Purpose: Currently used methods to determine glycemia have certain disadvantages, including cost, heavy labor involvement, and storage problems. Determination of serum fructosamine levels, on the other hand, offers several potential advantages over these current measures. Our goal was to evaluate the utility of serum fructosamine as a measure of glycemia.
Subjects and methods: Fructosamine levels were measured in 145 normal and diabetic subjects aged 20 to 86 years. The measured levels were then related to standard measures of glycemia, including glycosylated hemoglobin, glycosylated albumin, and fasting glucose. The effects of chronic illness and medications known to alter glucose tolerance were also investigated.
Results: Fructosamine levels were well correlated with other measures: r = 0.73 with glucose, 0.76 with hemoglobin A1C (HbA1C), and 0.80 with glycosylated albumin. Levels of fructosamine were significantly higher (p less than 0.001) in diabetic subjects compared with those in non-diabetic subjects, but were not affected by age and were only minimally affected by chronic illness. Values for diabetic subjects with well-controlled and poorly controlled disease were also significantly different.
Conclusion: Assay of serum fructosamine appears to be comparable to that of HbA1C for determination of glycemic control. The automaticity, reproducibility, and lower cost for the fructosamine assay argue strongly in favor of this assay in comparison to those for other glycosylated proteins.