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Background <p>The comparison between conventional glycemic markers and continuous glucose monitoring (CGM) in relation to adverse outcomes in the elderly with type 2 diabetes remains unclear. We aimed to assess associations of 1,5-anhydroglucitol (1,5-AG) and CGM metrics with carotid intima-media thickness (CIMT) as a surrogate of cardiovascular disease.</p> Methods <p>The study included 2509 adults aged ≥ 60&#xa0;years with type 2 diabetes. CIMT was measured by high-resolution ultrasonography, with abnormal CIMT defined as a mean thickness of ≥ 1.0&#xa0;mm. Time in range (TIR), mean sensor glucose (MSG), time above range (TAR, &gt; 10.0&#xa0;mmol/L), standard deviation (SD), and coefficient of variation (CV) were calculated from CGM data.</p> Results <p>The median serum 1,5-AG was 3.9 (2.0, 8.0) μg/mL, and the prevalence of abnormal CIMT was 44.2% (n = 1,109). The prevalence of abnormal CIMT decreased across ascending 1,5-AG categories (<i>P</i> for trend &lt; 0.01). In the fully adjusted model, each 1-standard deviation decrease in 1,5-AG conferred 10% higher odds of abnormal CIMT. Compared with 1,5-AG ≥ 10.0&#xa0;μg/mL, 1,5-AG &lt; 6.0&#xa0;μg/mL was associated with an odds ratio of 1.25 (95% CI 1.00–1.55) for abnormal CIMT. Among CGM metrics, TIR, MSG, and TAR <sub>&gt;</sub> <sub>10.0</sub>, but not CV or SD, were significantly associated with abnormal CIMT. The C-statistics for 1,5-AG in predicting abnormal CIMT were comparable to those for TIR, MSG, and TAR <sub>&gt;10.0</sub> (all <i>P</i> &gt; 0.05).</p> Conclusions <p>In older adults with type 2 diabetes, 1,5-AG demonstrated a performance comparable to CGM for detecting abnormal CIMT, supporting its potential as a clinical biomarker for identifying subclinical atherosclerosis.</p> Graphical abstract <p></p>

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Comparable performance of 1,5-anhydroglucitol and continuous glucose monitoring in detecting subclinical atherosclerosis in elderly patients with type 2 diabetes

  • 期刊论文

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  • 发表日期：

    2025年11月21日

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  • Hang Su,
  • Jiaying Ni,
  • Jingyi Lu,
  • Wei Lu,
  • Wei Zhu,
  • Yufei Wang,
  • Xiaojing Ma,
  • Danfeng Peng,
  • Jian Zhou

摘要

Background

The comparison between conventional glycemic markers and continuous glucose monitoring (CGM) in relation to adverse outcomes in the elderly with type 2 diabetes remains unclear. We aimed to assess associations of 1,5-anhydroglucitol (1,5-AG) and CGM metrics with carotid intima-media thickness (CIMT) as a surrogate of cardiovascular disease.

Methods

The study included 2509 adults aged ≥ 60 years with type 2 diabetes. CIMT was measured by high-resolution ultrasonography, with abnormal CIMT defined as a mean thickness of ≥ 1.0 mm. Time in range (TIR), mean sensor glucose (MSG), time above range (TAR, > 10.0 mmol/L), standard deviation (SD), and coefficient of variation (CV) were calculated from CGM data.

Results

The median serum 1,5-AG was 3.9 (2.0, 8.0) μg/mL, and the prevalence of abnormal CIMT was 44.2% (n = 1,109). The prevalence of abnormal CIMT decreased across ascending 1,5-AG categories (P for trend < 0.01). In the fully adjusted model, each 1-standard deviation decrease in 1,5-AG conferred 10% higher odds of abnormal CIMT. Compared with 1,5-AG ≥ 10.0 μg/mL, 1,5-AG < 6.0 μg/mL was associated with an odds ratio of 1.25 (95% CI 1.00–1.55) for abnormal CIMT. Among CGM metrics, TIR, MSG, and TAR > 10.0, but not CV or SD, were significantly associated with abnormal CIMT. The C-statistics for 1,5-AG in predicting abnormal CIMT were comparable to those for TIR, MSG, and TAR >10.0 (all P > 0.05).

Conclusions

In older adults with type 2 diabetes, 1,5-AG demonstrated a performance comparable to CGM for detecting abnormal CIMT, supporting its potential as a clinical biomarker for identifying subclinical atherosclerosis.

Graphical abstract