Institute of Forensic Medicine, University of Bonn, Stiftsplatz 12, 53111, Bonn, Germany.
Int J Legal Med. 2013 Mar;127(2):385-93. doi: 10.1007/s00414-012-0740-4. Epub 2012 Jul 21.
The postmortem determination of hyperglycaemic coma is quite difficult because of the lack of morphological findings and the difficult interpretation of biochemical parameters. Methylglyoxal (MG) is a reactive oxoaldehyde, which is mainly derived from glycolysis. An electrospray ionisation liquid chromatography-tandem mass spectrometric procedure for the determination of methylglyoxal in human serum and postmortem blood was developed. It involves protein precipitation with perchloric acid and a derivatisation step with 2,3-diaminonaphthalene. The assay was validated according to international guidelines. Serum samples from diabetics obtained at a diabetes clinic and from non-diabetics were used to assess data about reference concentrations in human serum. The assay showed linearity within the physiological concentrations in serum (5-500 ng/ml). Intraday imprecision at three concentrations was 10.3, 9.2 and 8.3 %, and interday imprecision was 15.3, 14.2 and 9.4 %; the limit of detection was 1.3 ng/ml, and limit of quantification, 3.2 ng/ml. One hundred and eighteen clinical (100 diabetics, 18 non-diabetics) and 98 forensic samples (84 non-diabetics, 14 in a status of hyperglycaemic coma) were measured. During life, diabetics showed significantly (p < 0.001) higher serum concentrations of MG than non-diabetics. After death, concentrations of MG increased significantly (p < 0.001). However, there was no correlation between the sum formula of Traub in vitreous humour and MG femoral blood concentrations (R = 0.237). This indicates that MG concentrations in the deceased cannot distinguish deaths due to a hyperglycaemic coma from other causes of death.
死后确定高血糖性昏迷相当困难，因为缺乏形态学发现，且生化参数的解读较为困难。甲基乙二醛（MG）是一种反应性的醛，主要来源于糖酵解。建立了一种电喷雾离子化液相色谱-串联质谱法测定人血清和死后血中甲基乙二醛的方法。该方法涉及用高氯酸沉淀蛋白质和用 2,3-二氨基萘进行衍生化步骤。该测定方法按照国际指南进行了验证。在糖尿病诊所获得的糖尿病患者和非糖尿病患者的血清样本用于评估人血清参考浓度的数据。该测定方法在血清的生理浓度（5-500ng/ml）内显示出线性。三个浓度的日内精密度分别为 10.3%、9.2%和 8.3%，日间精密度分别为 15.3%、14.2%和 9.4%；检测限为 1.3ng/ml，定量限为 3.2ng/ml。共测量了 118 例临床（100 例糖尿病患者，18 例非糖尿病患者）和 98 例法医样本（84 例非糖尿病患者，14 例高血糖性昏迷状态）。在生命期，糖尿病患者的血清 MG 浓度明显高于非糖尿病患者（p<0.001）。死后，MG 浓度显著升高（p<0.001）。然而，玻璃体液中 Traub 总和公式与股骨血 MG 浓度之间无相关性（R=0.237）。这表明死者的 MG 浓度不能区分因高血糖性昏迷引起的死亡与其他死因的死亡。
