Fructosamine Assay As a Diagnostic Criterion In Thyroid Disorders

Background: Glycation is the process of non enzymatic addition or insertion of sugar to proteins, DNA and lipids. Fructosamine is the generic name for plasma proteins ketoamines; it refers to structure of ketoamine rearrangement product formed by interaction of fructose with ε-amino group of lysine residues of albumin. Its determination monitors the short term glycemic changes and may have a role in conjunction with glycated hemoglobin. Methodology: Total of 100 cases selected, (n=25 in each group) newly diagnosed hypothyroidism, subclinical hypothyroidism, hyperthyroidism and normal controls between the ages 25-55 years of both sexes. Serum obtained from the blood collected in a sterile vacutainer. Estimation of T3, T4, and TSH was done using the Cobas e-411 analyzer by “ECLIA” method, fructosamine (Fructosamine TestPlus method), total protein (Biuret method) and albumin (Bromocresol Green method). Statistical analysis was done by ANOVA and Tukey‟s test. Results were expressed as mean±standard deviation (SD). P-value <0.05 was considered statistically significant. Results: Fructosamine values were found to be significantly correlated among the different groups (p =0.001). In thyroid disorders, the sensitivity, specificity, PPV, NPV in hypothyroidism is 100%, 96.4%, 100%, 100% and in hyperthyroidism is 75%, 92.9%, 42.6% and 100% respectively. Albumin values negatively correlated with hypothyroidism which was statistically significant (p-0.034).Conclusion: Fructosamine values significantly increased in hypothyroidism, subclinical hypothyroidism and lowered in hyperthyroidism group compared to normal group. Significant correlation was found between T3, T4, TSH and fructosamine levels. It was concluded that it is useful to consider serum fructosamine as a diagnostic indicator in patients with thyroid diseases.