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At least 19 recordsLinked to original sources
PubMed1991

Fructosamine Test-Plus, a modified fructosamine assay evaluated.

We have evaluated Fructosamine Test-Plus, a commercial fructosamine assay based on the reduction of nitro-blue tetrazolium dye in alkaline buffer (Clin Chem 1985;31:1550-4), modified by including a detergent and uricase in the reagent, by changing the concentrations of buffer and dye, and by changing the approach to primary calibration. Specimens were from 2321 participants in a health screening survey in a local workforce. Compared with the original fructosamine method, the Fructosamine Test-Plus method was less affected by protein concentration in the sample and less subject to interference from hyperlipidemia. The changes have also extended the linearity of the assay in the pathological range. However, as a screening method for diabetes mellitus in a population with a disease prevalence of 2.28%, the performance of Fructosamine Test-Plus was similar to the original assay.

Adult↗
PubMed1992

Influence of pH and phosphate ions on the kinetics of enolisation and degradation of fructosamines. Studies with the model fructosamine, N epsilon-1-deoxy-D-fructos-1-yl-hippuryl-lysine.

Investigation of the rate of enolisation and degradation of the model peptide fructosamine N epsilon-1-deoxy-D-fructos-1-yl-hippuryl-lysine and related monosaccharides revealed the fructosamine to be activated towards enolisation but little of the enolic intermediates proceeded to form advanced glycation endproducts. For the oxidative degradation of monosaccharides, enolisation was rate-limiting. Enolisation of the fructosamine was promoted by hydroxide, phosphate and pyrophosphate buffer ions but not directly influenced by the protonation state of the fructosyl amino group. The formation of advanced glycation end-products may be greatly enhanced in the presence of suitable catalysts (trace metal ions) of the degradation of fructosamine-derived enolic intermediates.

Anions↗
PubMed1988

Long-term performance of the fructosamine assay.

We have investigated the long-term performance of the fructosamine assay based on secondary glycated protein standards and attempted to define the interpretation of varying degrees of increase in fructosamine concentration in comparison to haemoglobin A1 (HbA1) values both in insulin dependent (IDDM) and non-insulin dependent (NIDDM) diabetic patients. Between-batch imprecision of fructosamine over 5 months was (CV) 2.5% at 2.09 mmol/L, 2.8% at 3.52 mmol/L and 3.6% at 4.14 mmol/L. Variation of fructosamine concentration in vivo in stable diabetic patients monitored over 8-18 weeks was 2.3% to 7.1%. Fructosamine correlated with HbA1 both in IDDM (n = 110, r = 0.701, P less than 0.001) and NIDDM (n = 71, r = 0.764, P less than 0.001). Specificity and sensitivity of fructosamine for the prediction of degree of control assessed on the basis of HbA1 level (cut-off point for good vs. poor control, HbA1 = 10%) was determined. In NIDDM, specificity above 90% was achieved at a fructosamine concentration of 3.4 mmol/L with a corresponding sensitivity of 64.1%. 22.5% of patients were classified differently on the basis of fructosamine as compared to HbA1. In IDDM, specificity over 90% was achieved at 3.8% mmol/L fructosamine with a sensitivity of 35%. Discordancy rate between HbA1 and fructosamine based assessment of control was 31.8%. The assessment of diabetic control based on fructosamine may be different from that based on HbA1, particularly in IDDM. Fructosamine and HbA1 should be used as complementary rather than alternative tests.

Adult↗
PubMed1990

[Diurnal variations of fructosamine in patients with type II diabetes mellitus].

During the last years fructosamine has been presented as a measurement of diabetic long term control, particularly a shorter half life of fructosamine was seen as an advantage over HbAlc (half life of fructosamine: 16 days, half life of HbAlc: 28 days). Due to diurnal variations of fructosamine levels especially in dependence of variations of the albumin-and protein concentrations the interpretation of this parameter was somewhat limited. Recently a new colorimetric fructosamine-assay was developed. We investigated the diurnal variations of fructosamine in 28 patients with type II diabetes. Fructosamine, glucose, albumin, total protein and creatinine were measured at the times towards 3, 6, 9, 12 a.m. and 3, 6, 9, and 12 p.m. In relation to the 6 a.m. fructosamine value (= 100%) the fructosamine levels showed a daily variation from -4% at 3 a.m. to +11% at 9 a.m. Correcting fructosamine levels with total protein or with albumin reduced the variations to -1% to +6% or -3% to +9%. Daily profiles of the new fructosamine assay show a daily variation which can be minimized by correcting with protein-or with albumin concentrations. For clinical routine the daily variations especially of the corrected fructosamine levels are neglectible.

Adult↗
PubMed1990

A comparison of fructosamine and glycosylated haemoglobin measurements at a diabetic clinic.

Fructosamine or glycosylated haemoglobin (HbA1) measurements are most useful in the diabetic clinic if results are available when the patient is seen, with minimum waiting time. Fructosamine measurements have the advantage of being cheaper and faster to perform on large numbers of patients than HbA1 measurements. In order to assess the acceptability of fructosamine as a complete alternative to HbA1, fructosamine, HbA1 and random plasma glucose measurements were made on all patients attending the diabetic clinic for a 6-week period. Either the fructosamine or the HbA1 result was made available when the patient was seen and the other result was given at the end of the clinic for comment as to whether or not it would have altered management. The clinicians indicated that in 7% of cases, the HbA1 result would have altered management if available when the patient was seen, whereas in 2.5% of cases, the fructosamine result would have altered management. The commonest discrepancy was disproportionate elevation of HbA1 with a normal or near normal fructosamine. For the whole group, 32% had a normal fructosamine but only 16% a normal HbA1. The best overall correlation was between HbA1 and glucose (r = 0.67). Fructosamine correlated less well with both HbA1 (r = 0.55) and glucose (r = 0.51). Thus fructosamine was an acceptable alternative to HbA1 in most cases but caution is required, particularly in patients with persistently normal fructosamine results for whom additional HbA1 checks are advised.

Biomarkers↗
PubMed1990

[Fructosamine as a diagnostic parameter in the clinical routine].

The fructosamine normal range was established from a collective of 90 healthy individuals as 219-285 mumol/l (+/- 2s; mean 240 mumol/l). From a group of 10 diabetics day profiles of glucose, protein, albumin, and fructosamine were recorded by measuring these parameters three times per day at 8.00, 11.30, and 15.00. The fructosamine concentration was essentially constant also when related to protein or albumin. Fructosamine, HbAlc, CK, and CK-MB were determined from 12 diabetics with fresh myocard infarct (7 diabetics, 5 non-diabetics). Surprisingly, diabetics as well as non-diabetics manifested high fructosamine concentrations. The origin of the fructosamine increase with non-diabetic myocard infarct patients is not yet known. Possibly the acute metabolic disorder plays an important role. An influence of fibrinogen on fructosamine is also conceivable. Additional investigations, including therapy of lysis, will be carried on. The stability of the fructosamine was examined by storing 50 sera (fructosamine 295-491 mumol/l, glucose 180-279 mg/dl) at different temperatures (+ 25 degrees C, + 4 degrees C, - 20 degrees C). At - 20 degrees C and + 4 degrees C fructosamine increases by up to 2% in 24 hours. At + 25 degrees C a 6% increase in fructosamine was observed within the same observation period.

Blood Proteins↗
PubMed1988

Clinical utility of serum fructosamine in diabetes mellitus compared with hemoglobin A1c.

To evaluate the clinical utility of fructosamine as a mean of monitor glycaemic control, fructosamine and HbA1c were compared in 46 random out-patients visiting a Diabetic Clinic as well as in 25 inpatients admitted to a Diabetes Day Care Unit. In the out-patients, there were a significant correlations between fructosamine and fasting blood glucose (r = 0.75) as well as between fructosamine and HbA1c (r = 0.91). However, when the reference values were considered, interesting differences were found; only 4% of the out-patients showed normal HbA1c values while 39% showed normal fructosamine values. Accordingly, fructosamine and HbA1c evaluate different aspects of glycaemic control. During an admission of 7 days to the Diabetes Day Care Unit no statistical changes in mean blood glucose and fructosamine values occurred. On the other hand, two weeks after discharge from the Unit, not only fructosamine (3.58 +/- 0.16 mmol vs 3.09 +/- 0.08 mmol/l) but also HbA1c (9.52 +/- 0.38% vs 8.33 +/- 0.23%) had improved significantly. Thus HbA1c measures improvements in glycaemic control as early as 3 weeks after changes in treatment. At six weeks after discharge HbA1c (7.63 +/- 0.34%) but not fructosamine (3.02 + 0.14 mmol/l) had improved further. HbA1c is a reliable marker of glycaemic control while the value of fructosamine in clinical practice is unclear.

Adult↗
PubMed1991

Use of fructosamine test in diabetic children.

OBJECTIVE: The goal of this study was to assess the effect of glucose and the contribution of the aldimine component on the measurement of fructosamine, the relationship of serum fructosamine with glycosylated plasma proteins, as measured by a new high-performance liquid chromatography methodology (Glyc PP-HPLC) and by an affinity chromatography (Glyc PP), and the ability of serum fructosamine to assess acute, short-term (1-2 wk), and long-term (2-3 mo) glycemic control. RESEARCH DESIGN AND METHODS: The measurement of fructosamine was unaltered by the addition of up to 27.5 mM glucose or by the elimination of the aldimine component of serum specimens by dialysis. Fructosamine was generated in vitro by incubating serum aliquots. This generation was dependent on time, glucose concentration, and temperature. RESULTS: Fructosamine (n = 27) correlated well with Glyc PP (r = 0.76, P less than 0.01) and significantly less with Glyc PP-HPLC (r = 0.46, P less than 0.01). Although oral glucose ingestion increased serum glucose acutely by 200%, fructosamine was unchanged at each time interval. Improving glycemic control decreased the mean serum fructosamine concentration from 3.68 (baseline) to 3.28 mM (P less than 0.01) at 1 wk and to 3.13 mM (P less than 0.01) at 2 wk. HbA1c correlated with fructosamine (r = 0.59) and Glyc PP-HPLC (r = 0.47) but correlated best with Glyc PP (r = 0.83). CONCLUSIONS: These results indicate the fructosamine assay is unaltered by serum glucose, solely measures the ketoamine component, correlates well with glycosylated plasma proteins measured by aminophenylboronic acid column chromatography, is unaffected by acute changes of serum glucose, and may be used to monitor changes in glycemic control over a 1-wk interval.

Administration, Oral↗
PubMed1990

[Determination of fructosamine in chronic kidney diseases (dialysis-dependent patients)].

The serum fructosamine normal range was confirmed. Correction to protein or albumin did not significantly affect the results. Therefore, correction of fructosamine values from patients with normal protein and albumin values would not improve the clinical significance of fructosamine. Fructosamine concentrations of heparin plasma from non-diabetics also fell within the serum fructosamine normal range. The fructosamine concentration from non-diabetic dialysis patients was significantly higher and more widely distributed than that of the reference collective despite normal blood glucose concentration. Relating fructosamine to protein had no substantial effect, whereas the differences were even increased when fructosamine was related to albumin. On the present stage of knowledge it might be considered to establish a reference interval for dialysis patients. It appears that the fructosamine estimation may then be successfully applied also to dialysis patients. Although dialysis resulted in hemoconcentration, the fructosamine concentration remained virtually unchanged. Referencing both values before and after dialysis to protein or albumin improved the correlation, but substantial differences were introduced as well. However, none of several parameters measured in parallel interfered to a degree which might explain such differences. In order to find a reasonable explanation for these findings further experiments are necessary.

Adult↗
PubMed1987

Serum fructosamine in the assessment of glycaemic control in diabetes mellitus.

Serum fructosamine determination was evaluated in the assessment of glycaemic control in diabetes mellitus. Intra- and inter-assay variation of the method was 0.5-0.8 and 1.5-2.9%, respectively. The fructosamine concentration in serum was found to be stable for at least 10 days independent of prevailing serum glucose concentration is stored at +4 degrees C or colder. Stability of serum fructosamine with respect to rapid fluctuations of blood glucose was of the same order as that of HbA1c. The reference interval (mean +/- 2 SD) for 92 non-diabetic individuals was 1.9-2.7 mmol/l. Good correlation was found between HbA1c and serum fructosamine (r = 0.79). Serum fructosamine and HbA1c correlated well with the mean blood glucose values of the preceding week (r = 0.88 and 0.75, respectively, p less than 0.001). Significant correlations of fructosamine and HbA1c with fasting blood glucose were also found (r = 0.53 and 0.55, respectively, p less than 0.001). Fructosamine determined simultaneously with fasting blood glucose in 65 oral glucose tolerance tests (OGTT) did not separate normal subjects from those with impaired glucose tolerance. Two of the three subjects with diabetic response in the OGTT had, however, elevated fructosamine concentrations. Determination of serum fructosamine is a technically simple, reproducible and moderately inexpensive method for the assessment of glycaemic control in diabetes mellitus. Standardization of the method is, however, not without problems. Uniformity of the calibration and assay protocol is essential for reliable interlaboratory comparison of results. Physiological states altering the rate of synthesis or elimination of serum proteins should be considered in the interpretation of fructosamine levels.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1989

The effect of hypoalbuminaemia, hyperbilirubinaemia and renal failure on serum fructosamine concentration in non-diabetic individuals.

We have investigated the effects of hypoalbuminaemia, hyperbilirubinaemia and renal failure on serum fructosamine concentration in 39 non-diabetic patients. All patients were hypoalbuminaemic (median serum albumin 25 g/l, range 12-34 g/l). Group 1 (n = 19) were patients with hypoalbuminaemia alone, group 2 (n = 7) with hypoalbuminaemia and impaired renal function (median serum creatinine 226 mumol/l, range 154-461 mumol/l) and group 3 (n = 13) were subjects with hypoalbuminaemia and hyperbilirubinaemia (median serum bilirubin 34 mumol/l, range 19-83 mumol/l). Serum fructosamine was significantly lower in all three groups compared to age-matched normoalbuminaemic controls, but there was no significant difference in fructosamine concentrations between the groups. There was a correlation between fructosamine concentration and serum albumin. (r = 0.82, p less than 0.001) in all three groups combined. Serum fructosamine did correlate with serum bilirubin in patients with normal renal function (r = 0.0, p less than 0.001). In patients with abnormal renal function there was no correlation between serum fructosamine and either urea (r = 0.22, ns) or creatinine (r = 0.31, ns). Albumin is the major factor affecting serum fructosamine concentrations. Moderate hyperbilirubinaemia does not affect fructosamine concentration. No difference in fructosamine concentration could be demonstrated in patients with renal failure.

Adult↗
PubMed1992

Fructosamine in human and bovine semen.

We detected the presence of fructosamine in human and bovine semen. In seminal plasma of healthy normozoospermic men (N = 17) fructosamine was found in 53% of the cases (fru+). In fru+ semen samples the concentration of fructosamine was (mean +/- S.E.M., N = 9) 0.45 +/- 0.09 mmol/L and varied from 0.15 to 0.75 mmol/L. It was 3-12 times lower than in blood serum of healthy men. In semen of infertile men (N = 57) fructosamine was present only in 21% of the cases and its concentration was lower than in fertile men i.e. (mean +/- S.E.M., N = 12) 0.27 +/- 0.007 mmol/L. In bulls (N = 98) fructosamine was found in semen of 82% of animals. In fru+ semen samples the concentration of fructosamine was (mean +/- S.E.M., N = 80) 0.77 +/- 0.12 mmol/L and varied from 0.30 to 1.15 mmol/L. We did not find any correlation between the concentration of fructosamine on one hand, and that of fructose and glucose on the other hand, in either human or bull semen. The difference in the frequency of fructosamine appearance in semen of fertile and infertile men suggests that fructosamine may be in some way involved in the process of fertilisation.

Animals↗
PubMed1989

The role of serum fructosamine as a screening test for gestational diabetes mellitus.

The serum fructosamine concentration indicates the degree of glycation of serum proteins, particularly albumin, and reflects an average blood glucose level over the previous 1-3 weeks. Serum fructosamine, glycated haemoglobin (HbA1c), total serum protein, serum albumin, fasting plasma glucose and oral glucose tolerance test (OGTT) have been measured in 127 healthy control subjects, 102 type 1 and 152 type 2 diabetes mellitus patients and 106 nondiabetic pregnant women. Fructosamine concentration of 2.24 +/- 0.16 and 3.21 +/- 0.41 mmol/l (mean +/- S.D.) has been found in control subjects and diabetics respectively (P less than 0.001). During the second trimester a significantly lower fructosamine level (1.92 +/- 0.21 mmol/l) has been found in pregnant women, most likely due to the low serum albumin concentration (31.35 +/- 3.97 g/l). None of them had a fructosamine level above the normal limit of 2.55 mmol/l. On the other hand, 12 pregnant women showed a disturbed OGTT with normal fructosamine. If the serum fructosamine concentration was adjusted for 40 g/l albumin, then a mean fructosamine of 2.16 +/- 0.24 mmol/l was found in patients with gestational diabetes. Our results show that serum fructosamine has a similar diagnostic value as HbA1c for non-pregnant adults, but neither can replace OGTT for the diagnosis of gestational diabetes.

Adolescent↗
PubMed1989

Serum fructosamine in assessment of diabetic control and relation to thyroid function.

Measurement of serum fructosamine using a Roche kit is a simple and reliable method for the estimation of glycated serum proteins. The value of serum fructosamine can be affected by hyperglycemia in diabetics and an abnormal turnover rate of serum protein in patients with thyroid dysfunction. We measured the serum fructosamine level in 18 normal control subjects, 71 diabetics (8 IDDM, 63 NIDDM) and 46 non-diabetic untreated patients with thyroid dysfunction (28 hyperthyroidism, 18 hypothyroidism). The serum fructosamine level was significantly increased in the diabetics compared with the normal control subjects (3.84 +/- 0.15 mmol/l vs 2.58 +/- 0.08; mean +/- SE, P less than 0.01). The serum fructosamine level in the diabetics was positively correlated with the fasting plasma glucose and HbAlc level, showing the highest correlation with fasting plasma glucose at 2 weeks before and with the HbAlc level at 2 weeks after serum fructosamine measurement. In the patients with thyroid dysfunction, the serum fructosamine level in hyperthyroidism (2.08 +/- 0.03 mmol/l) and hypothyroidism (3.11 +/- 0.07 mmol/l) were significantly lower (P less than 0.001) and higher (P less than 0.001) than the normal control subjects (2.58 +/- 0.08 mmol/l), respectively. Furthermore, the serum fructosamine level in these patients was negatively correlated with the level of serum thyroid hormones such as T3 (P less than 0.001) and T4 (P less than 0.001). It is concluded that measurement of serum fructosamine is clinically useful for the evaluation of shorter-term glycemic control in diabetics, but its level for diabetic patients with thyroid dysfunction must be cautiously interpreted.

Adult↗
PubMed1988

Fructosamine or glycated haemoglobin as a measure of diabetic control?

Glycated haemoglobin A1 (HbA1c), fructosamine, and total serum proteins were measured in 30 normal and 61 diabetic children. The normal range for HbA1c was 4.7-8.8% and for fructosamine was 0.98-1.88 mmol/l. These were similar to adult normal ranges and there were no significant age differences during childhood. There was a highly significant correlation between HbA1c and fructosamine in the diabetic children but this was lost when only concentrations within the established normal ranges were considered. Adjustment of concentrations of fructosamine for total serum proteins made no difference to the results. Changes in HbA1c and fructosamine were followed in three newly diagnosed patients and in one whose diabetes was getting worse. HbA1c decayed with a half life of 28.7 days and fructosamine decayed with a half life of 16.5 days. Fructosamine concentrations were lower than expected in the patients who were improving and higher than expected in the patient who was deteriorating. It is suggested that while fructosamine is not a direct substitute for HbA1c it may be a useful adjunct in determining whether a patient is worsening or improving in the short term. A change from HbA1c to fructosamine for routine assessment of diabetes while retaining HbA1c on selected occasions would result in some cost savings while retaining the advantages of having both assays available.

Adolescent↗
PubMed1992

Evaluation of serum fructosamine concentration as an index of blood glucose control in cats with diabetes mellitus.

Fructosamine, a glycated serum protein, was evaluated as an index of glycemic control in normal and diabetic cats. Fructosamine was determined manually by use of a modification of an automated method. The within-run precision was 2.4 to 3.2%, and the day-to-day precision was 2.7 to 3.1%. Fructosamine was found to be stable in serum samples stored for 1 week at 4 C and for 2 weeks at -20 C. The reference range for serum fructosamine concentration in 31 clinically normal colony cats was 2.19 to 3.47 mmol/L (mean, 2.83 +/- 0.32 mmol/L). In 27 samples from 16 cats with poorly controlled diabetes mellitus, the range for fructosamine concentration was 3.04 to 8.83 mmol/L (mean, 5.93 +/- 1.35 mmol/L). Fructosamine concentration was directly and highly correlated to blood glucose concentration. Fructosamine concentration also remained high in consort with increased blood glucose concentration in cats with poorly controlled diabetes mellitus over extended periods. It is concluded that measurement of serum fructosamine concentration can be a valuable adjunct to blood glucose monitoring to evaluate glycemic control in diabetic cats. The question of whether fructosamine can replace glucose for monitoring control of diabetes mellitus requires further study.

Animals↗
PubMed1990

[The value of fructosamine in hemodialysis patients].

Fructosamine is thought to be an alternative diabetic long term parameter to HbAlc. A possible advantage of fructosamine is the shorter half life of this parameter. Therefore changes in the metabolic control of diabetes can be evaluated faster. However, daily variations of protein concentrations limit the clinical usefulness of fructosamine, especially in patients on hemodialysis, where we see variations in total protein- and albumin concentration during dialysis. Due to these limitations we studied the clinical usefulness of a new fructosamine assay in 38 patients with chronic renal failure. Fructosamine values, total protein, albumin, blood glucose and creatinine were measured before and after three hours hemodialysis treatment as well as glycosylated hemoglobin. Before dialysis HbA1c correlated with HbA1c after dialysis (r = 0.99), which documents the usefulness of glycosylated hemoglobin in patients on hemodialysis. Fructosamine before dialysis shows a correlation with fructosamine values after dialysis of r = 0.77. After correction with total protein the correlation was r = 0.95, also after correction with albumin. Fructosamine values before and after dialysis correlated excellently (r = 0.95). Fructosamine values before and after dialysis can only be compared after correction with total protein or with albumin.

Blood Glucose↗