Occurrence of I,5-anhydroglucitol in human cerebrospinal fluid

1,5-Anhydro-D-Fructose Exhibits Satiety Effects via the Activation of Oxytocin Neurons in the Paraventricular Nucleus

1,5-Anhydro-D-fructose (1,5-AF) is a bioactive monosaccharide that is produced by the glycogenolysis in mammalians and is metabolized to 1,5-anhydro-D-glucitol (1,5-AG). 1,5-AG is used as a marker of glycemic control in diabetes patients. 1,5-AF has a variety of physiological activities, but its effects on energy metabolism, including feeding behavior, are unclarified. The present study examined whether 1,5-AF possesses the effect of satiety. Peroral administration of 1,5-AF, and not of 1,5-AG, suppressed daily food intake. Intracerebroventricular (ICV) administration of 1,5-AF also suppressed feeding. To investigate the neurons targeted by 1,5-AF, we investigated c-Fos expression in the hypothalamus and brain stem. ICV injection of 1,5-AF significantly increased c-Fos positive oxytocin neurons and mRNA expression of oxytocin in the paraventricular nucleus (PVN). Moreover, 1,5-AF increased cytosolic Ca²⁺ concentration of oxytocin neurons in the PVN. Furthermore, the satiety effect of 1,5-AF was abolished in oxytocin knockout mice. These findings reveal that 1,5-AF activates PVN oxytocin neurons to suppress feeding, indicating its potential as the energy storage monitoring messenger to the hypothalamus for integrative regulation of energy metabolism.

Recent Developments in Biomarkers for Diagnosis and Screening of Type 2 Diabetes Mellitus

PURPOSE OF REVIEW

Diabetes mellitus is a complex, chronic illness characterized by elevated blood glucose levels that occurs when there is cellular resistance to insulin action, pancreatic β-cells do not produce sufficient insulin, or both. Diabetes prevalence has greatly increased in recent decades; consequently, it is considered one of the fastest-growing public health emergencies globally. Poor blood glucose control can result in long-term micro- and macrovascular complications such as nephropathy, retinopathy, neuropathy, and cardiovascular disease. Individuals with diabetes require continuous medical care, including pharmacological intervention as well as lifestyle and dietary changes.

RECENT FINDINGS

The most common form of diabetes mellitus, type 2 diabetes (T2DM), represents approximately 90% of all cases worldwide. T2DM occurs more often in middle-aged and elderly adults, and its cause is multifactorial. However, its incidence has increased in children and young adults due to obesity, sedentary lifestyle, and inadequate nutrition. This high incidence is also accompanied by an estimated underdiagnosis prevalence of more than 50% worldwide. Implementing successful and cost-effective strategies for systematic screening of diabetes mellitus is imperative to ensure early detection, lowering patients' risk of developing life-threatening disease complications. Therefore, identifying new biomarkers and assay methods for diabetes mellitus to develop robust, non-invasive, painless, highly-sensitive, and precise screening techniques is essential. This review focuses on the recent development of new clinically validated and novel biomarkers as well as the methods for their determination that represent cost-effective alternatives for screening and early diagnosis of T2DM.

Hypothesis: A Novel Neuroprotective Role for Glucose-6-phosphatase (G6PC3) in Brain-To Maintain Energy-Dependent Functions Including Cognitive Processes

The isoform of glucose-6-phosphatase in liver, G6PC1, has a major role in whole-body glucose homeostasis, whereas G6PC3 is widely distributed among organs but has poorly-understood functions. A recent, elegant analysis of neutrophil dysfunction in G6PC3-deficient patients revealed G6PC3 is a neutrophil metabolite repair enzyme that hydrolyzes 1,5-anhydroglucitol-6-phosphate, a toxic metabolite derived from a glucose analog present in food. These patients exhibit a spectrum of phenotypic characteristics and some have learning disabilities, revealing a potential linkage between cognitive processes and G6PC3 activity. Previously-debated and discounted functions for brain G6PC3 include causing an ATP-consuming futile cycle that interferes with metabolic brain imaging assays and a nutritional role involving astrocyte-neuron glucose-lactate trafficking. Detailed analysis of the anhydroglucitol literature reveals that it competes with glucose for transport into brain, is present in human cerebrospinal fluid, and is phosphorylated by hexokinase. Anhydroglucitol-6-phosphate is present in rodent brain and other organs where its accumulation can inhibit hexokinase by competition with ATP. Calculated hexokinase inhibition indicates that energetics of brain and erythrocytes would be more adversely affected by anhydroglucitol-6-phosphate accumulation than heart. These findings strongly support the paradigm-shifting hypothesis that brain G6PC3 removes a toxic metabolite, thereby maintaining brain glucose metabolism- and ATP-dependent functions, including cognitive processes.

Protective effects of dietary 1,5-anhydro-D-glucitol as a blood glucose regulator in diabetes and metabolic syndrome

1,5-Anhydro-D-glucitol (1,5-AG) is fairly widespread in food products. It is also one of the major polyols in the human body, and its concentration is homeostatically regulated. We report here on the beneficial effects of 1,5-AG in preventing hyperglycemia and its role in improving metabolic syndrome. The findings revealed that it does not affect blood glucose levels itself under normal conditions but clearly has a suppressive effect on the levels of dietary sugars, such as glucose, maltose, and sucrose. A long-term administration study revealed that feeding db/db diabetic mice 3% 1,5-AG for 8 weeks significantly decreased blood glucose levels compared to untreated mice (339 ± 30 versus 438 ± 34 mg/dL; p < 0.05). Furthermore, this treatment also significantly suppressed serum cholesterol levels (110.2 ± 18.0 versus 168.4 ± 9.8 mg/dL; p < 0.01). 1,5-AG did not inhibit intestinal α-glucosidase activities but regulated liver glucose levels via affecting both the glycogenolysis and gluconeogenesis pathways. Furthermore, the oral administration of 1,5-AG significantly increased urinary glucose excretion in hyperglycemic conditions. These results clearly suggest that dietary 1,5-AG acts as a modulator of glucose levels in hyperglycemia. 1,5-AG therefore represents a new class of promising functional sweeteners, where the daily consumption of 1,5-AG with meals could inhibit the progress of hyperglycemia and metabolic syndrome.

1,5-anhydroglucitol monitoring in diabetes: a mass balance perspective

1,5-anhydroglucitol (AG) is a nonmetabolizable glucose analogue found in plasma due to ingestion. The normal steady-state concentration can be dramatically decreased by inhibition of tubular reabsorption during periods of hyperglycemia. For this reason, monitoring of AG has been plausibly advocated for detection of periodic glucosuric hyperglycemia. In this review, we examine the influence of variation in factors affecting both steady-state and transient changes in plasma AG. Among normals, the lower and upper limits of the plasma AG reference range vary by a factor of 5. Using a simplified mass balance model (a single compartment model with 3-6x larger-than-plasma volume of distribution), reasonable inter-individual variations of ingestion rate, glomerular filtration rate and fractional post-filtration reabsorption are each able to account for the wide range of normal, steady-state AG concentrations. In monitoring of changes in AG, inter-individual variations in the threshold for glucose excretion, volume of distribution and glomerular filtration rate are all likely to significantly affect correspondence of integral changes in AG to integral glucosuria/hyperglycemia. This combination of variables, affecting both steady-state and transient changes, is significantly confounding with respect to interpretation of serial plasma AG concentrations. Resolution of information content of AG monitoring is thus largely that of crossing simple characterization of deltas [+,0,-] for changes in AG concentration against the information content of hemoglobin A1c monitoring. Despite this limitation, AG monitoring can in principle provide information about glycemic control in the short term that is not apparent through monitoring of hemoglobin A1c alone. However, whether AG monitoring can lead to improved outcomes in diabetes management remains to be established.

A novel fully enzymatic method for determining glucose and 1,5-anhydro-D-glucitol in serum of one cuvette

The aim of the study was to set up a novel fully enzymatic method for screening glucose and 1,5-anhydro-D-glucitol (1,5-AG) in one cuvette. We have determined glucose and 1,5-AG, based on glucokinase (GK) converting glucose to G6P, a compound that can be catalyzed ultimately into 6-PGA by G-6PD and its coenzyme NADP(+), and then calculated glucose concentration according to absorbance variety. Furthermore, pyranose oxidase was used to oxidize 1,5-AG with the formation of 1, 5-anhydro-fructose and H(2)O(2). Measurement was done according to Trinder's reaction principle. The mean within-run and day-to-day precision (CV) of this method for glucose was 0.88% and 1.4%, and also that for 1,5-AG was 1.05% and 1.94%, respectively. The mean recovery rate of two targets was 100.2% and 101.6%, respectively. The correlation (R(2)) between the results of 1,5-AG obtained with our proposed method (y) and those obtained with LanaAG method (x) was 0.999 (y=1.002x-0.675 micromol/l; n=86), and the correlation (R(2)) of glucose between the results obtained with our GK method (y) and those obtained with recommendatory hexokinase method (x) was 0.9999 (y=1.0043x+0.1229 mmol/l; n=86). The reference range (95%) of serological glucose and 1,5-AG was 3.7 to 5.7 mmol/l (4.70+/-0.51 mmol/l) and 83.1 to 240.7 micromol/l (161.9+/-40.2 micromol/l), respectively; and there was no difference with age and sex (P>0.05). This newly developed method was dependable and steady-going, with analysis automatization, and allows quicker and easier measurement of serum glucose and 1,5-AG in one identical reaction cuvette in-phase than previously described methods.

Determination of 1,5-anhydro-D-glucitol on the basis of its inhibitory effect on trehalase activity

1,5-Anhydro-D-glucitol (1,5-AG) was found to inhibit trehalase and trehalose phosphorylase activities competitively, because of its structural similarity with D-glucose. Trehalase from Nocardia sp., one of the most 1,5-AG-sensitive enzymes, was used in the determination of 1,5-AG concentration, which is a useful marker for the diagnosis of diabetes. A good linear relationship was observed between 1,5-AG concentration in the range of 0.02 to 1.0 mM and the extent of trehalase inhibition by 1,5-AG. The 1,5-AG concentration range could be determined by estimating enzymatically the amount of the reaction product, D-glucose, produced by the trehalase.

Circulating 1,5-anhydroglucitol levels in adult patients with diabetes reflect longitudinal changes of glycemia: a U.S. trial of the GlycoMark assay

OBJECTIVE

1,5-Anhydroglucitol (1,5AG) is a major circulating polyol arising primarily from ingestion and excreted competitively with glucose. Japanese studies have demonstrated reduced concentrations of 1,5AG in serum in hyperglycemic patients in comparison with euglycemic subjects and a gradual normalization of 1,5AG values for patients responding to antihyperglycemic therapies. In this first U.S. study, we assessed the ability of 1,5AG measurements to monitor glycemic control in a cohort of 77 patients with diabetes (22 with type 1 diabetes, 55 with type 2 diabetes) who presented with suboptimal glycemic control at baseline (defined as HbA(1c) >or=7%).

RESEARCH DESIGN AND METHODS

Each patient received therapies consisting of combinations of diabetes education, nutritional counseling, and addition or dose adjustment of various insulins or oral antihyperglycemic medications. Therapy was targeted to reduce mean HbA(1c) by >or=1.0% over the monitoring period. 1,5AG, HbA(1c), fructosamine, and random glucose measurements were performed at baseline and at 2, 4, and 8 weeks after the initiation of therapy.

RESULTS

1,5AG, fructosamine, and glucose values progressed significantly toward euglycemia by week 2 of monitoring (Wilcoxon's signed-rank test, P < 0.05), with median changes of 93, -7, and -13% for 1,5AG, fructosamine, and glucose, respectively. In contrast, HbA(1c) values did not respond significantly to therapy until week 4. On an individual patient basis, 89.6% of patients displayed longitudinal changes of 1,5AG from baseline to week 8 in concordance with HbA(1c). 1,5AG was also highly correlated with HbA(1c) and fructosamine (Spearman rho = -0.6459 and -0.6751, respectively; both P < 0.0001).

CONCLUSIONS

We conclude that 1,5AG responds sensitively and rapidly to changes in glycemia and monitors glycemic control in accordance with established markers.

1,5-Anhydro-D-fructose; a versatile chiral building block: biochemistry and chemistry

There is a steadily increasing need to expand sustainable resources, and carbohydrates are anticipated to play an important role in this respect, both for bulk and fine chemical preparation. The enzyme alpha-(1-->4)-glucan lyase degrades starch to 1,5-anhydro-D-fructose. This compound, which has three different functional properties, a prochiral center together with a permanent pyran ring, renders it a potential chiral building block for the synthesis of valuable and potentially biologically active compounds. 1,5-Anhydro-D-fructose is found in natural materials as a degradation product of alpha-(1-->4)-glucans. The occurrence of lyases and the metabolism of 1,5-anhydro-D-fructose are reviewed in the biological part of this article. In the chemical part, the elucidated structure of 1,5-anhydro-D-fructose will be presented together with simple stereoselective conversions into hydroxy/amino 1,5-anhydro hexitols and a nojirimycin analogue. Synthesis of 6-O-acylated derivatives of 1,5-anhydro-D-fructose substituted with long fatty acid residues is carried out using commercially available enzymes. Those reactions lead to compounds with potential emulsifying properties. The use of protected derivatives of 1,5-anhydro-D-fructose for the synthesis of natural products is likewise reviewed. The potential utilization of this chemical building block is far from being exhausted. Since 1,5-anhydro-D-fructose now is accessible in larger amounts through a simple-enzyme catalyzed degradation of starch by alpha-(1-->4)-glucan lyase, the application of 1,5-anhydro-D-fructose may be considered a valuable contribution to the utilization of carbohydrates as the most abundant resource of sustainable raw materials.

Predicting long-term glycemic control of post-educational type II diabetic patients by evaluating serum 1,5-anhydroglucitol levels

1,5-Anhydroglucitol (1.5-AG) is known to closely reflect diabetic control within several days. The possibility of predicting long-term glycemic control after an educational hospitalization of type II diabetic patients was investigated by examining the relationship between changes in serum 1,5-AG levels after a short-term trial home stay following an educational program and long-term changes in glycosylated hemoglobin A1c (HbA1c) levels after discharge. After 22 patients with type II diabetes had successfully completed the educational hospitalization program, they returned as outpatients for 5 nights in a row. Changes in serum 1,5-AG levels were determined during this period. The HbA1c levels were then determined over a period of 3 months after discharge, and the relationship between changes in 1,5-AG and HbA1c levels was examined. Changes in serum 1,5-AG levels during the 5-day trial home stay and the changes in HbA1c levels during the 3 months after discharge from the hospital were found to be significantly correlated (r = 0.70, P < 0.01). A comparison of the decreased group, which exhibited a decrease in 1.5-AG levels of 5.0 mumol/l or more during the trial home stay, and the unchanged group, revealed that increases in body mass index 3 months after discharge were significantly higher in the decreased group (1.2 +/- 0.4%) than in the unchanged group (0.2 +/- 0.5%) (P < 0.05). Determination of serum 1,5-AG levels of patients with type II diabetes before and after a trial home stay following educational hospitalization was found to be useful in identifying patients at high risk of recurrence of poor glycemic control in the future.

Production of 1,5-anhydroglucitol from 1,5-anhydrofructose in erythroleukemia cells

The pyranoid polyol 1,5-anhydroglucitol (1,5AnGlc-ol) occurs in a wide variety of organisms. In humans, it is present as one of the major monosaccharide components in body fluids and serves as an indicator for glycemic control in diabetic care. However, its metabolic origin and fate have been poorly understood. Here we demonstrate that 1,5AnGlc-ol is produced from glucose in erythroleukemia cells, K-562. We show the occurrence of 1,5-anhydrofructose (1,5AnFru), a derivative of 1,5AnGlc-ol oxidized at the C2 position, in K-562 cells. In addition, several pieces of evidence indicated that 1,5AnFru, rather than glucose, was the immediate precursor in 1,5AnGlc-ol production in erythroleukemia cells: exogenous 1,5AnFru was readily taken up into the cells and reduced to 1,5AnGlc-ol, but the reverse reaction, oxidation of 1,5AnGlc-ol to 1,5AnFru, was scarcely observed. The apparent K(m) of the overall cellular reduction for 1,5AnFru was estimated as 70 mg/l. This reduction was markedly inhibited by glucose in the culture medium but not by 1,5AnGlc-ol or glucitol. Since 1,5AnFru arises from alpha-1,4-glucans through lyase reactions in fungi and algae, we suggest the possibilities that glycogen in the precursor of 1,5AnFru and, therefore, 1,5AnGlc-ol originates from glycogen in mammals.

Comparison of micro-enzymatic and high-performance liquid chromatographic methods for the assay of serum 1,5-anhydroglucitol

Serum 1,5-anhydro-D-glucitol (AG) has been proposed as a marker of glycaemic control in diabetic patients. Two methods have been developed which could be applied to routine clinical monitoring of serum AG. We have compared the assay characteristics of an adapted enzyme assay, based on the enzyme pyranose oxidase, with a high-performance anion-exchange chromatographic method using pulsed amperometric detection (HPAEC-PAD). Linearity and minimum detectable concentrations were practically identical (to at least 400 mumol/l and 4 mumol/l AG, respectively), though intra- and inter-assay precision was better with the HPAEC PAD system at a clinically relevant concentration of 40 mumol/l AG (9.8% vs. 11.8% and 9.2% vs. 13.0%, respectively). The recovery of added AG to serum samples was lower with the micro-enzyme assay than the HPAEC-PAD assay (74 +/- 15% vs. 102 +/- 8%). Despite good agreement by linear regression (r = 0.974, P < 0.005), the assay methods did not demonstrate satisfactory agreement when using a difference plot (limits of agreement -16.1 to 18.7 mumol/l). We conclude that although both assay methods are applicable to routine analyses, the HPAEC-PAD is more precise and is more specific for AG than the enzyme based assay.

Serum 1,5-anhydroglucitol (1,5 AG): new clinical marker for glycemic control

We review the use of 1,5-anhydroglucitol (1,5 AG) in diagnosing and monitoring patients with diabetes. This six-carbon chain monosaccharide is one of the major polyols present in humans. Its concentration in serum is normally about 12 to 40 micrograms/ml. This substance is derived mainly from food, is well absorbed in the intestine, and is distributed to all organs and tissues. It is metabolically stable, being excreted in the urine when its level exceeds the renal threshold. It is reabsorbed in the renal tubules, and is competitively inhibited by glucosuria, which leads to a reduction in its level in serum. The correlation between this reduction and the amount of glucose present in urine is so close that 1,5 AG can be used as a sensitive, day-to-day, real-time marker of glycemic control. It provides useful information on current glycemic control and is superior to both HbA1c and fructosamine in detecting near-normoglycemia.

A new method of quantitating serum and urinary levels of 1,5-anhydroglucitol in insulin-dependent diabetes mellitus

A new method was developed for quantitating the serum and urinary levels of 1,5-anhydroglucitol (AG), a sensitive and informative marker of glycemic control. This method utilized a combination of ODS and pyranose oxidase-immobilized columns for HPLC, and monitored hydrogen peroxide production with an electrochemical detector. We applied this method to determine the serum and urinary AG levels in 15 patients with insulin-dependent diabetes mellitus (IDDM) as well as in control subjects. Baseline separation of AG from other sugars such as glucose and myoinositol was achieved. Quantitation of AG was achieved over the range from 0.2 ng to 0.3 micrograms based upon peak heights. The serum and urinary AG levels in the IDDM patients were 4.4 +/- 8.3 mg/l and 5.1 +/- 4.3 mg/day, respectively. We found that the urinary AG to serum AG ratio showed a linear correlation with the urinary glucose level in the IDDM patients (urinary glucose (y) vs. urinary AG to serum AG ratio (x): y = 9.071x-0.991; r = 0.968, P < 0.001). This method proved efficient and reliable for quantitating urinary AG. Since determination of both the AG and glucose levels in urine gives equivalent clinical information to the serum AG level, urinary monitoring could provide a valuable addition to the available methods for assessing the glycemic status of IDDM patients.

Conditional synthesis and utilization of 1,5-anhydroglucitol in Escherichia coli

A cyclic polyol, 1,5-anhydro-D-glucitol (AG), is widely detected in most organisms, although little is known about its metabolism and physiological roles. The present study demonstrates the synthesis of AG in Escherichia coli C600. The major portion of the synthesized AG was indicated to be derived from glucose retaining all the six carbon atoms, and only 5% was attributed to AG synthesized from C3 compounds. AG synthesis is apparent in an early stage of the stationary phase, and accumulation is transient both in cells and in medium. Evidence is also presented for AG uptake and metabolism and for effects of cyclic AMP.

Synthesis of deoxyglucose-1-phosphate, deoxyglucose-1,6-bisphosphate, and other metabolites of 2-deoxy-D-[14C]glucose in rat brain in vivo: influence of time and tissue glucose level

When the kinetics of interconversion of deoxy[14C]glucose ([14C]DG) and [14C]DG-6-phosphate ([14C]DG-6-P) in brain in vivo are estimated by direct chemical measurement of precursor and products in acid extracts of brain, the predicted rate of product formation exceeds the experimentally measured rate. This discrepancy is due, in part, to the fact that acid extraction regenerates [14C]DG from unidentified labeled metabolites in vitro. In the present study, we have attempted to identify the 14C-labeled compounds in ethanol extracts of brains of rats given [14C]DG. Six 14C-labeled metabolites, in addition to [14C]DG-6-P, were detected and separated. The major acid-labile derivatives, DG-1-phosphate (DG-1-P) and DG-1,6-bisphosphate (DG-1,6-P2), comprised approximately 5 and approximately 10-15%, respectively, of the total 14C in the brain 45 min after a pulse or square-wave infusion of [14C]DG, and their levels were influenced by tissue glucose concentration. Both of these acid-labile compounds could be synthesized from DG-6-P by phosphoglucomutase in vitro. DG-6-P, DG-1-P, DG-1,6-P2, and ethanol-insoluble compounds were rapidly labeled after a pulse of [14C]DG, whereas there was a 10-30-min lag before there was significant labeling of minor labeled derivatives. During the time when there was net loss of [14C]DG-6-P from the brain (i.e., between 60 and 180 min after the pulse), there was also further metabolism of [14C]DG-6-P into other ethanol-soluble and ethanol-insoluble 14C-labeled compounds. These results demonstrate that DG is more extensively metabolized in rat brain than commonly recognized and that hydrolysis of [14C]DG-1-P can explain the overestimation of the [14C]DG content and underestimation of the metabolite pools of acid extracts of brain. Further metabolism of DG does not interfere with the autoradiographic DG method.

High performance liquid chromatographic determination of 1,5-anhydroglucitol in human plasma for diagnosis of diabetes mellitus

This paper describes a high performance liquid chromatographic (HPLC) method for determining 1,5-anhydroglucitol in plasma, in which anion exchange chromatography and pulsed amperometric detection are used. Plasma samples deproteinized with trichloroacetic acid are passed through a three-layer column packed with (1) strongly basic anion (BO3(3-) form, the upper layer), (2) strongly basic anion (OH- form, the middle layer) and (3) strongly acidic cation (H+ form, the lower layer) exchange resins. 1,5-Anhydroglucitol is efficiently recovered in the flow-through fraction and interfering substances are completely removed by the column treatment. The analytical response of the method is linear with concentration to 40 mg/L, and it is possible to detect as little as 0.1 mg 1,5-anhydroglucitol per litre of plasma. Analytical recovery is between 96 and 103%, and there is good agreement between the results measured by our method and by a gas/liquid chromatographic method (r = 0.998). The method has been successfully used for the determination of very low 1,5-anhydroglucitol concentrations (less than 1 mg/L) in the plasma of diabetic patients.

Plasma 1,5-anhydroglucitol in experimental galactosemia in the rat

Feeding with a galactose-rich diet induced a substantial drop in blood plasma 1,5-anhydroglucitol concentration. The decline was proportional to the dose of galactose. The decline was less marked in xylose-fed rats.

Urinary excretion of 1,5-anhydro-D-glucitol accompanying glucose excretion in diabetic patients

The urinary excretion of 1,5-anhydro-D-glucitol, a pyranoid polyol, in humans was studied. The plasma of nondiabetic human subjects contained high concentrations of this polyol (greater than 110 mumol/l), and there was a tendency for the 24-h excretion of it to become more variable in direct proportion to its plasma concentration. In contrast, diabetic patients showed lower plasma concentrations of this polyol, and the variation in the 24-h excretion of 1,5-anhydro-D-glucitol was especially notable among the patients with an extremely low plasma concentration of the polyol. This diabetic group showed a statistically significant correlation (p less than 0.01), between the urinary 1,5-anhydro-D-glucitol and urinary glucose. This correlation was more markedly demonstrated during a 100-g oral glucose tolerance test: parallel changes were observed in the concentrations of 1,5-anhydro-D-glucitol and glucose in the urine collected every hour after the glucose load. These observations led to the proposal that low plasma concentration of this polyol, which is observed in diabetes mellitus, may be the result of a frequent and/or prolonged high blood glucose concentration beyond the renal threshold for glucose excretion.

Effect of an amino group at carbon 2 of 1-deoxyglucose analogues on anorexia in the rat

A steric hindering group at carbon 2 of 1-deoxyglucose analogues was introduced by epimerization, deoxidation and substitution of a hydroxyl group with either an acetamido or a fluoro group. Injection of this analogue into the rat third cerebroventricle attenuated the feeding suppression produced by 1-deoxyglucose. In contrast, the replacement of a hydroxyl group at carbon 2 with an amino group produced anorexia of the same magnitude as that produced by 1-deoxyglucose. Amination at carbon 2 was more potent than that at carbon 3, 4 or 6. These results indicate that an amino group at carbon 2 of the glucose molecule is important to reinforce the feeding suppression caused by 1-deoxyglucose analogues.

Reduction of plasma 1,5-anhydroglucitol (1-deoxyglucose) concentration in diabetic patients

The plasma concentration of 1,5-anhydro-D-glucitol(AG)(1-deoxyglucose) is known to decrease in diabetic patients. In order to evaluate the usefulness of this polyol as a diabetic marker, we examined the specificity of the plasma AG reduction in various diseases: the plasma AG level was determined in 108 newly diagnosed diabetic patients, 229 normal subjects and 200 patients with various other disorders. The mean plasma AG concentration in diabetes mellitus was 1.9 +/- 1.8 micrograms/ml (mean +/- SD), which was definitely lower than that in healthy subjects and patients with other diseases including some metabolic and hormonal diseases (mean value range: 13.4-28.3 micrograms/ml). Only the "malignancies" group showed statistically different mean values from that in normal subjects; however, these values were much higher than those of diabetic patients. The AG concentration seemed to be relatively low in some severe by uraemic patients, but is likely to be little influenced by the glomerular filtration rate. Upon adjustment for sex and age, AG concentration was not found to be correlated with the degree of obesity in both healthy subjects and diabetic patients. The plasma AG concentration showed a tendency to be higher in healthy males than in healthy females in all age-matched groups; however, statistically significant differences were not seen. Also, no significant influence of age was observed.

Metabolic profiling with gas chromatography-mass spectrometry and its application to clinical medicine

Nowadays, metabolic profiling is widely applied in clinical medicine for the diagnosis and study of human diseases. The number of these applications and their diversity have increased rapidly in the past few years. This review summarizes recent advances in the methods for sample pretreatment and the clinical application of GC-MS to the study of uraemia, diabetes mellitus, dicarboxylic aciduria and other organic acidurias. High-resolution GC-MS is well suited to the profile analysis of metabolic disorders.

Profiling of organic acids and polyols in nerves of uraemic and non-uraemic patients

Organic acids, polyols and lipid-bound polyols in the cauda equina nerves of uraemic patients and non-uraemic patients were analysed with high-resolution gas chromatography-mass spectrometry. In the uraemic nervous tissue, the concentrations of myoinositol and 4-hydroxyphenylacetic acid were increased. Levulinic acid was first detected in the nervous tissue as a normal component. 1-Deoxyglucose and free and lipid phosphatide scylloinositol were detected in the nervous tissue as normal components.

The elimination of 1,5-anhydroglucitol administered to rats

Rat serum contains natural 1,5-anhydroglucitol. Injected or orally administered 1,5-anhydroglucitol was efficiently reabsorbed by the renal tubuli via a mechanism which had a saturation point at high serum 1,5- anhydroglucitol levels. The compound had a slow turnover rate in the body; its half-life is approximately 3 days. The compound was readily absorbed in the gut when administered orally.

Feeding suppression induced by intra-ventricle III infusion of 1,5-anhydroglucitol

1,5-Anhydroglucitol (1-DG) has been known as an antimetabolic glucose analogue. Using gas chromatography, 1-DG was found to be physiologically present in rat serum. In order to investigate its direct and long-term effects on feeding, 1-DG was infused during the light period into the rat third ventricle in doses of 3.0, 6.0 and 12.0 mumol/rat. Its effects were then compared to those of similarly applied 2-deoxy-D-glucose (2-DG). Following initial hyperphagia, both of these glucose-analogues produced suppressive effects on feeding during the subsequent day throughout the light and dark periods. On the third day after 2-DG injection reduction of feeding did not recover completely to the pretreatment baseline levels, but it did recover after 1-DG. Both 1-DG and 2-DG caused linear dose-related hypophagia, with the slope for 1-DG being about half of that for 2-DG. It is suggested that the delayed hypophagia which followed the initial hyperphagia produced by deoxyglucose was a result of sustained inactivation of the Na-pump due to intracellular ATP deficiency caused by accumulation of deoxy-glucose-6-phosphate.

Serum 1,5-anhydroglucitol in normal subjects and in patients with insulin-dependent diabetes mellitus

The serum levels of 1,5-anhydroglucitol were measured by gas chromatography in normal subjects and in patients with type 1 (insulin-dependent) diabetes mellitus and compared with those found in some other common diseases. The identity of the compound was checked by thin-layer chromatography and by means of mass fragmentography. The mean level was 81 mumol/l (range 10-146 mumol/l, n = 139) in normal subjects and comparable levels were found in patients with rheumatic disease (n = 20) and in several patients with circulatory diseases. The level was less than 10 mumol/l in 44 patients with insulin-dependent diabetes mellitus, both in newly diagnosed cases and in patients with a long history of the disease with or without nephropathy. The compound did not appear in serum during near normoglycaemic periods elicited by continuous subcutaneous insulin infusion therapy, nor after successful kidney transplantation.

Identification of 1,5-anhydroglucitol in thin-layer chromatograms

The chromatographical characteristics of 1,5-anhydroglucitol in thin-layer chromatograms can be studied using the customary carbohydrate solvents. Both hydrogen peroxide and sodium metaperiodate oxidation reactions were tested in order to find a specific colour reaction for the detection of the compound. 1,5-anhydroglucitol was readily converted by periodate into an intermediate product which produced an intense orange-red colour with diphenylamine aniline reagent. According to data obtained from periodate oxidation, IR spectroscopy and mass fragmentography, the intermediate product was a dialdehyde compound with a C6 structure, possibly formed through cleavage at C2-C3. The formation of a compound of this kind without chain cleavage in the periodate oxidation of C6 carbohydrates is uncommon. Periodate oxidation followed by diphenylamine-aniline reaction affords a sensitive and specific method for the detection of 1,5-anhydroglucitol.

Mass spectrometry of some ultraviolet absorbing derivatives of sugars and related alditols: identification in biologic fluids after separation by high performance liquid chromatography

The 70 eV electron impact mass spectra of the acyclic perbenzoyl 0-benzyloximes of several mono- and disaccharides of clinical interest and the perbenzoates of certain related alditols have been obtained and compared with those of other similar derivatives studied previously. In general, the spectra of the benzyloximes contain molecular ions and characteristic fragments due to [C6H5]+,[C7H7]+,[C6H5CO]+ and [C6H5CooH]+., losses of HCHO, C6H5COO. and C6H5COOH, and cleavages along the carbon chain. The most unique ions in these spectra arise from the combined loss of C7H7. and C6H5COO.from the molecular ion: m/z 191 (C3), m/z 339 (deoxy-C5), m/z 459 (C5), m/z 473 (deoxy-C6), and m/z 593 (C6). The alditol benzoates fragment similarly, but they do not yield molecular ions. These data are being used to help confirm the identities of carbohydrates in biologic fluids fractionation by high performance liquid chromatography, prior to the establishment of routine quantitative assays for several of these compounds.

Gas chromatographic study of free polyols and aldoses in cataractous human lens tissue

An analytical procedure for the qualitative and quantitative analysis of human lens tissue for polyol and aldose content is described. Profile samples are obtained by direct derivatization of lyophilized lenses. The components are analyzed as per-O-acetylpolyols (from the polyols) and per-O-acetylaldononitriles (from the aldoses). This procedure converts each component into a single derivative and terminal dissymmetry for each aldose is retained. The derivatives form in quantitative yield, give good chromatographic peaks, are thermally stable and readily volatilized. They are not subject to adsorption on gas chromatographic columns and are suitable for both qualitative and quantitative analytical studies. Six non-cataractous lenses and fourteen lenses from patients with senile cataract (in seven instances complicated by diabetic pathology) were analyzed. Thermostable borosilicate glass open-tubular capillary columns, coated with the nonpolar phase SE-30, and containing dispersed particles of silanized silicic acid, were used for the gas chromatographic separations. The results are discussed in relation to what is known from earlier studies of human and animal cataracts. A gas chromatographic method for determining the polyol and aldose excretion levels of controlled diabetics is also reported along with a typical metabolic profile.

Variation in polyol levels in cerebrospinal fluid and serum in diabetic patients

Cerebrospinal fluid (CSF) or CSF and plasma levels of sorbitol, 1,5-anhydroglucitol and myoinositol of diabetic and non-diabetic patients with normal kidney function and of diabetic and non-diabetic patients with impaired kidney function were measured by gas-liquid chromatography. The CSF sorbitol level correlated with the plasma glucose level (p less than or equal to 0.05) in diabetic patients with normal kidney function, having received insulin for less than 12 months. The correlation between CSF sorbitol and plasma glucose levels in patients not dependent on insulin was not significant. Sorbitol was not detected in the plasma. The highest sorbitol levels in CSF were seen in insulin-dependent diabetic patients with impaired kidney function. No rise was seen in non-diabetic uremia. 1,5-anhydroglucitol, normally present in plasma, was absent from CSF and plasma in diabetic patients receiving insulin. In non-diabetic uremic patients, 1,5-anhydroglucitol levels in CSF and plasma were lower than in healthy subjects, but htere was no correlation with plasma glucose levels. The myoinositol level was higher in CSF than in the plasma of both non-diabetic and diabetic patients with normal kidney function. Both plasma and CSF levels were significantly (p less than 0.001) elevated in diabetic as well as in non-diabetic uremic patients, the plasma myoinositol increasing relatively more than the CSF levels. The elevation of plasma myoinositol correlated with the elevation of plasma creatinine and thus also with the impairment of kidney function. Plasma and CSF myoinositol levels were not influenced by the plasma glucose level.