Serum fructosamine, serum glycated albumin and serum glycated β-lipoprotein in type 2 diabetes mellitus patients with and without microvascular complications

BACKGROUND: Glycation of serum proteins has been proposed as an important mechanism of complications of diabetes but whether there are differences in glycation of different serum proteins and whether it has any correlation with development of microvascular complications has not been studied in depth. This study aimed to assess level of serum fructosamine, glycated albumin and glycated β-lipoprotein in type 2 diabetes mellitus patients with and without microvascular complications and to find out their correlation with diabetes complications. METHODS: Case–control study involving 150 individuals at a tertiary care hospital in western India. Fifty participants were healthy controls (group 1), 50 were type 2 diabetes patients without any evident microvascular complication (group 2) and 50 were type 2 diabetes patients with one or more microvascular complications (group 3). Serum fructosamine, FBS, PP2BS and other biochemical parameters were measured. Glycated albumin and glycated β-lipoprotein were measured by agarose gel electrophoresis followed by NBT staining. Unpaired t-test was used to find out significance of difference between two groups and correlation coefficient to find out statistical correlation between two variables. RESULTS: Type 2 diabetes patients with one or more microvascular complications had poor glycemic control as indicated by markers of short and mid-term glycemia. Differences between the groups for fructosamine, glycated albumin and glycated β-lipoprotein were significant (p < 0.001). Glycated albumin correlated with FBS, PP2BS and fructosamine in all diabetic patients (group 2 and 3) whereas glycated β-lipoprotein correlated with these parameters only in group 3 and it was markedly elevated in group 3. CONCLUSION: Serum glycated β-lipoprotein was disproportionately elevated compared to fructosamine and glycated albumin in diabetes patients with microvascular complications (group 3) and it correlated with rest of glycemic markers only in this group. Glycated β-lipoprotein might help in identifying diabetic individuals at high future risk of developing microvascular complications.