Association of a Biomarker of Glucose Peaks, 1,5-Anhydroglucitol, With Subclinical Cardiovascular Disease

Diabetes Care. 2016 Oct;39(10):1752-9. doi: 10.2337/dc16-0840. Epub 2016 Aug 1.


Objective: 1,5-Anhydroglucitol (1,5-AG) is a biomarker of glucose peaks and has been associated with clinical cardiovascular disease. However, the association between 1,5-AG and subclinical cardiovascular disease is unknown. We investigated the association of 1,5-AG with subclinical myocardial damage (assessed by high-sensitivity cardiac troponin T [hs-cTnT]) and atherosclerosis (assessed by carotid intima-media thickness [CIMT] and carotid plaque).

Research design and methods: We measured 1,5-AG, hs-cTnT, CIMT, and carotid plaque among 10,072 people without diabetes and 681 with diabetes who attended the second examination of the Atherosclerosis Risk in Communities (ARIC) Study (baseline, 1990-1992). We used Poisson regression to characterize the associations between 1,5-AG and prevalent elevated hs-cTnT, thick CIMT, or carotid plaque. Among 9,145 people with a second hs-cTnT measurement 6 years later, we used multinomial logistic regression to assess associations with incident elevation in hs-cTnT.

Results: We found that in people with diabetes, lower 1,5-AG (<6 μg/mL) was cross-sectionally associated with elevated hs-cTnT (prevalence ratio 2.06, 95% CI 1.23-3.46) compared with higher 1,5-AG (≥10 μg/mL). Associations in people without diabetes and with thick CIMT or the presence of carotid plaque were less robust. Low 1,5-AG was prospectively associated with the 6-year incident elevation in hs-cTnT (relative risk 2.90, 95% CI 1.23-6.85) in people with diabetes. All associations were strongly attenuated with further adjustment for HbA1c.

Conclusions: In people with diabetes, 1,5-AG was associated with subclinical cardiovascular disease, particularly chronic subclinical myocardial damage. Nonetheless, whether observed associations are truly independent of average glycemia is unclear.

MeSH terms

  • Adult
  • Aged
  • Atherosclerosis / blood
  • Biomarkers / blood
  • Blood Glucose / metabolism*
  • Cardiovascular Diseases / blood*
  • Carotid Intima-Media Thickness
  • Cross-Sectional Studies
  • Deoxyglucose / blood*
  • Diabetes Mellitus / blood*
  • Female
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Plaque, Atherosclerotic / blood
  • Risk Factors
  • Sensitivity and Specificity
  • Troponin T / blood
  • Young Adult


  • Biomarkers
  • Blood Glucose
  • Troponin T
  • 1,5-anhydroglucitol
  • Deoxyglucose