A comparison of direct measures of glycaemia and glycated blood proteins in insulin-dependent diabetes mellitus.
We have studied associations between various direct measures of glycaemia and glycated blood proteins in 113 subjects with insulin-dependent diabetes mellitus (IDDM), and examined whether or not the 'fructosamine' assay results were affected by differing patient serum concentrations of lipids, albumin or C peptide. Serum fructosamine correlated less closely with HbA1 (r = 0.44) than did HbA1 with glycated serum albumin (GSA) (r = 0.68). Serum fructosamine and GSA also were poorly correlated (r = 0.48). Although fructosamine, HbA1 and GSA correlated to a similar degree with fasting blood glucose (r range 0.34 to 0.37), GSA was most closely related to mean blood glucose (r = 0.39 vs. 0.30-0.35) and the M value (a marker of diurnal glycaemic instability) (r = 0.42 vs. 0.33-0.35). The serum concentration of fructosamine was not significantly affected by a variation in serum cholesterol, but tended to be lower in subjects with moderate hypertriglyceridaemia (p = 0.05). The fructosamine assay may be altered by moderately lipaemic serum but is not affected by serum albumin concentration in normoalbuminaemic patients with IDDM. Our study indicates, however, that GSA is a more reliable marker of short-term glycaemic control in IDDM than fructosamine.
Winocour
P H
PH
Department of Medicine, University of Manchester, Hope Hospital, Salford, UK.
Bhatnagar
D
D
Kalsi
P
P
Hillier
V F
VF
Anderson
D C
DC
D000293:Adolescent; D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism*; D001798:Blood Proteins / Q000378:metabolism*; D002096:C-Peptide / Q000097:blood; D003922:Diabetes Mellitus, Type 1 / Q000097:blood*; D005260:Female; D019270:Fructosamine; D017127:Glycation End Products, Advanced; D006023:Glycoproteins; D006031:Glycosylation; D006595:Hexosamines / Q000097:blood; D006801:Humans; D015228:Hypertriglyceridemia / Q000097:blood; D007328:Insulin / Q000097:blood; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D012709:Serum Albumin / Q000378:metabolism; D000093422:Glycated Serum Proteins; D000093423:Glycated Serum Albumin
D001786:Blood Glucose; D001798:Blood Proteins; D002096:C-Peptide; D017127:Glycation End Products, Advanced; D006023:Glycoproteins; D006595:Hexosamines; D007328:Insulin; D008055:Lipids; D012709:Serum Albumin; D019270:Fructosamine; D000093422:Glycated Serum Proteins; D000093423:Glycated Serum Albumin