Brunnbauer M, Küenburg E, Winter F, Müller M M, Prager R
II. Medizinische Universitätsklinik, Wien.
Wien Klin Wochenschr Suppl. 1990;180:72-3; discussion 78-81.
During the last years fructosamine has been presented as a measurement of diabetic long term control, particularly a shorter half life of fructosamine was seen as an advantage over HbAlc (half life of fructosamine: 16 days, half life of HbAlc: 28 days). Due to diurnal variations of fructosamine levels especially in dependence of variations of the albumin-and protein concentrations the interpretation of this parameter was somewhat limited. Recently a new colorimetric fructosamine-assay was developed. We investigated the diurnal variations of fructosamine in 28 patients with type II diabetes. Fructosamine, glucose, albumin, total protein and creatinine were measured at the times towards 3, 6, 9, 12 a.m. and 3, 6, 9, and 12 p.m. In relation to the 6 a.m. fructosamine value (= 100%) the fructosamine levels showed a daily variation from -4% at 3 a.m. to +11% at 9 a.m. Correcting fructosamine levels with total protein or with albumin reduced the variations to -1% to +6% or -3% to +9%. Daily profiles of the new fructosamine assay show a daily variation which can be minimized by correcting with protein-or with albumin concentrations. For clinical routine the daily variations especially of the corrected fructosamine levels are neglectible.
在过去几年中,果糖胺一直被用作衡量糖尿病长期控制情况的指标,尤其是果糖胺较短的半衰期被视为相对于糖化血红蛋白(HbAlc)的一个优势(果糖胺半衰期:16天,糖化血红蛋白半衰期:28天)。由于果糖胺水平存在日间变化,特别是依赖于白蛋白和蛋白质浓度的变化,该参数的解读受到一定限制。最近开发了一种新的比色法果糖胺检测方法。我们研究了28例2型糖尿病患者果糖胺的日间变化。在凌晨3点、6点、9点、12点以及下午3点、6点、9点和12点测量果糖胺、葡萄糖、白蛋白、总蛋白和肌酐。相对于凌晨6点的果糖胺值(=100%),果糖胺水平的日间变化为从凌晨3点的-4%到上午9点的+11%。用总蛋白或白蛋白校正果糖胺水平后,变化幅度降至-1%至+6%或-3%至+9%。新的果糖胺检测方法的每日曲线显示出日间变化,通过用蛋白质或白蛋白浓度校正可将其最小化。对于临床常规应用来说,尤其是校正后的果糖胺水平的日间变化可以忽略不计。