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

J Cyst Fibros. 2018 Jan;17(1):121-124. doi: 10.1016/j.jcf.2017.05.010. Epub 2017 Jun 22.

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.

MeSH terms

  • Adult
  • Canada
  • Correlation of Data
  • Cystic Fibrosis* / blood
  • Cystic Fibrosis* / complications
  • Cystic Fibrosis* / diagnosis
  • Diabetes Mellitus* / blood
  • Diabetes Mellitus* / diagnosis
  • Diabetes Mellitus* / etiology
  • Female
  • Forced Expiratory Volume*
  • Fructosamine / blood*
  • Glucose Tolerance Test / methods
  • Glycated Hemoglobin A / analysis
  • Humans
  • Male
  • Mass Screening / methods*
  • Reproducibility of Results
  • Respiratory Function Tests / methods

Substances

  • Glycated Hemoglobin A
  • Fructosamine