Glycation of fibrinogen in uncontrolled diabetic patients and the effects of glycaemic control on fibrinogen glycation.
BACKGROUND
Evidence exists for a relationship between glycaemic control and macrovascular disease. Non-enzymatic glycation of proteins may explain this relationship in part. We investigated the effect of blood glucose control, under out-patient conditions, on fibrinogen glycation as well as the relationship between glycated fibrinogen and glycaemic control using a new sensitive method for the measurement of glycated fibrinogen.


METHODS
Blood samples were taken from twenty subjects with uncontrolled Type 2 diabetes (HbA1c>7%) to determine the levels of glycation. The subjects were then treated with insulin in order to control blood glucose. Twenty age and BMI matched non-diabetic subjects were included as a reference group.


RESULTS
The subjects with diabetes had significantly higher mean fibrinogen glycation at baseline than the non-diabetic subjects (7.84 vs 3.89 mol glucose/mol fibrinogen; p<0.001). After control of blood glucose, fibrinogen glycation was reduced significantly in the subjects with diabetes (7.84 to 5.24 mol glucose/mol fibrinogen; p<0.0002). The change in glycation during the intervention correlated significantly with the change in capillary glucose in the diabetic group (r=0.6, p=0.005). Fibrinogen glycation was comparable to HbA1c in predicting glycaemic control (p=0.54). Fibrinogen glycation correlated best with the average fasting capillary glucose of the preceding 5-8 days (r=0.54, p=0.014).


CONCLUSIONS
We conclude that glucose control under out-patient conditions decreases fibrinogen glycation in subjects with Type 2 diabetes and that glycated fibrinogen compares well with HbA1c in its relation to glycaemic control.
Pieters
Marlien
M
School of Physiology, Nutrition and Consumer Science, Department of Nutrition, North-West University, Potchefstroom Campus, Potchefstroom, South Africa. vgemp@puk.ac.za
van Zyl
Danie G
DG
Rheeder
Paul
P
Jerling
Johann C
JC
Loots
Du Toit
du T
van der Westhuizen
Francois H
FH
Gottsche
Louise T
LT
Weisel
John W
JW
D000328:Adult; D044383:Black People; D001786:Blood Glucose / Q000032:analysis / Q000378:metabolism*; D016022:Case-Control Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood*; D005260:Female; D005340:Fibrinogen / Q000378:metabolism*; D006442:Glycated Hemoglobin / Q000378:metabolism; D006031:Glycosylation; D006801:Humans; D007328:Insulin / Q000008:administration & dosage* / Q000494:pharmacology; D008297:Male; D008875:Middle Aged
D001786:Blood Glucose; D005340:Fibrinogen; D006442:Glycated Hemoglobin; D007328:Insulin