Perspective: measurement of circulating glycated proteins to monitor intermediate-term changes in glycaemic control.
The effective clinical management of diabetes requires accurate means to measure and monitor prevailing blood glucose concentrations. This can be accomplished with regular home glucose monitoring and periodic measurement of indicators that reflect ambient glycaemia during defined temporal intervals. The amount of glycated haemoglobin provides an index of integrated long-term glycaemia, whereas the amount of glycated albumin provides an index of short to intermediate term integrated glycaemic control. However, there is confusion regarding the various methods for estimation of glycated serum or plasma proteins, in part because the different methods use different reaction principles, measure different substances, and express results in different units. This article reviews the principles underlying different assays for measurement of glycated albumin and glycated serum proteins, compares their ranges of values, and discusses their clinical relevance assessed by studies published in the recent medical literature. The methods evaluated include commercially available assays for measuring glycated albumin with monoclonal antibodies and with affinity chromatography (including HPLC), and the fructosamine assay for glycated serum proteins.
Cohen
M P
MP
University City Science Center, Philadelphia, PA.
D000911:Antibodies, Monoclonal; D001786:Blood Glucose / Q000032:analysis*; D001798:Blood Proteins / Q000032:analysis*; D002846:Chromatography, Affinity; D002851:Chromatography, High Pressure Liquid; D003920:Diabetes Mellitus / Q000097:blood*; D004587:Electrophoresis, Agar Gel; D019270:Fructosamine; D017127:Glycation End Products, Advanced; D006031:Glycosylation; D006595:Hexosamines / Q000032:analysis*; D006801:Humans; D012709:Serum Albumin / Q000032:analysis*; D000093423:Glycated Serum Albumin
D000911:Antibodies, Monoclonal; D001786:Blood Glucose; D001798:Blood Proteins; D017127:Glycation End Products, Advanced; D006595:Hexosamines; D012709:Serum Albumin; D019270:Fructosamine; D000093423:Glycated Serum Albumin