Diabetes Mellitus, Protein Glycation, and Laboratory Assays for Monitoring Long-Term Glycemic Control.

摘要

Diabetes mellitus is a major medical problem in our society. Recent evidence suggests that hyperglycemia results in increased nonenzymic posttranslational glycation of proteins. Glycated long-lived structural proteins can contribute to the long-term complications of diabetes including vascular disease, renal failure, and blindness. Short-lived blood proteins also undergo glycation and are currently being used as long-term monitors of glycemic control, supplementing the blood glucose determination. Glycated hemoglobin is determined by several methods with ion-exchange and affinity chromatography being the most popular. Glycated hemoglobin reflects the average blood glucose concentration over the previous six to eight weeks. Glycated serum protein, commonly called fructosamine, is a newer assay that approximates the mean blood glucose level over the previous two to three weeks. Fructosamine is most commonly assayed via the nitroblue tetrazolium (NBT) method or affinity chromatography. The glycated hemoglobin and fructosamine tests may be used concurrently but in particular clinical situations one of the two assays may be more advantageous.