Abstract:
Diabetes mellitus is a chronic metabolic disorder characterized by persistent
hyperglycemia; monitoring glycemic status is crucial for effective diabetes
management, with fasting plasma glucose (FPG), postprandial plasma glucose (PPPG),
and glycated hemoglobin (HbA1c) being commonly used biomarkers. Fructosamine,
which is a glycated protein (GP), is an alternative marker that can overcome the
limitations of HbA1c associated with red cell abnormalities that reflect intermediate
term glycemic control over 2–3 weeks. Since albumin accounts for 60%to 70% of all
extracellular plasma proteins, fructosamine levels primarily reflect glycated albumin
(GA) levels. However, the Fructosamine test is not routinely used in developing
countries due to its high cost and a lack of awareness of well-established reference
ranges. Therefore, this study aims to investigate the correlation between GP and
average glucose and total serum albumin concentrations. Patients over 18 years old
diagnosed with DM, who met the inclusion criteria were selected for the study (n=202).
The laboratory results, including FPG, PPPG, serum albumin, and serum fructosamine,
were obtained from Colorimetric assays. Mainly, descriptive statistics and bivariate
correlation analysis were conducted to establish associations between serum albumin,
FPG, PPPG, and fructosamine. Fructosamine exhibited a strong positive correlation
with the average FPG and PPPG (r = 0.825, P < 0.01) and a moderate correlation with
serum albumin (r = 0.258, P < 0.01). Also, a higher association was observed with
lower albumin levels [<3.5 mg/dl], while a weak correlation was found at normal
albumin levels [>3.5 mg/dl], indicating that glucose exposure time and albumin half
life are directly influencing glycated protein levels. This study establishes a strong
association between Average plasma glucose levels and albumin, emerging as the most
reliable predictor for fructosamine. Even though, due to the bromocresol purple assay
limitations, the study couldn’t obtain the non-glycated albumin portion separately, the
study found that glycation of proteins is primarily influenced by the duration of
glycemic exposure and the half-life of albumin.
