Postmortem determination of HbA1c and glycated albumin concentrations using the UHPLC-QqQ-MS/MS method for the purposes of medicolegal opinions

Nowak, Karolina; Zawadzki, Marcin

doi:10.1016/j.microc.2020.104733

Cited by 4 publications

(4 citation statements)

References 14 publications

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“…The effect of reducing blood glucose levels in normal mice may be due to an increase in the efficiency of peripheral tissue for the absorption of glucose from the blood. Thus the extract can also be beneficial in patients with type II diabetes (Giles-Rivas et al, 2020;Nowak et al, 2020).…”

Section: Discussionmentioning

confidence: 99%

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Effect of Ethanol Extract of Jamblang Aceh (Syzygium cumini) in Diabetic Mice (Mus musculus) and Its Potential As Anti-Diabetic Agent

Sari

Januardi

Diningrat

2020

EKW

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: This study was designed to evaluate the anti-diabetic activity of the ethanol extract of Syzygium cumini leaves in alloxan-induced diabetes mice. The anti-diabetic activity of EDS was investigated in mice (Mus musculus SW.) Alloxan-induced diabetes. The effect of ethanol extract of Syzygium cumini leaves on normal blood glucose levels and oral glucose tolerance tests were studied in normoglycemic mice while the anti-diabetic effect was evaluated in alloxan-induced hyperglycemic mice. Ethanol extract of Syzygium cumini leaves (200 and 400 mg/kg) is given orally for 21 days. Glibenclamide (5 mg/kg, oral for 21 days) is used as a reference standard. Giving ethanol extract of Syzygium leaves causes a significant decrease in blood glucose levels in normoglycemic and hyperglycemic mice and also increases glucose tolerance test. Ethanol extract of Syzygium leaves reduces glycosylated hemoglobin levels, lactate dehydrogenase, and creatinine kinase in alloxan-treated mice. Ethanol extract of Syzygium leaves also improves TBARS oxidative stress parameters, catalase and superoxide dismutase activity and glutathione levels. The ethanol extract of Syzygium cumini leaves shows anti-diabetic activity through increased insulin secretion and this effect can be attributed to the content of flavonoids and phenolic compounds present in the ethanol extract of Syzygium cumini leaves.Abstrak : Penelitian ini dirancang untuk mengevaluasi aktivitas anti-diabetes dari ekstrak etanol daun Syzygium cumini (L) Skeels (EDS) pada mencit diabetes yang diinduksi aloksan. Aktivitas anti-diabetes EDS diselidiki pada mencit (Mus musculus SW.) diabetes yang diinduksi aloksan. Pengaruh ekstrak etanol daun Syzygium cumini (EDS) pada kadar glukosa darah normal dan uji toleransi glukosa oral dipelajari pada mencit normoglikemik sedangkan efek antidiabetik dievaluasi pada mencit hiperglikemik yang diinduksi aloksan. EDS (200 dan 400 mg/kg) diberikan secara oral selama 21 hari. Glibenclamide (5mg/kg, oral selama 21 hari) digunakan sebagai standar referensi. Pemberian EDS menyebabkan penurunan signifikan dalam kadar glukosa darah pada mencit normoglikemik dan hiperglikemik dan juga meningkatkan uji toleransi glukosa. EDS mengurangi kadar hemoglobin glikosilasi, laktat dehidrogenase, dan kreatinin kinase pada mencit yang diberi aloksan. EDS juga memperbaiki parameter stres oksidatif TBARS, aktivitas katalase dan superoksida dismutase dan kadar glutathione. Ekstrak etanol daun Syzygium cumini (EDS) menunjukkan aktivitas antidiabetik melalui peningkatan sekresi insulin dan efek ini dapat dikaitkan dengan kandungan flavonoid dan senyawa fenolik yang ada dalam ekstrak daun.

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Section: Discussionmentioning

confidence: 99%

“…Estimation of biochemical parameters: On the 22nd day, other biochemical parameters were assessed in blood/ serum. Glycosylated hemoglobin (HbA1c) was tested from blood samples by the Drabkin method (Nowak et al, 2020). The serum creatinine kinase was tested by the Tomas method.…”

Section: Methodsmentioning

confidence: 99%

Effect of Ethanol Extract of Jamblang Aceh (Syzygium cumini) in Diabetic Mice (Mus musculus) and Its Potential As Anti-Diabetic Agent

Sari

Januardi

Diningrat

2020

EKW

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“…We also considered the concentration of a long-term marker (glycated hemoglobin; HbA1c). Statistical analysis of correlations occurring in both groups in terms of HbA1c levels was discussed in detail in our previous study [10].…”

Section: Assessment Of the Correlation Between Concentrations Of The mentioning

confidence: 99%

Postmortem Determination of Short-Term Markers of Hyperglycemia for the Purposes of Medicolegal Opinions

Nowak

Zawadzki

2020

Diagnostics

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Diabetes mellitus is classified as the epidemic of the 21st century. Due to the fact that acute carbohydrate metabolism disorders usually do not indicate morphological change, postmortem diagnosis is required to perform biochemical tests. The authors decided to evaluate the usefulness of determining glucose, lactate, acetone, β-hydroxybutyric acid (BHB), and 1,5-anhydroglucitol (1,5-AG) in postmortem blood/serum, urine, and vitreous humor (VH). Biological material was collected during autopsies. The study group consisted of 50 diabetics, while the control group consisted of 50 non-diabetics, who died a sudden death, with negative test results for the presence of ethyl alcohol and were not resuscitated before death. Statistical analysis was performed using the IBM SPSS Statistics 25 software package. The most statistically significant difference between the two groups was observed for mean 1,5-AG concentration. The authors found many correlations between the concentration of the examined markers in different materials, mainly between blood/serum and VH. The most suitable short-term glycemic marker in postmortem diagnosis is 1,5-AG. Diagnosis may be supported with determinations of acetone and BHB. For medicolegal assessment, the interpretation of the biochemical test results should comprise information on circumstances of death, medical history, results of other toxicological and histopathological tests, and autopsy report.

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“…The protein level reflects the average blood glucose concentration over a period of 8–12 weeks, a concentration directly proportional to the average lifetime of erythrocytes [ 7 ]; this statement is valid only if the blood glucose concentration as well as the life span of erythrocytes have been stable during 3–4 months preceding the time when HbA1c was tested [ 8 ]. Conditions associated with erythrocyte instability, such as in hemolytic anemia, splenectomy, liver diseases, chronic kidney and chronic opioid use should be identified and taken into consideration as influencing factors of the true positive rates and should be considered as exclusion criteria when measuring postmortem HbA1c levels with the purpose of identifying DM [ 8 , 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

Thanatochemical Study of Glycated Hemoglobin in Diabetic Status Assessment

et al. 2021

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Background and objectives. In forensic medicine, the postmortem determination of glycated hemoglobin (HbA1c) helps identify undiagnosed cases of diabetes or cases with uncontrolled glycemic status. In order to contribute to the solidification of thanatochemistry, both globally and especially nationally, we aimed to determine this biomarker postmortem, for the first time in our institution, in order to identify undiagnosed pre-mortem diabetics, as well as those with inadequate glycemic control. Materials and Methods. Our research consisted of analyzing a total number of 180 HbA1c values, 90 determinations from the peripheral blood and 90 from the central blood. The determination of HbA1c was performed by means of a fully automatic analyzer (HemoCue HbA1c 501), certified by the National Glycohemoglobin Standardization Program (NGSP)/Diabetes Control and Complications Trial (DCCT) and calibrated according to the standards developed by the International Federation of Clinical Chemistry (IFCC). According to ADA criteria, HbA1c values can provide us with the following information about the diagnosis of diabetes: normal 4.8–5.6%; prediabetes 5.7–6.4%; diabetes ≥ 6.5%. Results. A considerable number of cases with an altered glycemic status (cases that had HbA1c values equal to or greater than 5.7%) were identified—51% demonstrable by peripheral blood determinations and 41% by central blood determinations. Notably, 23 people with diabetes (25%) were identified by analyzing the peripheral blood; 18 other people with diabetes (20%) were identified by analyzing the central blood. Conclusions. Our study managed to confirm the antemortem diagnosis of DM using a simple point-of-care analyzer and applying standardized and certified criteria on HbA1c levels measured postmortem. We also identified a considerable number of cases with DM in patients with no antemortem history of glucose imbalance—at least 20% more cases. Although the two different sites used for blood collection showed a strong statistical correlation, it seems that the peripheral site could have a higher sensibility in detecting postmortem altered glycemic status.

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Postmortem determination of HbA1c and glycated albumin concentrations using the UHPLC-QqQ-MS/MS method for the purposes of medicolegal opinions

Cited by 4 publications

References 14 publications

Effect of Ethanol Extract of Jamblang Aceh (Syzygium cumini) in Diabetic Mice (Mus musculus) and Its Potential As Anti-Diabetic Agent

Effect of Ethanol Extract of Jamblang Aceh (Syzygium cumini) in Diabetic Mice (Mus musculus) and Its Potential As Anti-Diabetic Agent

Postmortem Determination of Short-Term Markers of Hyperglycemia for the Purposes of Medicolegal Opinions

Thanatochemical Study of Glycated Hemoglobin in Diabetic Status Assessment

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