AIM： TO unravel the possible association of malondialdehyde （MDA） and fructosamine in anemic H pylori infected patients and to observe the alteration in MDA and fructosamine levels in these patients after treatment...AIM： TO unravel the possible association of malondialdehyde （MDA） and fructosamine in anemic H pylori infected patients and to observe the alteration in MDA and fructosamine levels in these patients after treatment for one month. METHODS： Fructosamine, MDA and glucose were estimated in 22 anemic H pylori infected patients and 16 healthy controls. Hematological parameters were also evaluated in both the groups using Sysmex-K-100 automated cell counter. The H pylori infected patients were randomly divided into two groups. Hpylori infected patients in Group Ⅰ received both iron supplementation and anti-H pylori therapy, while patients in Group Ⅱ received only iron supplementation. All the biochemical and hematological parameters were estimated after one month of treatment. RESULTS： In anemic H pylori infected patients, while MDA （5.41 ± 2.16 vs 2.26 ± 0.50; P 〈 0.05） and fructosamine （2.64 ± 0.93 vs 1.60 ± 0.35; P 〈 0.05） were significantly increased, iron （32.72 ± 14.93 vs 110.25 ± 26.58; P 〈 0.05）, hemoglobin （6.9 ± 2.6 vs 12.66 ± 0.74; P 〈 0.05） and ferritin （28.82 ± 16.27 vs 140.43 ± 30.72; P 〈 0.05） levels were significantly decreased compared with the controls. With partial correlation analysis, fructosamine was found to have a significant positive correlation with MDA. In Group I, while MDA level decreased significantly （3.11 ± 1.73 vs 5.50 ± 2.46; P 〈 0.05）, there was a significant increase in iron （84.09 ± 29.51 vs 36.09 ± 17.81; P 〈 0.05）, hemoglobin （10.40 ± 1.11 vs 7.42 ± 1.90; P 〈 0.05） and ferritin （116.91 ± 63.34 vs 30.46 ± 17.81; P 〈 0.05） levels after one month. There was no significant change in the levels of fructosamine in group Ⅰ after treatment. Similarly, no significant alterations were noted in the levels of IDA, fructosamine, hemoglobin or ferritin in Group Ⅱ patients after one month of treatment. CONCLUSION： An increased level of fructosamine and MDA was found in anemic H pylori infected patients. Present data supports the premise that lipid peroxides per se do play a role in the glycation of plasma proteins. Furthermore, the findings from this study indicate that treatment for both anemia and H pylori infections is required for lowering the levels of lipid peroxides in these patients.展开更多
Background: Diabetes mellitus complicates 1%-2% of all pregnancies, and associates with high perinatal morbidity. Gestational diabetes mellitus (GDM) is treatable condition, and women who have adequate glycemic contro...Background: Diabetes mellitus complicates 1%-2% of all pregnancies, and associates with high perinatal morbidity. Gestational diabetes mellitus (GDM) is treatable condition, and women who have adequate glycemic control during pregnancy can effectively decrease the adverse outcomes of GDM. Objectives: This study was designed to compare the serum fructosamine, and the glycosylated hemoglobin (HbA1c), in monitoring the glycemic control in GDM. Patients and Methods: 1516 women with GDM included, and were advised for dietary modification to achieve proper glycemic control. If the target glucose levels were not reached by the diet regimen or by the dietary modification, insulin was prescribed for the studied women. The average values of the pre- and post-prandial glucose levels were calculated, and the insulin doses were adjusted to achieve the target glucose values during the antenatal visits. HbA1c, and fructosamine were measured to assess the glycemic control for the studied women. Results: The fructosamine, and the HbA1c were significantly high in the uncontrolled GDM compared to controlled group, and there was positive significant correlation between fractuosamine, and HbA1c in monitoring the glycemic control in GDM (r = 0.93, and P = 0.001). The Odds ratio (OR), and relative risk (RR) analysis for the current pregnancy outcome showed that the polyhydramnios (OR 3.8;RR 3.7), the cesarean delivery (OR 1.7;RR 1.4), the fetal macrosomia (OR 6.4;RR 6.3), the fetal anomalies (OR 6.5;RR 6.4), and the (IUFD) intrauterine fetal death (OR 8.7;RR 8.6) were significantly high in uncontrolled GDM group. In addition, the (NND) neonatal death (OR 11.6;RR 11.4), the neonatal intensive care unit (NICU) admission (OR 3.1;RR 2.9), the neonatal hyperbilirubinemia (OR 3.7;RR 3.6), the transient tachypnea of the newborn (OR 3.1;RR 2.9), and the neonatal hypoglycemia (OR 3.5;RR 3.4) were significantly high in uncontrolled GDM group. Conclusion: Fructosamine assay is simple, reliable, useful indicator for the glycemic control in GDM over the last 2 - 3 weeks, and poor glycemic control in GDM increases the risk of adverse maternal and neonatal outcomes.展开更多
BACKGROUND The association between blood levels of fructosamine(FMN)and recurrent coronavirus disease 2019(COVID-19)is currently unclear.AIM To investigate a prospective relationship between blood levels of FMN and se...BACKGROUND The association between blood levels of fructosamine(FMN)and recurrent coronavirus disease 2019(COVID-19)is currently unclear.AIM To investigate a prospective relationship between blood levels of FMN and severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)reinfection.METHODS A total of 146 Chinese hospitalized patients infected with SARS-CoV-2 were consecutively collectively recruited and followed from January 2020 to May 2021.Diagnosis of COVID-19 and SARS-CoV-2 reinfection was based on the diagnostic criteria and treatment protocol in China.The levels of FMN were determined in blood and divided into tertiles based on their distribution in the cohort of COVID-19 patients.Multivariate-adjusted hazard ratios(HRs)with 95%confidence intervals(CIs)were estimated for SARS-CoV-2 reinfection across the tertiles of FMN levels.A Cox regression model was used to generate the HR for SARS-CoV-2 reinfection in the participants in the top tertile of FMN levels compared with those at the bottom.Disease-free survival was used as the time variable,and relapse was used as the state variable,adjusted for age,gender,influencing factors such as diabetes mellitus,hypertension,and corticosteroid therapy,and clinical indexes such as acute liver failure,acute kidney failure,white blood cell(WBC)count,C-reactive protein,prognostic nutritional index(PNI),and blood lipids.Kaplan-Meier analysis with log-rank tests was used to compare the survival rate between patients with elevated FMN levels(FMN>1.93 mmol/L,the top tertile)and those with nonelevated levels.RESULTS Clinical data for the 146 patients with confirmed COVID-19[age 49(39-55)years;49%males]were analyzed.Eleven patients had SARS-CoV-2 reinfection.The SARS-CoV-2 reinfection rate in patients with elevated FMN levels was significantly higher than that in patients with nonelevated FMN(17%vs 3%;P=0.008)at the end of the 12-mo follow-up.After adjustments for gender,age,diabetes mellitus,hypertension,corticosteroid therapy,WBC count,PNI,indexes of liver and renal function,and blood lipids,patients with nonelevated FMN levels had a lower risk of SARS-CoV-2 reinfection than those with elevated FMN levels(HR=6.249,95%CI:1.377-28.351;P=0.018).Kaplan-Meier analysis showed that the cumulative survival rate of patients infected with SARSCoV-2 was higher in patients with nonelevated FMN levels than in those with elevated FMN levels(97%vs 83%;log rank P=0.002).CONCLUSION Elevated levels of FMN are independently associated with SARS-CoV-2 reinfection,which highlights that patients with elevated FMN should be cautiously monitored after hospital discharge.展开更多
BACKGROUND:Diabetes mellitus is one of the risk factors in patients with acute cerebral disease,and always leads to stroke or get it worse.There is often a high level of blood glucose in those patients with diabetes m...BACKGROUND:Diabetes mellitus is one of the risk factors in patients with acute cerebral disease,and always leads to stroke or get it worse.There is often a high level of blood glucose in those patients with diabetes mellitus and cerebral disease,but it is hard to distinguish from both kinds of hyperglycemia.Serum fructosamine is said to be correlated with blood glucose.OBJECTIVE:To explore the relationship between serum fructosamine and blood glucose in patients with acute cerebrovascular disease.DESIGN:A case-controlled study.SETTINGS:Department of Clinical Laboratory,Health Department for Cadres and Department of Neurology of Affiliated Hospital,Qingdao University Medical College.PARTICIPANTS:Forty-eight inpatients and outpatients with cerebrovascular diseases were selected from the Department of Neurology,Affiliated Hospital of Qingdao University Medical College from December 2004 to April 2005.All the patients were confirmed with CT and MRI.There were 25 patients with diabetes mellitus secondary cerebrovascular diseases,who met the diagnostic standards of diabetes mellitus set by WHO,including 12 males and 13 females with an average of(60±8)years old,the course of diabetes mellitus ranged from 1 to 21 years..The other 23 patients had no diabetes mellitus(without diabetes mellitus group),including 14 males and 9 females with an average of(62±6)years old.Meanwhile,another 50 healthy physical examinees in the hospital were selected as control group,including 26 males and 24 females with the average age of(62±5)years old.Informed content was obtained from all the participants.METHODS:Venous blood was drawn from all the participants,and content of blood glucose was assayed by means of glucose oxidase,and the concentration of serum fructosamine was determined by nitroblue tetrazolium colorimetric method.Comparison between groups was performed by the analysis of variance and q test,and the correlation was tested by linear regression analysis.MAIN OUTCOME MEASURES:①Comparison of blood glucose and serum fructosamine among the groups;②Correlation between serum fructosamine and blood glucose in patients with diabetes mellitus secondary cerebrovascular diseases and those without diabetes mellitus.RESULTS:All the 48 patients with cerebrovascular disease and 50 healthy subjects were involved in the analysis of results.①Contents of blood glucose and serum fructosamine:There were obvious differences in the contents of blood glucose and serum fructosamine among the diabetes mellitus group,without diabetes mellitus group and control group(F=577.7,115.1,P<0.01).The content of serum fructosamine in the diabetes mellitus group[(4.25±1.35)mmol/L]was obviously higher than those in the control group and without diabetes mellitus group[(1.65±0.27),(1.96±0.25)mmol/L,q=1.47,1.30,P<0.01],whereas there was no significant difference between the without diabetes mellitus group and control group(P>0.05).The content of blood glucose was obviously higher in the patients with and without diabetes mellitus groups[(15.80±2.13),(9.50±1.78)mmol/L]than in the control group[(4.56±0.77)mmol/L,q=1.86,2.46,P<0.01],also markedly higher in the with diabetes mellitus group than in the without diabetes mellitus group(q=1.42,P<0.01).②Results of correlation analysis:The content of serum fructosamine was positively correlated with the level of fasting blood glucose in the patients with diabetes mellitus secondary cerebrovascular diseases(r=0.603,P<0.01).But there was no relationship between serum fructosamine and fasting blood glucose in the patients without diabetes mellitus(r=0.357,P>0.05).CONCLUSION:The contents of blood glucose and serum fructosamine were obviously different among the diabetes mellitus group,without diabetes mellitus group and control group.There are closer relations between serum fructosamine and blood glucose in patients with diabetes mellitus secondary cerebral disorders,which are not observed in the patients without diabetes mellitus.Fructosamine is significant in differentiating the reasons for the increased blood glucose in patients with acute cerebrovascular disease.展开更多
Background The concentration of serum fructosamine is correlated with plasma glucose level. The aim of this study was to determine whether the level of serum fructosamine can be diagnostic for abnormal glucose toleran...Background The concentration of serum fructosamine is correlated with plasma glucose level. The aim of this study was to determine whether the level of serum fructosamine can be diagnostic for abnormal glucose tolerance in pregnant women. Methods Serum samples were collected from 161 pregnant women between November 2004 and April 2005. The women were divided into three groups according to the gestational age （16-20 weeks group, 56 patients; 28 -34 weeks group, 72; and 37-41 weeks group, 33）. Each group was subdivided into normal and abnormal glucose tolerance subgroups. The levels of serum fructosamine were measured. Differences among the groups were assessed by ANOVA and Student-Newman-Keuls test. Correlations between the level of fructosamine and other variables including the results of glucose challenge test （GCT）, oral glucose tolerance test （OGTT）, and glycosylated hemoglobin （HbAlc） test, and infant＇s birth weight were analyzed by Pearson correlation. Results The level of serum fructosamine decreased with gestational age [（223.25±48.90） μmol/L, （98.44±29.57） μmol/L, and （53.99±29.94） μmol/L, respectively. P〈0.05]. It was higher in women with abnormal glucose tolerance than that in women with normal glucose tolerance, however, the difference reached statistical significance only in the 28-34 weeks group （P〈0.05）. In this group, the level of serum fructosamine correlated positively with the GCT result （r=0.28, P〈0.05）. No correlation was found between fructosamine level and OGTr result, HbAlc level, or neonatal weight. Conclusions Fructosamine can be used to monitor the glucose level of pregnant women with abnormal glucose tolerance, and to identify the patients at high risk of abnormal glucose tolerance, but can not be used to predict gestational diabetes mellitus （GDM） in early stage of pregnancy.展开更多
Recently, it has become clear that mild abnormal glucose tolerance increases the incidence of perinatal maternalinfant complications, and so the definition and diagnostic criteria of gestational diabetes mellitus(GDM)...Recently, it has become clear that mild abnormal glucose tolerance increases the incidence of perinatal maternalinfant complications, and so the definition and diagnostic criteria of gestational diabetes mellitus(GDM) have been changed. Therefore, in patients with GDM and pregnant women with diabetes mellitus, even stricter glycemic control than before is required to reduce the incidence of perinatal maternal-infant complications. Strict glycemic control cannot be attained without an indicator of glycemic control; this review proposes a reliable indicator. The gold standard indicator of glycemic control in patients with diabetes mellitus is hemoglobin A1c(Hb A1c); however, we have demonstrated that Hb A1 c does not reflect glycemic control accurately during pregnancy because of iron deficiency. It has also become clear that glycated albumin, another indicator of glycemic control, is not influenced by iron deficiency and therefore might be a better indicator of glycemic control in patients with GDM and pregnant women with diabetes mellitus. However, largepopulation epidemiological studies are necessary in order to confirm our proposal. Here, we outline the most recent findings about the indicators of glycemic control during pregnancy including fructosamine and 1,5-anhydroglucitol.展开更多
Attaining and maintaining good glycemic control is a cornerstone of diabetes care. The monitoring of glycemic control is currently based on the self-monitoring of blood glucose(SMBG) and laboratory testing for hemoglo...Attaining and maintaining good glycemic control is a cornerstone of diabetes care. The monitoring of glycemic control is currently based on the self-monitoring of blood glucose(SMBG) and laboratory testing for hemoglobin A1 c(HbA1 c),which is a surrogate biochemical marker of the average glycemia level over the previous 2-3 mo period. Although hyperglycemia is a key biochemical feature of diabetes, both the level of and exposure to high glucose, as well as glycemic variability, contribute to the pathogenesis of diabetic complications and follow different patterns in type 1 and type 2 diabetes. HbA1 c provides a valuable,standardized and evidence-based parameter that is relevant for clinical decision making, but several biological and analytical confounders limit its accuracy in reflecting true glycemia. It has become apparent in recent years that other glycated proteins such as fructosamine, glycated albumin, and the nutritional monosaccharide 1,5-anhydroglucitol, as well as integrated measures from direct glucose testing by an SMBG/continuous glucose monitoring system, may provide valuable complementary data, particularly in circumstances when HbA1 c results may be unreliable or are insufficient to assess the risk of adverse outcomes. Long-term associations of these alternative biomarkers of glycemia with the risk of complications need to be investigated in order to provide clinically relevant cut-off values and to validate their utility in diverse populations of diabetes patients.展开更多
AIM:To evaluate the glycated hemoglobin(HbA_(1c)) determination methods and to determine fructosamine in patients with chronic hepatitis,compensated cirrhosis and in patients with chronic hepatitis treated with ribavi...AIM:To evaluate the glycated hemoglobin(HbA_(1c)) determination methods and to determine fructosamine in patients with chronic hepatitis,compensated cirrhosis and in patients with chronic hepatitis treated with ribavirin. METHODS:HbA_(1c) values were determined in 15 patients with compensated liver cirrhosis and in 20 patients with chronic hepatitis using the ion-exchange high performance liquid chromatography and the immunoassay methods. Fructosamine was determined using nitroblue tetrazolium. RESULTS:Forty percent of patients with liver cirrhosis had HbA_(1c) results below the non-diabetic reference range by at least one HbA_(1c)method,while fructosamine results were either within the reference range or elevated.Twenty percent of patients with chronic hepatitis(hepatic fibrosis) had HbA_(1c)results below the non-diabetic reference range by at least one HbA_(1c)method.In patients with chronic hepatitis treated with ribavirin,50% of HbA_(1c)results were below the non-diabetic reference using at least one of the HbA_(1c)methods. CONCLUSION:Only evaluated in context with all liver function parameters as well as a red blood count including reticulocytes,HbA_(1c)results should be used in patients with advanced liver disease.HbA_(1c)and fructosamine measurements should be used with caution when evaluating long-term glucose control in patients with hepatic cirrhosis or in patients with chronic hepatitis and dbavidn treatment.展开更多
Neonatal diabetes mellitus(NDM) is a type of diabetes mellitus caused by genetic abnormality which devel ops in insulin dependent state within 6 mo after birth HbA1c is widely used in clinical practice for diabetes me...Neonatal diabetes mellitus(NDM) is a type of diabetes mellitus caused by genetic abnormality which devel ops in insulin dependent state within 6 mo after birth HbA1c is widely used in clinical practice for diabetes mellitus as the gold standard glycemic control indica tor; however, fetal hemoglobin(HbF) is the main he moglobin in neonates and so HbA1c cannot be used as a glycemic control indicator in NDM. Glycated albumin(GA), another glycemic control indicator, is not affected by HbF. We reported that GA can be used as a glycemic control indicator in NDM. However, it was later found that because of increased metabolism of albumin, GA shows an apparently lower level in relation to plasma glucose in NDM; measures to solve this problem were needed. In this review, we outlined the most recen findings concerning glycemic control indicators in neo nates or NDM.展开更多
Introduction: Good glycaemic control without causing excessive hypoglycaemia reduced the risk of macrovascular and microvascular complications in type 2 DM patients on regular haemodialysis (HD). The objectives of thi...Introduction: Good glycaemic control without causing excessive hypoglycaemia reduced the risk of macrovascular and microvascular complications in type 2 DM patients on regular haemodialysis (HD). The objectives of this study were to assess the efficacy and safety of add-on saxagliptin to insulin therapy in blood sugar control compared to insulin therapy alone in diabetic patients undergoing HD. Design and Methods: In this prospective open-labelled randomized controlled trial, HD patients with type 2 DM and on stable insulin therapy with HbA1c 7% - 13% were randomized to receive add-on saxagliptin 2.5 mg once daily to insulin therapy or insulin therapy only for 12 weeks. Results: 24 patients were randomized into each arm equally. Baseline and week-12 serum HbA1c, fructosamine, fasting blood glucose (FBS) and mean self monitoring blood glucose (SMBG) were comparable in the groups. Reduction of HbA1c and mean SMBG were significant in both groups. There was a significant drop in fructosamine levels (p = 0.004) and trend of lower FBS (p = 0.097) in add-on saxagliptin group but not in insulin alone group. The incidence of hypoglycaemia was the same in both groups. Conclusion: Add-on saxagliptin to insulin is comparable to insulin therapy alone in blood sugar control in regular HD patients and is safe and generally well tolerated. Add-on saxagliptin group may have more persistent and less fluctuation of glucose control compared to insulin only group.展开更多
文摘AIM： TO unravel the possible association of malondialdehyde （MDA） and fructosamine in anemic H pylori infected patients and to observe the alteration in MDA and fructosamine levels in these patients after treatment for one month. METHODS： Fructosamine, MDA and glucose were estimated in 22 anemic H pylori infected patients and 16 healthy controls. Hematological parameters were also evaluated in both the groups using Sysmex-K-100 automated cell counter. The H pylori infected patients were randomly divided into two groups. Hpylori infected patients in Group Ⅰ received both iron supplementation and anti-H pylori therapy, while patients in Group Ⅱ received only iron supplementation. All the biochemical and hematological parameters were estimated after one month of treatment. RESULTS： In anemic H pylori infected patients, while MDA （5.41 ± 2.16 vs 2.26 ± 0.50; P 〈 0.05） and fructosamine （2.64 ± 0.93 vs 1.60 ± 0.35; P 〈 0.05） were significantly increased, iron （32.72 ± 14.93 vs 110.25 ± 26.58; P 〈 0.05）, hemoglobin （6.9 ± 2.6 vs 12.66 ± 0.74; P 〈 0.05） and ferritin （28.82 ± 16.27 vs 140.43 ± 30.72; P 〈 0.05） levels were significantly decreased compared with the controls. With partial correlation analysis, fructosamine was found to have a significant positive correlation with MDA. In Group I, while MDA level decreased significantly （3.11 ± 1.73 vs 5.50 ± 2.46; P 〈 0.05）, there was a significant increase in iron （84.09 ± 29.51 vs 36.09 ± 17.81; P 〈 0.05）, hemoglobin （10.40 ± 1.11 vs 7.42 ± 1.90; P 〈 0.05） and ferritin （116.91 ± 63.34 vs 30.46 ± 17.81; P 〈 0.05） levels after one month. There was no significant change in the levels of fructosamine in group Ⅰ after treatment. Similarly, no significant alterations were noted in the levels of IDA, fructosamine, hemoglobin or ferritin in Group Ⅱ patients after one month of treatment. CONCLUSION： An increased level of fructosamine and MDA was found in anemic H pylori infected patients. Present data supports the premise that lipid peroxides per se do play a role in the glycation of plasma proteins. Furthermore, the findings from this study indicate that treatment for both anemia and H pylori infections is required for lowering the levels of lipid peroxides in these patients.
文摘Background: Diabetes mellitus complicates 1%-2% of all pregnancies, and associates with high perinatal morbidity. Gestational diabetes mellitus (GDM) is treatable condition, and women who have adequate glycemic control during pregnancy can effectively decrease the adverse outcomes of GDM. Objectives: This study was designed to compare the serum fructosamine, and the glycosylated hemoglobin (HbA1c), in monitoring the glycemic control in GDM. Patients and Methods: 1516 women with GDM included, and were advised for dietary modification to achieve proper glycemic control. If the target glucose levels were not reached by the diet regimen or by the dietary modification, insulin was prescribed for the studied women. The average values of the pre- and post-prandial glucose levels were calculated, and the insulin doses were adjusted to achieve the target glucose values during the antenatal visits. HbA1c, and fructosamine were measured to assess the glycemic control for the studied women. Results: The fructosamine, and the HbA1c were significantly high in the uncontrolled GDM compared to controlled group, and there was positive significant correlation between fractuosamine, and HbA1c in monitoring the glycemic control in GDM (r = 0.93, and P = 0.001). The Odds ratio (OR), and relative risk (RR) analysis for the current pregnancy outcome showed that the polyhydramnios (OR 3.8;RR 3.7), the cesarean delivery (OR 1.7;RR 1.4), the fetal macrosomia (OR 6.4;RR 6.3), the fetal anomalies (OR 6.5;RR 6.4), and the (IUFD) intrauterine fetal death (OR 8.7;RR 8.6) were significantly high in uncontrolled GDM group. In addition, the (NND) neonatal death (OR 11.6;RR 11.4), the neonatal intensive care unit (NICU) admission (OR 3.1;RR 2.9), the neonatal hyperbilirubinemia (OR 3.7;RR 3.6), the transient tachypnea of the newborn (OR 3.1;RR 2.9), and the neonatal hypoglycemia (OR 3.5;RR 3.4) were significantly high in uncontrolled GDM group. Conclusion: Fructosamine assay is simple, reliable, useful indicator for the glycemic control in GDM over the last 2 - 3 weeks, and poor glycemic control in GDM increases the risk of adverse maternal and neonatal outcomes.
文摘BACKGROUND The association between blood levels of fructosamine(FMN)and recurrent coronavirus disease 2019(COVID-19)is currently unclear.AIM To investigate a prospective relationship between blood levels of FMN and severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)reinfection.METHODS A total of 146 Chinese hospitalized patients infected with SARS-CoV-2 were consecutively collectively recruited and followed from January 2020 to May 2021.Diagnosis of COVID-19 and SARS-CoV-2 reinfection was based on the diagnostic criteria and treatment protocol in China.The levels of FMN were determined in blood and divided into tertiles based on their distribution in the cohort of COVID-19 patients.Multivariate-adjusted hazard ratios(HRs)with 95%confidence intervals(CIs)were estimated for SARS-CoV-2 reinfection across the tertiles of FMN levels.A Cox regression model was used to generate the HR for SARS-CoV-2 reinfection in the participants in the top tertile of FMN levels compared with those at the bottom.Disease-free survival was used as the time variable,and relapse was used as the state variable,adjusted for age,gender,influencing factors such as diabetes mellitus,hypertension,and corticosteroid therapy,and clinical indexes such as acute liver failure,acute kidney failure,white blood cell(WBC)count,C-reactive protein,prognostic nutritional index(PNI),and blood lipids.Kaplan-Meier analysis with log-rank tests was used to compare the survival rate between patients with elevated FMN levels(FMN>1.93 mmol/L,the top tertile)and those with nonelevated levels.RESULTS Clinical data for the 146 patients with confirmed COVID-19[age 49(39-55)years;49%males]were analyzed.Eleven patients had SARS-CoV-2 reinfection.The SARS-CoV-2 reinfection rate in patients with elevated FMN levels was significantly higher than that in patients with nonelevated FMN(17%vs 3%;P=0.008)at the end of the 12-mo follow-up.After adjustments for gender,age,diabetes mellitus,hypertension,corticosteroid therapy,WBC count,PNI,indexes of liver and renal function,and blood lipids,patients with nonelevated FMN levels had a lower risk of SARS-CoV-2 reinfection than those with elevated FMN levels(HR=6.249,95%CI:1.377-28.351;P=0.018).Kaplan-Meier analysis showed that the cumulative survival rate of patients infected with SARSCoV-2 was higher in patients with nonelevated FMN levels than in those with elevated FMN levels(97%vs 83%;log rank P=0.002).CONCLUSION Elevated levels of FMN are independently associated with SARS-CoV-2 reinfection,which highlights that patients with elevated FMN should be cautiously monitored after hospital discharge.
文摘BACKGROUND:Diabetes mellitus is one of the risk factors in patients with acute cerebral disease,and always leads to stroke or get it worse.There is often a high level of blood glucose in those patients with diabetes mellitus and cerebral disease,but it is hard to distinguish from both kinds of hyperglycemia.Serum fructosamine is said to be correlated with blood glucose.OBJECTIVE:To explore the relationship between serum fructosamine and blood glucose in patients with acute cerebrovascular disease.DESIGN:A case-controlled study.SETTINGS:Department of Clinical Laboratory,Health Department for Cadres and Department of Neurology of Affiliated Hospital,Qingdao University Medical College.PARTICIPANTS:Forty-eight inpatients and outpatients with cerebrovascular diseases were selected from the Department of Neurology,Affiliated Hospital of Qingdao University Medical College from December 2004 to April 2005.All the patients were confirmed with CT and MRI.There were 25 patients with diabetes mellitus secondary cerebrovascular diseases,who met the diagnostic standards of diabetes mellitus set by WHO,including 12 males and 13 females with an average of(60±8)years old,the course of diabetes mellitus ranged from 1 to 21 years..The other 23 patients had no diabetes mellitus(without diabetes mellitus group),including 14 males and 9 females with an average of(62±6)years old.Meanwhile,another 50 healthy physical examinees in the hospital were selected as control group,including 26 males and 24 females with the average age of(62±5)years old.Informed content was obtained from all the participants.METHODS:Venous blood was drawn from all the participants,and content of blood glucose was assayed by means of glucose oxidase,and the concentration of serum fructosamine was determined by nitroblue tetrazolium colorimetric method.Comparison between groups was performed by the analysis of variance and q test,and the correlation was tested by linear regression analysis.MAIN OUTCOME MEASURES:①Comparison of blood glucose and serum fructosamine among the groups;②Correlation between serum fructosamine and blood glucose in patients with diabetes mellitus secondary cerebrovascular diseases and those without diabetes mellitus.RESULTS:All the 48 patients with cerebrovascular disease and 50 healthy subjects were involved in the analysis of results.①Contents of blood glucose and serum fructosamine:There were obvious differences in the contents of blood glucose and serum fructosamine among the diabetes mellitus group,without diabetes mellitus group and control group(F=577.7,115.1,P<0.01).The content of serum fructosamine in the diabetes mellitus group[(4.25±1.35)mmol/L]was obviously higher than those in the control group and without diabetes mellitus group[(1.65±0.27),(1.96±0.25)mmol/L,q=1.47,1.30,P<0.01],whereas there was no significant difference between the without diabetes mellitus group and control group(P>0.05).The content of blood glucose was obviously higher in the patients with and without diabetes mellitus groups[(15.80±2.13),(9.50±1.78)mmol/L]than in the control group[(4.56±0.77)mmol/L,q=1.86,2.46,P<0.01],also markedly higher in the with diabetes mellitus group than in the without diabetes mellitus group(q=1.42,P<0.01).②Results of correlation analysis:The content of serum fructosamine was positively correlated with the level of fasting blood glucose in the patients with diabetes mellitus secondary cerebrovascular diseases(r=0.603,P<0.01).But there was no relationship between serum fructosamine and fasting blood glucose in the patients without diabetes mellitus(r=0.357,P>0.05).CONCLUSION:The contents of blood glucose and serum fructosamine were obviously different among the diabetes mellitus group,without diabetes mellitus group and control group.There are closer relations between serum fructosamine and blood glucose in patients with diabetes mellitus secondary cerebral disorders,which are not observed in the patients without diabetes mellitus.Fructosamine is significant in differentiating the reasons for the increased blood glucose in patients with acute cerebrovascular disease.
基金This study was supported by a grand from the National "211 project" Peking University EMB group (No. 91000-242156028).
文摘Background The concentration of serum fructosamine is correlated with plasma glucose level. The aim of this study was to determine whether the level of serum fructosamine can be diagnostic for abnormal glucose tolerance in pregnant women. Methods Serum samples were collected from 161 pregnant women between November 2004 and April 2005. The women were divided into three groups according to the gestational age （16-20 weeks group, 56 patients; 28 -34 weeks group, 72; and 37-41 weeks group, 33）. Each group was subdivided into normal and abnormal glucose tolerance subgroups. The levels of serum fructosamine were measured. Differences among the groups were assessed by ANOVA and Student-Newman-Keuls test. Correlations between the level of fructosamine and other variables including the results of glucose challenge test （GCT）, oral glucose tolerance test （OGTT）, and glycosylated hemoglobin （HbAlc） test, and infant＇s birth weight were analyzed by Pearson correlation. Results The level of serum fructosamine decreased with gestational age [（223.25±48.90） μmol/L, （98.44±29.57） μmol/L, and （53.99±29.94） μmol/L, respectively. P〈0.05]. It was higher in women with abnormal glucose tolerance than that in women with normal glucose tolerance, however, the difference reached statistical significance only in the 28-34 weeks group （P〈0.05）. In this group, the level of serum fructosamine correlated positively with the GCT result （r=0.28, P〈0.05）. No correlation was found between fructosamine level and OGTr result, HbAlc level, or neonatal weight. Conclusions Fructosamine can be used to monitor the glucose level of pregnant women with abnormal glucose tolerance, and to identify the patients at high risk of abnormal glucose tolerance, but can not be used to predict gestational diabetes mellitus （GDM） in early stage of pregnancy.
文摘Recently, it has become clear that mild abnormal glucose tolerance increases the incidence of perinatal maternalinfant complications, and so the definition and diagnostic criteria of gestational diabetes mellitus(GDM) have been changed. Therefore, in patients with GDM and pregnant women with diabetes mellitus, even stricter glycemic control than before is required to reduce the incidence of perinatal maternal-infant complications. Strict glycemic control cannot be attained without an indicator of glycemic control; this review proposes a reliable indicator. The gold standard indicator of glycemic control in patients with diabetes mellitus is hemoglobin A1c(Hb A1c); however, we have demonstrated that Hb A1 c does not reflect glycemic control accurately during pregnancy because of iron deficiency. It has also become clear that glycated albumin, another indicator of glycemic control, is not influenced by iron deficiency and therefore might be a better indicator of glycemic control in patients with GDM and pregnant women with diabetes mellitus. However, largepopulation epidemiological studies are necessary in order to confirm our proposal. Here, we outline the most recent findings about the indicators of glycemic control during pregnancy including fructosamine and 1,5-anhydroglucitol.
文摘Attaining and maintaining good glycemic control is a cornerstone of diabetes care. The monitoring of glycemic control is currently based on the self-monitoring of blood glucose(SMBG) and laboratory testing for hemoglobin A1 c(HbA1 c),which is a surrogate biochemical marker of the average glycemia level over the previous 2-3 mo period. Although hyperglycemia is a key biochemical feature of diabetes, both the level of and exposure to high glucose, as well as glycemic variability, contribute to the pathogenesis of diabetic complications and follow different patterns in type 1 and type 2 diabetes. HbA1 c provides a valuable,standardized and evidence-based parameter that is relevant for clinical decision making, but several biological and analytical confounders limit its accuracy in reflecting true glycemia. It has become apparent in recent years that other glycated proteins such as fructosamine, glycated albumin, and the nutritional monosaccharide 1,5-anhydroglucitol, as well as integrated measures from direct glucose testing by an SMBG/continuous glucose monitoring system, may provide valuable complementary data, particularly in circumstances when HbA1 c results may be unreliable or are insufficient to assess the risk of adverse outcomes. Long-term associations of these alternative biomarkers of glycemia with the risk of complications need to be investigated in order to provide clinically relevant cut-off values and to validate their utility in diverse populations of diabetes patients.
文摘AIM:To evaluate the glycated hemoglobin(HbA_(1c)) determination methods and to determine fructosamine in patients with chronic hepatitis,compensated cirrhosis and in patients with chronic hepatitis treated with ribavirin. METHODS:HbA_(1c) values were determined in 15 patients with compensated liver cirrhosis and in 20 patients with chronic hepatitis using the ion-exchange high performance liquid chromatography and the immunoassay methods. Fructosamine was determined using nitroblue tetrazolium. RESULTS:Forty percent of patients with liver cirrhosis had HbA_(1c) results below the non-diabetic reference range by at least one HbA_(1c)method,while fructosamine results were either within the reference range or elevated.Twenty percent of patients with chronic hepatitis(hepatic fibrosis) had HbA_(1c)results below the non-diabetic reference range by at least one HbA_(1c)method.In patients with chronic hepatitis treated with ribavirin,50% of HbA_(1c)results were below the non-diabetic reference using at least one of the HbA_(1c)methods. CONCLUSION:Only evaluated in context with all liver function parameters as well as a red blood count including reticulocytes,HbA_(1c)results should be used in patients with advanced liver disease.HbA_(1c)and fructosamine measurements should be used with caution when evaluating long-term glucose control in patients with hepatic cirrhosis or in patients with chronic hepatitis and dbavidn treatment.
文摘Neonatal diabetes mellitus(NDM) is a type of diabetes mellitus caused by genetic abnormality which devel ops in insulin dependent state within 6 mo after birth HbA1c is widely used in clinical practice for diabetes mellitus as the gold standard glycemic control indica tor; however, fetal hemoglobin(HbF) is the main he moglobin in neonates and so HbA1c cannot be used as a glycemic control indicator in NDM. Glycated albumin(GA), another glycemic control indicator, is not affected by HbF. We reported that GA can be used as a glycemic control indicator in NDM. However, it was later found that because of increased metabolism of albumin, GA shows an apparently lower level in relation to plasma glucose in NDM; measures to solve this problem were needed. In this review, we outlined the most recen findings concerning glycemic control indicators in neo nates or NDM.
文摘Introduction: Good glycaemic control without causing excessive hypoglycaemia reduced the risk of macrovascular and microvascular complications in type 2 DM patients on regular haemodialysis (HD). The objectives of this study were to assess the efficacy and safety of add-on saxagliptin to insulin therapy in blood sugar control compared to insulin therapy alone in diabetic patients undergoing HD. Design and Methods: In this prospective open-labelled randomized controlled trial, HD patients with type 2 DM and on stable insulin therapy with HbA1c 7% - 13% were randomized to receive add-on saxagliptin 2.5 mg once daily to insulin therapy or insulin therapy only for 12 weeks. Results: 24 patients were randomized into each arm equally. Baseline and week-12 serum HbA1c, fructosamine, fasting blood glucose (FBS) and mean self monitoring blood glucose (SMBG) were comparable in the groups. Reduction of HbA1c and mean SMBG were significant in both groups. There was a significant drop in fructosamine levels (p = 0.004) and trend of lower FBS (p = 0.097) in add-on saxagliptin group but not in insulin alone group. The incidence of hypoglycaemia was the same in both groups. Conclusion: Add-on saxagliptin to insulin is comparable to insulin therapy alone in blood sugar control in regular HD patients and is safe and generally well tolerated. Add-on saxagliptin group may have more persistent and less fluctuation of glucose control compared to insulin only group.
