CAP TODAY Pathology/Laboratory Medicine/Laboratory Management
There are some considerations that need to be borne in mind when interpreting fructosamine or glycated albumin results. Values can be altered independently of glycemia, particularly when albumin concentrations are changed. Examples include cirrhosis, nephrotic syndrome, and hyperuricemia. Conditions that alter serum protein concentrations include liver disease, thyroid disease, and renal disease. In addition, both assays are limited by the absence of strong evidence linking them to clinical outcomes in patients, particularly the long-term complications of diabetes. Therefore, there are no accepted thresholds for diagnosis of diabetes or goals for therapy in diabetes. Additional clinical studies are required to yield further insight into the clinical roles of fructosamine and glycated albumin in patients with diabetes.
Welsh KJ, Kirkman MS, Sacks DB. Role of glycated proteins in the diagnosis and management of diabetes: research gaps and future directions. Diabetes Care. 2016;39(8):1299–1306.
David B. Sacks, MB ChB, Chief of Clinical Chemistry, Department of Laboratory Medicine,
National Institutes of Health Clinical Center, Bethesda, Md.
Member, CAP Chemistry Resource Committee