title: Corrected Fructosamine improves both correlation with HbA1Cand diagnostic performance.
abstract: OBJECTIVE
  There is increasing interest in using fructosamine measurements in screening for or managing diabetes, yet uncertainty remains as to whether these measurements should be corrected for variation in serum protein concentrations.
  
  
  METHODS
  We considered all sets of simultaneous measurements of fructosamine, albumin, total serum protein (TP), fasting plasma glucose (FPG) and HbA1Crecorded in our laboratory over 10years. The relationships between fructosamine and other variables were studied by multivariate linear regression and other analyses, and receiver operating curves (ROCs) were analysed to compare the diabetes screening performance of uncorrected fructosamine to those of albumin-corrected fructosamine (FAAlb) and TP-corrected fructosamine (FATP).
  
  
  RESULTS
  40,938 sets of measurements were collected from 20,114 patients. Though correlation between fructosamine and serum proteins was strongest among patients with HbA1C<6.5% (48mmol/mol), it was also significant in the whole sample (r=0.193 for albumin, r=0.213 for TP). With diabetes defined by HbA1C≥6.5% (48mmol/mol), the areas under the ROCs of FAAlb(0.905) and FATP(0.895) were both significantly greater (P<0.001) than that of uncorrected fructosamine (0.878). Correction of fructosamine for albumin or TP slightly improved its correlation with HbA1C. There was no correlation of protein (albumin or TP) with log(fructosamine/protein).
  
  
  CONCLUSIONS
  Fructosamine concentration correlates significantly with albumin and total protein concentrations throughout their ranges. Correction of fructosamine improves its correlation with HbA1Cand its performance in detecting diabetes.
authors: Department of Biochemistry and Molecular Biology, University of Santiago de Compostela. Santiago de Compostela, Spain; Clinical Biochemistry Laboratory, University Hospital Complex of Santiago de Compostela. Santiago de Compostela, Spain.
authors: S
authors: S
authors: Rodríguez-Segade
authors: Clinical Biochemistry Laboratory, University Hospital Complex of Santiago de Compostela. Santiago de Compostela, Spain.
authors: J
authors: J
authors: Rodríguez
authors: Department of Biochemistry and Molecular Biology, University of Santiago de Compostela. Santiago de Compostela, Spain. Electronic address: felix.camina@usc.es.
authors: F
authors: F
authors: Camiña
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D001798:Blood Proteins / Q000032:analysis / Q000378:metabolism; D003920:Diabetes Mellitus / Q000097:blood* / Q000175:diagnosis*; D005260:Female; D019270:Fructosamine / Q000097:blood*; D006442:Glycated Hemoglobin / Q000032:analysis / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged
chemical_list: D001786:Blood Glucose; D001798:Blood Proteins; D019270:Fructosamine; D006442:Glycated Hemoglobin
keywords: Albumin; Fructosamine; HbA(1C); Total serum protein; Type 1 diabetes; Type 2 diabetes