Detection of a Serum Biomarker for Short - term Glycemic Control: Correlation with Clinical, Physiological, and Demographic Factors among Iraqi T2DM Patients
DOI:
https://doi.org/10.46649/pfmjyf49Keywords:
Keywords: Diabetes Mellitus, 1.5-AG, Glycemic Control, HbA1c, HOMA-IR, TYG IndexAbstract
Background: Two important types of diabetes, type 1 among children and type 2 in adults, D.M is metabolic disorder leading to hyperglycemia. A potential biomarker for monitoring glycemic conditions 1.5-Anhydroglucitol (1.5AG) that can be administered as a very sensitive clinical marker reflecting briefly the glycemic fluctuations of the last 1-2 weeks. HbA1c, on the other hand, represents the average levels of glucose over a longer period of time while 1.5-AG very effectively reveals the hidden short-term peaks of hyperglycemia. The main objective of this work was to analyze the clinical usefulness of serum 1.5-AG being a diagnostic marker of T2DM with a simultaneous determination of its relation to insulin resistance (HOMA-IR), lipid-induced metabolic stress (TYG Index) as well as various clinic-demographic parameters.
Methods: This case-control study included 120 subjects (60 diabetic patients and 60 healthy controls) in total, with measurement BMI for all participants. Serum levels of 1.5-AG and insulin were measured by means of ELISA method. FBS and HbA1c were determined in order to assess the glycemic status besides renal and triglyceride levels. Insulin resistance was calculated by HOMA-IR method and also using the TYG index. The diagnostic accuracy of the test was assessed by analyzing the ROC curve.
Results: Serum 1.5-AG levels were significantly lower in the patients with T2DM than in controls (8.78 ± 3.92 vs. 21.54±7.33 mg/L; P<0.001). The four most important metabolic markers, FBS, HbA1c, HOMA-IR, and the TYG Index, all exhibited a very strong and highly significant negative association with 1, 5-AG (P < 0. 05). In addition, a substantial decrease in 1.5-AG was observed when FBS levels exceeded the renal threshold of 180 mg/dL. ROC analysis demonstrated that 1.5-AG possessed excellent diagnostic potential with an AUC of 0.82, at a cut-off of 12.36 mg/L, with a sensitivity and specificity of 88.3% and 90.0%, respectively.
Conclusion: Serum 1.5-AG measurement is a simple and reliable tool for recording short-term glycemic fluctuations and metabolic dysregulation in T2DM. Given its strong association with insulin resistance and the TYG index, it can also be a part of more comprehensive, personalized diabetes management and even in the prediction of cardiovascular risk onset.
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