The Clinical Impact of Serum 1,5-anhydro-D-glucitol Levels on Coronary Artery Calcification and Adverse Outcomes Assessed by Coronary Optical Coherence Tomography in Diabetic Patients

Overview

Journal Front Cardiovasc Med

Specialty Cardiology & Vascular Diseases

Date 2022 Sep 16

PMID 36110416

Authors

Hsin-I Teng

Hsiang-Yao Chen

Chuan-Tsai Tsai

Wei-Chieh Huang

Ying-Ying Chen

Chien-Hung Hsueh

William K Hau

Tse-Min Lu

Affiliations

Soon will be listed here.

Abstract

Background: Serum 1,5-anhydro-D-glucitol (1,5-AG) is a novel biomarker for short-term glycemic status and postprandial hyperglycemia. The association between serum 1,5-AG levels and coronary artery calcification (CAC) through a quantitative assessment using optical coherence tomography (OCT) is unclear. We aimed to evaluate this association using OCT in patients with diabetes mellitus (DM).

Methods: From June 2016 to December 2019, we prospectively enrolled 256 patients who underwent OCT-guided percutaneous coronary intervention (PCI). Half of the patients had diabetes. Patients were followed up for a mean period of 1.8 ± 0.8 years (median: 2.2 years). The relative calcium index and relative lipid core index measured by quantitative OCT analysis were used to evaluate the intra-plaque calcium and lipid levels of culprit plaques. We also analyzed the correlation between serum 1,5-AG levels and long-term major adverse cardiovascular events.

Results: Serum 1,5-AG levels were significantly lower in diabetic patients than in non-diabetic patients (DM vs. non-DM: 55.6 ± 27.9 μg/mL vs. 63.7 ± 26.1 μg/mL, = 0.016), and lower in fibrocalcified lesions than in fibrotic or fibrolipidic lesions (fibrocalcified vs. fibrotic or fibrolipidic: 42.8 ± 19.1 vs. 72.9 ± 25.2 or 66.4 ± 27.5 μg/mL, < 0.001, respectively). In addition, we found a significant inverse correlation between serum 1,5-AG levels and relative calcium index ( = -0.729, < 0.001). In multivariate Cox regression analysis, low serum 1,5-AG level was identified as an independent predictor for major adverse cardiovascular events in diabetic patients ( = 0.043), but not in non-diabetic patients ( = 0.748) after adjusting for age and sex.

Conclusion: This study revealed that low serum 1,5-AG levels were associated with an increased risk of CAC as assessed by OCT, especially in diabetic patients. Low serum 1,5-AG levels may predict future major adverse cardiovascular events in diabetic patients undergoing OCT-guided PCI.

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