Serum Fructosamine and Related Biochemical Parameters in  Pregnant Women with Pre-Eclampsia

Basheer Aziz, Sahar; Shareef Mula-Abed, Waad-Allah

	Serum Fructosamine and Related Biochemical Parameters in Pregnant Women with Pre-Eclampsia
Medical Journal of Babylon
Article 1, Volume 2, Issue 1, 2005, Pages 61-75
Authors
Sahar Basheer Aziz; Waad-Allah Shareef Mula-Abed
Abstract
The objective of this study is to determine the pattern of change in serum fructosamine and related biochemical parameters in normally pregnant women and to compare them with pregnant women complicated with pre-eclampsia and also to examine the influence of serum albumin or total protein on fructosamine concentrations with the need for correcting their values accordingly. Fasting plasma glucose (FPG) and serum fructosamine (FAm), albumin and total protein were measured in three groups of women who were attending Al-Batool antenatal clinic and Al-Khansa antenatal clinic in Mosul during the period of 7 months from 1 st November 2000 to 31 st May 2001. These included 250 non-pregnant apparently healthy women (group 1), 242 normally pregnant women (group 2) and 53 pregnant women complicated by pre-eclamptic toxaemia (group 3). The distribution of serum FAm in group 1 showed a normal (Gaussian] pattern with reference range calculated as mean ± 2SD of 1.37-2.49 mmol/L. 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 as their means were (1.82, 1.80, 1.77 mmol/L) in the early, middle and late stages respectively which were significantly lower than the mean value of 1.93 mmol/L in group 1. 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 from group 1. Correction of FAm for albumin or total protein is required in group 2 and comparison between corrected fructosamine (FAc) in group 1 and group 2 revealed no significant difference. In group 3, lower FAm values were obtained with mean ± SD of 1.60 ± 0.27 mmol/L, which is significantly (p<0.001) lower than group 1 (Z=6.2) and group 2 (Z=3.4). There was also a tendency for mean FAm to decrease with the increase in the degree of proteinuria. Following correction according to albumin or total protein, the difference was eliminated as compared with group 2, but in comparison with group 1 the difference was eliminated only when correction according to total protein was made. These data highlight the importance of measuring serum fructosamine in women during pregnancy. Its concentration is affected by the changes in serum albumin and total protein during the different stages of gestation. In pregnancy complicated by pre-eclamptic toxaemia, correction of fructosamine according to albumin or total protein, is mandatory as the values differ from those in non-pregnant and normal pregnant women.

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