Glycated nail protein as an indicator of longterm glycemic control

A study was conducted in Government Stanley Medical College and Hospital, in the Department of Biochemistry, titled glycated nail protein as an indicator of long term glycemic control. A total of 70 individuals, 35 known diabetic patients and 35 healthy individuals were enrolled for the study. The patients were longitudinally followed up for three months to assess their glycemic status. The aim was to establish whether the nail fructosamine could be used to determine the glycemic status of the diabetic patients over the preceding three months which is the turnover time of the nail from root to the free edge. The Hemoglobin A1C estimation in the same patients at a same time was used to confirm the changes in the patient’s glycemic status and compared with nail fructosamine. A linear relationship was established after analysis of the results. (p value 0.009). A value of less than 0.5 is significant. There was also a significant difference of nail fructosamine between cases and controls (p value 0.09). The mean value of controls (2.18μmol/g equivalents of nail) lie in the physiological range (2.0-2.5μmol/g)as reported by Goldsmith et al in 1985. The patients values determined initially and finally were above the physiological range (2.68 and 3.1μmol/g) The fasting blood glucose and serum fructosamine were also measured for assessing the blood glucose levels. These parameters on comparison with nail fructosamine showed linear relationship. No interference was done in the treatment schedule of the patients. The risk factors like positive family history, blood pressure, BMI, lipid profile were also analyzed. Results showed only moderate increase in risk factors among patients than in the controls. To conclude the nail fructosamine assay could be standardized for testing the levels of blood glucose over the previous three month’s duration. The reference range in south Indian population needs to be established. The interference like drugs and other dietary substances which might react with nitrobluetetrazolium need to ...