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

作者：Hang Su, Jiaying Ni, Jingyi Lu, Wei Lu, Wei Zhu, Yufei Wang, Xiaojing Ma, Danfeng Peng, Jian Zhou · 发表于：Cardiovascular Diabetology · 年份：2025 · DOI：10.1186/s12933-025-02993-1 · 被引用次数：4 · 研究领域：Diabetes, Cardiovascular Risks, and Lipoproteins、Hyperglycemia and glycemic control in critically ill and hospitalized patients、Cardiovascular Function and Risk Factors

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. 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. 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). In older adults with type 2 diabetes, 1,5-AG demonstrated a performance comparable to CGM for detec...