Serum fructosamine and glycemic status in the presence of the sickle cell mutation

Abstract

The glycated hemoglobin (HbA1c) test can be unreliable in the presence of hemoglobinopathies. The co-existence of type 2 diabetes (T2D) with sickle cell anemia calls for alternative tests. Therefore, we established a reference interval for serum fructosamine and evaluated its utility as a potential glycemic biomarker that is not affected by abnormal hemoglobin. Methods: The accuracies of serum fructosamine in monitoring and diagnosing T2D were evaluated using the Area under the Receiver Operating Characteristics and other measures in 618 Nigerians with or without sickle cell trait. The estimated diagnostic cut-off for serum fructosamine was then validated in an independent multi-ethnic cohort of 634 West Africans. Results: Serum fructosamine was similar between individuals with or without sickle cell trait (median: 287 vs 275 umol/L, p = 0Á11, respectively) despite statistically different HbA1c.Fructosamine was highly correlated with both HbA1c and fasting glucose independently of sickle cell trait. The areas under the curve (AUC) of serum fructosamine in identifying individuals with uncontrolled glycemia and individuals with T2D were similar and independent of sickle cell trait: 0Á92 (95% confidence interval [95% CI ], 0Á88-0Á95 and 0.92 (95% CI, (0.89-0.95) respectively. Conclusions: Serum fructosamine is a good alternative to HbA1c for monitoring and diagnosing T2D in the presence of sickle cell trait.

Untargeted metabolomic profiling reveals molecular signatures associated with type 2 diabetes in Nigerians

“…The parent study, the Africa America Diabetes Mellitus study (AADM), is a long-standing genetic epidemiology study of T2D and other cardiometabolic traits, enrolled participants from multiple medical centers in Nigeria, Ghana, and Kenya [ 53 ]. Participants in this metabolomics study were selected from the AADM longitudinal sub-study of 650 participants enrolled from a single study site in Ibadan, Nigeria, for deep phenotyping in order to better characterize multiple cardiometabolic traits in an urban setting [ 54 ]. A sample of 310 participants was randomly selected for the discovery sample without conditioning on any specific phenotype.…”

Fructosamine and HbA1c A: Correlational Study in a Southeast Asian Population

“…The correlation between HbA1c and blood glucose is further eroded in the setting of pregnancy, advanced kidney disease, and conditions altering erythrocyte life expectancy, such as haemoglobin variants, haemoglobinopathies, and iron deficiency. [5][6][7][8][9] Glycation of plasma proteins form ketoamines. These are collectively known as fructosamine because of the 1-amino-1-deoxy-D-fructose groups that are present in the glycated protein molecules.…”

“…The correlation between HbA1c and blood glucose is further eroded in the setting of pregnancy, advanced kidney disease, and conditions altering erythrocyte life expectancy, such as haemoglobin variants, haemoglobinopathies, and iron deficiency. 5 – 9 …”

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“…The fructosamine molecules are formed via glucose inside blood stream, by its group of carbonyl that reacts and binds to residues of protein amino debris which leads to form Schiff's base, and they are also a kind of Macromolecules-Alkone-Amines-Compounds, MAAC, which have about 1-3 weeks of life span [15]. By anyhow, fructosamine is combined to complications with microvascular dysfunctioning; both in suffering diabetes and non-diabetic individuals; where the more fructosamine was higher; the more cardiovascular problems; disease, congestion, stroke, or even death [16]. People with elevated concentration of fructosamine were more in risk in years forward to get type II of diabetes mellitus, if that was descended from their grandparents along [17].…”