Standardization of serum fructosamine assays

We have calibrated a secondary serum protein standard by use (as primary standards) of samples of albumin and polylysine glycated with [14C]glucose in vitro, the glycation of which was assessed by radioactivity measurements and by elementary analysis for C and N. Using this standard for calibration in our improved fructosamine assay, one obtains an average fructosamine value of 247 mumol/L for nondiabetic individuals (or, in terms of total serum protein, 3.2 mumol/g)--about a tenth the value we obtained when we used the fructosamine assay of Johnson et al. (Clin Chim Acta 1983;127:87-95), standardized with desoxymorpholinofructose. In contrast, results corresponded well with the value for mean glycation of serum proteins, 3 mumol/g, determined by a furosine/HPLC method. Evidently the proposed procedure, in which a standard sharing the binding characteristics of endogenous glycated proteins is used together with our modified new fructosamine assay, leads to more realistic values for the concentrations of glycated serum proteins.