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Diederich J, Mounkoro P, Tirado HA, Chevalier N, Van Schaftingen E, Veiga-da-Cunha M. SGLT5 is the renal transporter for 1,5-anhydroglucitol, a major player in two rare forms of neutropenia. Cell Mol Life Sci 2023; 80:259. [PMID: 37594549 PMCID: PMC10439028 DOI: 10.1007/s00018-023-04884-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 06/20/2023] [Accepted: 07/17/2023] [Indexed: 08/19/2023]
Abstract
Neutropenia and neutrophil dysfunction in glycogen storage disease type 1b (GSD1b) and severe congenital neutropenia type 4 (SCN4), associated with deficiencies of the glucose-6-phosphate transporter (G6PT/SLC37A4) and the phosphatase G6PC3, respectively, are the result of the accumulation of 1,5-anhydroglucitol-6-phosphate in neutrophils. This is an inhibitor of hexokinase made from 1,5-anhydroglucitol (1,5-AG), an abundant polyol in blood. 1,5-AG is presumed to be reabsorbed in the kidney by a sodium-dependent-transporter of uncertain identity, possibly SGLT4/SLC5A9 or SGLT5/SLC5A10. Lowering blood 1,5-AG with an SGLT2-inhibitor greatly improved neutrophil counts and function in G6PC3-deficient and GSD1b patients. Yet, this effect is most likely mediated indirectly, through the inhibition of the renal 1,5-AG transporter by glucose, when its concentration rises in the renal tubule following inhibition of SGLT2. To identify the 1,5-AG transporter, both human and mouse SGLT4 and SGLT5 were expressed in HEK293T cells and transport measurements were performed with radiolabelled compounds. We found that SGLT5 is a better carrier for 1,5-AG than for mannose, while the opposite is true for human SGLT4. Heterozygous variants in SGLT5, associated with a low level of blood 1,5-AG in humans cause a 50-100% reduction in 1,5-AG transport activity tested in model cell lines, indicating that SGLT5 is the predominant kidney 1,5-AG transporter. These and other findings led to the conclusion that (1) SGLT5 is the main renal transporter of 1,5-AG; (2) frequent heterozygous mutations (allelic frequency > 1%) in SGLT5 lower blood 1,5-AG, favourably influencing neutropenia in G6PC3 or G6PT deficiency; (3) the effect of SGLT2-inhibitors on blood 1,5-AG level is largely indirect; (4) specific SGLT5-inhibitors would be more efficient to treat these neutropenias than SGLT2-inhibitors.
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Affiliation(s)
- Jennifer Diederich
- Metabolic Research Group, de Duve Institute and UCLouvain, de Duve Institute, 75, Av. Hippocrate, 1200, Brussels, Belgium
| | - Pierre Mounkoro
- Metabolic Research Group, de Duve Institute and UCLouvain, de Duve Institute, 75, Av. Hippocrate, 1200, Brussels, Belgium
| | - Hernan A Tirado
- Metabolic Research Group, de Duve Institute and UCLouvain, de Duve Institute, 75, Av. Hippocrate, 1200, Brussels, Belgium
| | - Nathalie Chevalier
- Metabolic Research Group, de Duve Institute and UCLouvain, de Duve Institute, 75, Av. Hippocrate, 1200, Brussels, Belgium
| | - Emile Van Schaftingen
- Metabolic Research Group, de Duve Institute and UCLouvain, de Duve Institute, 75, Av. Hippocrate, 1200, Brussels, Belgium
| | - Maria Veiga-da-Cunha
- Metabolic Research Group, de Duve Institute and UCLouvain, de Duve Institute, 75, Av. Hippocrate, 1200, Brussels, Belgium.
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Veiga-da-Cunha M, Wortmann SB, Grünert SC, Van Schaftingen E. Treatment of the Neutropenia Associated with GSD1b and G6PC3 Deficiency with SGLT2 Inhibitors. Diagnostics (Basel) 2023; 13:diagnostics13101803. [PMID: 37238286 DOI: 10.3390/diagnostics13101803] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 05/12/2023] [Accepted: 05/17/2023] [Indexed: 05/28/2023] Open
Abstract
Glycogen storage disease type Ib (GSD1b) is due to a defect in the glucose-6-phosphate transporter (G6PT) of the endoplasmic reticulum, which is encoded by the SLC37A4 gene. This transporter allows the glucose-6-phosphate that is made in the cytosol to cross the endoplasmic reticulum (ER) membrane and be hydrolyzed by glucose-6-phosphatase (G6PC1), a membrane enzyme whose catalytic site faces the lumen of the ER. Logically, G6PT deficiency causes the same metabolic symptoms (hepatorenal glycogenosis, lactic acidosis, hypoglycemia) as deficiency in G6PC1 (GSD1a). Unlike GSD1a, GSD1b is accompanied by low neutrophil counts and impaired neutrophil function, which is also observed, independently of any metabolic problem, in G6PC3 deficiency. Neutrophil dysfunction is, in both diseases, due to the accumulation of 1,5-anhydroglucitol-6-phosphate (1,5-AG6P), a potent inhibitor of hexokinases, which is slowly formed in the cells from 1,5-anhydroglucitol (1,5-AG), a glucose analog that is normally present in blood. Healthy neutrophils prevent the accumulation of 1,5-AG6P due to its hydrolysis by G6PC3 following transport into the ER by G6PT. An understanding of this mechanism has led to a treatment aimed at lowering the concentration of 1,5-AG in blood by treating patients with inhibitors of SGLT2, which inhibits renal glucose reabsorption. The enhanced urinary excretion of glucose inhibits the 1,5-AG transporter, SGLT5, causing a substantial decrease in the concentration of this polyol in blood, an increase in neutrophil counts and function and a remarkable improvement in neutropenia-associated clinical signs and symptoms.
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Affiliation(s)
- Maria Veiga-da-Cunha
- Metabolic Research Group, de Duve Institute and UCLouvain, B-1200 Brussels, Belgium
| | - Saskia B Wortmann
- University Children's Hospital, Paracelsus Medical University, 5020 Salzburg, Austria
- Amalia Children's Hospital, Radboudumc, 6525 Nijmegen, The Netherlands
| | - Sarah C Grünert
- Department of General Pediatrics, Adolescent Medicine and Neonatology, Medical Center, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany
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Jiménez-Sánchez C, Mezza T, Sinturel F, Li L, Di Giuseppe G, Quero G, Jornayvaz FR, Guessous I, Dibner C, Schrauwen P, Alfieri S, Giaccari A, Maechler P. Circulating 1,5-Anhydroglucitol as a Biomarker of ß-cell Mass Independent of a Diabetes Phenotype in Human Subjects. J Clin Endocrinol Metab 2022; 107:2833-2843. [PMID: 35867405 DOI: 10.1210/clinem/dgac444] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Indexed: 11/19/2022]
Abstract
CONTEXT During an asymptomatic prediabetic state, the functional ß-cell mass decreases to a critical threshold, triggering diabetes and related symptoms. To date, there are no reliable readouts able to capture in vivo a potential drop of the ß-cell mass. OBJECTIVE Beside its use as a short-term marker of glycemic control, the deoxyhexose 1,5-anhydroglucitol was identified in rodents as a circulating biomarker of the functional ß-cell mass already in the asymptomatic prediabetic stage. The present study investigated the putative corresponding relevance of circulating 1,5-anhydroglucitol in different human cohorts. METHODS We analyzed clinical and blood parameters in patients with established type 2 diabetes and subjects considered at high risk of developing diabetes, as well as patients with no history of diabetes scheduled for pancreaticoduodenectomy. RESULTS Circulating 1,5-anhydroglucitol was reduced in type 2 diabetic patients, negatively correlating with fasting plasma glucose (P < 0.0001) and hemoglobin A1c (P < 0.0001). In healthy subjects, 1,5-AG levels positively correlated with body mass index (P = 0.004) and Homeostatic Model Assessment of Insulin Resistance %S (P < 0.03) and was particularly high in nondiabetic obese individuals, potentially accounting for compensatory ß-cell expansion. Patients with no history of diabetes undergoing pancreaticoduodenectomy exhibited a 50% reduction of circulating 1,5-anhydroglucitol levels following surgery leading to an acute loss of their ß-cell mass (P = 0.002), regardless their glucose tolerance status. CONCLUSION In summary, plasma concentration of 1,5-anhydroglucitol follows the ß-cell mass and its noninvasive monitoring may alert about the loss of ß cells in subjects at risk for diabetes, an event that cannot be captured by other clinical parameters of glycemic control.
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Affiliation(s)
- Cecilia Jiménez-Sánchez
- Department of Cell Physiology and Metabolism, University of Geneva Medical Center, 1206 Geneva, Switzerland
- Faculty Diabetes Center, University of Geneva Medical Center, 1206 Geneva, Switzerland
| | - Teresa Mezza
- Pancreas Unit, CEMAD, Department of Internal medicine & Gastroenterology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy
- Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, 00168 Roma, Italy
| | - Flore Sinturel
- Department of Cell Physiology and Metabolism, University of Geneva Medical Center, 1206 Geneva, Switzerland
- Faculty Diabetes Center, University of Geneva Medical Center, 1206 Geneva, Switzerland
- Department of Surgery, Geneva University Hospitals, 1211 Geneva, Switzerland
| | - Lingzi Li
- Department of Cell Physiology and Metabolism, University of Geneva Medical Center, 1206 Geneva, Switzerland
- Faculty Diabetes Center, University of Geneva Medical Center, 1206 Geneva, Switzerland
| | - Gianfranco Di Giuseppe
- Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, 00168 Roma, Italy
- Endocrine and Metabolic Diseases Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Roma, Italy
| | - Giuseppe Quero
- Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, 00168 Roma, Italy
- Pancreatic Surgery Unit, Department of Surgery, Gemelli Pancreatic Center, CRMPG (Advanced Pancreatic Research Center), Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Roma, Italy
| | - François R Jornayvaz
- Department of Cell Physiology and Metabolism, University of Geneva Medical Center, 1206 Geneva, Switzerland
- Faculty Diabetes Center, University of Geneva Medical Center, 1206 Geneva, Switzerland
- Department of Medicine, Geneva University Hospitals, 1211 Geneva, Switzerland
| | - Idris Guessous
- Department of Primary Care Medicine, Geneva University Hospitals, 1211 Geneva, Switzerland
| | - Charna Dibner
- Department of Cell Physiology and Metabolism, University of Geneva Medical Center, 1206 Geneva, Switzerland
- Faculty Diabetes Center, University of Geneva Medical Center, 1206 Geneva, Switzerland
- Department of Surgery, Geneva University Hospitals, 1211 Geneva, Switzerland
| | - Patrick Schrauwen
- Department of Nutrition and Movement Sciences, Maastricht University Medical Center, 6200MD Maastricht, The Netherlands
| | - Sergio Alfieri
- Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, 00168 Roma, Italy
- Pancreatic Surgery Unit, Department of Surgery, Gemelli Pancreatic Center, CRMPG (Advanced Pancreatic Research Center), Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Roma, Italy
| | - Andrea Giaccari
- Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, 00168 Roma, Italy
- Endocrine and Metabolic Diseases Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Roma, Italy
| | - Pierre Maechler
- Department of Cell Physiology and Metabolism, University of Geneva Medical Center, 1206 Geneva, Switzerland
- Faculty Diabetes Center, University of Geneva Medical Center, 1206 Geneva, Switzerland
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Ortiz-Martínez M, González-González M, Martagón AJ, Hlavinka V, Willson RC, Rito-Palomares M. Recent Developments in Biomarkers for Diagnosis and Screening of Type 2 Diabetes Mellitus. Curr Diab Rep 2022; 22:95-115. [PMID: 35267140 PMCID: PMC8907395 DOI: 10.1007/s11892-022-01453-4] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/27/2022] [Indexed: 11/03/2022]
Abstract
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.
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Affiliation(s)
- Margarita Ortiz-Martínez
- Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey, Nuevo León, México
| | - Mirna González-González
- Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey, Nuevo León, México.
- Tecnologico de Monterrey, The Institute for Obesity Research, Monterrey, Nuevo León, México.
| | - Alexandro J Martagón
- Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey, Nuevo León, México
- Tecnologico de Monterrey, The Institute for Obesity Research, Monterrey, Nuevo León, México
- Unidad de Investigación de Enfermedades Metabólicas, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México City, México
| | - Victoria Hlavinka
- Department of Chemical and Biomolecular Engineering, University of Houston, Houston, TX, USA
| | - Richard C Willson
- Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey, Nuevo León, México
- Department of Chemical and Biomolecular Engineering, University of Houston, Houston, TX, USA
| | - Marco Rito-Palomares
- Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey, Nuevo León, México
- Tecnologico de Monterrey, The Institute for Obesity Research, Monterrey, Nuevo León, México
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Tanaka K, Sakasai-Sakai A, Motomiya Y, Yoneda T, Takeuchi M. Serum levels of 1,5-anhydroglucitol and 1,5-anhydrofructose-derived advanced glycation end products in patients undergoing hemodialysis. Diabetol Metab Syndr 2021; 13:85. [PMID: 34399831 PMCID: PMC8369766 DOI: 10.1186/s13098-021-00685-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Accepted: 06/07/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND 1,5-anhydroglucitol is a reduction product of 1,5-anhydrofructose. Circulating 1,5-anhydroglucitol is usually excreted by the kidneys and is reabsorbed via sodium-glucose co-transporter 4 in the renal tubules. In patients on hemodialysis, serum levels of 1,5-anhydroglucitol have been reported to be low; however, the underlying mechanism remains unclear. METHODS We measured inter-dialysis changes in the levels of serum 1,5-anhydroglucitol and 1,5-anhydrofructose-derived advanced glycation end products (AGEs) in 78 patients on hemodialysis. Serum levels of 1,5-anhydrofructose-derived AGEs were also determined using a polyclonal antibody. RESULTS The serum 1,5-anhydroglucitol level was decreased to as low as 2.0 μg/mL in the regular hemodialysis group; however, we could not verify changes in the serum 1,5-anhydroglucitol level during inter-dialysis days because of undetectable levels in 29 patients. The measured serum level of 1,5-anhydrofructose-derived AGEs was significantly increased in both patient groups. In addition, the 1,5-anhydrofructose-derived AGEs/1,5-anhydroglucitol ratio was higher in patients on hemodialysis than in controls. CONCLUSIONS Accelerated glycation of 1,5-anhydrofructose is one possible mechanism by which serum 1,5-anhydroglucitol levels are lowered in patients on HD, and we propose that the 1,5-anhydrofructose-derived AGEs/1,5-anhydroglucitol ratio should be measured in clinical settings in which patients have low serum levels of 1,5-AG.
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Affiliation(s)
- Kenji Tanaka
- Suiyukai Clinic, Kashihara, Nara, 634-0007, Japan.
| | - Akiko Sakasai-Sakai
- Department of Advanced Medicine, Medical Research Institute, Kanazawa Medical University, Ishikawa, Japan
| | | | - Tatsuo Yoneda
- Unit of Hemodialysis, Nara Medical University, Nara, Japan
| | - Masayoshi Takeuchi
- Department of Advanced Medicine, Medical Research Institute, Kanazawa Medical University, Ishikawa, Japan
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Failure to eliminate a phosphorylated glucose analog leads to neutropenia in patients with G6PT and G6PC3 deficiency. Proc Natl Acad Sci U S A 2019; 116:1241-1250. [PMID: 30626647 PMCID: PMC6347702 DOI: 10.1073/pnas.1816143116] [Citation(s) in RCA: 90] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Neutropenia presents an important clinical problem in patients with G6PC3 or G6PT deficiency, yet why neutropenia occurs is unclear. We discovered that G6PC3 and G6PT collaborate to dephosphorylate a noncanonical metabolite (1,5-anhydroglucitol-6-phosphate; 1,5AG6P) which is produced when glucose-phosphorylating enzymes erroneously act on 1,5-anhydroglucitol, a food-derived polyol present in blood. In patients or mice with G6PC3 or G6PT deficiency, 1,5AG6P accumulates and inhibits the first step of glycolysis. This is particularly detrimental in neutrophils, since their energy metabolism depends almost entirely on glycolysis. Consistent with our findings, we observed that treatment with a 1,5-anhydroglucitol-lowering drug treats neutropenia in G6PC3-deficient mice. Our findings highlight that the elimination of noncanonical side products by metabolite-repair enzymes makes an important contribution to mammalian physiology. Neutropenia represents an important problem in patients with genetic deficiency in either the glucose-6-phosphate transporter of the endoplasmic reticulum (G6PT/SLC37A4) or G6PC3, an endoplasmic reticulum phosphatase homologous to glucose-6-phosphatase. While affected granulocytes show reduced glucose utilization, the underlying mechanism is unknown and causal therapies are lacking. Using a combination of enzymological, cell-culture, and in vivo approaches, we demonstrate that G6PT and G6PC3 collaborate to destroy 1,5-anhydroglucitol-6-phosphate (1,5AG6P), a close structural analog of glucose-6-phosphate and an inhibitor of low-KM hexokinases, which catalyze the first step in glycolysis in most tissues. We show that 1,5AG6P is made by phosphorylation of 1,5-anhydroglucitol, a compound normally present in human plasma, by side activities of ADP-glucokinase and low-KM hexokinases. Granulocytes from patients deficient in G6PC3 or G6PT accumulate 1,5AG6P to concentrations (∼3 mM) that strongly inhibit hexokinase activity. In a model of G6PC3-deficient mouse neutrophils, physiological concentrations of 1,5-anhydroglucitol caused massive accumulation of 1,5AG6P, a decrease in glucose utilization, and cell death. Treating G6PC3-deficient mice with an inhibitor of the kidney glucose transporter SGLT2 to lower their blood level of 1,5-anhydroglucitol restored a normal neutrophil count, while administration of 1,5-anhydroglucitol had the opposite effect. In conclusion, we show that the neutropenia in patients with G6PC3 or G6PT mutations is a metabolite-repair deficiency, caused by a failure to eliminate the nonclassical metabolite 1,5AG6P.
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Welter M, Boritza KC, Anghebem-Oliveira MI, Henneberg R, Hauser AB, Rego FGM, Picheth G. Data for serum 1,5 anhydroglucitol concentration in different populations. Data Brief 2018; 20:753-760. [PMID: 30211270 PMCID: PMC6129696 DOI: 10.1016/j.dib.2018.08.165] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 08/10/2018] [Accepted: 08/27/2018] [Indexed: 11/10/2022] Open
Abstract
1,5 anhydroglucitol (1,5-AG), is a nonmetabolized 1-deoxy form of glucose, originate mainly from the diet. 1,5-AG is a biomarker to detect and magnify hyperglycemic excursions (postprandial hyperglycemia) in diabetic patients. Concentrations of 1,5-AG has been applied as supporting biomarker to diagnosis of the major forms of diabetes (type 1, type 2, and gestational). The serum 1,5-AG reference interval is relevant to the appropriate clinical application of this biomarker. This article contains data regards to serum concentration of the biomarker primarily for healthy subjects, capture from the literature, in different populations. Correlation analysis between 1,5-AG and markers associated with diabetes and its complication were presented. The data was complementary to the study “Reference intervals for serum 1,5-anhydroglucitol in children, adolescents, adults, and pregnant women” (Welter et al., 2018). The data present in this article improve the comparisons for 1,5-AG in different conditions and methodologies.
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Affiliation(s)
- Marciane Welter
- Post Graduate Program in Pharmaceutical Sciences, Federal University of Parana, Curitiba, Parana, Brazil
| | - Kátia C Boritza
- Post Graduate Program in Pharmaceutical Sciences, Federal University of Parana, Curitiba, Parana, Brazil
| | - Mauren I Anghebem-Oliveira
- Department of Clinical Analysis, Federal University of Parana, Rua Prefeito Lothário Meissner, 632, 80210-170 Curitiba, Parana, Brazil
| | - Railson Henneberg
- Department of Clinical Analysis, Federal University of Parana, Rua Prefeito Lothário Meissner, 632, 80210-170 Curitiba, Parana, Brazil
| | - Aline B Hauser
- Department of Clinical Analysis, Federal University of Parana, Rua Prefeito Lothário Meissner, 632, 80210-170 Curitiba, Parana, Brazil
| | - Fabiane G M Rego
- Post Graduate Program in Pharmaceutical Sciences, Federal University of Parana, Curitiba, Parana, Brazil.,Department of Clinical Analysis, Federal University of Parana, Rua Prefeito Lothário Meissner, 632, 80210-170 Curitiba, Parana, Brazil
| | - Geraldo Picheth
- Post Graduate Program in Pharmaceutical Sciences, Federal University of Parana, Curitiba, Parana, Brazil.,Department of Clinical Analysis, Federal University of Parana, Rua Prefeito Lothário Meissner, 632, 80210-170 Curitiba, Parana, Brazil
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8
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Welter M, Boritza KC, Anghebem-Oliveira MI, Henneberg R, Hauser AB, Rego FGM, Picheth G. Reference intervals for serum 1,5-anhydroglucitol in children, adolescents, adults, and pregnant women. Clin Chim Acta 2018; 486:54-58. [PMID: 30017617 DOI: 10.1016/j.cca.2018.07.018] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Revised: 06/08/2018] [Accepted: 07/09/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND 1,5-anhydroglucitol (1,5-AG) is a validated marker of short-term glycemic control. We determined the reference intervals of 1,5-AG in different age groups and during pregnancy. METHODS Blood samples were collected from 2303 Euro-Brazilian healthy subjects: 580 children, 496 adolescents, 922 adults matched by age and sex, and 305 pregnant women in four gestational periods. Serum 1,5-AG was measured using an enzymatic reagent in an automated system. RESULTS The calculated reference intervals (nonparametric, 2.5th-97.5th) for males and females were, respectively: children, 96-302 and 89-277 μmol/l; adolescents, 84-311 and 79-277 μmol/l; and adults, 80-260 and 62-241 μmol/l. Males consistently showed significantly higher concentrations than females. 1,5-AG reference intervals in pregnant women were 56-298 μmol/l at <23 weeks gestation (n = 110), 37-166 μmol/l at 24-28 weeks gestation (n = 106), 34-155 μmol/l at 29-32 weeks gestation (n = 52), and 33-246 μmol/l at >32 weeks gestation (n = 37). No significant differences in 1,5-AG concentration were observed between non-pregnant and pregnant women at <23 weeks of gestation. A negative correlation (r = -0.287; p < .001) between 1,5-AG concentration and age was observed. CONCLUSIONS The reference intervals for 1,5-AG were affected by sex and age.
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Affiliation(s)
- Marciane Welter
- Post Graduate Program in Pharmaceutical Sciences, Federal University of Parana, Curitiba, PR, Brazil
| | - Kátia C Boritza
- Post Graduate Program in Pharmaceutical Sciences, Federal University of Parana, Curitiba, PR, Brazil
| | | | - Railson Henneberg
- Department of Clinical Analysis, Federal University of Parana, Curitiba, Parana, Brazil
| | - Aline B Hauser
- Department of Clinical Analysis, Federal University of Parana, Curitiba, Parana, Brazil
| | - Fabiane G M Rego
- Post Graduate Program in Pharmaceutical Sciences, Federal University of Parana, Curitiba, PR, Brazil; Department of Clinical Analysis, Federal University of Parana, Curitiba, Parana, Brazil.
| | - Geraldo Picheth
- Post Graduate Program in Pharmaceutical Sciences, Federal University of Parana, Curitiba, PR, Brazil; Department of Clinical Analysis, Federal University of Parana, Curitiba, Parana, Brazil
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9
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Pitkänen E. 1,5-Anhydro-D-glucitol—A novel type of sugar in the human organism. Scandinavian Journal of Clinical and Laboratory Investigation 2011. [DOI: 10.1080/00365519009085801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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10
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Tazoe S, Masuda-Kato T, Chikama Y, Aisaka K. Determination of 1,5-anhydro-D-glucitol on the basis of its inhibitory effect on trehalase activity. J Biosci Bioeng 2005; 92:186-8. [PMID: 16233082 DOI: 10.1263/jbb.92.186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2001] [Accepted: 05/16/2001] [Indexed: 11/17/2022]
Abstract
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.
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Affiliation(s)
- S Tazoe
- Tokyo Research Laboratories, Kyowa Hakko Kogyo Co. Ltd., 3-6-6 Asahimachi, Machida-shi, Tokyo 194-8533, Japan
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Yoshida N, Uchida E, Katsuragi T, Tani Y. A novel NAD-dependent dehydrogenase, highly specific for 1,5-anhydro-D-glucitol, from Trichoderma longibrachiatum strain 11-3. Appl Environ Microbiol 2003; 69:2603-7. [PMID: 12732527 PMCID: PMC154545 DOI: 10.1128/aem.69.5.2603-2607.2003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
A novel NAD-dependent dehydrogenase highly specific for 1,5-anhydro-D-glucitol (1,5-AG) was found in the cell extract of an imperfect fungus, Trichoderma longibrachiatum strain 11-3. This fungus used 1,5-AG as a sole carbon source for growth and transformed 1,5-AG into glucose. 1,5-AG dehydrogenase (AGH) was purified to homogeneity, as determined by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE). The molecular mass of the purified enzyme was estimated to be 36 and 141 kDa by SDS-PAGE and by gel filtration, respectively, suggesting that the enzyme was homotetrameric. The enzyme was highly specific for 1,5-AG and did not exhibit activity with any sugar or sugar alcohol tested in this study other than 1,5-AG. A linear relationship between the initial rate of the enzyme reaction and the concentration of 1,5-AG at the physiological level was observed. The presence of glucose in abundance did not interfere with the relationship. The optimum temperature for the enzyme reaction was 50 degrees C, and the enzyme was stable at temperatures up to 70 degrees C. These results suggested that AGH is a novel enzyme and is useful for specifically diagnosing diabetes mellitus.
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Affiliation(s)
- Nobuyuki Yoshida
- Graduate School of Biological Sciences, Nara Institute of Science and Technology, Ikoma, Nara 630-0192, Japan.
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12
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Stickle D, Turk J. A kinetic mass balance model for 1,5-anhydroglucitol: applications to monitoring of glycemic control. THE AMERICAN JOURNAL OF PHYSIOLOGY 1997; 273:E821-30. [PMID: 9357814 DOI: 10.1152/ajpendo.1997.273.4.e821] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The polyol 1,5-anhydroglucitol (AG) present in human plasma is derived largely from ingestion and is excreted unmetabolized. Reduction of plasma [AG] has been noted in diabetics and is due to accelerated excretion of AG during hyperglycemia. Plasma [AG] has therefore been proposed as a marker for glycemic control. A precise understanding of its utility relies on a quantitative understanding of the mass balance for AG. In this study, non-steady-state data from the literature were analyzed to develop a dynamic mass balance model for AG that is based on the two-compartment model proposed by Yamanouchi et al. [T. Yamanouchi, Y. Tachibana, H. Akanuma, S. Minoda, T. Shinohara, H. Moromizato, H. Miyashita, and I. Akaoka. Am. J. Physiol. 263 (Endocrinol. Metab. 26): E268-E273, 1992]. The data are consistent with a model in which exchange between tissue and plasma pools is rapid and in which the tissue compartment mass is two to three times the mass of the plasma compartment. According to model estimates, accelerated excretion of AG due to hyperglycemia can cause marked net depletion of total AG over a time scale of days. Recovery from a depleted state is slow because the total body capacity represents >5 wk of normal intake. Accordingly, AG monitoring should be able to indicate the presence of past glucosuric hyperglycemic episodes during a period of days to weeks, as well as provide information on the extent to which high deviations from the average plasma glucose concentration are operative.
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Affiliation(s)
- D Stickle
- Department of Pathology, Washington University School of Medicine, St. Louis, Missouri 63110, USA
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13
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Tanabe T, Tajima S, Suzuki T, Okawa E, Machida R, Ichimura S, Yabuuchi M. Quantification of 1,5-anhydro-D-glucitol in urine by automated borate complex anion-exchange chromatography with an immobilized enzyme reactor. JOURNAL OF CHROMATOGRAPHY. B, BIOMEDICAL SCIENCES AND APPLICATIONS 1997; 692:23-30. [PMID: 9187379 DOI: 10.1016/s0378-4347(96)00466-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
HPLC using a borate form of a strongly anion-exchange resin column and an immobilized enzyme reactor for colorimetric detection was used to quantify urinary 1,5-anhydro-D-glucitol. Urine samples were introduced into the system every 7 min without any pretreatment, and after separation of interfering substances in the column, 1,5-anhydro-D-glucitol was successively detected. Quantitative determination of urinary 1,5-anhydro-D-glucitol was possible within the 1.2-300 micromol/l range. The coefficient of variance was less than 3% and the correlation between results obtained with our system (y) and those obtained by gas chromatography-mass spectrometry (x) was y=0.983x-1.287 micromol/l (n=42, r=0.998).
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Affiliation(s)
- T Tanabe
- Research and Development Division, Pharmaceuticals Group, Nippon Kayaku Co., Takasaki-shi, Gunma, Japan
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14
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Tajima S, Hashiba M, Suzuki T, Akanuma H, Yabuuchi M. Determination of 1,5-anhydroglucitol in urine by high performance liquid chromatography and an enzyme sensor. Biomed Chromatogr 1993; 7:41-4. [PMID: 8431679 DOI: 10.1002/bmc.1130070111] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
A simple high performance liquid chromatographic method combined with an enzyme sensor has been developed to measure 1,5-anhydroglucitol in urine. The enzyme sensor consists of a hydrogen peroxide electrode and a chitosan membrane of an immobilized pyranose oxidase. As the system does not resist interfering substances, urine samples are first purified by passing them through a two-layer column packed with (1) strongly basic anion (OH- form, the upper layer) and (2) strongly acidic cation (H+ form, the lower layer) exchange resins. 1,5-Anhydroglucitol is efficiently recovered in the flow-through fraction of the column. In this system, the minimum detectable concentration of 1,5-anhydroglucitol is 0.1 mg/L, and the measurable range extends from 0.1 to 60 mg/L. The coefficient of variation values of the within-day and day-to-day precisions are 3.0-6.5% and and 4.4-6.7% respectively, and there is good agreement between the results measured by our method and those obtained by the gas-liquid chromatographic/mass spectrometric method (r = 0.994). The method we have described here has been successfully used to elucidate a mechanism for the reducing 1,5-anhydroglucitol level in the serum and plasma of patients.
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Affiliation(s)
- S Tajima
- Takasaki Research Laboratories, Nippon Kayaku Co. Ltd., Gumma, Japan
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15
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Kiba N, Ueda F, Saegusa K, Toto Y, Furusawa M, Yamane T. Flow-injection determination of 1,5-anhydroglucitol in serum with an immobilized pyranose oxidase reactor and chemiluminescence detection. Anal Chim Acta 1993. [DOI: 10.1016/0003-2670(93)80550-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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16
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Pitkänen E, Pitkänen OM. Plasma 1,5-anhydroglucitol in experimental galactosemia in the rat. EXPERIENTIA 1990; 46:85-7. [PMID: 2298285 DOI: 10.1007/bf01955424] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
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.
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Affiliation(s)
- E Pitkänen
- Fourth Department of Medicine, University Central Hospital Unioninkatu, Helsinki, Finland
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17
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Akanuma Y, Morita M, Fukuzawa N, Yamanouchi T, Akanuma H. Urinary excretion of 1,5-anhydro-D-glucitol accompanying glucose excretion in diabetic patients. Diabetologia 1988; 31:831-5. [PMID: 3234638 DOI: 10.1007/bf00277486] [Citation(s) in RCA: 56] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
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.
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Affiliation(s)
- Y Akanuma
- Institute for Diabetes Care and Research, Asahi Life Foundation, Tokyo, Japan
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18
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Yamanouchi T, Akanuma H, Nakamura T, Akaoka I, Akanuma Y. Reduction of plasma 1,5-anhydroglucitol (1-deoxyglucose) concentration in diabetic patients. Diabetologia 1988; 31:41-5. [PMID: 3350220 DOI: 10.1007/bf00279131] [Citation(s) in RCA: 29] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
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.
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Affiliation(s)
- T Yamanouchi
- Department of Internal Medicine, University of Teikyo, Japan
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Niwa T. Metabolic profiling with gas chromatography-mass spectrometry and its application to clinical medicine. JOURNAL OF CHROMATOGRAPHY 1986; 379:313-45. [PMID: 3525594 DOI: 10.1016/s0378-4347(00)80688-x] [Citation(s) in RCA: 82] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
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.
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Pitkänen E, Pitkänen O. The elimination of 1,5-anhydroglucitol administered to rats. EXPERIENTIA 1984; 40:463-5. [PMID: 6723908 DOI: 10.1007/bf01952387] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
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.
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