Abe N, Kashiwagi A, Kida Y, Sigeta Y, Hattori A, Yamamoto M, Kato M
Third Department of Internal Medicine, Shiga University of Medical Science.
Nihon Ronen Igakkai Zasshi. 1991 Jul;28(4):530-5. doi: 10.3143/geriatrics.28.530.
Recently, plasma fructosamine concentration has been used as an indication of mean plasma glucose level preceding at last 1 to 2 weeks. In the present study, to characterize the clinical significance and problems of plasma fructosamine concentration in aged subjects (greater than or equal to 65 yrs), we determined plasma fructosamine concentration as well as serum albumin, total protein, HbA1, AbA1c and fasting plasma glucose concentrations in 81 (less than 65 yrs) non-diabetic subjects (group A), 161 aged (greater than or equal to 65 yrs) non-diabetic subjects and 26 aged diabetics (group D). Aged non-diabetic subjects were further classified into 75 subjects with good ADL (group B) and 86 with poor ADL (group C). The normal limit of plasma fructosamine concentration (mean +/- 2SD) in group A was 24% higher (3.1 mmol/l) than that in group B (2.5 mmol/l) but the plasma fructosamine/serum albumin ratio (F/ALB) was similar in these two groups. Plasma fructosamine correlated negatively (p less than 0.01) with age. This aging effect was explained by the reduced serum albumin in aged subjects. However, in group C, reduced plasma albumin was not associated with reduced plasma fructosamine. Plasma fructosamine corrected by albumin (F/ALB) is a useful parameter of blood glucose control in aged subjects. In aged subjects with poor ADL, HbA1, HbA1c and plasma glucose should be determined with fructosamine.
最近,血浆果糖胺浓度已被用作过去1至2周平均血浆葡萄糖水平的指标。在本研究中,为了描述老年受试者(≥65岁)血浆果糖胺浓度的临床意义和问题,我们测定了81名(<65岁)非糖尿病受试者(A组)、161名老年(≥65岁)非糖尿病受试者和26名老年糖尿病患者(D组)的血浆果糖胺浓度以及血清白蛋白、总蛋白、HbA1、糖化血红蛋白(HbA1c)和空腹血浆葡萄糖浓度。老年非糖尿病受试者进一步分为75名日常生活活动能力良好者(B组)和86名日常生活活动能力较差者(C组)。A组血浆果糖胺浓度的正常范围(均值±2标准差)比B组高24%(3.1 mmol/L对2.5 mmol/L),但两组的血浆果糖胺/血清白蛋白比值(F/ALB)相似。血浆果糖胺与年龄呈负相关(p<0.01)。老年受试者血清白蛋白降低解释了这种衰老效应。然而,在C组中,血浆白蛋白降低与血浆果糖胺降低无关。经白蛋白校正的血浆果糖胺(F/ALB)是老年受试者血糖控制的一个有用参数。在日常生活活动能力较差的老年受试者中,应同时测定果糖胺、HbA1、HbA1c和血浆葡萄糖。