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PubMed1993

Serum glycated albumin and fructosamine in renal dialysis patients.

The effect of uraemia on protein glycation was studied by measuring glycated albumin and fructosamine in 50 non-diabetic dialysis patients (31 continuous ambulatory peritoneal dialysis, CAPD, 19 haemodialysis). After correction for serum albumin concentration, glycated albumin (g/100 g) was increased in the haemodialysis group (1.94 +/- 0.40) compared with both CAPD patients (1.46 +/- 0.37; p < 0.001) and controls (1.52 +/- 0.29; p < 0.001), but did not differ between CAPD patients and controls (p > 0.05). Serum fructosamine, corrected for either serum albumin or total protein concentration (mumol/100 g), was raised in CAPD (828 +/- 90, 386 +/- 41, respectively) and haemodialysis patients (802 +/- 123, 391 +/- 42, respectively) compared with controls (609 +/- 69, 332 +/- 27, respectively; p < 0.0001 in all cases), but did not differ between the two dialysis groups (p > 0.05). A single haemodialysis cycle had no effect on the measurement of glycated albumin or fructosamine (p > 0.05). The results confirm that glycated protein levels are generally raised in dialysis patients. In CAPD patients, altered albumin metabolism resulting from large peritoneal losses is likely to have caused a decrease in the amount of albumin glycated, an effect less apparent on the concentration of fructosamine because of the additional contribution of glycated globulins.

Adolescent↗
PubMed1987

The value of HbA1 and fructosamine in predicting impaired glucose tolerance--an alternative to OGTT to detect diabetes mellitus or gestational diabetes.

Glycosylated haemoglobin and glycosylated serum protein concentrations (fructosamine) have been monitored in patients suspected of diabetes mellitus (n = 183), in pregnant women suspected of gestational diabetes (n = 250) and in control groups (n = 184). The response to the standard 75 g oral glucose tolerance test was used to confirm or reject the diagnosis, using different criteria for detection of diabetes mellitus compared to detection of gestational diabetes. A slightly higher sensitivity was observed for fructosamine compared to glycosylated haemoglobin to detect impaired glucose tolerance (52 vs 44%) or gestational diabetes (17% vs 8%). For detection of diabetic oral glucose tolerance no difference was observed between glycosylated haemoglobin and fructosamine; sensitivity for both parameters was 67%. The results suggest that fructosamine is slightly more sensitive in detecting borderline-abnormal glucose tolerance, whereas no differences are observed for detection of clearly abnormal oral glucose tolerance tests.

Administration, Oral↗
PubMed1991

Fructosamine in diabetes screening of the elderly.

The use of serum fructosamine in diabetes detection was investigated during a diabetes survey performed with a modified oral glucose tolerance test (MOGTT) on 742 residents of the Melton Mowbray area aged between 65 and 85 years. Subjects were tested in the morning and remained at rest. MOGTT results were classified by WHO criteria. The fructosamine concentration was measured in a random sub-group of 264 normal subjects and had a Gaussian distribution (mean = 1.67 mmol/L, SD = 0.126 mmol/L). In the survey as a whole 25 new diabetics were found of which 23 had fructosamine measured; 17 had values above the 95th percentile and four more had values above the 90th percentile. We have found fructosamine concentration to be a useful screen for diabetes but this may be dependent upon the standardized sampling procedure used, and the population studied.

Aged↗
PubMed1991

Correlation between glycated lipoproteins and fructosamine level in serum.

The correlation between the level of fructosamine and glycated proteins, including glycated lipoproteins, in serum from diabetic and nondiabetic subjects was studied. Assay of glycated proteins in serum was performed using an agarose gel film electrophoresis with nitroblue tetrazolium coloration. Glycated albumin correlated well with the fructosamine level in the diabetics (r = 0.83-0.92, p less than 0.01) but showed no correlation with the nondiabetics (r = 0.25-0.26). Also, a high correlation between the glycated beta-lipoprotein and fructosamine levels was observed in diabetic patients with hyperglycemia and in nondiabetic subjects with a high risk of atherogenesis (atherogenic index, low-density lipoprotein-cholesterol/high-density lipoprotein-cholesterol greater than 2.8) (r = 0.51-0.66, p less than 0.01). Nondiabetics with a high level of beta-lipoprotein, which is well known to cause high atherogenesity, showed a high level of glycated beta-lipoprotein similar to that in the diabetic groups with hyperglycemia; therefore, the high level of glycated beta-lipoprotein seems to be attributable not only to the hyperglycemia-accelerated glycation of beta-lipoprotein but also to an increase in the level of beta-lipoprotein in serum. Consequently, the present results show that the fructosamine level in serum reflects not only the glycation of albumin but also that of lipoproteins which are known to increase in diabetes mellitus.

Adult↗
PubMed1993

Fructosamine as a possible monitoring parameter in non-insulin dependent diabetes mellitus patients with periodontal disease.

Fructosamine assay is a new test used in the diagnosis and monitoring of diabetic patients. This assay may be of interest to the periodontist for, while the traditional plasma glucose value would give a general view and information about diabetic control at a certain point, the fructosamine concentration gives an indication of the plasma glucose level over a considerable period of time, such as 1 to 3 weeks. We investigated whether there was any relation between the diseased state of the periodontal tissues and plasma fructosamine and the plasma glucose values in non-insulin dependent diabetes mellitus (NIDDM) patients. We found that fructosamine correlated with the degree of gingival bleeding, however serum glucose levels had little or no correlation.

Blood Glucose↗
PubMed1988

Fructosamine concentrations in general population of Kawerau.

We measured fructosamine concentrations in nonfasted serum from 7094 residents (82.8% of the estimated population) of Kawerau, New Zealand, including 65 known diabetic patients (prevalence of 0.92%). Fructosamine results showed a trimodal frequency distribution, with cutting points corresponding to 5th and 95th percentile values. Forty-two diabetic individuals had levels that exceeded the 95th percentile. These individuals had more severe metabolic abnormalities, characterized by lower plasma C-peptide and elevated fasting plasma glucose concentrations. Mean fructosamine values also showed a significant increase with age and a highly significant age-ethnic interaction that paralleled the higher frequency of diabetes in older age groups and among elderly Maori people. However, as a screening method in the general population, fructosamine measurement was diagnostically deficient because of a weak correlation with serum albumin. Arithmetic correction for albumin concentration in the sample did not increase the diagnostic usefulness of the test.

Adult↗
PubMed1988

Comparison of fructosamine with glycosylated hemoglobin and plasma proteins as measures of glycemic control.

The relative value of fructosamine as an alternative to glycosylated hemoglobin (HbA1) and other measures of glycemic control was assessed in 100 insulin-dependent (IDDM) and 104 non-insulin-dependent (NIDDM) diabetic patients. We measured HbA1 (by electrophoretic and affinity methods), plasma glucose, glycosylated plasma proteins, and fructosamine in blood taken at a single clinic visit. The values were compared both by correlation analysis and by considering whether the various indices of glycemic control placed the patients in the same clinical decision categories as they were in by the HbA1 (affinity) result. Fructosamine correlated moderately well with HbA1 (affinity; r = .8) and placed 71% of IDDM and 72% of NIDDM patients in the same clinical category of good, moderate, or poor control. Differences can probably be partly attributed to the different periods over which HbA1 and fructosamine reflect average glycemia and partly to imprecision.

Adolescent↗
PubMed1990

Comparison of HbA1 and fructosamine in diagnosis of glucose-tolerance abnormalities.

Total glycosylated hemoglobin (HbA1) and fructosamine were evaluated as screening tools for detection of glucose-tolerance abnormalities in 144 asymptomatic subjects undergoing a 75-g oral glucose tolerance test. Subjects were classified according to World Health Organization criteria as having normal (n = 78), impaired (n = 40), or diabetic (n = 26) glucose tolerance. We found good specificity for HbA1 and fructosamine (100 and 97%, respectively) but low sensitivity (15 and 19%, respectively). At the intersection of the curves of sensitivity and specificity drawn from various thresholds of normality, both sensitivity and specificity were 75% for HbA1 and 55% for fructosamine. Thus, neither HbA1 nor fructosamine seems to be suitable for the diagnosis of mild abnormalities in glucose tolerance.

Blood Glucose↗
PubMed2003

Performance indicators and validity of serum fructosamine assay as a diagnostic test in a screening program for diabetes mellitus.

OBJECTIVE: To evaluate the performance indicators and validity of fructosamine assay as a diagnostic tool in screening for Diabetes mellitus (DM). METHODS: Fasting plasma glucose (FPG) and serum fructosamine (FA) were compared in 1015 subjects aged >or= 25 years from different urban and rural areas in Mosul city, Northern Iraq. The subjects were classified into 5 groups: Group 1: Subjects with FPG < 6.1 mmol/L (n=883), Group 2: Subjects with impaired FPG 6.1-6.9 mmol/L (n=29), Group 3: New diabetics diagnosed solely by new 1997 American Diabetes Association (ADA) criteria with FPG 7.0-7.7 mmol/L (n=20), Group 4: New diabetics diagnosed according to old 1980-1985 World Health Organization (WHO) criteria with FPG >or= 7.8 mmol/L (n=23), and Group 5: Known diabetics (n=60). Subjects in groups 2 and 3 underwent a standard 75 gm oral glucose tolerance test (OGTT) as recommended by the WHO. Reclassification of subjects into 3 groups according to FPG or 2hPG, or both was carried out for all subjects. Group A (non-diabetics): Subjects with FPG < 6.1 mmol/L or 2hPG < 7.8 mmol/L, or both (n=910). Group B (Diabetics): Subjects with FPG >or= 7.8 mmol/L or 2hPG >or= 11.1 mmol/L, or both (n=92) including 60 known diabetics in group 5 and 23 new diabetics in group 4 in addition to 2 subjects in group 2 and 7 subjects in group 3. Group C (impaired glucose tolerance, IGT): Subjects with 2hPG between 7.8-11.1 mmol/L (n=13). RESULTS: Having all subjects had their serum FA being measured; the Receiver Operator Characteristic (ROC) curve was constructed on the data to determine the trade off between sensitivity and specificity of the FA test in the diagnosis of DM. This construction decided that serum FA value of 2.65 mmol/L would be the cutoff point, or the positivity criterion in the calculation of the validity parameters of FA test. Of 910 non-diabetics, 886 subjects had measured FA values within the 95th percentile, while 24 had FA higher than the cutoff point. Consequently, FA in non-diabetics yielded 886 (true negatives) and 24 (false positives). Of the 92 diabetics, 30 subjects had normal FA values, while 62 diabetics showed FA higher than the cutoff point. Consequently, FA in diabetics yielded 30 (false negatives) and 62 (true positives). Accordingly, the sensitivity, specificity, positive predictive value, negative predictive value, accuracy rate, positive likelihood ratio and negative likelihood ratio were 67.3%, 97.3%, 72.3%, 96.7%, 94.6%, 26 and 2.99. A highly significant correlation was observed between FPG and measured FA in non-diabetics (r=0.85, p<0.0001) and diabetics (r=0.92, p<0.0001). No significant correlation was observed between serum FA and albumin in non-diabetics (r= 0.14, p>0.05) and diabetics (r=0.08, p>0.05). CONCLUSION: Fructosamine test shows a moderate sensitivity with a high specificity as a diagnostic test for diabetes mellitus. The considerable overlap between diabetics and non-diabetics limit its usefulness. It is recommended that fructosamine test is not a suitable screening test for the disease. Measurement of plasma glucose (fasting or post-OGTT) remains the corner stone as a diagnostic test.

Adult↗
PubMed1992

Influence of obesity on plasma fructosamine concentration.

The influence of obesity on plasma fructosamine concentration was studied in 68 diabetic and 1335 nondiabetic subjects from a Chinese community. Obese nondiabetic men (body mass index > 25 kg/m2) had lower fructosamine concentrations than nonobese nondiabetic men (body mass index < or = 25 kg/m2); the pattern was similar for diabetic women. Stepwise multiple-regression analysis showed that, apart from known factors (total protein, albumin, and indices of glycemic control), fructosamine was also associated with body mass index and plasma fasting triglycerides. However, the contribution of these were small except in diabetic women. We conclude that the effect of obesity on fructosamine is small.

Adult↗
PubMed2004

[Fructosamine 3-kinase and protein repair].

It was thought until recently that fructosamines are not metabolized in mammalian cells. Quite to the contrary, a mammalian enzyme, fructosamine 3-kinase, has recently been identified, which phosphorylates fructosamines on their third carbon, making them unstable and leading to their shedding from proteins. Fructosamine 3-kinase is therefore responsible for protein deglycation, one of the few protein repair mechanisms that have been identified.

Animals↗
PubMedDate not supplied

The influence of calorie restriction during the Ramadan fast on serum fructosamine and the formation of beta hydroxybutirate in type 2 diabetes mellitus patients.

AIM: To determine whether the Ramadan fasting can improve metabolic control evaluated from serum fructosamine and beta hydroxybutirate in patients with Type 2 diabetes mellitus. METHODS: This was a prospective one group before and after study (self-controlled study). Twenty four patients from the outpatient clinic of the Metabolic Endocrinology Division of the Department of Internal Medicine, Faculty of Medicine, University of Indonesia/ Cipto Mangunkusumo General Hospital who were well under control underwent assessment for serum fructosamine at weeks -1, 4, and 6 (2 weeks after the Ramadan fast) and beta hydroxybutirate formation at week 4. RESULTS: The mean serum fructosamine on weeks -1, 4, and 6 were 334.2 +/-45.7; 303.9 +/-34.5 dan 313.6 +/-45.9 umol/L. The beta hydroxybutirate level was 0.3 mmol/L. CONCLUSION: The Ramadan fasting in patients with well-controlled and medium-controlled type 2 diabetes mellitus could cause a reduction in serum fructosamine and does not cause formation of beta hyroxybutirate.

3-Hydroxybutyric Acid↗
PubMed1992

[Establishment of reference values for fructosamine and HbA1c in childhood].

Reference values for fructosamine and glycated haemoglobin in children are still lacking. Using samples from 522 children (age range 1 day to 9 years), plasma electrophoresis was performed, fructosamine and total protein were determined in EDTA-plasma, and glucose and the fraction of glycated haemoglobin (HbA1c) were determined in EDTA blood. The results were grouped according to age (1, 3 and 5 days, 6-28 days, 2-12 months, 2-3 years, 4-6 years, and 7-9 years). Differences between the age groups were determined using the Mann-Whitney-U-test, and the values in each group were summarized where possible. The 95%-interval was calculated for fructosamine, protein-corrected fructosamine, and HbA1c.

Child↗
PubMedDate not supplied

[Value of determining fructosamine levels in serum of pregnant patients with diabetes to evaluate the level of compensation for glycemia].

The results in 16 pregnant women with diabetes mellitus are analysed. All patients were treated with an intensive insulin-therapy at the Voivodeship Clinic for Diabetic Patients in Zabrze. Multipoint glycaemia profiles made by the treated patients as a self control were compared with serum fructosamine and HbAlC concentrations. A significant correlation of fructosamine levels with glycaemia and HbAlC levels was noted. No significant dependence of fructosamine and glycaemia fasting levels, incidence of hyperglycaemia and Schlichtkrull's Mw index was noted. Results suggest, that the fructosamine serum concentration is a useful marker of metabolic compensation in pregnant women with diabetes mellitus. It enables less frequent performance of the daily profiles of glycaemia by the patients.

Adult↗
PubMedDate not supplied

The use of plasma fructosamine in the assessment of diabetic control.

Plasma fructosamine and glycosylated haemoglobin were measured in insulin-dependent (n = 30) and in non-insulin-dependent diabetics (n = 90) and in healthy controls (n = 45). Fructosamine correlated significantly with glycosylated haemoglobin in the non-insulin dependent (r = 0.5, P less than 0.001) better than in the insulin-dependent group (r = 0.39, P less than 0.05). No correlation was found between plasma fructosamine and albumin or total protein concentrations when the concentrations of albumin and protein are within normal reference range. The fructosamine test has got many desirable characteristics, which will give it a role in the assessment of diabetic control.

Adult↗
PubMed1991

[Evaluation of the status of diabetes mellitus during a 2-year period using traditional methods and determination of glycosylated hemoglobin A1c and fructosamine in the blood].

In the course of two years the authors checked 23 diabetic patients (13 type 2, 10 type 1), using the traditional approach, by assessment of haemoglobin A1c and serum fructosamine. The patients were classified according to compensation into four and three groups resp. Assessment of haemoglobin A1c evaluated the patients, in the same group as the traditional evaluation in 57.7% into the best compensated group and in 62.5% into the worst compensated group. In fructosamine agreement with traditional evaluation in the best compensated group was in 84.2% and in the worst compensated group in 50.0%. In 40.2% the evaluation was in agreement for all three methods of evaluation, differences between evaluation according to haemoglobin A1c and serum fructosamine were recorded in 51.5%. Assessment of haemoglobin A1c and serum fructosamine improves information on the state of diabetes, concurrent estimation of both is, however, often associated with difficulties as regards interpretation. These problems are discussed in the presented paper.

Diabetes Mellitus↗
PubMed1991

Comparative study of glycosylated haemoglobin and serum fructosamine values in children with protein-energy malnutrition.

Serum fructosamine, glycosylated haemoglobin (HbAic), fasting blood glucose and serum proteins were determined in 50 malnourished children aged 1-5 years and in 25 healthy and nutritionally normal children of the same age group. It was observed that both HbAic and fructosamine values correlated well with the blood glucose values of the patients. It was also observed that the patients had significantly elevated values of HbAic, indicating the existence of glucose intolerance in them. In contrast, the fructosamine values were significantly reduced in the patients and this was attributed to the hypoproteinaemia in such patients. It was concluded that while both HbAic frustosamine correlate well with blood glucose values, HbAic gives a better reflection of the glycaemic status of malnourished children because its level is not significantly altered by hypoproteinaemia. HbAic measurement may, therefore, be a more reliable indicator of glucose status than serum fructosamine in children with protein-energy malnutrition.

Blood Glucose↗
PubMed1991

Serial measurement of serum fructosamine and glycosylated haemoglobin as indices of glycaemic control in diabetic pregnancy.

Management of diabetic pregnancy requires objective information regarding blood glucose levels with the aim of achieving strict euglycaemia. Self-blood glucose monitoring and measurement of glycosylated haemoglobin (HbA1) are two methods widely adopted in clinical practice. Serum fructosamine assay was recently introduced as a parameter for assessing short-term glycaemic control. Our study compared serial measurement of serum fructosamine with HbA1 as indices of short-term glycaemic control in a group of diabetic pregnant women prospectively from early/mid-trimester till delivery. Patients performed self-blood glucose glucose concentration of the preceding two weeks were assessed. Our results showed that both serum fructosamine and HbA1 gave comparable information regarding short-term glycaemic control. Serum fructosamine estimation did not offer any distinct additional advantage as a retrospective index of diabetic control in the management of diabetic pregnancy.

Blood Glucose↗