Is examination of fructosamine levels valuable as a diagnostic test for diabetes mellitus?
In order to develop a simple, one-point diagnostic test for diabetes mellitus in a mass population surveys, we measured levels of fructosamine (FRA), one of the glycated proteins. Seven hundred and thirty-eight people had their levels of fasting plasma glucose (FPG), FRA and hemoglobin A1c (HbA1c) examined before taking 75 g oral glucose tolerance tests (OGTT). The results of OGTT distinguished a diabetic group (DM) of 143 from a non-diabetic group (non-DM) of 595 subjects. Since there was a significant correlation between FRA levels and plasma glucose levels 2 h after OGTT (PG-2h), as well as between FPG and PG-2h, a discriminant analysis using FPG and FRA was carried out in order to separate the DM group from the non-DM group. According to this analysis, a positive f, where f = FPG-(mg/dl) + 12.0 FRA(mmol/l) - 150, would determine a subject to be a diabetic. However, the sensitivity of this analysis was only 0.521. It can be concluded that the sensitivity of a simple, one-point determination for diabetes mellitus using measured levels of FRA was insufficient, even by application of discriminant analysis, and that the OGTT is still needed for a diagnostic test for diabetes mellitus in mass population surveys.
Sekikawa
A
A
Third Department of Internal Medicine, Yamagata University School of Medicine, Japan.
Tominaga
M
M
Takahashi
K
K
Watanabe
H
H
Miyazawa
K
K
Sasaki
H
H
D015415:Biomarkers / Q000097:blood*; D001786:Blood Glucose / Q000032:analysis; D003920:Diabetes Mellitus / Q000097:blood / Q000175:diagnosis* / Q000517:prevention & control; D019270:Fructosamine; D005951:Glucose Tolerance Test; D006442:Glycated Hemoglobin / Q000032:analysis; D006595:Hexosamines / Q000097:blood*; D006801:Humans; D007564:Japan; D008403:Mass Screening
D015415:Biomarkers; D001786:Blood Glucose; D019270:Fructosamine; D006442:Glycated Hemoglobin; D006595:Hexosamines