Negoro H, Morley J E, Rosenthal M J
Sepulveda Veterans Administration Medical Center, Geriatric Research, Education, and Clinical Center, California 91343.
Am J Med. 1988 Sep;85(3):360-4. doi: 10.1016/0002-9343(88)90587-6.
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.
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.
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.
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.
目前用于测定血糖的方法存在某些缺点，包括成本、劳动强度大以及储存问题。另一方面，测定血清果糖胺水平相对于这些现有方法具有若干潜在优势。我们的目标是评估血清果糖胺作为血糖测量指标的效用。
对145名年龄在20至86岁的正常和糖尿病受试者测定果糖胺水平。然后将测得的水平与血糖的标准测量指标相关联，包括糖化血红蛋白、糖化白蛋白和空腹血糖。还研究了已知会改变葡萄糖耐量的慢性病和药物的影响。
果糖胺水平与其他测量指标相关性良好：与血糖的相关系数r = 0.73，与糖化血红蛋白A1C（HbA1C）的相关系数为0.76，与糖化白蛋白的相关系数为0.80。糖尿病受试者的果糖胺水平显著高于非糖尿病受试者（p < 0.001），但不受年龄影响，仅受慢性病的轻微影响。疾病控制良好和控制不佳的糖尿病受试者的值也有显著差异。
血清果糖胺检测在测定血糖控制方面似乎与HbA1C检测相当。与其他糖化蛋白检测相比，果糖胺检测的自动化程度、可重复性和较低成本有力地支持了该检测方法。
