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EVALUATION OF SERUM FRUCTOSAMINE AS A SCREENING TEST FOR THE DETECTION OF GESTATIONAL DIABETES MELLITUS
Abstract
BACKGROUND: The use of serum fructosamine as a screening test for gestational diabetes
mellitus (GDM) may provide a simpler alternative compared to oral glucose tolerance test which
is tedious, requires multiple venepunctures, overnight fasting and may be associated with
unpleasant side effects.
OBJECTIVE: This study evaluated the clinical usefulness of serum fructosamine as a screening
test for the detection of GDM.
METHODS: This descriptive cross sectional study recruited a total of 313 participants, made up
of 193 pregnant women with risk factors for GDM referred from antenatal clinic for oral glucose
tolerance test (OGTT) and 120 apparently healthy non pregnant women as controls. A 75 g
OGTT, serum fructosamine, albumin and total protein assays were performed. Data generated
were collated and analysed using SPSS version-22.0. The statistical significance of fructosamine
values were assessed by student’s t-test and the validity of the test was assessed by calculating
the sensitivity, specificity, positive predictive value and negative predictive value.
RESULTS: Forty one of the 193 pregnant women, tested positive for GDM based on the World
Health Organisation’s (WHO) criteria for OGTT. Although there was a statistically significant
difference in the serum fructosamine levels across the 3 groups (GDM patients, non-GDM
patients and controls), there was no statistically significant difference (p=0.102) in the levels of
fructosamine between the GDM and non GDM patients. In comparison with 75 g OGTT, single
assay of serum fructosamine gave a sensitivity, specificity, positive and negative predictive
values of 44%, 63%, 24% and 63% respectively with regard to detection of GDM.
CONCLUSION: Serum fructosamine may not be a useful screening test in the detection of
GDM.
