Vitreous humor fructosamine concentrations in the autopsy diagnosis of diabetes mellitus

Osuna, Eduardo; García-víllora, Ana; Pérez-Cárceles, María D.; Conejero, J. Alberto; Abenza, José M.; Martínez, P.; Luna, A.

doi:10.1007/s004140050249

Cited by 40 publications

(24 citation statements)

References 17 publications

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“…Furthermore, death may be preceded by agonal processes and cardiopulmonary resuscitation, which are often associated with the secretion or administration of catecholamines. This results in further mobilisation of liver glycogen and release of glucose into the blood circulation as a counterbalancing phenomenon [18]. Due to the difficulty interpreting postmortem blood glucose levels, other fluids have been proposed as being more reliable in the estimation of antemortem blood glucose concentrations, particularly the cerebrospinal fluid and vitreous humor [19][20][21][22][23][24].…”

Section: Discussionmentioning

confidence: 99%

Is the formula of Traub still up to date in antemortem blood glucose level estimation?

et al. 2012

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According to the hypothesis of Traub, also known as the 'formula of Traub', postmortem values of glucose and lactate found in the cerebrospinal fluid or vitreous humor are considered indicators of antemortem blood glucose levels. However, because the lactate concentration increases in the vitreous and cerebrospinal fluid after death, some authors postulated that using the sum value to estimate antemortem blood glucose levels could lead to an overestimation of the cases of glucose metabolic disorders with fatal outcomes, such as diabetic ketoacidosis. The aim of our study, performed on 470 consecutive forensic cases, was to ascertain the advantages of the sum value to estimate antemortem blood glucose concentrations and, consequently, to rule out fatal diabetic ketoacidosis as the cause of death. Other biochemical parameters, such as blood 3-beta-hydroxybutyrate, acetoacetate, acetone, glycated haemoglobin and urine glucose levels, were also determined. In addition, postmortem native CT scan, autopsy, histology, neuropathology and toxicology were performed to confirm diabetic ketoacidosis as the cause of death.According to our results, the sum value does not add any further information for the estimation of antemortem blood glucose concentration. The vitreous glucose concentration appears to be the most reliable marker to estimate antemortem hyperglycaemia and, along with the determination of other biochemical markers (such as blood acetone and 3-betahydroxybutyrate, urine glucose and glycated haemoglobin), to confirm diabetic ketoacidosis as the cause of death.

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Section: Discussionmentioning

confidence: 99%

Is the formula of Traub still up to date in antemortem blood glucose level estimation?

et al. 2012

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“…The detection limits for the different markers were as follows: 2 mg/dl (0.11 mmol/l) for glucose, 10 µmol/l for fructosamine and 2 mg/dl (0.22 mmol/l) for lactate. The validity and reliability of the different markers used in the post-mortem diagnosis have been demonstrated previously by our research group [9,10].…”

Section: Methodsmentioning

confidence: 53%

“…The two samples were pooled and centrifuged at 1500 g for 15 min, stored at -80ºC, analyzed in duplicate for glucose, lactate and fructosamine and tested in a HITACHI 917 autoanalyzer using Roche Diagnostic kits (Hoffmann La Roche, Ltd., Basel, Switzerland). The characteristics of the analytical methods have been previously described [9][10][11][12][13]. The detection limits for the different markers were as follows: 2 mg/dl (0.11 mmol/l) for glucose, 10 µmol/l for fructosamine and 2 mg/dl (0.22 mmol/l) for lactate.…”

Section: Methodsmentioning

confidence: 99%

“…Some authors have proposed that the combined determination of glucose and lactic acid in vitreous humor would be a useful indicator to confirm ante-mortem hyperglycemia as a probable cause of death [5][6][7][8]. In previous studies, we demonstrated the diagnostic usefulness of determining fructosamine levels in vitreous humor [9,10]. Because serum proteins have a much shorter half-life than erythrocyte hemoglobin, the fructosamine test, which measures glycated proteins, reflects glycemic control during the preceding 1-3 weeks [11].…”

Section: Introductionmentioning

confidence: 92%

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Combined Determination of Glucose and Fructosamine in Vitreous Humor as a Post-Mortem Tool to Identify Antemortem Hyperglycemia

Vivero

Vivero-Salmerón²,

Cárceles³

et al. 2008

Rev Diabet Stud

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■ AbstractIn clinical practice, serum glucose levels are used to diagnose diabetes mellitus. In post-mortem diagnosis, however, biochemical markers in vitreous humor are more useful because of the difficulty involved in interpreting blood glucose levels and relatively non-specific pathological features. The aim of this study was to analyze the usefulness of post-mortem determination of glucose and fructosamine combined and to compare the results with those obtained for fructosamine and combined glucose and lactate levels in two diagnostic groups (one diabetic and the other non-diabetic). We studied 377 cadavers (mean age 57.6 yr, SD 20.4, range 15 to 98 yr) with a mean post-mortem interval of 14.9 h. (SD 6.0; range 2 to 24 h). The highest levels were obtained in cases where diabetes mellitus had previously been diagnosed. In relation to diagnostic performance, the most reliable values were those in which glucose and fructosamine were determined jointly. The findings provide information concerning the usefulness of measuring glucose and fructosamine levels as a post-mortem tool for identifying antemortem glycemic control in diabetics.

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“…Before then, the understanding of these constituents was limited to animals and enucleated human eyes. Subsequently, numerous researchers [4][5][6][7]9,10,[14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33] have performed postmortem biochemical analyses on vitreous humor. These analyses typically focused on levels of vitreous glucose, lactate, sodium, chloride, potassium, urea nitrogen and creatinine.…”

Section: Discussionmentioning

confidence: 99%

Postmortem biochemistry performed on vitreous humor after postmortem CT-angiography

et al. 2012

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a b s t r a c tPostmortem angiography is becoming increasingly essential in forensic pathology as an adjunct to con-ventional autopsy. Despite the numerous advantages of this technique, some questions have been raised regarding the influence of the contrast agent injected on the results of toxicological and biochemical anal-yses. The aim of this study was to investigate the effect of the injection of the contrast agent Angiofil Ò , mixed with paraffin oil, on the results of postmortem biochemical investigations performed on vitreous humor. Postmortem biochemical investigations were performed on vitreous samples collected from bodies that had undergone postmortem angiography (n = 50) and from a control group (n = 50). Two vit-reous samples were analyzed for each group and the results compared. Glucose, urea, creatinine, 3-b-hydroxybutyrate, sodium and chloride were tested. Different values were observed between the first and second samples in each group. However, these differences were not clinically relevant, suggesting that the injection of this contrast agent mixture does not modify the concentration of the analyzed sub-stances in the vitreous humor.

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Vitreous humor fructosamine concentrations in the autopsy diagnosis of diabetes mellitus

Cited by 40 publications

References 17 publications

Is the formula of Traub still up to date in antemortem blood glucose level estimation?

Is the formula of Traub still up to date in antemortem blood glucose level estimation?

Combined Determination of Glucose and Fructosamine in Vitreous Humor as a Post-Mortem Tool to Identify Antemortem Hyperglycemia

Postmortem biochemistry performed on vitreous humor after postmortem CT-angiography

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