A cross-sectional study on the association between serum 1,5-anhydro-D-glucitol (1,5-AG) levels and cardiovascular disease risk

doi:10.12092/j.issn.1009-2501.2026.06.007

Abstract

Abstract:

AIM: To evaluate the association between serum 1,5-anhydro-D-glucitol (1,5-AG) levels and the risk of developing cardiovascular diseases (CVDs), and to explore its potential value as a predictive biomarker for CVDs. METHODS: A cross-sectional study design was adopted, enrolling 873 community residents from Nanjing and Jurong, Jiangsu Province. Serum 1,5-AG levels were measured using a chemiluminescence enzyme immunoassay. Demographic characteristics, physical examination data, and laboratory parameters were collected. Multivariate logistic risk models were constructed to analyze the association between 1,5-AG levels and CVD events. Predictive performance was evaluated using Receiver Operating Characteristic (ROC) curves and Decision Curve Analysis (DCA). RESULTS: A total of 829 subjects (166 in the CVDs group and 663 in the control group) were included in the final analysis. Serum 1,5-AG levels in the CVDs group were significantly lower than those in the control group (0.11 [0.08, 0.14] μmol/L vs. 0.12 [0.09, 0.16] μmol/L, P = 0.003). After adjustment via multivariate logistic regression analysis, the established model indicated that low serum 1,5-AG levels were associated with an increased risk of CVDs (OR = 0.0111, P = 0.039). ROC analysis showed that the predictive model integrating serum 1,5-AG with conventional indicators demonstrated good discriminative performance for CVD risk (AUC=0.797), with a sensitivity of 0.681, specificity of 0.780, and a Youden index of 0.461. After adjusting for age and sex, serum 1,5-AG levels were negatively correlated with 10-year cardiovascular risk (r=?0.223), hemorrhagic stroke (r=?0.260), and ischemic stroke (r=?0.274), with all P<0.001. CONCLUSION: Decreased serum 1,5-AG levels are independently associated with CVD risk. Combining 1,5-AG with traditional indicators can improve predictive performance, potentially providing a new perspective for early CVD screening.

Key words: 1,5-anhydro-D-glucitol, cardiovascular disease, ischemic stroke, hemorrhagic stroke, disease risk

CLC Number:

R54
R446.11

Qianhao XU, Jiachen WANG, Yu FU, Yue LI, Tao YANG. A cross-sectional study on the association between serum 1,5-anhydro-D-glucitol (1,5-AG) levels and cardiovascular disease risk[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2026, 31(6): 782-788.

Figures/Tables 6

References 20

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Variable	With CVDs (n=166)	Without CVDs (n=663)	P value
Male, n(%)	125 (75.3%)	363 (54.8%)	<0.001
Age(years)	49.95±9.99	39.66±11.54	<0.001
SBP(mmHg)	131.00 [120.62, 144.88]	120.50 [111.50, 131.00]	<0.001
DBP(mmHg)	88.00 [79.62, 97.00]	81.00 [74.75, 88.00]	<0.001
TC(mmol/L)	5.06 [4.45, 5.70]	4.66 [4.16, 5.35]	<0.001
TG(mmol/L)	1.75 [1.06, 2.62]	1.07 [0.72, 1.57]	<0.001
LDL-C(mmol/L)	3.25 [2.67, 3.74]	2.95 [2.49, 3.48]	0.002
HDL-C(mmol/L)	1.32 [1.12, 1.56]	1.48 [1.27, 1.71]	<0.001
Cr(μmol/L)	67.00 [60.00, 75.75]	64.00 [53.00, 73.00]	0.002
eGFR [mL/(min?1.73 m²)]	111.25 [95.68, 132.12]	117.52[102.25, 135.81]	0.028
HbA1c(%)	5.70 [5.40, 6.00]	5.40 [5.20, 5.70]	<0.001
FBG(mmol/L)	6.09 [5.67, 6.60]	5.64 [5.33, 6.06]	<0.001
Lp(α) (mg/L)	23.00 [13.00, 55.20]	26.15 [13.30, 59.45]	0.496
1,5-AG(μmol/L)	0.11 [0.08, 0.14]	0.12 [0.09, 0.16]	0.003

Variable	With CVDs (n=166)	Without CVDs (n=663)	P value
Male, n(%)	125 (75.3%)	363 (54.8%)	<0.001
Age(years)	49.95±9.99	39.66±11.54	<0.001
SBP(mmHg)	131.00 [120.62, 144.88]	120.50 [111.50, 131.00]	<0.001
DBP(mmHg)	88.00 [79.62, 97.00]	81.00 [74.75, 88.00]	<0.001
TC(mmol/L)	5.06 [4.45, 5.70]	4.66 [4.16, 5.35]	<0.001
TG(mmol/L)	1.75 [1.06, 2.62]	1.07 [0.72, 1.57]	<0.001
LDL-C(mmol/L)	3.25 [2.67, 3.74]	2.95 [2.49, 3.48]	0.002
HDL-C(mmol/L)	1.32 [1.12, 1.56]	1.48 [1.27, 1.71]	<0.001
Cr(μmol/L)	67.00 [60.00, 75.75]	64.00 [53.00, 73.00]	0.002
eGFR [mL/(min?1.73 m²)]	111.25 [95.68, 132.12]	117.52[102.25, 135.81]	0.028
HbA1c(%)	5.70 [5.40, 6.00]	5.40 [5.20, 5.70]	<0.001
FBG(mmol/L)	6.09 [5.67, 6.60]	5.64 [5.33, 6.06]	<0.001
Lp(α) (mg/L)	23.00 [13.00, 55.20]	26.15 [13.30, 59.45]	0.496
1,5-AG(μmol/L)	0.11 [0.08, 0.14]	0.12 [0.09, 0.16]	0.003

	OR (95%CI)	P value
Model 1
(Intercept)	0.4314(0.2732,0.6777)	<0.001
1,5-AG	0.0110(0.0003,0.3762)	0.014
Model 2
(Intercept)	0.0210(0.0075,0.0559)	<0.001
1,5-AG	0.0032(0.0001,0.1163)	0.002
Age	1.0796(1.0610,1.0995)	<0.001
Gender (male=0，female=1)	0.4620(0.3023,0.6959)	<0.001

	OR (95%CI)	P value
Model 1
(Intercept)	0.4314(0.2732,0.6777)	<0.001
1,5-AG	0.0110(0.0003,0.3762)	0.014
Model 2
(Intercept)	0.0210(0.0075,0.0559)	<0.001
1,5-AG	0.0032(0.0001,0.1163)	0.002
Age	1.0796(1.0610,1.0995)	<0.001
Gender (male=0，female=1)	0.4620(0.3023,0.6959)	<0.001

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