Diabetes screening: Detection and application of saliva 1,5-anhydroglucitol by liquid chromatography-mass spectrometry

Context: Unlike other commonly used invasive blood glucose-monitoring methods, salivadetection prevents patients from suffering physical uneasiness. However, there are few studieson 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 screeningin a Chinese population.Design and Participants: This was a population-based cross-sectional study. A total of 641subjects 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. Theefficiency of saliva 1,5-AG for diabetes screening was analyzed by receiver operating characteristiccurves, 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 didnot have DM (both P <.05). Saliva 1,5-AG was positively correlated with serum 1,5-AG andnegatively correlated with blood glucose and glycated hemoglobin (HbA1c) (all P <.05). Theoptimal cutoff points of saliva 1,5-AG0 and 1,5-AG120 for diabetes screening were 0.436 μ g/mL (sensitivity: 63.58%, specificity: 60.61%) and 0.438 μ g/mL (sensitivity: 62.25%, specificity:60.41%), respectively. Fasting plasma glucose (FPG) combined with fasting saliva 1,5-AG reducedthe proportion of people who required an oral glucose tolerance test by 47.22% compared withFPG alone.Conclusion: Saliva 1,5-AG combined with FPG or HbA1c improved the efficiency of diabetesscreening. Saliva 1,5-AG is robust in nonfasting measurements and a noninvasive andconvenient tool for diabetes screening.