Reciprocal rule
Fructosamines are compounds that result from glycation reactions between a sugar (such as fructose or glucose) and a primary amine, followed by isomerization via the Amadori rearrangement. Biologically, fructosamines are recognized by fructosamine-3-kinase, which may trigger the degradation of advanced glycation end-products (though the true clinical significance of this pathway is unclear). Fructosamine can also refer to the specific compound 1-amino-1-deoxy-D-fructose (isoglucosamine), first synthesized by Nobel laureate Hermann Emil Fischer in 1886.
Most commonly, fructosamine refers to a laboratory test for diabetes management that it is rarely used in clinical practice (simple blood glucose monitoring or hemoglobin A1c testing are preferred). Many unnecessary and direct-to-consumer lab testing companies sell fructosamine tests, but they are of limited clinical value.
Use in medicine
In diabetes, maintaining a normal blood glucose is essential to preventing many medical complications, including heart attacks and blindness. Most commonly, blood sugars are measured by either blood glucose monitoring which measures the current blood glucose level, or by Glycated hemoglobin (HbA1c) which measures average glucose levels over approximately 3 months.
Similar to the hemoglobin A1c testing (which measures the glycation of hemoglobin), fructosamine testing calculates the fraction of total serum proteins that have undergone glycation (the glycated serum proteins). Since albumin is the most common protein in blood, fructosamine levels typically reflect albumin glycation. (Some fructosamine tests specifically quantify the glycation of albumin, or glycated serum albumin instead of all proteins.). Because albumin has a half-life of approximately 20 days, the plasma fructosamine concentration reflects relatively recent (1-2 week) changes in blood glucose.
In patients with diseases that reduce red blood cell lifespan, such as hemolytic anaemia or hemoglobinopathies such as sickle-cell disease, a hemoglobin-based A1c test can be misleadingly low. A1c results may also be falsely high or low in hemoglobinopathies because abnormal hemoglobin variants can interfere in the analysis. In these cases, fructosamine measurement can be used as a marker of blood sugar levels, as its measurements are based on albumin instead of hemoglobin. However, any condition that changes serum albumin (such as the nephrotic syndrome) will affect the fructosamine result.
In practice, fructosamine is rarely measured clinically (even in individuals with hemoglobinopathies or other red cell disorders) due to a number of pragmatic concerns. First, diabetes care is rarely changed in short (1-4 week) intervals, since diabetes medications can take months to reach a steady state. An exception to this is pregnancy, where medication needs can change more rapidly and fructosamine may help provide closer short-term monitoring. Second, fructosamine has higher variability than A1c tests. Third, the overwhelming majority of studies in diabetes care are based on A1c measurements, which can make fructosamine results difficult to interpret. Fourth, the A1c test is incredibly well standardized[1] and trusted due to its nearly universal use. A variety of more advanced forms of the A1c test (e.g. some types of HPLC, immunoassay and capillary electrophoresis) can more accurately assay A1c levels during complex hemoglobinopathies and other conditions.[2] However this does not overcome the effect on A1c results of reduced red cell lifespan.
Interpretation of results
There is no standard reference range available for this test. The reference values depends upon the factors of patient age, gender, sample population, and test method. Hence, each laboratory reports will include the patient's specific reference range for the test. An increase in fructosamine in lab testing results usually means an increase in glucose in the blood.
On average, each change of 3.3 mmol (60 mg/dl) in average blood sugar levels will give rise to changes of 2% HbA1c and 75 µmol fructosamine values.[3] However, this overemphasizes the upper-limit of many laboratories' reference ranges of 285 μmol/L as equivalent to HbA1c 7.5% rather than 6.5%. A comparative study,[4] which has been used in official advice for Quality and Outcomes Framework guidance in the UK[5] and summaried by the United States' National Quality Measures Clearinghouse:[6] gives the following formula and resulting values:
- Hence:
| Fructosamine (µmol) |
HbA1c % |
HbA1c IFCC (mmol/mol) |
|---|---|---|
| 200 | 5 | 31 |
| 258 | 6 | 42 |
| 288 | 6.5 | 48 |
| 317 | 7 | 53 |
| 346 | 7.5 | 58 |
| 375 | 8 | 64 |
| 435 | 9 | 75 |
| 494 | 10 | 86 |
| 552 | 11 | 97 |
| 611 | 12 | 108 |
See also
Footnotes
43 year old Petroleum Engineer Harry from Deep River, usually spends time with hobbies and interests like renting movies, property developers in singapore new condominium and vehicle racing. Constantly enjoys going to destinations like Camino Real de Tierra Adentro.
External links
- Fructosamine at Lab Tests Online
- Fructosamine: analyte monograph - The Association for Clinical Biochemistry and Laboratory Medicine
- ↑ National Glycohemoglobin Standardization Program, http://www.ngsp.org
- ↑ Template:Cite pmid
- ↑ Template:Cite web - gives a comparison chart and cites following source:
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In its statement, the singapore property listing - website link, government claimed that the majority citizens buying their first residence won't be hurt by the new measures. Some concessions can even be prolonged to chose teams of consumers, similar to married couples with a minimum of one Singaporean partner who are purchasing their second property so long as they intend to promote their first residential property. Lower the LTV limit on housing loans granted by monetary establishments regulated by MAS from 70% to 60% for property purchasers who are individuals with a number of outstanding housing loans on the time of the brand new housing purchase. Singapore Property Measures - 30 August 2010 The most popular seek for the number of bedrooms in Singapore is 4, followed by 2 and three. Lush Acres EC @ Sengkang
Discover out more about real estate funding in the area, together with info on international funding incentives and property possession. Many Singaporeans have been investing in property across the causeway in recent years, attracted by comparatively low prices. However, those who need to exit their investments quickly are likely to face significant challenges when trying to sell their property – and could finally be stuck with a property they can't sell. Career improvement programmes, in-house valuation, auctions and administrative help, venture advertising and marketing, skilled talks and traisning are continuously planned for the sales associates to help them obtain better outcomes for his or her shoppers while at Knight Frank Singapore. No change Present Rules
Extending the tax exemption would help. The exemption, which may be as a lot as $2 million per family, covers individuals who negotiate a principal reduction on their existing mortgage, sell their house short (i.e., for lower than the excellent loans), or take part in a foreclosure course of. An extension of theexemption would seem like a common-sense means to assist stabilize the housing market, but the political turmoil around the fiscal-cliff negotiations means widespread sense could not win out. Home Minority Chief Nancy Pelosi (D-Calif.) believes that the mortgage relief provision will be on the table during the grand-cut price talks, in response to communications director Nadeam Elshami. Buying or promoting of blue mild bulbs is unlawful.
A vendor's stamp duty has been launched on industrial property for the primary time, at rates ranging from 5 per cent to 15 per cent. The Authorities might be trying to reassure the market that they aren't in opposition to foreigners and PRs investing in Singapore's property market. They imposed these measures because of extenuating components available in the market." The sale of new dual-key EC models will even be restricted to multi-generational households only. The models have two separate entrances, permitting grandparents, for example, to dwell separately. The vendor's stamp obligation takes effect right this moment and applies to industrial property and plots which might be offered inside three years of the date of buy. JLL named Best Performing Property Brand for second year running
The data offered is for normal info purposes only and isn't supposed to be personalised investment or monetary advice. Motley Fool Singapore contributor Stanley Lim would not personal shares in any corporations talked about. Singapore private home costs increased by 1.eight% within the fourth quarter of 2012, up from 0.6% within the earlier quarter. Resale prices of government-built HDB residences which are usually bought by Singaporeans, elevated by 2.5%, quarter on quarter, the quickest acquire in five quarters. And industrial property, prices are actually double the levels of three years ago. No withholding tax in the event you sell your property. All your local information regarding vital HDB policies, condominium launches, land growth, commercial property and more
There are various methods to go about discovering the precise property. Some local newspapers (together with the Straits Instances ) have categorised property sections and many local property brokers have websites. Now there are some specifics to consider when buying a 'new launch' rental. Intended use of the unit Every sale begins with 10 p.c low cost for finish of season sale; changes to 20 % discount storewide; follows by additional reduction of fiftyand ends with last discount of 70 % or extra. Typically there is even a warehouse sale or transferring out sale with huge mark-down of costs for stock clearance. Deborah Regulation from Expat Realtor shares her property market update, plus prime rental residences and houses at the moment available to lease Esparina EC @ Sengkang - ↑ 20 year-old Real Estate Agent Rusty from Saint-Paul, has hobbies and interests which includes monopoly, property developers in singapore and poker. Will soon undertake a contiki trip that may include going to the Lower Valley of the Omo.
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