Clinical usefulness of estimation of serum fructosamine concentration as screening test for gestational diabetes.
Serum fructosamine levels and fructosamine/protein ratios were measured in 100 pregnant women who underwent glucose tolerance tests because of clinical risk. Compared with normal pregnant women, the 13 study participants with gestational diabetes had higher fructosamine/protein levels (39 +/- 3.9 mumol/gm versus 37 +/- 3.2 mumol/gm, p less than 0.05), fasting serum glucose levels (107 +/- 13.7 mg/dl versus 82 +/- 8.6 mg/dl, p less than 0.001), and area under curve of glucose tolerance test (36 +/- 5 gm x min x dl-1 versus 22 +/- 3.6 gm x min x dl-1, p less than 0.001). The serum fructosamine levels were not significantly different between the two groups of participants (2.3 +/- 0.26 mmol/L versus 2.2 +/- 0.17 mmol/L); 10 of the 13 women with diabetes had a fructosamine/protein ratio within 2 SD of the mean of the groups of normal pregnant women. Spontaneous caloric intakes (r = 0.72, p less than 0.005) and the hospital mean daily capillary glucose levels during diabetic diet (r = 0.72, p less than 0.005) correlated better with the fructosamine/protein ratio than with fasting serum glucose levels (r = 0.58, p less than 0.05) and area under curve (r = 0.57, p less than 0.05). Consequently, serum fructosamine and fructosamine/protein ratio levels should be considered insensitive as a screening test in pregnant patients with clinical risk of gestational diabetes.
Comtois
R
R
Department of Medicine, Notre-Dame Hospital, University of Montreal, Quebec, Canada.
Desjarlais
F
F
Nguyen
M
M
Beauregard
H
H
D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D001798:Blood Proteins / Q000032:analysis; D005260:Female; D019270:Fructosamine; D005951:Glucose Tolerance Test; D006595:Hexosamines / Q000097:blood*; D006801:Humans; D009994:Osmolar Concentration; D011247:Pregnancy; D011254:Pregnancy in Diabetics / Q000097:blood / Q000175:diagnosis*
D001786:Blood Glucose; D001798:Blood Proteins; D006595:Hexosamines; D019270:Fructosamine