Abstract
There has been considerable interest in the serum fructosamine assay as a measure of glycated serum proteins. We have measured serum fructosamine in three groups of patients—those with uraemia; those with multiple myeloma; and those with acute inflammatory conditions—none of whom were known to have diabetes. Serum fructosamine was significantly higher in the uraemic group than in the other two, and also than in a control group. When allowance was made for prevailing serum albumin levels fructosamine was shown to be increased in the acute inflammatory group also. There was a significant correlation between random plasma glucose and serum fructosamine only when fructosamine was adjusted for prevailing albumin levels.
In control and uraemic subjects there was a significant positive correlation between serum fructosamine and albumin levels, whereas in the myeloma group there was a negative correlation with serum protein.
These data would suggest the need to take into account serum albumin levels and protein composition if serum fructosamine is accurately to reflect short-term integrated glycaemia.
| 1. | Mazze, RS, Shamoon, H, Pasmentier, R Reliability of blood glucose monitoring by patients with diabetes mellitus. Am J Med. 1984; 77: 211–7. Google Scholar, Crossref, Medline, ISI |
| 2. | Koenig, RJ, Peterson, CM, Jones, RL, Saudek, C, Lehrman, M, Cerami, A. The correlations of glucose regulation and haemoglobin A1c in diabetes mellitus. N Engl J Med. 1976; 295: 417–20. Google Scholar, Crossref, Medline, ISI |
| 3. | Gonen, B, Rubenstein, AH, Rochman, H, Tanega, SP, Horwitz, DL. Haemoglobin A1: an indicator of the metabolic control of diabetic patients. Lancet. 1977; ii, 734–7. Google Scholar, Crossref |
| 4. | Kennedy, AL, Merimee, TJ. Glycosylated serum protein and hemoglobin A1 levels to measure control of glycemia. Ann Intern Med. 1981; 95: 56–8. Google Scholar, Crossref, Medline, ISI |
| 5. | Dolhofer, R, Wieland, OH. Increased glycosylation of serum albumin in diabetes mellitus. Diabetes 1980; 29: 417–422. Google Scholar, Crossref, Medline, ISI |
| 6. | Yue, DK, Morris, K, McLennan, S, Turtle, JR. Glycosylation of plasma protein and its relation to glycosylated haemoglobin. Diabetes 1980; 29: 296–300. Google Scholar, Crossref, Medline, ISI |
| 7. | Johnson, RN, Metcalf, PA, Baker, JR. Fructosamine: a new approach to the estimation of serum glycosylprotein. An index of diabetic control. Clin Chim Acta 1982; 127: 87–95. Google Scholar, Crossref, ISI |
| 8. | Hadden, DR, Kennedy, L. Fructosamine (glycosylated protein) and the diagnosis of diabetes. Diabetic Med. 1984; 1: 91–2. Google Scholar, Crossref, Medline |
| 9. | Baker, JR, O'Connor, JP, Metcalf, PA, Lawson, MR, Johnson, RN. Clinical usefulness of estimation of serum fructosamine concentration as a screening test for diabetes mellitus. Br Med J 1983; 287: 863–7. Google Scholar, Crossref, Medline |
| 10. | Baker, JR, Johnson, RN, Scott, DJ. Serum fructosamine concentrations in patients with type II (non-insulin-dependent) diabetes mellitus during changes in management. Br Med J 1984; 288: 1484–6. Google Scholar, Crossref, Medline |
| 11. | Baker, JR, Metcalf, PA, Holdaway, IM, Johnson, RN. Serum fructosamine concentration as measure of blood glucose control in type 1 (insulin-dependent) diabetes mellitus. Br Med J 1985; 290: 352–5. Google Scholar, Crossref, Medline |
| 12. | Baker, JR, Metcalf, PA, Johnson, RN, Newman, D, Rietz, P. Use of protein-based standards in automated colorimetric determinations of fructosamine in serum. Clin Chem. 1985; 31: 1550–4. Google Scholar, Medline, ISI |
| 13. | Hindle, EJ, Rostron, GM, Gatt, JA. The estimation of serum fructosamine: an alternative measurement to glycated haemoglobin. Ann Clin BioChem. 1985; 22: 84–9. Google Scholar, SAGE Journals, ISI |
| 14. | Lloyd, DR, Nott, M, Marples, J. Comparison of serum fructosamine with glycosylated serum protein (determined by affinity chromatography) for the assessment of diabetes control. Diabetic Med. 1985; 2: 474–8. Google Scholar, Crossref, Medline, ISI |
| 15. | Lim, YS, Staley, MJ. Measurement of plasma fructosamine evaluated for monitoring diabetes. Clin Chem. 1985; 31: 731–3. Google Scholar, Medline, ISI |
| 16. | McCance, DR, Coulter, D, Smye, M, Kennedy, L. Effect of fluctuations in albumin on serum fructosamine assay. Diabetic Med. 1987; 4: 434–6. Google Scholar, Crossref, Medline, ISI |
| 17. | Menard, L, Dempsey, ME, Blankstein, LA, Aleyassine, H, Wacks, M, Soeldner, JS. Quantitative determination of glycosylated haemoglobin A1 by agar gel electrophoresis. Clin Chem. 1980; 26: 1598–1602. Google Scholar, Medline, ISI |
| 18. | Lloyd, D, Marples, J. Simple colorimetry of glycated serum protein in a centrifugal analyzer. Clin Chem. 1984; 30: 1686–8. Google Scholar, Medline, ISI |
| 19. | Dolhofer, R, Wieland, OH. Improvement of the thiobarbituric acid assay for serum glycosylprotein determination. Clin Chim Acta 1981; 112: 197–205. Google Scholar, Crossref, Medline, ISI |
| 20. | Fluckiger, R, Harmon, W, Meier, W, Loo, S, Gabbay, KH. Haemoglobin carbamylation in uraemia. N Engl J Med. 1981; 304: 823–7. Google Scholar, Crossref, Medline, ISI |
| 21. | Fluckiger, R, Woodtli, T, Berger, W. Evaluation of the fructosamine test for the measurement of plasma protein glycation. Diabetologia 1987; 30: 648–52. Google Scholar, Medline, ISI |

