ABSTRACT
Background: Chronic alcohol ingestion is one of the major causes of liver disease. Uncontrolled glucose concentration in chronic alcoholic liver disease will have poor prognosis. Hence, the study is undertaken to see markers of chronic glucose control, that is, serum fructosamine and glycated hemoglobin and their usefulness to show the severity of chronic alcoholic liver disease. Aim and Objectives: The study is conducted to check that between glycated hemoglobin and fructosamine which is better to check glycemic control and severity/prognosis of chronic alcoholic liver disease. Materials and Methods: 60 cases of chronic alcoholic liver disease patients of age group 20–70 years of both sexes with 30 age- and sex-matched healthy controls were taken. Cases were divided into non-complicated and complicated groups. Glycated hemoglobin was estimated by immunoturbidimetry method, serum fructosamine level was estimated by colorimetry using nitro blue tetrazolium, SGOT was estimated by method by IFCC and serum total protein was estimated by biuret method. Results: The mean concentration of HbA1c and serum total protein was decreased in both groups of cases compared to controls. The mean concentrations of serum fructosamine and SGOT were increased in both groups of cases. There was no significant difference in the mean value of serum total protein in non-complicated cases with controls. There was no significant difference in the mean value of HbA1c between non-complicated and complicated cases. SGOT was considered for correlation, it was found out that it had significant negative correlation with serum total protein, significant positive correlation with serum fructosamine, and no correlation with HbA1c. Significant negative correlation was found between serum total protein and serum fructosamine. Conclusion: This study shows that serum fructosamine is a better marker to monitor chronic glucose control and severity of chronic alcoholic liver disease compared to HbA1c.
ABSTRACT
Glycated protein estimation is a diagnostic tool, used for the long term and short term monitoring of the glycemic status of diabetic patients. The present study is designed to compare and correlate modified NBT reduction method for the estimation of Glycated protein (serum fructosamine) with HbA1c estimated on DCA+2000 Analyzer. Glycated protein (serum fructosamine) reduces Nitro Blue Tetrazolium (NBT) reagent in alkaline medium to tetrazinolyl radical NBT+ which forms a highly colored monoformazen compound, absorbance of which is directly proportional to the concentration of glycated protein (serum fructosamine) present in the sample and is recorded as ΔA/min. The results of modified NBT were then compared with HbA1c estimated by immunoagglutination inhibition method. Correlation coefficient between HbA1c with serum fructosamine was found to be r = 0.739 using Schimadzu CL-750 spectrophotometer and r = 0.731 using colorimeter. Results of this study were found to be statistically significant P<0.001. Hence this method could be used for routine monitoring of blood glucose control in diabetics as HbA1c estimation.
ABSTRACT
The level of fructosamine was determined in the serum of 278 individuals ranging in age from 20 to 80 years who passed a physical check-up. The 130 males and 148 females had mean ages + standard deviation of 44.0+15.0 and 40.3+12.0 years, respectively. Serum fructosamine concentration was assayed using nitroblue tetrazoleum (NBT) reduction in alkaline medium. The reference values of serum fructosamine were 226 µmol/L to 296 µmol/L (Mean = 260.7, SD = 17.6 µmol/L). The serum fructosamine is unaffected by sex. Effect of food intake on fruc tosamine level has been carried out on a group of healthy subjects (n = 36). The means and SDs of serum fructosamine at eight-hour fasting, two-hour post-prandial and non-fasting specimens were studied and values of 269.4+17.9, 269.3+14.8 and 268.6+15.3 µmol/L respectively, were obtained. Results reveal that food intake has virtually no effect on fructosamine values (Analysis of variance p>0.05). Parallel assays of 46-paired sera was Y = 17.5 + 0.95 X, whereas X and Y were serum and plasma fructosamine levels, respectively. Values of plasma fructosamine were statistical significantly difference from those of serum (p<0.001). A small discrepancy of 1.9 percent was observed. Thus, whenever plasma is used as sample for fructosamine test, a slightly higher value of fructosamine would be obtained.