ASSOCIATION OF SERUM FRUCTOSAMINE WITH SERUM ALBUMIN AND AVERAGE PLASMA GLUCOSE CONCENTRATION AMONG DIABETES MELLITUS PATIENTS

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.