The association between serum fructosamine and random spot urine fructose levels with the severity of non-alcoholic fatty liver disease – an analytical cross-sectional study
Background. Non-alcoholic fatty liver disease (NAFLD) in South Africa and Africa at large is considered a hidden threat. Our local population is burdened with increased metabolic risk factors for NAFLD. Our setting requires a reasonable approach to screen for and aid the diagnosis of NAFLD. O...
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South African Medical Association
2024-05-01
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| Series: | South African Medical Journal |
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| Online Access: | https://samajournals.co.za/index.php/samj/article/view/1748 |
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| author | H Kamuzinzi M Kgomo P Rheeder N Dada P Bester |
| author_facet | H Kamuzinzi M Kgomo P Rheeder N Dada P Bester |
| author_sort | H Kamuzinzi |
| collection | DOAJ |
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Background. Non-alcoholic fatty liver disease (NAFLD) in South Africa and Africa at large is considered a hidden threat. Our local population is burdened with increased metabolic risk factors for NAFLD. Our setting requires a reasonable approach to screen for and aid the diagnosis of NAFLD.
Objectives. To investigate serum fructosamine and random spot urine fructose levels as biomarkers for the screening, diagnosis and monitoring of NAFLD. The primary objective of this study was to compare serum fructosamine and random spot urine fructose levels between groups with different levels of NAFLD severity as measured by ultrasound. A secondary objective was to determine the association, if any, between serum transaminases, the aspartate aminotransferase (AST) to platelet ratio index (APRI) score, serum fructosamine and urine fructose in different groups with steatosis.
Methods. Using a cross-sectional study design, 65 patients with three different levels of NAFLD, as detected by imaging, were enrolled. The primary exposures measured were serum fructosamine with random spot urine fructose, and secondary exposures were the serum transaminases (AST and alanine aminotransferase (ALT)) and the APRI score. Patients identified at the departments of gastroenterology, general internal medicine and diagnostic radiology were invited to participate.
Results. There were 38, 17 and 10 patients with mild, moderate and severe steatosis, respectively. There was no significant difference between the groups regarding serum fructosamine, measured as median (interquartile range): mild 257 (241 - 286) μmol/L, moderate 239 (230 - 280) μmol/L and severe 260 (221 - 341) μmol/L, p=0.5; or random spot urine fructose: mild 0.86 (0.51 - 1.30) mmol/L, moderate 0.84 (0.51 - 2.62) mmol/L and severe 0.71 (0.58 - 1.09) mmol/L, p = 0.8. ALT (U/L) differed between groups: mild 19 (12 - 27), moderate 27 (22 - 33), severe 27 (21 - 56), p=0.03, but not AST (U/L) (p=0.7) nor APRI (p=0.9). Urine fructose and ALT were correlated in the moderate to severe steatosis group (R=0.490, p<0.05), but not in the mild steatosis group. Serum fructosamine was associated with age in the mild steatosis group but not the moderate-severe steatosis group (R=0.42, p<0.01).
Conclusion. Serum fructosamine and random spot urine fructose did not vary with the severity of NAFLD, indicating that they would not be useful biomarkers in this condition.
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| format | Article |
| id | doaj-art-d786901716b548aa876854ecc469b3da |
| institution | Kabale University |
| issn | 0256-9574 2078-5135 |
| language | English |
| publishDate | 2024-05-01 |
| publisher | South African Medical Association |
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| series | South African Medical Journal |
| spelling | doaj-art-d786901716b548aa876854ecc469b3da2025-02-10T12:26:03ZengSouth African Medical AssociationSouth African Medical Journal0256-95742078-51352024-05-01114610.7196/SAMJ.2024.v114i6.1748The association between serum fructosamine and random spot urine fructose levels with the severity of non-alcoholic fatty liver disease – an analytical cross-sectional studyH Kamuzinzi0M Kgomo1P Rheeder2N Dada3P Bester4Department of Internal Medicine, School of Medicine, Faculty of Health Sciences, University of Pretoria, South AfricaDepartment of Gastroenterology, School of Medicine, Faculty of Health Sciences, University of Pretoria, South AfricaDepartment of Internal Medicine, School of Medicine, Faculty of Health Sciences, University of Pretoria, South AfricaDepartment of Radiology, School of Medicine, Faculty of Health Sciences, University of Pretoria, South AfricaDepartment of Radiology, School of Medicine, Faculty of Health Sciences, University of Pretoria, South Africa Background. Non-alcoholic fatty liver disease (NAFLD) in South Africa and Africa at large is considered a hidden threat. Our local population is burdened with increased metabolic risk factors for NAFLD. Our setting requires a reasonable approach to screen for and aid the diagnosis of NAFLD. Objectives. To investigate serum fructosamine and random spot urine fructose levels as biomarkers for the screening, diagnosis and monitoring of NAFLD. The primary objective of this study was to compare serum fructosamine and random spot urine fructose levels between groups with different levels of NAFLD severity as measured by ultrasound. A secondary objective was to determine the association, if any, between serum transaminases, the aspartate aminotransferase (AST) to platelet ratio index (APRI) score, serum fructosamine and urine fructose in different groups with steatosis. Methods. Using a cross-sectional study design, 65 patients with three different levels of NAFLD, as detected by imaging, were enrolled. The primary exposures measured were serum fructosamine with random spot urine fructose, and secondary exposures were the serum transaminases (AST and alanine aminotransferase (ALT)) and the APRI score. Patients identified at the departments of gastroenterology, general internal medicine and diagnostic radiology were invited to participate. Results. There were 38, 17 and 10 patients with mild, moderate and severe steatosis, respectively. There was no significant difference between the groups regarding serum fructosamine, measured as median (interquartile range): mild 257 (241 - 286) μmol/L, moderate 239 (230 - 280) μmol/L and severe 260 (221 - 341) μmol/L, p=0.5; or random spot urine fructose: mild 0.86 (0.51 - 1.30) mmol/L, moderate 0.84 (0.51 - 2.62) mmol/L and severe 0.71 (0.58 - 1.09) mmol/L, p = 0.8. ALT (U/L) differed between groups: mild 19 (12 - 27), moderate 27 (22 - 33), severe 27 (21 - 56), p=0.03, but not AST (U/L) (p=0.7) nor APRI (p=0.9). Urine fructose and ALT were correlated in the moderate to severe steatosis group (R=0.490, p<0.05), but not in the mild steatosis group. Serum fructosamine was associated with age in the mild steatosis group but not the moderate-severe steatosis group (R=0.42, p<0.01). Conclusion. Serum fructosamine and random spot urine fructose did not vary with the severity of NAFLD, indicating that they would not be useful biomarkers in this condition. https://samajournals.co.za/index.php/samj/article/view/1748NAFLD, FRUCTOSAMINE, ALANINE AMINO TRANSFERASE, PLATELETS, ULTRASOUND, |
| spellingShingle | H Kamuzinzi M Kgomo P Rheeder N Dada P Bester The association between serum fructosamine and random spot urine fructose levels with the severity of non-alcoholic fatty liver disease – an analytical cross-sectional study South African Medical Journal NAFLD, FRUCTOSAMINE, ALANINE AMINO TRANSFERASE, PLATELETS, ULTRASOUND, |
| title | The association between serum fructosamine and random spot urine fructose levels with the severity of non-alcoholic fatty liver disease – an analytical cross-sectional study |
| title_full | The association between serum fructosamine and random spot urine fructose levels with the severity of non-alcoholic fatty liver disease – an analytical cross-sectional study |
| title_fullStr | The association between serum fructosamine and random spot urine fructose levels with the severity of non-alcoholic fatty liver disease – an analytical cross-sectional study |
| title_full_unstemmed | The association between serum fructosamine and random spot urine fructose levels with the severity of non-alcoholic fatty liver disease – an analytical cross-sectional study |
| title_short | The association between serum fructosamine and random spot urine fructose levels with the severity of non-alcoholic fatty liver disease – an analytical cross-sectional study |
| title_sort | association between serum fructosamine and random spot urine fructose levels with the severity of non alcoholic fatty liver disease an analytical cross sectional study |
| topic | NAFLD, FRUCTOSAMINE, ALANINE AMINO TRANSFERASE, PLATELETS, ULTRASOUND, |
| url | https://samajournals.co.za/index.php/samj/article/view/1748 |
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