title: Clinical and forensic examinations of glycemic marker 1,5-anhydroglucitol by means of high performance liquid chromatography tandem mass spectrometry.
abstract: Postmortem diagnosis of diabetes and a diabetic coma can be difficult because of the lack of characteristic morphological findings. 1,5-Anhydroglucitol (1,5-AG), the 1-deoxy form of glucose, competes with glucose for reabsorption in the kidneys. Therefore, diabetics with a permanent hyperglycemia show significantly lower serum concentrations of 1,5-AG than non-diabetics. A liquid chromatography-mass spectrometric method for the determination of 1,5-AG in serum and postmortem blood was developed and validated according to international guidelines. Linearity was given between 1 μg/ml and 50 μg/ml. Recovery rates ranged between 70.8% and 89.8%, the limit of quantification of the procedure was 0.20 μg/ml, limit of quantification was 0.55 μg/ml. Serum of 199 diabetics and 116 non-diabetics and femoral blood of 31 diabetic and 27 non-diabetic deceased was measured. Average concentrations were significantly (p<0.001) higher in non-diabetics compared to diabetics ante and postmortem. Seven of the diabetics may have died because of a hyperglycemic coma indicated by a sum formula of Traub>450 mg/dl. 1,5-AG average concentrations in these deceased were not significantly different to diabetics which did not die because of a diabetic coma. Concentrations of 1,5-AG give a hint for not well controlled diabetes antemortem and postmortem and can be assumed as an additional and alternative information postmortem to the measurement of HbA1c or fructosamine.
authors: Institute of Forensic Medicine, University of Bonn, Stiftsplatz 12, D-53111 Bonn, Germany. cohess@uni-bonn.de
authors: Cornelius
authors: C
authors: Hess
authors: Bernd
authors: B
authors: Stratmann
authors: Wulf
authors: W
authors: Quester
authors: Burkhard
authors: B
authors: Madea
authors: Frank
authors: F
authors: Musshoff
authors: Diethelm
authors: D
authors: Tschoepe
mesh_terms: D015415:Biomarkers / Q000097:blood; D002853:Chromatography, Liquid; D003847:Deoxyglucose / Q000097:blood*; D003920:Diabetes Mellitus / Q000097:blood*; D003926:Diabetic Coma / Q000097:blood / Q000175:diagnosis; D049429:Forensic Pathology; D006801:Humans; D006943:Hyperglycemia / Q000097:blood / Q000175:diagnosis*; D053719:Tandem Mass Spectrometry
chemical_list: D015415:Biomarkers; C006584:1,5-anhydroglucitol; D003847:Deoxyglucose