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.

Disclosure

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.

Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. More information is available at http://www.diabetesjournals.org/content/license.