title: Clinical and forensic examinations of glycaemic marker methylglyoxal by means of high performance liquid chromatography-tandem mass spectrometry.
abstract: The postmortem determination of hyperglycaemic coma is quite difficult because of the lack of morphological findings and the difficult interpretation of biochemical parameters. Methylglyoxal (MG) is a reactive oxoaldehyde, which is mainly derived from glycolysis. An electrospray ionisation liquid chromatography-tandem mass spectrometric procedure for the determination of methylglyoxal in human serum and postmortem blood was developed. It involves protein precipitation with perchloric acid and a derivatisation step with 2,3-diaminonaphthalene. The assay was validated according to international guidelines. Serum samples from diabetics obtained at a diabetes clinic and from non-diabetics were used to assess data about reference concentrations in human serum. The assay showed linearity within the physiological concentrations in serum (5-500 ng/ml). Intraday imprecision at three concentrations was 10.3, 9.2 and 8.3 %, and interday imprecision was 15.3, 14.2 and 9.4 %; the limit of detection was 1.3 ng/ml, and limit of quantification, 3.2 ng/ml. One hundred and eighteen clinical (100 diabetics, 18 non-diabetics) and 98 forensic samples (84 non-diabetics, 14 in a status of hyperglycaemic coma) were measured. During life, diabetics showed significantly (p < 0.001) higher serum concentrations of MG than non-diabetics. After death, concentrations of MG increased significantly (p < 0.001). However, there was no correlation between the sum formula of Traub in vitreous humour and MG femoral blood concentrations (R = 0.237). This indicates that MG concentrations in the deceased cannot distinguish deaths due to a hyperglycaemic coma from other causes of death.
authors: Institute of Forensic Medicine, University of Bonn, Stiftsplatz 12, 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: Diethelm
authors: D
authors: Tschoepe
authors: Burkhard
authors: B
authors: Madea
authors: Frank
authors: F
authors: Musshoff
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000032:analysis; D016022:Case-Control Studies; D002853:Chromatography, Liquid; D003920:Diabetes Mellitus / Q000097:blood*; D003926:Diabetic Coma / Q000097:blood; D005260:Female; D049429:Forensic Pathology; D005947:Glucose / Q000032:analysis; D006801:Humans; D019344:Lactic Acid / Q000032:analysis; D008297:Male; D008875:Middle Aged; D011180:Postmortem Changes; D011765:Pyruvaldehyde / Q000032:analysis*; D053719:Tandem Mass Spectrometry; D014822:Vitreous Body / Q000737:chemistry
chemical_list: D015415:Biomarkers; D019344:Lactic Acid; D011765:Pyruvaldehyde; D005947:Glucose