The use of fructosamine in cystic fibrosis-related diabetes (CFRD) screening

Abstract

Objective: To determine whether serum fructosamine correlates with glycemic control and clinical outcomes in patients being screened for cystic fibrosis-related diabetes (CFRD).

Methods: Fructosamine and percent predicted forced expiratory volume in 1s (FEV₁) were measured in patients undergoing a 2h oral glucose tolerance test (OGTT) for CFRD screening. Fractional serum fructosamine (FSF) was calculated as fructosamine/total protein.

Results: FSF exhibited a positive correlation with 2h OGTT results (r²=0.3201, p=0.009), and ROC curve analysis suggested that FSF can identify patients with an abnormal OGTT (AUC=0.840, p=0.0002). FSF also exhibited a negative correlation with FEV₁ (r²=0.3732, p=0.035). Patients with FSF≥3.70μmol/g had significantly lower FEV₁ (median 47%) compared to those with FSF<3.70μmol/g (median 90%; p=0.015).

Conclusions: FSF correlated with both OGTT results and FEV₁, and reliably identified patients with abnormal OGTT results. This simple blood test shows potential as an effective tool in CFRD screening.

Keywords: Cystic fibrosis-related diabetes; FEV(1); Oral glucose tolerance test; Screening; Serum fructosamine.