title: Determinants of fructosamine levels in a multi-ethnic Sub-Saharan African population.
abstract: OBJECTIVE
  Fructosamine provides an estimate of diabetes control over a shorter period than HbA1c, and has been proposed as a suitable parameter to monitor glycemic control in low-income countries. The aim of this study was to investigate determinants of fructosamine levels in an urban non-diabetic population of Cameroon.
  
  
  METHODS
  This was a cross-sectional study including 437 healthy adults with no known history of diabetes mellitus, aged 40 years and above, recruited from the ten administrative regions, representing major ethnic groups in the country. Plasma glucose and fructosamine were measured after an overnight fasting. Univariable and multivariable analyses were used to investigate the factors associated with fructosamine measurements.
  
  
  RESULTS
  Fructosamine levels ranged from 68.2 to 940.8 μmol/l with a mean (standard deviation) of 294.4 (131.3) μmol/l. These levels varied significantly across regions and were higher in men than in women (p=0.001) and in those with screen-detected diabetes than in those with normoglycemia (p<0.0001). There was a negative correlation between fructosamine and body mass index (r=-0.15, p=0.009), and a positive correlation with fasting plasma glucose (FPG) (r=0.37, p<0.0001) and total bilirubinemia (r=0.21, p<0.0001). In multivariable model, sex, BMI, FPG, total bilirubine and screen-detected diabetes were no longer associated with fructosamine levels.
  
  
  CONCLUSIONS
  Fructosamine was not independently associated with age, sex, ethnicity, and the glycemic status. Further studies need to be carried out to better elucidate all the factors determining the measurement of fructosamine in order to accurately interpret its values in diabetic populations.
authors.affiliation: University of Mountains, Bangangte, Cameroon. Electronic address: audreynouya@yahoo.fr.
authors.forename: Audrey Yondjeu
authors.initials: AY
authors.lastname: Nouya
authors.affiliation: Sickle Cell Unit, Mother and Child Centre, Chantal Biya Foundation, Yaounde, Cameroon; Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon. Electronic address: jobertrichie_nansseu@yahoo.fr.
authors.forename: Jobert Richie N
authors.initials: JR
authors.lastname: Nansseu
authors.affiliation: Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon; Laboratory of Biochemistry, Yaounde University Teaching Hospital, Yaounde, Cameroon. Electronic address: movicky@yahoo.fr.
authors.forename: Vicky Joceline Ama
authors.initials: VJ
authors.lastname: Moor
authors.affiliation: Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon. Electronic address: conanpieme@gmail.com.
authors.forename: Constant Anatole
authors.initials: CA
authors.lastname: Pieme
authors.affiliation: Internal Medicine Unit, Edea Regional Hospital, Edea, Cameroon. Electronic address: noubiapjj@yahoo.fr.
authors.forename: Jean Jacques N
authors.initials: JJ
authors.lastname: Noubiap
authors.affiliation: Faculty of Sciences, University of Yaounde I, Yaounde, Cameroon. Electronic address: tchoulacorinne@yahoo.fr.
authors.forename: Corinne M
authors.initials: CM
authors.lastname: Tchoula
authors.affiliation: Faculty of Sciences, University of Yaounde I, Yaounde, Cameroon.
authors.forename: Bruno M
authors.initials: BM
authors.lastname: Mokette
authors.affiliation: University of Mountains, Bangangte, Cameroon. Electronic address: truthdan@yahoo.fr.
authors.forename: Ruth Danielle M
authors.initials: RD
authors.lastname: Takam
authors.affiliation: Faculty of Sciences, University of Yaounde I, Yaounde, Cameroon. Electronic address: yerema2003@yahoo.fr.
authors.forename: Francine
authors.initials: F
authors.lastname: Tankeu
authors.affiliation: Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon; Laboratory of Biochemistry, Yaounde University Teaching Hospital, Yaounde, Cameroon. Electronic address: jngogang@yahoo.fr.
authors.forename: Jeanne Yonkeu
authors.initials: JY
authors.lastname: Ngogang
authors.affiliation: Faculty of Sciences, University of Yaounde I, Yaounde, Cameroon; South African Medical Research Council and University of Cape Town, Cape Town, South Africa. Electronic address: apkengne@yahoo.com.
authors.forename: Andre Pascal
authors.initials: AP
authors.lastname: Kengne
mesh_terms: D000328:Adult; D017954:Africa South of the Sahara / Q000453:epidemiology; D000368:Aged; D044383:Black People; D001786:Blood Glucose / Q000032:analysis; D002163:Cameroon / Q000208:ethnology; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology; D005006:Ethnicity; D005215:Fasting / Q000097:blood; D005260:Female; D019270:Fructosamine / Q000097:blood*; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D014505:Urban Population / Q000706:statistics & numerical data
chemical_list: D001786:Blood Glucose; D019270:Fructosamine; D006442:Glycated Hemoglobin
keywords: Cameroon; Correlates; Fructosamine; Sub-Saharan Africa