Diabetes Screening: Detection and Application of Saliva 1,5-Anhydroglucitol by Liquid Chromatography-Mass Spectrometry.

ABSTRACT

CONTEXT Unlike other commonly used invasive blood glucose-monitoring methods, saliva detection prevents patients from suffering physical uneasiness. However, there are few studies on saliva 1,5-anhydroglucitol (1,5-AG) in patients with 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: This was a population-based cross-sectional study. A total of 641 subjects without a valid diabetic history were recruited from September 2018 to June 2019. Saliva 1,5-AG was measured with liquid chromatography-mass spectrometry. MAIN OUTCOME MEASURES: DM was defined per American Diabetes Association criteria. The efficiency of saliva 1,5-AG for diabetes screening was analyzed by receiver operating characteristic curves, and the optimal cutoff point was determined according to the Youden index. RESULTS: Saliva 1,5-AG levels in subjects with DM were lower than those in subjects who did not have DM (both P < .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 < .05). The optimal cutoff points of saliva 1,5-AG0 and 1,5-AG120 for diabetes screening were 0.436 µg/mL (sensitivity 63.58%, specificity 60.61%) and 0.438 µg/mL (sensitivity 62.25%, specificity 60.41%), respectively. Fasting plasma glucose (FPG) combined with fasting saliva 1,5-AG reduced the proportion of people who required an oral glucose tolerance test by 47.22% compared with FPG alone. CONCLUSION: 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.