The role of serum fructosamine as a screening test for gestational diabetes mellitus.
The serum fructosamine concentration indicates the degree of glycation of serum proteins, particularly albumin, and reflects an average blood glucose level over the previous 1-3 weeks. Serum fructosamine, glycated haemoglobin (HbA1c), total serum protein, serum albumin, fasting plasma glucose and oral glucose tolerance test (OGTT) have been measured in 127 healthy control subjects, 102 type 1 and 152 type 2 diabetes mellitus patients and 106 nondiabetic pregnant women. Fructosamine concentration of 2.24 +/- 0.16 and 3.21 +/- 0.41 mmol/l (mean +/- S.D.) has been found in control subjects and diabetics respectively (P less than 0.001). During the second trimester a significantly lower fructosamine level (1.92 +/- 0.21 mmol/l) has been found in pregnant women, most likely due to the low serum albumin concentration (31.35 +/- 3.97 g/l). None of them had a fructosamine level above the normal limit of 2.55 mmol/l. On the other hand, 12 pregnant women showed a disturbed OGTT with normal fructosamine. If the serum fructosamine concentration was adjusted for 40 g/l albumin, then a mean fructosamine of 2.16 +/- 0.24 mmol/l was found in patients with gestational diabetes. Our results show that serum fructosamine has a similar diagnostic value as HbA1c for non-pregnant adults, but neither can replace OGTT for the diagnosis of gestational diabetes.
Vermes
I
I
Department of Clinical Chemistry, H. d. K. Hospital, Oldenzaal, The Netherlands.
Zeyen
L J
LJ
van Roon
E
E
Brandts
H
H
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D019270:Fructosamine; D005951:Glucose Tolerance Test; D006595:Hexosamines / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011247:Pregnancy; D011254:Pregnancy in Diabetics / Q000175:diagnosis*
D006595:Hexosamines; D019270:Fructosamine