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【Diabetes Care】在HNF-1突变型MODY患者应用1,5-脱水葡
http://care.diabetesjournals.org/cgi/content/abstract/31/8/1496
OBJECTIVE—1,5-anhydroglucitol (1,5-AG) is a short-term marker of metabolic control in diabetes. Its renal loss is stimulated in hyperglycemic conditions by glycosuria, which results in a lowered plasma concentration. As a low renal threshold for glucose has been described in hepatocyte nuclear factor-1 (HNF-1) maturity-onset diabetes of the young (MODY), the 1,5-AG level may be altered in these patients. The purpose of this study was to assess the 1,5-AG levels in patients with HNF-1 MODY and in type 2 diabetic subjects with a similar degree of metabolic control. In addition, we aimed to evaluate this particle as a biomarker for HNF-1 MODY.
RESEARCH DESIGN AND METHODS—We included 33 diabetic patients from the Polish Nationwide Registry of MODY. In addition, we examined 43 type 2 diabetic patients and 47 nondiabetic control subjects. The 1,5-AG concentration was measured with an enzymatic assay (GlycoMark). Receiver operating characteristic (ROC) curve analysis was used to evaluate 1,5-AG as a screening marker for HNF-1 MODY.
RESULTS—The mean 1,5-AG plasma concentration in diabetic HNF-1 mutation carriers was 5.9 µg/ml, and it was lower than that in type 2 diabetic patients (11.0 µg/ml, P = 0.003) and in nondiabetic control subjects (23.9 µg/ml, P < 0.00005). The ROC curve analysis revealed 85.7% sensitivity and 80.0% specificity of 1,5-AG in screening for HNF-1 MODY at the criterion of <6.5 µg/ml in patients with an A1C level between 6.5 and 9.0%.
CONCLUSIONS—1,5-AG may be a useful biomarker for differential diagnosis of patients with HNF-1 MODY with a specific range of A1C, although this requires further investigation. However, the clinical use of this particle in diabetic HNF-1 mutation carriers for metabolic control has substantial limitations. [标签:content1][标签:content2]
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作者:admin@医学,生命科学 2011-03-24 14:05
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