To evaluate the use of serum 1,5-anhydroglucitol (AG) levels in screening for diabetes mellitus, we compared the sensitivity and specificity of HbA1c, fructosamine (FA), and AG in 1620 randomly selected subjects in 11 institutions throughout Japan. Most individuals were receiving diet and/or drug therapy for diabetes. Subjects were separated into four groups based on World Health Organization criteria: nondiabetic control subjects, subjects with impaired glucose tolerance (IGT), patients with diabetes, and patients with other disorders without IGT. The overlap of AG values between each group was less than that of HbA1c or FA values. AG levels were significantly correlated with fasting plasma glucose (r = −0.627), HbA1c (r = −0.629), and FA (r = −0.590) levels. If we took 14 μg/ml as the normal lower limit, AG level was highly specific (93.1%), and a decreased AG level indicated diabetes mellitus (84.2% sensitivity). According to the selectivity index (sensitivity value times specificity value), AG determinations were superior to both HbA1c and FA measurements for diabetes screening. When combinations of these tests were used, only AG and HbA1c together were slightly better than AG alone. Thus, together with other advantages of AG, e.g., its wide variance with relatively fair glycemic control and the negligible influence of the sampling conditions, AG level has more potential than HbA1c or FA level as a screening criterion for diabetes.
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Original Articles|
January 01 1991
Comparison of 1,5-Anhydroglucitol, HbA1c, and Fructosamine for Detection of Diabetes Mellitus
Toshikazu Yamanouchi;
Toshikazu Yamanouchi
Department of Internal Medicine, University of Teikyo, The Institute for Diabetes Care and Research, Asahi Life Foundation, The Third Department of Internal Medicine, University of Tokyo, the Kantoteishin Hospital, and the Toranomon Hospital
Tokyo
Department of Internal Medicine, University of Tohoku
Miyagi
Division of Endocrinology and Metabolism and the Department of Clinical Laboratory, Jichi Medical School
Tochigi
Department of Internal Medicine, Saitama Medical School, and the Department of Pediatrics, National Defense Medical College
Saitama
Department of Internal Medicine, University of Kobe
Hyogo, Japan
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Yasuo Akanuma;
Yasuo Akanuma
Department of Internal Medicine, University of Teikyo, The Institute for Diabetes Care and Research, Asahi Life Foundation, The Third Department of Internal Medicine, University of Tokyo, the Kantoteishin Hospital, and the Toranomon Hospital
Tokyo
Department of Internal Medicine, University of Tohoku
Miyagi
Division of Endocrinology and Metabolism and the Department of Clinical Laboratory, Jichi Medical School
Tochigi
Department of Internal Medicine, Saitama Medical School, and the Department of Pediatrics, National Defense Medical College
Saitama
Department of Internal Medicine, University of Kobe
Hyogo, Japan
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Takayoshi Toyota;
Takayoshi Toyota
Department of Internal Medicine, University of Teikyo, The Institute for Diabetes Care and Research, Asahi Life Foundation, The Third Department of Internal Medicine, University of Tokyo, the Kantoteishin Hospital, and the Toranomon Hospital
Tokyo
Department of Internal Medicine, University of Tohoku
Miyagi
Division of Endocrinology and Metabolism and the Department of Clinical Laboratory, Jichi Medical School
Tochigi
Department of Internal Medicine, Saitama Medical School, and the Department of Pediatrics, National Defense Medical College
Saitama
Department of Internal Medicine, University of Kobe
Hyogo, Japan
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Takeshi Kuzuya;
Takeshi Kuzuya
Department of Internal Medicine, University of Teikyo, The Institute for Diabetes Care and Research, Asahi Life Foundation, The Third Department of Internal Medicine, University of Tokyo, the Kantoteishin Hospital, and the Toranomon Hospital
Tokyo
Department of Internal Medicine, University of Tohoku
Miyagi
Division of Endocrinology and Metabolism and the Department of Clinical Laboratory, Jichi Medical School
Tochigi
Department of Internal Medicine, Saitama Medical School, and the Department of Pediatrics, National Defense Medical College
Saitama
Department of Internal Medicine, University of Kobe
Hyogo, Japan
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Tadashi Kawai;
Tadashi Kawai
Department of Internal Medicine, University of Teikyo, The Institute for Diabetes Care and Research, Asahi Life Foundation, The Third Department of Internal Medicine, University of Tokyo, the Kantoteishin Hospital, and the Toranomon Hospital
Tokyo
Department of Internal Medicine, University of Tohoku
Miyagi
Division of Endocrinology and Metabolism and the Department of Clinical Laboratory, Jichi Medical School
Tochigi
Department of Internal Medicine, Saitama Medical School, and the Department of Pediatrics, National Defense Medical College
Saitama
Department of Internal Medicine, University of Kobe
Hyogo, Japan
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Syouji Kawazu;
Syouji Kawazu
Department of Internal Medicine, University of Teikyo, The Institute for Diabetes Care and Research, Asahi Life Foundation, The Third Department of Internal Medicine, University of Tokyo, the Kantoteishin Hospital, and the Toranomon Hospital
Tokyo
Department of Internal Medicine, University of Tohoku
Miyagi
Division of Endocrinology and Metabolism and the Department of Clinical Laboratory, Jichi Medical School
Tochigi
Department of Internal Medicine, Saitama Medical School, and the Department of Pediatrics, National Defense Medical College
Saitama
Department of Internal Medicine, University of Kobe
Hyogo, Japan
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Shigetake Yoshioka;
Shigetake Yoshioka
Department of Internal Medicine, University of Teikyo, The Institute for Diabetes Care and Research, Asahi Life Foundation, The Third Department of Internal Medicine, University of Tokyo, the Kantoteishin Hospital, and the Toranomon Hospital
Tokyo
Department of Internal Medicine, University of Tohoku
Miyagi
Division of Endocrinology and Metabolism and the Department of Clinical Laboratory, Jichi Medical School
Tochigi
Department of Internal Medicine, Saitama Medical School, and the Department of Pediatrics, National Defense Medical College
Saitama
Department of Internal Medicine, University of Kobe
Hyogo, Japan
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Yasunori Kanazawa;
Yasunori Kanazawa
Department of Internal Medicine, University of Teikyo, The Institute for Diabetes Care and Research, Asahi Life Foundation, The Third Department of Internal Medicine, University of Tokyo, the Kantoteishin Hospital, and the Toranomon Hospital
Tokyo
Department of Internal Medicine, University of Tohoku
Miyagi
Division of Endocrinology and Metabolism and the Department of Clinical Laboratory, Jichi Medical School
Tochigi
Department of Internal Medicine, Saitama Medical School, and the Department of Pediatrics, National Defense Medical College
Saitama
Department of Internal Medicine, University of Kobe
Hyogo, Japan
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Meisei Ohta;
Meisei Ohta
Department of Internal Medicine, University of Teikyo, The Institute for Diabetes Care and Research, Asahi Life Foundation, The Third Department of Internal Medicine, University of Tokyo, the Kantoteishin Hospital, and the Toranomon Hospital
Tokyo
Department of Internal Medicine, University of Tohoku
Miyagi
Division of Endocrinology and Metabolism and the Department of Clinical Laboratory, Jichi Medical School
Tochigi
Department of Internal Medicine, Saitama Medical School, and the Department of Pediatrics, National Defense Medical College
Saitama
Department of Internal Medicine, University of Kobe
Hyogo, Japan
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Shigeaki Baba;
Shigeaki Baba
Department of Internal Medicine, University of Teikyo, The Institute for Diabetes Care and Research, Asahi Life Foundation, The Third Department of Internal Medicine, University of Tokyo, the Kantoteishin Hospital, and the Toranomon Hospital
Tokyo
Department of Internal Medicine, University of Tohoku
Miyagi
Division of Endocrinology and Metabolism and the Department of Clinical Laboratory, Jichi Medical School
Tochigi
Department of Internal Medicine, Saitama Medical School, and the Department of Pediatrics, National Defense Medical College
Saitama
Department of Internal Medicine, University of Kobe
Hyogo, Japan
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Kinori Kosaka
Kinori Kosaka
Department of Internal Medicine, University of Teikyo, The Institute for Diabetes Care and Research, Asahi Life Foundation, The Third Department of Internal Medicine, University of Tokyo, the Kantoteishin Hospital, and the Toranomon Hospital
Tokyo
Department of Internal Medicine, University of Tohoku
Miyagi
Division of Endocrinology and Metabolism and the Department of Clinical Laboratory, Jichi Medical School
Tochigi
Department of Internal Medicine, Saitama Medical School, and the Department of Pediatrics, National Defense Medical College
Saitama
Department of Internal Medicine, University of Kobe
Hyogo, Japan
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Address correspondence and reprint requests to Dr. Toshikazu Yamanouchi, The Second Department of Internal Medicine, University of Teikyo, Kaga, ltabashiku, Tokyo 173, Japan.
Diabetes 1991;40(1):52–57
Article history
Received:
October 13 1989
Revision Received:
August 28 1990
Accepted:
August 28 1990
PubMed:
2015974
Citation
Toshikazu Yamanouchi, Yasuo Akanuma, Takayoshi Toyota, Takeshi Kuzuya, Tadashi Kawai, Syouji Kawazu, Shigetake Yoshioka, Yasunori Kanazawa, Meisei Ohta, Shigeaki Baba, Kinori Kosaka; Comparison of 1,5-Anhydroglucitol, HbA1c, and Fructosamine for Detection of Diabetes Mellitus. Diabetes 1 January 1991; 40 (1): 52–57. https://doi.org/10.2337/diab.40.1.52
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