1,5-Anhydroglucitol in type 2 diabetes mellitus patients with ST elevation myocardial infarction.

Dinara Sheryazdanova 1 * , Yelena Laryushina 1
More Detail
1 Department of Internal Diseases, Karaganda Medical University, Karaganda, Kazakhstan
* Corresponding Author
J CLIN MED KAZ, Volume 18, Issue 4, pp. 52-57. https://doi.org/10.23950/jcmk/11042
OPEN ACCESS 1641 Views 953 Downloads
Download Full Text (PDF)

ABSTRACT

Aim: The study aimed to investigate the potential association of 1,5-AG and cardiovascular events in patients with type 2 diabetes mellitus.
Methods: The study was an observational non-matched case-control study. The study included 114 patients with type 2 diabetes mellitus; 42 were with STEMI (STEMI group) and 72 without  STEMI (non-STEMI group). Clinical data, fasting blood glucose, HbA1c, and 1,5 Anhydro-D-glucitol were analyzed. The Mann-Whitney U-test and the χ2 test was used for categorical variables to assess the significance of differences between the groups. The binary logistic regression was used to determine the association of 1,5-AG and STEMI.
Results: There were 43.86% men and 56.14% women among the investigated patients. The median age of patients in the STEMI and non-STEMI groups were 61 (Q25-75 54-71) and 53 (Q25-15 75 57-60) years of age, р=0.027. Median fasting plasma glycemia in the STEMI group was 9.81 mmol/l (Q25-75 7.7-14.8), in the non-STEMI group (8.55 mmol/l, Q25-75 6.72-10.07, р=0.012). 1,5-AG was significantly lower in the STEMI group than in the non-STEMI (the STEMI group: Ме=215.85, Q25-75 186.35-19 280.77; the non-STEMI group Ме=314.64, Q25-75 250.83-415.08, р=0.000). No significant difference in concentration of HbA1c was found between the groups. The logistic regression model adjusted on confounders demonstrated that low plasma 1,5-AG concentration increases the odds ratio of STEMI in diabetic patients [OR 3,217 (95% CI 2,567–7,732), p = 0,002]. 
Conclusion: The association between 1,5-AG and STEMI in patients with T2DM suggests the potential beneficial role of 1,5-AG as a cardiovascular risk marker in patients with type 2 diabetes mellitus.
Keywords: Diabetes Mellitus, Type 2, 1, 5-anhydroglucitol, ST Elevation Myocardial Infarction.

CITATION

Sheryazdanova D, Laryushina Y. 1,5-Anhydroglucitol in type 2 diabetes mellitus patients with ST elevation myocardial infarction.. J CLIN MED KAZ. 2021;18(4):52-7. https://doi.org/10.23950/jcmk/11042

REFERENCES

  • Einarson TR, Acs A, Ludwig C, Panton UH. Prevalence of cardiovascular disease in type 2 diabetes: a systematic literature review of scientific evidence from across the world in 2007-2017. Cardiovasc Diabetol. 2018;17(1):83.
  • Kannel WB, McGee DL. Diabetes and cardiovascular disease. The Framingham study. JAMA. 1979;241(19):2035-8.
  • Stamler J, Vaccaro O, Neaton JD, Wentworth D. Diabetes, other risk factors, and 12-yr cardiovascular mortality for men screened in the Multiple Risk Factor Intervention Trial. Diabetes Care. 1993;16(2):434-444.
  • Aronson D, Rayfield EJ, Chesebro JH. Mechanisms determining course and outcome of diabetic patients who have had acute myocardial infarction. Ann Intern Med. 1997;126(4):296-306.
  • Sandler CN, McDonnell ME. The role of hemoglobin A1c in the assessment of diabetes and cardiovascular risk. Cleve Clin J Med. 2016;83(5 Suppl 1):S4-S10.
  • Fleischer J. Diabetic autonomic imbalance and glycemic variability. J Diabetes Sci Technol. 2012;6(5):1207-1215.
  • Monnier L., Mas E., Ginet C. et al. Activation of oxidative stress by acute glucose fluctuations compared with sustained chronic hyperglycemia in patients with type 2 diabetes. JAMA 2006;295:1681–1687.
  • Rodbard D. Clinical interpretation of indices of quality of glycemic control and glycemic variability. Postgrad Med. 2011;123(4):107-118.
  • Chon S., Lee Y.J., Fraterrigo G. et al. Evaluation of glycemic variability in well-controlled type 2 diabetes mellitus. Diabetes Technol Ther. 2013;15(6):455-60.
  • Kovatchev B, Cobelli C. Glucose Variability: Timing, Risk Analysis, and Relationship to Hypoglycemia in Diabetes. Diabetes Care. 2016;39(4):502-510.
  • Ceriello A, Colagiuri S. International Diabetes Federation guideline for management of postmeal glucose: a review of recommendations. Diabet Med. 2008;25(10):1151-6.
  • Ma C, Sheng J, Liu Z, Guo M. Excretion rates of 1,5-anhydro-D-glucitol, uric acid and microalbuminuria as glycemic control indexes in patients with type 2 diabetes. Sci Rep. 2017;7:44291.
  • Klimontov VV, Myakina NE. Glucose variability indices predict the episodes of nocturnal hypoglycemia in elderly type 2 diabetic patients treated with insulin. Diabetes Metab Syndr. 2017;11(2):119-24.
  • Kametani S, Hashimoto Y, Yamanouchi T, Akanuma Y, Akanuma H. Reduced renal reabsorption of 1,5-anhydro-D-glucitol in diabetic rats and mice. J Biochem. 1987;102(6):1599-607.
  • Yoshioka S., Saitoh S., Negishi C. et al. Variations of 1-deoxyglucose (1,5-anhydroglucitol) content in plasma from patients with insulin-dependent diabetes mellitus // Clin Chem. – 1983. – Vol. 29. – P. 1396– 1398.
  • Yamanouchi T, Minoda S, Yabuuchi M, Akanuma Y, Akanuma H, Miyashita H, et al. Plasma 1,5-anhydro-D-glucitol as new clinical marker of glycemic control in NIDDM patients. Diabetes. 1989;38(6):723-9.
  • Yamanouchi T, Tachibana Y, Akanuma H, Minoda S, Shinohara T, Moromizato H, et al. Origin and disposal of 1,5-anhydroglucitol, a major polyol in the human body. Am J Physiol. 1992;263(2 Pt 1):E268-73.
  • Summary of the 2007 European Society of Hypertension (ESH) and European Society of Cardiology (ESC) guidelines for the management of arterial hypertension. Vasc Health Risk Manag. 2007;3(6):783-795.
  • Standards of Medical Care in Diabetes-2018 Abridged for Primary Care Providers. Clin Diabetes. 2018;36(1):14-37.
  • Thygesen K, Alpert JS, Jaffe AS, Simoons ML, Chaitman BR, White HD, et al. Third universal definition of myocardial infarction. Eur Heart J. 2012;33(20):2551-2567.
  • Dworacka M., Winiarska H. The application of plasma 1,5-anhydro-D-glucitol for monitoring type 2 diabetic patients. Dis Markers. 2005;21(3):127-32.
  • Ikeda N., Hara H., Hiroi Y. 1,5-Anhydro-D-glucitol predicts coronary artery disease prevalence and complexity. J Cardiol. 2014;64(4):297-301.
  • Kuroda M., Shinke T., Sakaguchi K. et al. Effect of daily glucose fluctuation on coronary plaque vulnerability in patients pre-treated with lipid-lowering therapy: a prospective observational study. JACC Cardiovasc Interv. 2015;8(6):800-811.
  • Pieber TR, Marso SP, McGuire DK, Zinman B, Poulter NR, Emerson SS, et al. DEVOTE 3: temporal relationships between severe hypoglycaemia, cardiovascular outcomes and mortality. Diabetologia. 2018;61(1):58-65.
  • Yang CD, Shen Y, Ding FH, Yang ZK, Hu J, Shen WF, et al. Visit-to-visit fasting plasma glucose variability is associated with left ventricular adverse remodeling in diabetic patients with STEMI. Cardiovasc Diabetol. 2020;19(1):131.
  • Tatti P, Strollo F, Passali D. Sleep apnea, sleep disturbance, and fasting glucose variability: a pilot study. J Diabetes Sci Technol. 2013;7(3):743-8.
  • Hu Y. Advances in reducing cardiovascular risk in the management of patients with type 2 diabetes mellitus. Chronic Dis Transl Med. 2019;5(1):25-36.
  • Svensson E, Baggesen LM, Johnsen SP, Pedersen L, Nørrelund H, Buhl ES, et al. Early Glycemic Control and Magnitude of HbA1c Reduction Predict Cardiovascular Events and Mortality: Population-Based Cohort Study of 24,752 Metformin Initiators. Diabetes Care. 2017;40(6):800-807.
  • Ghaffari S, Niafar F, Separham A, Niafar M, Pourafkari L, Nader ND. Association between HbA1c levels with severity of coronary artery disease and short-term outcomes of acute ST-elevation myocardial infarction in nondiabetic patients. Ther Adv Cardiovasc Dis. 2015;9(5):305-313.
  • Kranenburg G, van der Graaf Y, van der Leeuw J, Nathoe HM, de Borst GJ, Kappelle LJ, et al. The relation between HbA1c and cardiovascular events in patients with type 2 diabetes with and without vascular disease. Diabetes Care. 2015;38(10):1930-1936.
  • Di Angelantonio E, Gao P, Khan H, Butterworth AS, Wormser D, Kaptoge S, et al. Glycated hemoglobin measurement and prediction of cardiovascular disease. JAMA. 2014;311(12):1225-1233.
  • Jarmul JA, Pignone M, Pletcher MJ. Interpreting Hemoglobin A1C in Combination цith сonventional risk factors for prediction of cardiovascular risk. Circ Cardiovasc Qual Outcomes. 2015;8(5):501-507.
  • Dworacka M, Winiarska H. The application of plasma 1,5-anhydro-D-glucitol for monitoring type 2 diabetic patients. Dis Markers. 2005;21(3):127-132.
  • Piconi L., Quagliaro L., Assaloni R., et al. Constant and intermittent high glucose enhances endothelial cell apoptosis through mitochondrial superoxide overproduction. Diabetes Metab. Res. Rev. 2006;22(3):198–203.
  • El-Osta A., Brasacchio D., Yao D. et al. Transient high glucose causes persistent epigenetic changes and altered gene expression during subsequent normoglycemia. Journal of Experimental Medicine. 2008;205(10).2409–2417.