Context: Unlike other commonly used invasive blood glucose monitoring methods, saliva detection prevents patients from suffering the physical uneasiness. Serum 1,5-anhydroglucitol (1,5-AG) is a new indicator for assessing short-term glycemic control. However, there are currently few studies on saliva 1,5-AG in diabetes mellitus (DM).

Objective: This study aimed to evaluate the effectiveness of saliva 1,5-AG in diabetes screening in a Chinese population.

Design and Participants: A total of 641 subjects without a valid diabetic history (251 men and 390 women) were recruited from September 2018 to June 2019 and underwent an oral glucose tolerance test (OGTT). Fasting saliva 1,5-AG (1,5-AG0) and postload 2-hour saliva 1,5-AG (1,5-AG120) were measured with liquid chromatography-mass spectrometry. Serum 1,5-AG0 and 1,5-AG120 were measured with enzymatic method.

Results: Saliva 1,5-AG levels in DM subjects were lower than those in nondiabetes mellitus subjects (both P < 0.05). Saliva 1,5-AG was positively correlated with serum 1,5-AG and negatively correlated with blood glucose and glycated hemoglobin (HbA1c) (all P < 0.05). The optimal cutoff points of saliva 1,5-AG0 and 1,5-AG120 for diabetes screening were 0.436 μg/mL and 0.438 μg/mL, respectively. Fasting plasma glucose (FPG) combined with saliva 1,5-AG0 and HbA1c combined with saliva 1,5-AG120 reduced the proportion of people who required an OGTT by 47.22% and 51.41% compared with FPG alone and HbA1c combined with FPG, respectively.

Conclusion: The optimal cutoff point of saliva 1,5-AG for diabetes screening was 0.44 μg/mL. Saliva 1,5-AG combined with FPG or HbA1c improved the efficiency of diabetes screening. Saliva 1,5-AG is robust in nonfasting measurements and a noninvasive and convenient tool for diabetes screening.


Y. Bao: None. C. Jian: None. A. Zhao: None. X. Ma: None. K. Ge: None. W. Lu: None. W. Zhu: None. Y. Wang: None. J. Zhou: None. W. Jia: None.

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