Fructosamine Reference Range Established for Brazil

Traditional markers used in diabetes diagnosis and monitoring include fasting plasma glucose (FPG), two-hour plasma glucose (2-hPG) measured during the oral glucose tolerance test (OGTT), and glycated hemoglobin (HbA1c) levels.

The fructosamine test is used in the monitoring of diabetes mellitus, particularly in cases with restrictions on the use of glycated hemoglobin, mainly in the setting of altered red blood cell lifespan and interference by hemoglobin variants. It could also provide additional information on shorter-term glycemic control.


Scientists at the Federal University of Minas Gerais, (Belo Horizonte, Brazil) collected blood samples from 2,288, that were part of a comprehensive study and available for fructosamine testing. The team excluded from the study individuals with a previous history of diabetes (n = 161), with FPG ≥ 5.6 mmol/L (100 mg/dL) and/or 2-hPG ≥ 7.8 mmol/L (140 mg/dL) and/or HbA1c ≥ 38.8 mmol/mol, (5.7%). They also excluded individuals with microalbuminuria ≥ 20 μg/min and creatinine> 114.9 µmol/L (1.3 mg/dL).

Samples were collected after a 12-h fasting period. The OGTT was conducted in all participants included in the present study. Samples were stored at −80 °C. Serum fructosamine levels were determined by the colorimetric nitroblue tetrazolium method in an AU 5800 automatic analyzer. The scientists proposed that the reference interval should be 186 to 248 μmol/L for women and 196 to 269 μmol/L for men. Fructosamine levels were higher in men than in women and in the non-white population and had a negative correlation with the body mass index.

The authors concluded that their study represents the first effort to establish a reference range for fructosamine levels in the Brazilian population. The report, which used the ELSA-Brazil baseline as a source of data, might contribute to future work on the diagnosis and monitoring of diabetes mellitus (DM), especially in situations when HbA1c and OGTT cannot be used. The study was published in the January 2019 issue of the journal Practical Laboratory Medicine.

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Federal University of Minas Gerais