-AG level [<39.7 mu mol/L vs >= 66.2 mu mol/L (<6 mu g/mL vs >= 10 mu g/mL)] was associated with microvascular events (hazard ratio 1.28, 95% confidence interval 1.03-1.60) after adjustment for risk factors and baseline glycated haemoglobin (HbA1c); however, the associations for macrovascular events and mortality were not independent of HbA1c. The glucose-lowering intervention was associated with a significant 1-year increase in 1,5-AG (vs standard control) of 6.69 mu mol/L (SE 2.52) [1.01 mu g/mL (SE 0.38)], corresponding to an 8.26% (SE 0.10%) increase from baseline. We also observed an increase in 1,5-AG of similar magnitude in response to the blood pressure intervention independent of the glucose-lowering effect. Conclusions Our results suggest that 1,5-AG is a marker of risk in adults with type 2 diabetes, but only for microvascular events independently of HbA1c. We found that 1,5-AG was improved (increased) in response to an intensive glucose-lowering intervention, although the independent effect of the blood pressure-lowering intervention on 1,5-AG suggests potential non-glycaemic influences.
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- Title
- Response of 1,5-anhydroglucitol level to intensive glucose- and blood-pressure lowering interventions, and its associations with clinical outcomes in the ADVANCE trial
- Creators
- Elizabeth Selvin - Johns Hopkins UniversityDan Wang - Johns Hopkins UniversityJohn William McEvoy - Ollscoil na Gaillimhe – University of GalwayStephen P. Juraschek - Beth Israel Deaconess Medical CenterMariana Lazo - Johns Hopkins UniversityPavel Hamet - Centre Hospitalier de l’Université de MontréalMark E. Cooper - Monash UniversityMichel Marre - Assistance Publique – Hôpitaux de ParisBryan Williams - University College LondonStephen Harrap - The Royal Melbourne HospitalJohn Chalmers - The George Institute for Global HealthMark Woodward - Johns Hopkins University
- Publication Details
- Diabetes, obesity & metabolism, v 21(8), pp 2017-2023
- Publisher
- Wiley
- Number of pages
- 7
- Grant note
- R01DK108784; K24DK106414 / NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY DISEASES; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Diabetes & Digestive & Kidney Diseases (NIDDK) K23 HL135273; R21 HL144876 / NIH/NHLBI; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Heart Lung & Blood Institute (NHLBI) Servier Laboratories R21HL144876; K23HL135273 / NATIONAL HEART, LUNG, AND BLOOD INSTITUTE; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Heart Lung & Blood Institute (NHLBI) National Health and Medical Research Council (NHMRC) of Australia R01 DK108784 / National Institutes of Health (NIH), National Institute of Diabetes and Digestive and Kidney Diseases; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Diabetes & Digestive & Kidney Diseases (NIDDK) NHMRC; National Health and Medical Research Council (NHMRC) of Australia
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Urban Health Collaborative
- Web of Science ID
- WOS:000474931700030
- Scopus ID
- 2-s2.0-85066487602
- Other Identifier
- 991020550498704721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Endocrinology & Metabolism