Estimated average blood glucose level based on fructosamine level

ABSTRACT Objective: To define the mathematical relationship between fructosamine levels and average glucose values. Subjects and methods: The study comprised laboratory data of 1,227 patients with type 1 or 2 diabetes mellitus. Fructosamine levels measured at the end of a 3-week period were compared against the average blood glucose levels of the previous 3 weeks. Average glucose levels were determined by the weighted average of the daily fasting capillary glucose results performed during the study period, and the plasma glucose measured in the same sample collected for fructosamine measurement. Results: In total, 9,450 glucose measurements were performed. Linear regression analysis between fructosamine levels and average glucose levels showed that for each 1.0 µmol/L increase in fructosamine level there was a 0.5 mg/dL increase in average glucose level, as estimated by the equation Mean glucose level = (0.5157 x Fructosamine) - 20. The coefficient of determination (r2 = 0.353492, p < 0.006881) allowed the calculation of the estimated average glucose based on fructosamine level. Conclusion: Our study demonstrated a linear correlation between fructosamine level and mean blood glucose level, suggesting that fructosamine levels can be a proxy for the average glucose level in assessing the metabolic control of patients with diabetes.

Fructosamine and glycated hemoglobin as biomarkers of glycemic control in people with type 2 diabetes mellitus and cancer (GlicoOnco study)

Abstract Introduction Glycemic control is important to avoid diabetes complications in individuals with cancer. There is no evidence for HbA1c and fructosamine as reliable biomarkers in these conditions. There are particularities in caring for patients with diabetes and cancer that can alter these biomarkers. Objective The aim of this study was to evaluate HbA1c and fructosamine as glycemic biomarkers in people with type 2 diabetes and cancer, undergoing clinical or surgical oncological treatment. Methods The authors conducted a single-center, retrospective analysis with people who have cancer and diabetes. Comparison of glycemic biomarkers (HbA1c, fructosamine, and Self-Monitoring of Blood Glucose [SMBG]) was performed including evaluation in individuals undergoing chemotherapy, using glucocorticoids, with anemia, hypoproteinemia or with reduced estimated Glomerular Filtration Rate (eGFR). Results There was a strong positive correlation between fructosamine and HbA1c (n = 318, r= 0.66, p < 0.001) in people with diabetes and cancer even in those under chemotherapy (n = 101, r= 0.61, p < 0.001) or using glucocorticoids (n = 96, r= 0.67, p<0.001). There was a strong correlation between HbA1c and fructosamine in subjects with anemia (n = 111, r= 0.66, p < 0.001), hypoproteinemia (n = 54, r= 0.67, p < 0.001), or with eGFR ≥ 60 mL/min/1.73 m2 (n = 189, r= 0.70, p < 0.001), and moderate correlation with hypoalbuminemia (n = 21, r= 0.54, p = 0.001) and with reduced eGFR (n = 67, r= 0.57, p < 0.001). The correlations between fructosamine and HbA1c with SMBG were moderate (n = 164, r= 0.49, p < 0.001; n = 111, r= 0.55, p < 0.001, respectively), strong in subjects undergoing chemotherapy, with hypoalbuminemia or hypoproteinemia, and at least moderate, if eGFR < 60 mL/min/1.73 m2 or with anemia. Conclusions Fructosamine and HbA1c can be used as glycemic biomarkers in people with diabetes and cancer, even in those with anemia, hypoproteinemia, or undergoing chemotherapy.

Glycated hemoglobin and fructosamine level in complicated and non-complicated chronic alcoholic liver disease

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.

Relación entre los niveles basales de fructosamina y glucosa en adultos mayores / Relationship between basal levels of fructosamine and glucose in older adults

INTRODUCCIÓN: los cambios fisiológicos a los que están expuestos los adultos mayores, son muchas veces factores negativos en su calidad de vida, sobre todo en aquellos que se encuentran en residencias geriátricas, existen parámetros como la glicemia y hemoglobina glucosilada que podrían ser útiles en el control metabólico. OBJETIVO: relacionar los niveles basales de Fructosamina y Glucosa en adultos mayores institucionalizados en residencias geriátricas del municipio de Tiquipaya, septiembre 2019. METODOLOGÍA: estudio no experimental, observacional, prospectivo, transversal, con enfoque de análisis positivista cuantitativo, con un universo de 97 adultos mayores de 65 años, con una muestra de 79 que cumplen con los criterios de inclusión y exclusión, con un 4,77% de error máximo aceptable. RESULTADOS: el 71% (n=56) de los pacientes fueron mujeres. Los ancianos predominaron como grupo etario. Se evidenció que no hay una buena concordancia entre los niveles basales de Glicemia y Fructosamina, mediante el cálculo estadístico del índice de Kappa que fue de 0,023; Test de Wilcoxon 0.081; Test correlación Pearson r=0.281. Los niveles basales de Fructosamina tienen una sensibilidad y especificidad altas del 82,14% (L.I. 62,42% -L.S. 93,23%) y 56.92% (L.I. 47,95% - L.S. 65,48%), respectivamente. CONCLUSIONES: no existe relación entre los niveles basales de Glucosa y la Fructosamina puesto que son parámetros de evaluación metabólica en diferente tiempo y una no remplaza la otra, por lo tanto, se debería implementar adicionalmente a la Glucosa la determinación de la Fructosamina para monitorizar a los pacientes adultos a mediano plazo.

INTRODUCTION: the physiological changes to which older adults are exposed; are many times negative factors in their quality of life, especially in those who are in geriatric residences. Glycemia and glycosylated hemoglobin are useful as metabolic control parameters. OBJECTIVE: to relate the basal levels of Fructosamine and Glucose in institutionalized older adults in geriatric residences in the municipality of Tiquipaya, September 2019. METHODOLOGY: non-experimental, observational, prospective, cross-sectional study, with a quantitative positivist analysis approach, with a universe of 97 adults over 65 years of age, with a sample of 79 that met the inclusion and exclusion criteria, with a maximum acceptable error of 4.77%. RESULTS: 71% (n=56) of the patients were female. The elderly dominated as an age group. It was evidenced that there is not a good agreement between basal levels of Glycemia and Fructosamine, through the statistical calculation of the Kappa index which was 0.023; Wilcoxon test 0.081; Pearson correlation test r= 0.281. The basal levels of Fructosamine have a high sensitivity and specificity of 82.14% (L.I. 62.42% - L.S. 93.23%) and 56.92% (L.I.47.95% - L.S. 65.48%), respectively. CONCLUSIONS: there is no relationship between basal levels of Glucose and Fructosamine since they are parameters of metabolic evaluation in different time and one does not replace the other, therefore, the determination of Fructosamine should be implemented in addition to Glucose to monitor adult patients in the medium term.

Analysis of the level of fructosamine in liver diseases / 中国基层医药

Objective@#To investigate the level of fructosamine in different liver diseases.@*Methods@#From October 2016 to October 2017, 153 patients with liver diseases hospitalized in Tongling Municipal Hospital were selected as study group, including 58 patients with chronic hepatitis B(CHB), 35 patients with liver cirrhosis(LC), 60 patients with primary hepatocellular carcinoma(HCC). Meanwhile, 40 healthy subjects were selected as control group.The total protein(TP), albumin (ALB), cystatin C(CysC), sialic acid(SA) and fasting blood glucose(FBG) were statistically analyzed.@*Results@#The difference of fructosamine between the HCC group and the LC group, the CHB group and the control group was statistically significant[(299.1±96.9)μmmol/L, (259.3±41.5)μmmol/L, (248.7±29.5)μmmol/L, (234.9±20.2)μmmol/L](F=11.321, P<0.05). There was no statistically significant difference in FBG between the study group and the control group(P>0.05). Correlation analysis showed that there was a positive correlation between fructosamine and FBG in the CHB group(r=0.655, P<0.05). The fructosamine of LC group was positively correlated with TP, CysC and FBG (r=0.406, 0.418, 0.351, all P<0.05). The fructosamine was correlated with TP, ALB, CysC and SA in HCC group(r=-0.513, -0.610, 0.637, r=0.311, all P<0.05). There was no correlation between fructosamine and FBG in the HCC group (P>0.05). Logistic stepwise regression analysis showed that in the HCC group, fructosamine(OR=1.029, 95% CI: 1.007~1.052), CysC (OR=5 454.909, 95% CI: 78.117~380 916.873) and SA(OR=1.155, 95% CI: 1.047~1.275) were independent risk factors of HCC.@*Conclusion@#It has positive correlation between fructosamine and FBG in CHB and LC patients, fructosamine may not be related to glycometabolism in HCC patients, but the data of fructosamine reflect the degree of glycosylation of HCC tumor cells.

Analysis of the level of fructosamine in liver diseases / 中国基层医药

Objective To investigate the level of fructosamine in different liver diseases.Methods From October 2016 to October 2017,153 patients with liver diseases hospitalized in Tongling Municipal Hospital were selected as study group,including 58 patients with chronic hepatitis B(CHB),35 patients with liver cirrhosis(LC),60 patients with primary hepatocellular carcinoma (HCC).Meanwhile,40 healthy subjects were selected as control group.The total protein (TP),albumin (ALB),cystatin C (CysC),sialic acid (SA) and fasting blood glucose (FBG) were statistically analyzed.Results The difference of fructosamine between the HCC group and the LC group,the CHB group and the control group was statistically significant[(299.1 ± 96.9)μmmol/L,(259.3 ± 41.5)μmmol/L,(248.7 ± 29.5) μ mmol/L,(234.9 ± 20.2) μmmoL/L] (F =11.321,P ＜ 0.05).There was no statistically significant difference in FBG between the study group and the control group (P ＞ 0.05).Correlation analysis showed that there was a positive correlation between fructosamine and FBG in the CHB group (r =0.655,P ＜ 0.05).The fructosamine of LC group was positively correlated with TP,CysC and FBG (r =0.406,0.418,0.351,all P ＜ 0.05).The fructosamine was correlated with TP,ALB,CysC and SA in HCC group(r =-0.513,-0.610,0.637,r =0.311,all P ＜ 0.05).There was no correlation between fructosamine and FBG in the HCC group (P ＞ 0.05).Logistic stepwise regression analysis showed that in the HCC group,fructosamine (OR =1.029,95 ％ CI:1.007 ～ 1.052),CysC (OR =5 454.909,95％ CI:78.117 ～ 380 916.873) and SA(OR =1.155,95％ CI:1.047 ～ 1.275) were independent risk factors of HCC.Conclusion It has positive correlation between fructosamine and FBG in CHB and LC patients,fructosamine may not be related to glycometabolism in HCC patients,but the data of fructosamine reflect the degree of glycosylation of HCC tumor cells.

Serum level changes of Toll-like receptor 3,Toll-like receptor 4,fructosamine and glycosylated hemoglobin and the significance in predicting restenosis and re-occlusion after coronary stenting in aged patients with old myocardial infarction / 中华老年医学杂志

Objectives To study the predictive value of Toll-like receptors 3,4(TLR3,TLR4),fructosamine(FMN)and glycated hemoglobin A1c(HbA1c)in the in-stent restenosis and re-occlusion after primary percutaneous coronary intervention(PCI)in patients aged 70-85 years with old myocardial infarction.Methods 51 patients aged 70-85 years with in-stent restenosis after primary PCI from Jan 2007 to Sep 2016 were selected.Serum level changes in TLR3,TLR4 were detected by flow cytometry.The levels of FMN and HbA1c were tested by colorimetric endpoint reaction and high-pressure liquid chromatography respectively.Results The levels of TLR3,TLR4,FMN and HbA1c were gradually elevated along with the increases of artery numbers(0,1,2,>2)and percentage(0%,70-89%,90-99%,100%)of in-stent restenosis,LVEF(%)decrease and NYHA(Ⅰ,Ⅱ,Ⅲ,Ⅳ)increase(all P2)of in-stent restenosis in TLR3,and group of percentage(0%,70-89%,90-99%,100%)in the in-stent restenosis in TLR4,group of LVEF(%)in FMN,and group of NYHAⅠ,Ⅱ,Ⅲ,Ⅳ in HbA1c(%)(all P2)groups were(7.6±0.5),(18.9±0.6),(32.0±0.9),(51.3±0.8),respectively(all P<0.01).The levels of TLR4(%)in the in-stent restenosis percentage(0%,70-89%,90-99%,100%)groups were(10.5±7.0),(20.1±7.2),(33.3±9.7),(69.0±11.3%)respectively(all P<0.01).The levels of FMN(mmol/L)in LVEF[(49~59%),(37~48%),(25~36%)]groups were(0.6±0.4),(9.4±0.6),(18.1±0.8),respectively(all P<0.01).And the level of HbA1c(%)in groups of NYHA Ⅰ,NYHA Ⅱ,NYHA Ⅲ,NYHA Ⅳ were(6.1±0.4),(5.9±0.6),(8.9±0.9),(12.0±0.8),respectively(all P<0.01).Conclusions Serum level changes in TLR3,TLR4,FMN and HbA1c may become the new indicators to forecast the degree of in-stent restenosis in very old patients with old myocardial infarction after primary coronary intervention.

Correlação das dosagens de frutosamina e de hemoglobina glicosilada com o perfil glicêmico em gestantes com diabetes mellitus / Correlation of the Levels of Fructosamine and Glycated Hemoglobin with the Blood Glucose Profile in Pregnant Women with Diabetes Mellitus

Objetivo Avaliar se há correlação das dosagens de frutosamina e de hemoglobina glicosilada (HbA1c) com as frequências de desvios de glicemia capilar em gestantes com diabetes mellitus. Métodos estudo observacional, retrospectivo, de corte transversal, incluindo todas as gestantes comdiabetes que iniciaram o pré-natal emhospital terciário de ensino durante o ano de 2014 e que apresentavam pelo menos 20 dias de auto monitoramento glicêmico previamente às dosagens séricas de frutosamina e de HbA1c. Os desvios de glicemia capilar foram considerados "hipoglicemias" quando menores que 70mg/dL ou "hiperglicemias" quando acima do alvo glicêmico terapêutico para o horário. Foram testadas as correlações lineares par a par das dosagens de frutosamina e de HbA1c com as frequências de hipoglicemias e de hiperglicemias capilares pelo teste Tau-b de Kendall. Na sequência, foi avaliada a regressão linear entre as dosagens de HbA1c e de frutosamina e as frequências de hipoglicemias e de hiperglicemias. Resultados Foram incluídas 158 gestantes que contribuíram com 266 amostras para dosagem sérica de frutosamina e HbA1c. As dosagens de frutosamina e de HbA1c apresentaram, respectivamente, coeficientes τ de Kendall de 0,29 (p < 0,001) e 0,5 (p < 0,001) com a frequência de hiperglicemias, e de 0,09 (p = 0,04) e 0,25 (p < 0,001) com a frequência de hipoglicemias capilares. No modelo de regressão linear, as dosagens de frutosamina e de HbA1c apresentaram, respectivamente, coeficientes de determinação R2 = 0,26 (p < 0,001) e R2 = 0,51 (p < 0,001) para a predição de hiperglicemias, e R2 = 0,03 (p = 0,003) e R2 = 0,059 (p < 0,001) para a predição de hipoglicemias. Conclusão As dosagens de frutosamina e de HbA1c apresentam correlação fraca a moderada com as frequências de hiperglicemias e hipoglicemias capilares no auto monitoramento glicêmico e não são capazes de traduzir com precisão os desvios da meta glicêmica no tratamento de gestantes com diabetes.

Objective To evaluate the correlation of the levels of fructosamine and of glycated hemoglobin (HbA1c) with the frequency of blood glucose self-monitoring values out of the treatment target range in pregnant women with diabetes mellitus. Methods We performed an observational, retrospective, cross-sectional study, including all pregnant women with diabetes who attended prenatal care visits at a tertiary teaching hospital during the year of 2014 and who presented at least 20 days of blood glucose self-monitoring prior to assessment of serum levels of fructosamine and HbA1c. Capillary blood glucose values out of the treatment target range were considered "hypoglycemia" when lower than 70 mg/dL and "hyperglycemia" when above the glycemic therapeutic target. We evaluated the correlation of the levels of fructosamine and of HbA1c with the frequencies of hyperglycemia and hypoglycemia recorded in the glucometer device by performing Tau-b of Kendall correlation tests. Next, linear regression tests were performed between the levels of HbA1c and of fructosamine and the frequencies of hypoglycemia and hyperglycemia. Results We included 158 pregnant women, from whom 266 blood samples were obtained for assessing fructosamine and HbA1c levels. Measurements of fructosamine and of HbA1c presented, respectively, Kendall's τ coefficient of 0.29 (p < 0.001) and 0.50 (p < 0.001) regarding the frequency of hyperglycemia, and of 0.09 (p = 0.046) and 0.25 (p < 0.001) regarding the frequency of hypoglycemia. In the linear regression model, levels of fructosamine and of HbA1c respectively presented determination coefficients R2 = 0.265 (p < 0.001) and R2 = 0.513 (p < 0.001) for the prediction of hyperglycemia, and R2 = 0.033 (p = 0.003) and R2 = 0.059 (p < 0.001) for the prediction of hypoglycemia. Conclusion Levels of fructosamine and of HbA1c presented a weak to moderate correlation with the frequencies of hyperglycemia and hypoglycemia at blood glucose self-monitoring and were not able to accurately translate the deviations from the glycemic goals in pregnant women with diabetes.

Effects of Chinese Herbal Compounds on Levels of Blood Glucose, Froctosamine and Insulin of Diabetic Rats / 中国中医药信息杂志

Objective To observe the effects of Chinese herbal compounds (alkaloid of Coptidis Rhizoma 40%, total saponin of panax notoginseng 35%, and polysaccharide of Ophiopogonis Radix 25%) on levels of blood glucose, fructosamine, and insulin of diabetic rats, and explore mechanism of action.Methods Ten rats were randomly chosen as blank control group, and other rats were used to establish diabetic rat models by STZ intraperitoneal injection. Successfully molding rats were randomly divided into Chinese herbal compounds high, medium, low dose groups, metformin group, and model group, 10 rats in each group. Each rat received gavage for continuous 4 weeks. Then rat blood was collected by cutting head and taking caudal vein. FBG was detected by glucose oxidase method;insulin level was detected by radio-immunity double antibody method;fructosamine content was detected by fructosamine method.Results Compared with the blank control group, model group the levels of FBG, froctosamine content increased, while fasting insulin level were lower after 4 weeks'medication. Compared with the model group, the levels of FBG, froctosamine content in Chinese herbal compounds high and medium dose groups and metformin group were lower, while fasting insulin level increased after 4 weeks'medication (P<0.05).Conclusion TCM herbal compounds can increased the basic insulin level by decreasing the contents of FBG and fructosamine.

Clinical usefulness of the measurement of serum fructosamine in childhood diabetes mellitus

PURPOSE: Glycosylated hemoglobin (HbA1c) is often used as an indicator of glucose control. It usually reflects the average glucose levels over two to three months, and is correlated with the development of long-term diabetic complications. However, it can vary in cases of hemoglobinopathy or an altered red blood cell lifespan. The serum fructosamine levels reflect the mean glucose levels over two to three weeks. This study was designed to determine the clinical usefulness of the combined measurement of serum fructosamine and HbA1c in the management of childhood diabetes mellitus and the correlation between them. METHODS: Clinical data on 74 Korean children and adolescents with diabetes mellitus who were under management at the Department of Pediatrics of Dankook University Hospital were evaluated. Their fructosamine and HbA1c levels were reviewed based on clinical information, and analyzed using IBM SPSS Statistics ver. 21. RESULTS: Their HbA1c levels showed a strong correlation with their fructosamine levels (r=0.868, P<0.001). The fructosamine level was useful for the prompt evaluation of the recent therapeutic efficacy after the change in therapeutic modality. It was also profitable in determining the initial therapeutics and for the estimation of the onset of the disease, such as fulminant diabetes. CONCLUSION: The measurement of both fructosamine and HbA1c was useful in managing childhood diabetes mellitus, especially when there was discrepancy between the clinical information and the HbA1c level.

Alternative biomarkers for assessing glycemic control in diabetes: fructosamine, glycated albumin, and 1,5-anhydroglucitol

The growing attention to alternative glycemic biomarkers including fructosamine, glycated albumin (GA), 1,5-anhydroglucitol (1,5-AG), is attributable to the limitations of the glycated hemoglobin (HbA1c) assay. It is important to recognize the conditions in which HbA1c levels may be difficult to interpret. Serum fructosamine and GA have been proposed useful tools for monitoring of short-term glycemic control. These biomarkers not only reflect well glycemic control in hematologic disorder, but also represent postprandial glucose fluctuation. Serum 1,5-AG may be useful for estimating within-day glucose variation. Use of these nontraditional tests can be more helpful in the management of diabetes as complement traditional measures. Further larger cohort studies are warranted to determine whether nontraditional biomarkers have potential utility for early diagnosis, management of diabetes, and prevention of diabetic complications.

Avaliação da frutosamina como parâmetro de controle glicêmico na gestante diabética / Evaluation of fructosamine as a parameter of blood glucose control in diabetic pregnant women

Objetivo Avaliar parâmetros alternativos para monitorar a glicemia em portadoras de diabetes na gestação estudando a relação entre a frutosamina e a automonitoração em gestantes portadoras de diabetes. Materiais e métodos: A frutosamina sérica e os parâmetros da automonitoração nos 14 dias que antecederam a coleta da frutosamina foram avaliados em 47 gestantes portadoras de diabetes. Resultados Setenta e uma determinações de frutosamina e 2.238 glicemias capilares (GCs) foram analisadas. A frutosamina correlacionou-se com o índice de excursões hiperglicêmicas (HBGI) e o desvio-padrão das glicemias (r = 0,28; p = 0,021 e r = 0,26; p = 0,03, respectivamente). A comparação entre as mães dos neonatos com peso adequado ou grandes ao nascer com as genitoras que tiveram neonatos pequenos para a idade gestacional (PIG) revelou que estas tiveram menor média glicêmica (105 vs. 114 e 119 mg/dL), maior índice de excursões hipoglicêmicas (5,8 vs. 1,3 e 0,7) e maior percentual de hipoglicemias (11 vs. 0 e 0%) mesmo com frutosamina dentro dos valores de referência (242 vs. 218 e 213 μmol/l). Conclusão A frutosamina pode ser utilizada como parâmetro auxiliar à automonitoração para avaliação de hiperglicemias e variabilidade glicêmica, entretanto pode subestimar hipoglicemias em gestantes com fetos PIG. .

Objective To evaluate the alternative parameters to monitor glycemia in pregnant women with diabetes studying the relationship between fructosamine testing and self monitoring of blood glucose in pregnant women with diabetes. Materials and methods Serum fructosamine levels and the self monitoring of blood glucose over 14 days before the collection of fructosamine were evaluated in 47 diabetic pregnant women. Results Seventy-one fructosamine levels and 2,238 glucose measurements (CGs) were analysed. Levels of fructosamine correlated with high blood glucose index (HBGI) and the standard deviation of glycemias (r = 0.28; p = 0.021 and r = 0.26; p = 0.03, respectively). The comparison between the mothers of the newborns with appropriated or large birthweight and those who gave birth to small newborns for their gestational age (SGA) showed that the latter had a lower glycemic mean (105 vs. 114 and 119 mg/dL), a higher low blood glucose index (5.8 vs. 1.3 and 0.7) and a higher percentage of hyperglycemias (11 vs. 0 and 0%) even when the fructosamine falls within the reference values (242 vs. 218 and 213 μmol/l). Conclusion The levels of fructosamine can be used as further parameter to aid self monitoring of blood glucose to evaluate hyperglycemias and glycemic variability, however, this can underestimate hypoglycemias in pregnant women carrying small-for-gestational age fetuses. .

The analysis ofβ-lactam antibiotics interference in fructosamine testing / 国际检验医学杂志

Objective To evaluate the interference of 13 kinds of β‐lactam antibiotics in fructosamine detection .Methods A se‐ries of solution of antimicrobial drugs were formulated with water for injection ,and added into the mixture fresh serum volume by 5% .Interfere with antimicrobial drugs on the test results of fructosamine were evaluated .Results When the blood concentrations of cefathiamidine and ticarcillin sodium/clavulanate potassium were up to 37 .5 mg/L and 247 .5 μg/mL respectively ,they began to produce positive interference on fructosamine detection .However ,the degree of interference was not correlated to the serum concen‐tration of fructosamine .Conclusion Cephathiamidine and ticarcillin sodium/clavulanate potassium have positive interference on fructosamine detection .

Estudio del control metabólico en pacientes diabéticos en hemodiálisis crónica: hemoglobina glicosilada, fructosamina y glicemias capilares / Study of metabolic control in diabetic patients on chronic hemodialysis: glycated hemoglobin, fructosamine and capillary glycemia

Background: In conditions that may change red blood cell survival, such as hemodialysis, the accuracy of A1c glycosylated hemoglobin (HbA1c) to assess metabolic control can be hampered. Other glycosylated proteins such as fructosamine, could accomplish the role of HbA1c. Aim: To assess if HbA1c is a good metabolic control parameter in diabetic patients on chronic hemodialysis. To compare fructosamine, HbA1c and serial capillary glucose levels in the same patients. Material and Methods: Patients on hemodialysis three times per week were studied. Twenty one subjects with diabetes mellitus and 10 non-diabetic patients were included (70 percent were male). During a period of 14 days, fasting and post prandial capillary glucose levels were measured. Venous glucose, HbA1c and fructosamine were measured at the onset and completion of the monitoring period. Results: Diabetic patients were older than their non-diabetic counterparts (65 and 47 years respectively, p < 0.04). In diabetic and non-diabetic patients respectively, capillary blood glucose levels were 161 +/- 22 and 104 +/- 51 mg/dl, HbA1c levels were 6.8 +/- 1.2 and 5.4 +/- 0.4 percent and fructosamine levels were 282.0 +/- 126.6 and 154.6 +/- 73 umol/L. In all patients there was a positive correlation between blood glucose, HbA1c (r = 0.78 p < 0.01) and fructosamine (r = 0.52, p 0.02). There was a positive correlation between mean capillary glucose, HbA1c (r = 0.77, p < 0.01) and fructosamine (r = 0.69, p < 0.02). Among diabetic patients, the correlation coefficients between mean capillary glucose levels, HbA1c and fructosamine levels were 0.67 (p < 0.01) and 0.51 (NS), respectively. Conclusions: Among diabetic patients on hemodialysis fructosamine levels are not a better indicator of metabolic control than HbA1c.

Utilidad de la medición de fructosamina como indicador de control en pacientes con diabetes gestacional y pregestacional / Plasma fructosamine to evaluate metabolic control among women with gestational diabetes

Background: Metabolic control of diabetic pregnant women is assessed using glycated hemoglobin (HbAlc) levels and fasting blood sugar. Another glycated protein, namely fructosamine, can be an indicator of average glucose levels during the last three weeks. Aim: To evaluate plasma fructosamine as an indicator of glycemic control in women with gestational diabetes. Patients and Methods: Prospective cohort study of 41 pregnant women aged 30 to 37 years, with gestational and pre-gestational diabetes. Blood glucose, HbAlc, fructosamine were measured. Newborn weight, and other prenatal and postnatal variables, were used to evaluate the correlation between metabolic control and the presence or absence of macrosomia. Results: The correlation observed between fructosamine and fasting blood glucose (r = 0.627, p < 0.001) was superior to that of HbA1c and blood glucose (r = 0.516, p < 0.001). No association was observed between macrosomia and levels of fructosamine, nor between the other studied variables. Conclusions: Fructosamine levels were not associated with macrosomia, but it could be better for the evaluation of glycemic control in patients with gestational diabetes since it allows short-term monitoring.

Rastreamento de cardiopatias congênitas associadas ao diabetes mellitus por meio da concentração plasmática materna de frutosamina / Congenital cardiopathies screening associated with diabetes mellitus using maternal fructosamine plasma concentration

OBJETIVO: avaliar a importância da concentração plasmática materna de frutosamina como indicador de cardiopatias congênitas fetais, em gestações complicadas pelo diabetes mellitus. MÉTODOS: o estudo retrospectivo incluiu 91 gestantes portadoras de diabetes mellitus, as quais foram submetidas à ecocardiografia fetal de rotina em centro universitário de referência em Medicina Fetal. Foram selecionadas 65 pacientes que apresentavam diabete pré-gestacional e registro em prontuário médico de frutosamina plasmática anterior ao exame ultrassonográfico. A primeira dosagem registrada foi confrontada com o resultado da ecocardiografia fetal de rotina, realizada por médico especialista do serviço. A presença ou ausência de achados ecográficos de cardiopatia congênita (AECC) foi relacionada aos níveis plasmáticos de frutosamina, por meio de teste de médias, e sua acuidade para AECC verificada por curva ROC. Foram discutidos como pontos de corte os valores da concentração plasmática materna de frutosamina de 2,68, 2,9 e 2,23 mmol/L, que são, respectivamente, o valor de referência local do laboratório, o do kit de dosagem empregado e o de maior acurácia global. RESULTADOS: o AECC foi encontrado em 52,3 por cento dos fetos. A primeira dosagem de frutosamina durante o pré-natal aconteceu em média com 20,4±8,0 semanas de gestação. A capacidade da concentração materna de frutosamina em identificar fetos com AECC foi significante (p<0,0001) e apresentou área sob a curva ROC de 0,78 (IC95 por cento=0,66-0,89). A concentração plasmática de frutosamina de 2,9 mmol/L apontou AECC com maior especificidade e, porém, com maior porcentual de falso-negativo (96,8 e 55,9 por cento). Valores acima de 2,68 mmol/L associam-se à probabilidade de 4,6 em identificar fetos com AECC em relação a valores inferiores, com sensibilidade de 58,8 por cento e especificidade de 87,1 por cento. O valor de 2,23 mmol/L mostrou-se de maior acurácia global entre os três pontos sugeridos, ...

PURPOSE: to evaluate the importance of maternal plasma concentration of fructosamine as an indicator of fetal congenital cardiopathies in pregnancies complicated by diabetes mellitus. METHODS: this was a retrospective study conducted on 91 pregnant women with diabetes mellitus who underwent routine fetal echocardiography at a university reference center in fetal medicine. Sixty-five patientes who presented pre-gestational diabetes mellitus and plasma fructosamine level were registered in the medical records prior to the ultrasound exam. The first measurement recorded was compared with the result of routine fetal echocardiography, carried out by a specialist physician of the service. The presence or absence of echocardiographic findings of congenital cardiopathies (EFCC) was related to plasma levels of fructosamine by the mean t-test and its accuracy for EFCC was verified by the ROC curve. Plsama fructosamine concentrations of 2.68, 2.9 and 2.23 mmol/L, which are, respectively, the local reference laboratory values, the value of the kit employed for measurement and the one of highest overall accuracy, were discussed as the cut-off values. RESULTS: EFCC was found in 52.3 percent of the fetuses. The first measurement of fructosamine, during the prenatal care period, was performed, on average, at 20.4±8.0 weeks of pregnancy. The maternal concentration ability of the fructosamine to identify fetuses with EFCC was significant (p<0.0001) and had an area under the ROC curve of 0.78 (95 percentCI=0.66-0.89). The 2.9 mmol/L plasma concentration of fructosamine revealed EFCC with better specificity, but with a higher percentage of false-negative results (96.8 and 55.9 percent). Values above 2.68 mmol/L were associated with a probability of 4.6 to identify fetuses with EFCC compared with lower values, with 58.8 percent of sensitivity and 87.1 percent, specificity. The value of 2.23 mmol/L proved to be the most overall accurate of the three values ...

Elevated fructosamine concentrations caused by IgA paraproteinemia in two dogs

An 8-year-old male Austrian Pinscher and a 14-year-old male Golden Retriever were presented for evaluation due to unexplainable high fructosamine values despite euglycemia and epistaxis in combination with polydipsia/polyuria, respectively. Blood analysis revealed severe hyperglobulinemia, hypoalbuminemia and markedly elevated fructosamine concentrations in both dogs. Multiple myeloma with IgA-monoclonal gammopathy was diagnosed by serum and urine electrophoresis including immunodetection with an anti-dog IgA antibody and bone marrow aspirations. Diabetes mellitus was excluded by repeated plasma and urine glucose measurements. Fructosamine values were positively correlated with globulin, but negatively correlated with albumin concentrations. These cases suggest that, as in human patients, monoclonal IgA gammopathy should be considered as a possible differential diagnosis for dogs with high fructosamine concentrations.

Comparative study of NBT reduction method for estimation of glycated protein (serum fructoseamine) with glycated hba1c estimated on DCA 2000+analyzer (immunoagglutination inhibition).

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.

Correlation between molecular weight of plasma albumin determined with mass spectrometry and glycation indices in factory workers

<p><b>OBJECTIVES</b>To determine the difference in molecular weights of albumin in factory workers caused by non-enzymatic glycation of plasma albumin using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI TOF/MS), and examine the epidemiological validity of this method.</p><p><b>METHODS</b>Forty-eight male workers were tested by random sampling. The difference in molecular weights (ΔM) between the subjects' albumin and human serum albumin was determined by MALDI TOF/MS. Correlations between ΔM vs. fructosamine, fasting plasma glucose (FPG) and HbAlc were investigated.</p><p><b>RESULTS</b>ΔM showed a significant correlation with all of the tested glycation indices (ΔM vs. fructosamine: r=0.487, p<0.001) (ΔM vs. FPG: r=0.482, p<0.01) (ΔM vs. HbAlc: r=0.397, p<0.01).</p><p><b>CONCLUSIONS</b>Since a significant correlation between ΔM and the glycation indices was found in this investigation, further study with a larger number of subjects is needed for use in clinical applications.</p>

Correlation between Molecular Weight of Plasma Albumin Determined with Mass Spectrometry and Glycation Indices in Factory Workers

Objectives: To determine the difference in molecular weights of albumin in factory workers caused by non-enzymatic glycation of plasma albumin using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI TOF/MS), and examine the epidemiological validity of this method. Methods: Forty-eight male workers were tested by random sampling. The difference in molecular weights (ΔM) between the subjects’ albumin and human serum albumin was determined by MALDI TOF/MS. Correlations between ΔM vs. fructosamine, fasting plasma glucose (FPG) and HbA1c were investigated. Results: ΔM showed a significant correlation with all of the tested glycation indices (ΔM vs. fructosamine: r=0.487, p<0.001) (ΔM vs. FPG: r=0.482, p<0.01) (ΔM vs. HbA1c: r=0.397, p<0.01). Conclusions: Since a significant correlation between ΔM and the glycation indices was found in this investigation, further study with a larger number of subjects is needed for use in clinical applications.