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PubMed2001

Evaluation of fructosamine in dogs and cats with hypo- or hyperproteinaemia, azotaemia, hyperlipidaemia and hyperbilirubinaemia.

The influence of various pathological conditions on fructosamine levels in normoglycaemic dogs and cats was investigated. The most frequent and most pronounced deviations were found in animals with hypoproteinaemia, in which fructosamine was significantly lower than in the controls. In 66 per cent of the dogs and 67 per cent of the cats with hypoproteinaemia the levels were below the reference range. In the dogs the concentration of fructosamine was correlated with the level of albumin, but in the cats it was correlated with the level of total protein. Dogs with hyperlipidaemia and azotaemia also had significantly lower levels of fructosamine; 38 per cent of those with hyperlipidaemia and 47 per cent of those with azotaemia had fructosamine levels outside the reference range. No significant changes in fructosamine were detected in dogs or cats with hyperproteinaemia or hyperbilirubinaemia, or in cats with hyperlipidaemia or azotaemia.

Animals↗
PubMed1992

Low sensitivity of serum fructosamine as a screening parameter for gestational diabetes mellitus.

Oral glucose tolerance testing (OGTT) and quantification of serum fructosamine levels were performed in 190 asymptomatic women in weeks 24-28 of pregnancy. OGTT identified 10 of the 190 women as having gestational diabetes, but serum fructosamine quantification failed to do so because none of these 10 women exhibited levels exceeding the normal limit of 2.76 mmol/l. The mean fructosamine level in this group was 1.72 +/- 0.25 mmol/l compared to 1.60 +/- 0.15 mmol/l in the other 180 women without gestational diabetes. Fructosamine was found to correlate only with postload glucose values in excess of 180 mg/dl at 2 h (r = 0.87; p = 0.01), i.e. with the highest overall glucose values, but not with fasting glucose or milder postprandial hyperglycemia of under 180 mg/dl. We conclude that quantification of fructosamine detects only the rather severe cases of gestational hyperglycemia, but is too insensitive to uncover mild asymptomatic gestational diabetes mellitus, and we do not consider fructosamine to be a useful parameter for the diagnosis of this condition.

Diabetes, Gestational↗
PubMed1999

Comparison of serum fructosamine and blood glycosylated hemoglobin concentrations for assessment of glycemic control in cats with diabetes mellitus.

OBJECTIVE: To correlate serum fructosamine concentrations with established measures of glycemic control and to compare serum fructosamine and blood glycosylated hemoglobin (GHb) concentrations as a means for assessing glycemic control in diabetic cats. DESIGN: Longitudinal cohort study. ANIMALS: 26 healthy cats, 5 cats with stress-induced hyperglycemia, 15 untreated diabetic cats, and 36 treated diabetic cats. PROCEDURE: Control of glycemia was classified and monitored and serum fructosamine and blood GHb concentrations were measured for 12 poorly controlled diabetic cats before and after improving glycemic control, 8 well-controlled treated diabetic cats before and after glycemic control deteriorated, and 5 cats with diabetes mellitus before and after onset of stress-induced hyperglycemia. RESULTS: Mean serum fructosamine and blood GHb concentrations were significantly higher in untreated diabetic cats, compared with healthy cats, and in 24 poorly controlled diabetic cats, compared with 12 well-controlled diabetic cats. Mean serum fructosamine and blood GHb concentrations decreased significantly in 12 poorly controlled diabetic cats after improving glycemic control and increased significantly in 8 well-controlled diabetic cats after glycemic control deteriorated. A significant stress-induced increase in mean blood glucose concentration was evident 12 hours after insulin administration, but not in 5 docile diabetic cats that became fractious. CLINICAL IMPLICATIONS: Serum fructosamine and blood GHb concentrations are clinically useful tools for monitoring control of glycemia in cats with diabetes mellitus.

Animals↗
PubMed1992

Maternal fructosamine and glycosylated haemoglobin in the prediction of gestational glucose intolerance.

The value of maternal glycosylated haemoglobin (HBA1c) and fructosamine in the prediction of gestational diabetes is debated. One hundred high risk patients were grouped as normal, impaired glucose tolerance (IGT) and gestational diabetes mellitus, according to the WHO criteria, after 2 hours, 75 g oral glucose tolerance test (OGTT). Maternal HBA1c and fructosamine were measured at different gestational ages and at the start of labour. The aim of the study was to determine the most sensitive predictor of abnormal glucose tolerance. Maternal fructosamine was higher in gestational diabetics than in the other two groups, but the difference was not of statistical significance. The values for normal and IGT groups overlapped markedly. The fructosamine test sensitivity was 12.2%, specificity was 94.7% and predictability was 75%. Glycosylated haemoglobin was significantly higher in IGT and gestational diabetes mellitus (GDM) groups than in the normal group after 36 weeks of gestation. At 32 weeks or less the difference was not of statistical significance. As with fructosamine, there was a wide range of value that overlapped markedly, particularly between the normal and IGT patients. The HBA1c test sensitivity was 19.1%, specificity was 95% and predictability was 81.1%. This suggests that both HBA1c and fructosamine have very low sensitivity as predictors of gestational glucose intolerance.

Adult↗
PubMed1992

Effects of albumin and immunoglobulin A on fructosamine assay.

Serum fructosamine, albumin, and IgA were measured in three groups of human subjects: 54 nondiabetic normal individuals, 149 nondiabetic patients, and 149 diabetic patients. Normal subjects had significantly (P less than 0.05) higher fructosamine (2.91, SD 0.33, mmol/L) than did nondiabetic patients (2.49, SD 0.46, mmol/L). Each of these groups had significantly (P less than 0.05) lower fructosamine than did diabetic patients (3.76, SD 1.16, mmol/L). Increased fructosamine appeared to be associated with increases in both albumin and IgA. However, fructosamine was significantly (P less than 0.05) correlated with neither albumin nor IgA in the normal group, with only albumin in the nondiabetic group, but with both albumin and IgA in the diabetic group. Selective combinations of these populations not only shifted these significances but also eliminated some of the correlations. Our results suggest caution regarding the diagnostic role and universality of fructosamine and of its correlation with IgA as indicated by others.

Adult↗
PubMed1992

Influence of serum albumin & total protein on fructosamine measurement.

To assess the effect of serum albumin and total protein on the fructosamine level 57 hypoalbuminaemic patients (serum albumin less than 30 g/1), of whom 44 were nondiabetics and 13 were diabetics, were studied. Fructosamine levels of hypoalbuminaemic diabetics was increased only marginally in comparison to healthy controls (P greater than 0.05) whereas in 122 other normalbuminaemic diabetics, the level was found to be significantly higher (P less than 0.001). In control subjects, the correlation between fructosamine and serum albumin (r = 0.69, P less than 0.001) was better than that of total protein (r = 0.42, P less than 0.01) whereas in hypoalbuminaemic patients the pattern was reversed (r = 0.51 and 0.59 respectively), indicating substantial contribution by the globulins. A working formula suggesting approximate contribution of each gram of albumin and globulin in healthy subjects was calculated. It is inferred that the use of serum fructosamine for assessment of glycaemic status could be misleading in patients with lower albumin values. Calculating serum fructosamine values from serum albumin alone in these patients is likely to be inaccurate, as it ignores the contribution of globulins which can be substantial in certain disease conditions. A gross idea regarding the glycaemic status can be obtained by comparing actual and calculated values of fructosamine from the formula.

Analysis of Variance↗
PubMed1990

[Fructosamine as a parameter for monitoring carbohydrate metabolism in the treatment of diabetes mellitus].

Fructosamine, protein, albumin and HbA1c from 199 diabetics were followed for up to 220 days. An increase in average blood glucose during the preceding 10 days causes an increase in fructosamine by 50 mumol/l. During the day there is little variation in the fructosamine concentration, whereas relating fructosamine to protein or albumin results in substantial fluctuations. A possible cause is the necessity for two measurements which is associated with an increased error. Long term observations reveal a significant correlation between fructosamine and HbA1c which is little affected by relating fructosamine to protein or albumin. Diabetics exhibited significantly lower protein and albumin concentrations than the normal collective, yet the standard deviations from the individual means were only 7 and 7.9%, respectively.

Blood Glucose↗
PubMed1988

Reference values for fructosamine concentrations in children's sera: influence of protein concentration, age, and sex.

Fructosamine and protein (total and fractionated) were measured in the serum of 170 normal children, ages two weeks to 15 years. The mean fructosamine concentration was 2.12 mmol/L, 5% lower than the mean value observed for adults. We observed no sex-related difference in fructosamine values, but saw a pronounced age dependency of reference values. For children younger than three years, the mean concentration of fructosamine was 15% lower than in adults, but glycated protein concentrations increased with age, reaching essentially adult values by age six years. Expressing fructosamine concentrations per gram of serum total protein or of albumin weakened the influence of age, but did not eliminate it completely. We report reference intervals for fructosamine concentrations in children's sera.

Adolescent↗
PubMedDate not supplied

[Fructosamine and HbA1c during monitoring of glucose levels in diabetes].

The authors compared the nycthemeral variations of fructosamine levels in nineteen patients with diabetes to fluctuations in their glucose levels. Thirty-five other patients with poorly controlled diabetes were given an optimal treatment then followed up for 2 months (mean glucose levels, fructosamine and HbA1c assays). Mean nycthemeral variations in fructosamine levels did not appear to be correlated with glucose levels. However, intraindividual nycthemeral variability was greater than the analytic variability. After correction for total protein levels this variability was smaller but remained significative. In this longitudinal study, fructosamine and HbA1c levels decreased when control of glucose levels improved. However, decreases were notably greater in HbA1c than in fructosamine compared at 15, 45 and 60 days of follow up. Inversely, fructosamine was correlated better with the mean glucose levels of the preceding 7 days than was HbA1c. When mean glucose levels were calculated for the 15, 30, 45 and 60 preceding days, the results favored HbA1c. The findings presented in this study show that HbA1c remains the best criteria for monitoring medium term glucose levels. However, further word is needed before this conclusion can be confirmed.

Biomarkers↗
PubMedDate not supplied

[Influence of non-diabetic pregnancy on fructosamine and HbA1c concentration].

HbAIc and fructosamine concentrations were measured in the course of 177 nondiabetic pregnancies and compared with the corresponding values of 24 nondiabetic nonpregnant women. In all three trimesters HbAIc and fructosamine were significantly lower than the corresponding values in the nonpregnant women; HbAIc: 1st trimester 4.77 +/- 0.62%, 2nd trimester 4.38 +/- 0.59%, 3rd trimester 4.33 +/- 0.49%, p < 0.01; fructosamine 1st trimester 2.13 +/- 0.17 mmol/l, 2nd trimester 2.02 +/- 0.15 mmol/l, 3rd trimester 1.90 +/- 0.15 mmol/l, p < 0.01; nonpregnant women: HbAIc 5.13 +/- 0.41%, fructosamine 2.53 +/- 0.17 mmol/l. However, if the fructosamine is correlated to the respective total protein concentration a constant value results for the course of pregnancy. The changes in the HbAIc and fructosamine concentrations in pregnancy should be taken into account when treating pregnant diabetics.

Adult↗
PubMed2000

The value of serum fructosamine in comparison with oral glucose tolerance test (OGTT) as a screening test for detection of gestational diabetes mellitus.

The objective of this study was to evaluate the effectiveness of a single assay of serum fructosamine as a screening test for gestational diabetes in comparison with the oral glucose tolerance test. A cross-sectional descriptive study was performed on 210 pregnant women attending antenatal clinics at Colombo South Teaching Hospital. A 75 g oral glucose tolerance test and serum fructosamine assay in the fasting state and 2 hours after ingestion of oral glucose was performed. The statistical significance of fructosamine values were assessed by Student's t-test and the reliability of the test was assessed by calculating the sensitivity and specificity. There was no significant difference in serum fructosamine levels when measured fasting and 2 hours after ingestion of 75 grams of glucose. In comparison with 75 g glucose tolerance test single assay of serum fructosamine gave a sensitivity of 87.5% and a specificity of 94.5% with regard to detection of gestational diabetes mellitus. Therefore a single assay serum fructosamine test at any time of the day can be recommended as a screening test for detection of gestational diabetes mellitus.

Journal Article↗
PubMed1987

Evaluation of the fructosamine test for the measurement of plasma protein glycation.

Repeated estimation of plasma protein glycation by the fructosamine assay gave more variable results than expected from analytical variability (coefficient of variation approximately 2%). Fructosamine results obtained on plasma samples drawn at different times of the day differed by up to 1 mmol/l, corresponding to a coefficient of variation of greater than 10%. As a consequence, the information concerning averaged glycaemia of a fructosamine determination is subject to an uncertainty of 7.8 mmol/l. Fructosamine concentrations were linearly related to the protein concentration. Correction for the protein concentration decreased this variability; however, factors other than protein concentration, such as lipid content, also influence results of fructosamine determinations.

Adult↗
PubMedDate not supplied

Diagnostic use of fructosamine assay in the control of type II diabetes mellitus.

In an attempt to evaluate the usefulness of fructosamine assay in monitoring type II diabetes, 142 diabetic patients were investigated. Fructosamine values were found to be higher in patients on insulin treatment than on oral hypoglycemic agents. In order to evaluate the metabolic control by using the correlated variations of F, Gm and HbA1c, the patients were subdivided into many control classes: mean values of fructosamine were higher in poorly controlled patients. Fructosamine however correlated better with glycemia in patients with recent variations in metabolic state than HbA1c. It was concluded that fructosamine is a good index for short-term metabolic control, and if used in an integrated fashion with glycemia and HbA1c, can provide further information on the metabolic state of diabetes.

Adult↗
PubMedDate not supplied

Level of serum fructosamine in Saudi diabetic patients.

Fructosamine, a compound used to measure serum glycosylated proteins was assayed in 105 Saudi diabetic subjects and 54 healthy non-diabetic Saudi subjects. Fructosamine concentrations in diabetics were significantly higher than in healthy controls (p less than 0.0005). Fructosamine concentrations correlated significantly with fasting blood glucose and HbA1 in diabetics (r = 0.677, p less than 0.0005, and r = 0.598, p less than 0.0005, respectively). The correlation between fructosamine and HbA1 was significant in the oral hypoglycemic-treated diabetics and poor in the insulin-treated diabetic group (r = 0.568, p less than 0.0005, and r = 0.526, p = 0.01). Fructosamine concentrations correlated poorly with the duration of diabetes (r = 0.221, p less than 0.05).

Adolescent↗
PubMedDate not supplied

Fructosamine and glycated hemoglobin as indices of glycemic control in patients with liver cirrhosis.

Glucose intolerance often occurs in liver cirrhosis; therefore a long-term control of plasma glucose levels appears to be important. For this purpose glycated hemoglobin A (HbA1c) determination is proposed as a suitable method, while no data are available on fructosamine test. In 98 cirrhotic patients serum fructosamine and HbA1c levels were compared with those of normal controls and among cirrhotic patients grouped in non glucose-intolerant and with non insulin-dependent (NIDDM) or insulin-dependent diabetes mellitus (IDDM). The mean HbA1c values of cirrhotic patients with normal glycemic control were significantly lower than normal, and only a few IDDM and NIDDM cirrhotic patients showed high values of HbA1c, indicating that HbA1c is often underestimated in these patients. On the contrary, serum fructosamine levels were on the average higher than normal in nondiabetic patients, but they were significantly higher in IDDM and NIDDM patients than in nondiabetics, and the 72% of NIDDM and 85% of IDDM patients had fructosamine levels higher than the upper normal value. In conclusion, in diabetic patients with liver cirrhosis fructosamine seems to be a more suitable test than HbA1c for monitoring blood glucose levels.

Aged↗
PubMed1986

Serum fructosamine: a screening test for diabetes in pregnancy.

Serum fructosamine levels were measured in 1200 pregnant women at different stages of gestation, 167 of them having a glucose tolerance test. There was a significant fall in fructosamine levels throughout pregnancy and details of normal values at different gestational stages are presented. A good correlation was found between fructosamine and glucose tolerance test (r = 0.813). Nine women had gestational diabetes diagnosed by glucose tolerance test and eight of those had a serum fructosamine level greater than the ninety-fifth percentile. This study confirms our previous findings that serum fructosamine may be a useful screening test for gestational diabetes.

Adolescent↗
PubMed1988

Fructosamine in the management of gestational diabetes.

The role of maternal serum fructosamine estimation in the management of gestational diabetes was assessed in 78 consecutive patients over a 3-year period. Fructosamine results correlated significantly with mean plasma glucose levels over a 1- to 3-week interval, with the closest association being in the preceding week. Eighty-five percent of women with gestational diabetes had peak serum fructosamine levels above the normal range. If maternal levels exceeded 3.2 mmol/L, there was an 88% chance of abnormal glucose tolerance post partum. Our aim of management was a serum fructosamine level less than 2.5 mmol/L; patients who achieved this goal by 35 to 37 weeks' gestation had fewer obese babies with lower cord insulin and C-peptide levels as compared with neonates of mothers with elevated fructosamine concentrations.

Birth Weight↗
PubMed1987

Relationship between albumin and fructosamine concentration in diabetic and non-diabetic sera.

We investigated the contribution of albumin to serum fructosamine activity. On gel exclusion chromatography, pooled diabetic and pooled non-diabetic sera before and after incubation with [14C]glucose differed in fructosamine activity and radioactivity mainly in the albumin-containing fractions. We confirmed the major contribution of glycated albumin to serum fructosamine concentration using affinity chromatography on Blue Sepharose. The importance of high molecular mass species was further demonstrated by the recovery of reducing activity following dialysis and charcoal treatment. Fructosamine measurements in diabetic patients were not correlated with serum albumin concentration in individuals with urinary albumin less than 1 g/l. We conclude that fructosamine activity is a convenient measure of glycosylprotein concentration and that the index responds mainly to glycation of albumin. However, routine correction for serum albumin concentration is inappropriate.

Adolescent↗