Glycemic excursions and subclinical cardiac damage in adults with type 2 diabetes: Results from the ADVANCE Trial

Published:November 17, 2021DOI:


      We found that 1,5-anhydroglucitol—a marker of glucose excursions—was not independently associated with subclinical cardiac damage, nor with vascular outcomes, in the ADVANCE Trial. High-sensitivity cardiac troponin T and N-terminal pro-b-type natriuretic peptide provided better prognostic information regarding vascular risk in diabetes than 1,5-anhydroglucitol.
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        • Ceriello A.
        • Monnier L.
        • Owens D.
        Glycaemic variability in diabetes: clinical and therapeutic implications.
        Lancet Diabetes Endocrinol. 2019; 7: 221-230
        • Martinez M.
        • Santamarina J.
        • Pavesi A.
        • Musso C.
        • Umpierrez G.E.
        Glycemic variability and cardiovascular disease in patients with type 2 diabetes.
        BMJ Open Diabetes Res Care. 2021; 9: e002032
        • Selvin E.
        • Wang D.
        • McEvoy J.W.
        • Juraschek S.P.
        • Lazo M.
        • Hamet P.
        • et al.
        Response of 1,5-anhydroglucitol level to intensive glucose- and blood-pressure lowering interventions, and its associations with clinical outcomes in the ADVANCE trial.
        Diabetes Obes Metab. 2019; 21: 2017-2023
        • Selvin E.
        • Rawlings A.
        • Lutsey P.
        • et al.
        Association of 1,5-anhydroglucitol with cardiovascular disease and mortality.
        Diabetes. 2016; 65: 201-208
        • Liang M.
        • McEvoy J.W.
        • Chen Y.
        • Sharrett A.R.
        • Selvin E.
        Association of a biomarker of glucose peaks, 1,5-anhydroglucitol, with subclinical cardiovascular disease.
        Diabetes Care. 2016; 39: 1752-1759
        • Watanabe M.
        • Kokubo Y.
        • Higashiyama A.
        • Ono Y.
        • Miyamoto Y.
        • Okamura T.
        Serum 1,5-anhydro-D-glucitol levels predict first-ever cardiovascular disease: an 11-year population-based cohort study in Japan, the Suita study.
        Atherosclerosis. 2011; 216: 477-483
        • Ikeda N.
        • Hiroi Y.
        Cardiovascular disease and 1,5-anhydro-d-glucitol.
        Glob Health Med. 2019; 1: 83-87
        • Ikeda N.
        • Hara H.
        • Hiroi Y.
        • Nakamura M.
        Impact of serum 1,5-anhydro-d-glucitol level on prediction of major adverse cardiac and cerebrovascular events in non-diabetic patients without coronary artery disease.
        Atherosclerosis. 2016; 253: 1-6
        • Ouchi S.
        • Shimada K.
        • Miyazaki T.
        • Takahashi S.
        • Sugita Y.
        • Shimizu M.
        • et al.
        Low 1,5-anhydroglucitol levels are associated with long-term cardiac mortality in acute coronary syndrome patients with hemoglobin A1c levels less than 7.0.
        Cardiovasc Diabetol. 2017; 16
        • Shiga Y.
        • Kuriyama M.
        • Kanaya Y.
        • Takeshima S.
        • Takemaru M.
        • Takamatsu K.
        • et al.
        Serum 1,5-Anhydroglucitol: Risk Factor of Acute Ischemic Stroke and Transient Ischemic Attack in Well-Controlled Diabetes.
        Cerebrovasc Diseases (Basel, Switzerland). 2017; 44: 325-329
        • Tang O.
        • Matsushita K.
        • Coresh J.
        • Ndumele C.
        • McEvoy J.W.
        • Sharrett A.R.
        • et al.
        High-sensitivity cardiac Troponin I and T for cardiovascular risk stratification in adults with diabetes.
        Diabetes Care. 2020; 43: e144-e146
        • Gori M.
        • Gupta D.K.
        • Claggett B.
        • Selvin E.
        • Folsom A.R.
        • Matsushita K.
        • et al.
        Natriuretic peptide and high-sensitivity troponin for cardiovascular risk prediction in diabetes: the atherosclerosis risk in communities (ARIC) study.
        Diabetes Care. 2016; 39: 677-685
        • Patel A.
        • MacMahon S.
        • Chalmers J.
        • et al.
        Intensive blood glucose control and vascular outcomes in patients with type 2 diabetes.
        New England J Med. 2008; 358: 2560-2572
        • Patel A.
        • MacMahon S.
        • Chalmers J.
        • et al.
        Effects of a fixed combination of perindopril and indapamide on macrovascular and microvascular outcomes in patients with type 2 diabetes mellitus (the ADVANCE trial): a randomised controlled trial.
        Lancet (London, England). 2007; 370: 829-840
        • Dungan K.M.
        • Buse J.B.
        • Largay J.
        • Kelly M.M.
        • Button E.A.
        • Kato S.
        • et al.
        1,5-anhydroglucitol and postprandial hyperglycemia as measured by continuous glucose monitoring system in moderately controlled patients with diabetes.
        Diabetes Care. 2006; 29: 1214-1219
        • Selvin E.
        • Rynders G.P.
        • Steffes M.W.
        Comparison of two assays for serum 1,5-anhydroglucitol.
        Clin Chim Acta; Int J Clin Chem. 2011; 412: 793-795
        • Egger M.
        • Dieplinger B.
        • Mueller T.
        One-year in vitro stability of cardiac troponins and galectin-3 in different sample types.
        Clin Chim Acta; Int J Clin Chem. 2018; 476: 117-122
        • Cauliez B.
        • Guignery J.
        • Marinier S.
        • Mariau I.
        • Lavoinne A.
        Two-year stability of NT-proBNP in frozen samples using the Roche Elecsys system.
        Ann Clin Biochem. 2008; 45: 318-319
        • Ordonez-Llanos J.
        • Collinson P.O.
        • Christenson R.H.
        Amino-terminal pro-B-type natriuretic peptide: analytic considerations.
        Am J Cardiol. 2008; 101: S9-S15