title: Clinical validation of a second-generation fructosamine assay.
abstract: The serum fructosamine assay, used to monitor short-term clinical glycemic control, reportedly has several technical drawbacks. However, technical improvements have resulted in a new second-generation assay of fructosamine. We evaluated this second-generation assay (from Roche Diagnostics) in 529 nondiabetic and diabetic patients and found a highly significant correlation with results of the first-generation assay (r = 0.91, P less than 0.001). Use of the second-generation assay with samples from patients classified on the basis of glycemic control according to their glycohemoglobin (GHb) values, enabled us to discriminate between the nondiabetics, diabetics with "good/moderate" control (i.e., GHb less than 10%), and diabetics with "poor" control (GHb greater than or equal to 10%). We evaluated the validity of the second-generation assay to assess short-term glycemic control in 23 non-insulin-dependent diabetic patients who participated for 10 weeks in an intensive intervention program designed to rapidly normalize the clinical glycemic profile. Results correlated significantly with the one-week average capillary blood glucose concentration (CBG) and with the three-week average CBG in all 23 patients. In addition, the second-generation fructosamine assay results demonstrated a significant decrease at each week of study, as did the average CBG. Results of the first- and second-generation assays correlated significantly at each week of study. GHb correlated significantly with both the second- (r = 0.78, P less than 0.001) and first-generation fructosamine assay results (r = 0.77, P less than 0.001) for the baseline blood samples of the intervention study, but this correlation decreased (to r = 0.35, P = 0.09 and r = 0.34, P = 0.09, respectively) by the conclusion of the study.
authors.affiliation: Department of Medicine, Bowman Gray School of Medicine, Winston-Salem, NC 27103.
authors.forename: W T
authors.initials: WT
authors.lastname: Cefalu
authors.forename: A D
authors.initials: AD
authors.lastname: Bell-Farrow
authors.forename: M
authors.initials: M
authors.lastname: Petty
authors.forename: C
authors.initials: C
authors.lastname: Izlar
authors.forename: J A
authors.initials: JA
authors.lastname: Smith
mesh_terms: D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D003124:Colorimetry / Q000379:methods*; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000097:blood; D005260:Female; D019270:Fructosamine; D006595:Hexosamines / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results
chemical_list: D001786:Blood Glucose; D006595:Hexosamines; D019270:Fructosamine