Fructosamine

Source: Wikipedia, the free encyclopedia.

Fructosamines are compounds that result from

Hermann Emil Fischer in 1886.[citation needed
]

Most commonly, fructosamine refers to a laboratory test for

hemoglobin A1c testing are preferred). In small animal veterinary practice however it is part of the diabetic cat or dog diagnosis and monitoring[1] giving an indication of blood glucose levels over the previous week.[2] Many direct-to-consumer
lab testing companies sell fructosamine tests.

Use in medicine

In

blindness. Most commonly, blood sugars are measured by either blood glucose monitoring which measures the current blood glucose level, or by glycated hemoglobin (HbA1c) which measures average glucose levels over approximately 3 months. In a similar way to hemoglobin A1c testing (which measures the glycation of hemoglobin), fructosamine testing determines the fraction of total serum proteins that have undergone glycation (the glycated serum proteins). Since albumin is the most abundant protein in blood, fructosamine levels typically reflect albumin glycation. (Some fructosamine tests specifically quantify the glycation of albumin, or glycated serum albumin instead of all proteins.). Because albumin has a half-life of approximately 20 days, the plasma fructosamine concentration reflects relatively recent (1–2 week) changes in blood glucose.[citation needed
]

In patients with diseases that reduce red blood cell lifespan, such as

blood sugar levels, as its measurements are based on albumin instead of hemoglobin. However, any condition that changes serum albumin (such as the nephrotic syndrome) will affect the fructosamine result.[citation needed
]

In practice, fructosamine is rarely measured clinically (even in individuals with hemoglobinopathies or other red cell disorders) due to a number of pragmatic concerns. First, diabetes care is rarely changed in short (1–4 week) intervals, since diabetes medications can take months to reach a

HPLC, immunoassay and capillary electrophoresis) can more accurately assay A1c levels during complex hemoglobinopathies and other conditions.[4] However this does not overcome the effect of shortened red blood cell lifespan on A1c results.[citation needed
]

In End Stage Renal Disease (ESRD)

Because glycated albumin (GA) has a shorter half-life than glycated hemoglobin (HbA1c), glycated albumin reflects recent glycemic control more accurately and usefully for monitoring patients with diabetic

end stage renal disease (ESRD) (hemodialysis and peritoneal dialysis patients). It can be used less often than blood sugar testing. An average blood glucose level of 155–160 mg/dL could be matched to a GA value of 18–19% in patients with ESRD. The ratio of GA/HbA1c is 3.0 approximately.[5]

Interpretation of results

There is no standard reference range available for this test. The reference values depend upon the factors of patient age, gender, sample population, and test method. Hence, each laboratory report will include the patient's specific reference range for the test. An increase in fructosamine in lab testing results usually means an increase in glucose in the blood.

On average, each change of 3.3 mmol (60 mg/dl) in average blood sugar levels will give rise to changes of 2% HbA1c and 75 µmol fructosamine values.

gives the following formula and resulting values:

Hence:
Fructosamine
(µmol)
HbA1c
%
HbA1c IFCC
(mmol/mol)
200 5 31
258 6 42
288 6.5 48
317 7 53
346 7.5 58
375 8 64
435 9 75
494 10 86
552 11 97
611 12 108

See also

Footnotes

  1. PMID 20439947
    .
  2. .
  3. ^ National Glycohemoglobin Standardization Program, http://www.ngsp.org
  4. PMID 12881436
    .
  5. .
  6. ^ Bartol T (2000-12-01). "Comparison of Blood Glucose, HbA1c, and Fructosamine". Retrieved 2007-06-04. – gives a comparison chart and cites following source:
    • Nathan DM, Singer DE, Hurxthal K, Goodson JD (1984). "The clinical information value of the glycosylated hemoglobin assay".
      PMID 6690962
      .
  7. .
  8. ^ "Diabetes (DM) Indicator 20 The percentage of patients with diabetes in whom the last HbA1c is 7.5 or less (or equivalent test/reference range depending on local laboratory) in the previous 15 months" (PDF). Quality and outcomes framework Guidance 2006. BMA. p. 39. Retrieved 2008-01-02.
  9. ^ "Diabetes mellitus: the percentage of patients with diabetes in whom the last HbA1c is 7.5 or less (or equivalent test/reference range depending on local laboratory) in the previous 15 months". National Quality Measures Clearinghouse. 2007-12-31. Archived from the original on 2008-03-10. Retrieved 2008-01-02.

External links