Summary
Glucose intolerance often occurs in liver cirrhosis; therefore a long-term control of plasma glucose levels appears to be important. For this purpose glycated hemoglobin A (HbA1c) determination is proposed as a suitable method, while no data are available on fructosamine test. In 98 cirrhotic patients serum fructosamine and HbA1c levels were compared with those of normal controls and among cirrhotic patients grouped in non glucose-intolerant and with non insulin-dependent (NIDDM) or insulin-dependent diabetes mellitus (IDDM). The mean HbA1c values of cirrhotic patients with normal glycemic control were significantly lower than normal, and only a few IDDM and NIDDM cirrhotic patients showed high values of HbA1c, indicating that HbA1c is often underestimated in these patients. On the contrary, serum fructosamine levels were on the average higher than normal in nondiabetic patients, but they were significantly higher in IDDM and NIDDM patients than in nondiabetics, and the 72% of NIDDM and 85% of IDDM patients had fructosamine levels higher than the upper normal value. In conclusion, in diabetic patients with liver cirrhosis fructosamine seems to be a more suitable test than HbA1c for monitoring blood glucose levels.
Similar content being viewed by others
References
Armbruster D.: Fructosamine structure analysis and clinical usefulness — Clin. Chem.33, 2153, 1987.
Backer J. R., Metcalf P. A., Johnson R. N., Newman D., Rietz P.: Use of protein-based standards in automated colorimetric determinations of fructosamine in serum — Clin. Chem.31, 1550, 1985.
Backer J. R., O’Connor J. P., Metcalf P. A., Lawson M. R., Johnson R. N.: Clinical usefulness of estimation of serum fructosamine concentration as a screening test for diabetes mellitus — Brit. med. J.287, 863, 1983.
Dolhofer R., Stadele A., Wieland O. H.: Clinical and biochemical studies on the significance and formation of hemoglobin Alc and Ala+b in diabetes mellitus — Klin. Wschr.55, 945, 1984.
Greco A. V., Rebuzzi A. G., Altomonte A., Manna R., Bertoli A., Ghirlanda G.: Glucose insulin and somatostatin infusion for the determination of insulin resistance in liver cirrhosis — Hormone metabol. Res.11, 547, 1979.
Howey J. E. A., Browning M. C. K., Frazer C. G.: Assay of serum fructosamine that minimizes standardization and matrix problems: use to assess components of biological variation — Clin. Chem.33, 269, 1987.
Hwang Y. S., Kim J. Q., Cho H. I.: Correction of serum fructosamine concentration in hypoalbuminemia — Clin. Chem.33, 1003, 1987.
Johnson R. N., Metcalf P. A., Backer J. R.: Fructosamine: a new approach to the estimation of serum glycosyl protein as index of diabetic control — Clin. chim. Acta127, 87, 1983.
Kynoogh P. A. M., Leheman H.: Rapid estimation of glycated hemoglobin for routine purpose — Lancetii, 16, 1977.
Larner J.: Insulin and oral hypoglycemic drugs, glucagon. In:Goodman L. S., Gilman A. (Eds): The Pharmacological Basis of Therapeutics. 6th ed., MacMillan, New York, 1980; p. 1511.
Lloyd D., Marples J.: Simple colorimetry of glycated serum protein in a centrifugal analyzer — Clin. Chem.30, 1686, 1984.
Mosca A., Carenini A., Zoppi F., Carpinelli A., Banfi G., Ceriotti F., Bonini P., Pozza G.: Plasma protein glycation as measured by fructosamine assay — Clin. Chem.33, 1141, 1987.
National Diabetes Data Group: Report of the Expert Committee on glycosylated hemoglobin — Diabetes Care7, 602, 1974.
Petit S., Chimenes H., Darvis F., Senan C., Blouquit Y., Rosa J.: Modification du taux de l’hémoglobine glycosylée HbA1c au cours des cirrhoses — Nouv. Presse méd.35, 10, 1981.
Rodriguez-Segade S., Lojo S., Camina M. F., Paz M. J., Del Rio R.: Effects of various serum proteins on quantification of fructosamine — Clin. Chem.35, 134, 1989.
Shurberg J. L., Resnick R. H., Koff R. S., Ross E., Baum R. A., Pallotta J. A.: Serum lipids, insulin and glucagon after portacaval shunt in cirrhosis — Gastroenterology72, 301, 1977.
Simon M., Eissler J.: Critical factors in the chromatographic measurement of glycohemoglobin HbAl — Diabetes29, 467, 1980.
Son-Gil F., Schirer G. M., Moses R. G., Gan I. E. T.: Improved estimation of fructosamine as a measure of glycated serum protein with Technicon RA 1000 analyzer — Clin. Chem.31, 2005, 1985.
van Diejjen-Visser M. P., Seynaeve C., Brumbacher P. J.: Influence of variations in albumin or total protein concentration on serum fructosamine — Clin. Chem.32, 1610, 1986.
Young S. L., Stanley M. J.: Measurement of plasma fructosamine evaluated for monitoring diabetes — Clin. Chem.31, 731, 1985.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Trenti, T., Cristani, A., Cioni, G. et al. Fructosamine and glycated hemoglobin as indices of glycemic control in patients with liver cirrhosis. La Ricerca in Clin. Lab. 20, 261–267 (1990). https://doi.org/10.1007/BF02900711
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF02900711