Serum fructosamine (glycated protein)‎ and related biochemical parameters during normal pregnancy

Abstract EN

Objectives : Determine the pattern of change in serum fructosamine and related biochemical parameters during pregnancy, the influence of serum albumin or total protein on frcuctosamine values and the need for correcting them accordingly.

Methods : Fasting plasma glucose (FPG) and serum fructosamine (FAm), corrected frucosamine (FAc), albumin and total protein were measured, in three groups of women who were attending Al-Batool and Al-Khansa antenatal clinics in Mosul from1st November 2000 to 31st May 2001.

These included 250 non-pregnant apparently healthy women (group 1), 242 normally pregnant women (group 2) and 39 normally pregnant women who were followed in their early, middle and late stages of pregnancy (group 3).

Results : The distribution of serum FAm in group 1 showed a normal (Gaussian) pattern with a reference range of 1.37- 2.49 mmol / l.

A significant positive correlation was noted between FAm and albumin (r = 0.18, p < 0.01), but no significant correlation with total protein.

In group 2, a significantly lower FAm values were observed (Z = 4.1, p < 0.001) with no significant correlation between FAm and albumin or total protein.

There was a downward trend in FAm values with the progress of pregnancy.

Serum albumin and total protein showed also a trend to decrease during the gestational stages with a highly significant difference from group 1 (p < 0.001).

FPG showed no significant difference in all stages in comparison with group 1.

Correction of FAm for albumin or total protein is required in group 2 and comparison between FAc in group 1 and group 2 revealed no significant difference.

In group 3, all the parameters showed a significant difference in middle and late stages compared with early stage.

In the early stage, no significant difference between FAm and FAc according to albumin was noted while there was a significant difference in FAc according to total protein (p < 0.01).

In the middle and late stages, there was a significant difference between FAm and FAc according to albumin and a highly significant difference between FAm and FAc according to total protein.

Conclusion : Serum fructosamine concentration is affected by the changes in serum albumin and total protein during the different stages of gestation.

Hence, correction of its value accordingly improves its usefulness as an index of glycated protein for assessing glycaemic state.