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1 Division of Laboratory
Medicine,
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.
mathematical model; diabetes; hyperglycemia; glycated hemoglobin
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