Volume 41, Issue 1 (January 1996)

    Postmortem Diagnosis of Diabetic Metabolic Derangement: Elevated α1-Antitrypsin and Haptoglobin Glycosylation Levels as an Index of Antemortem Hyperglycemia

    (Received 3 November 1994; accepted 9 June 1995)

    CODEN: JFSOAD

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    Abstract

    Fatal diabetic metabolic derangement is difficult to diagnose postmortem because of the paucity of characteristic morphologic findings. Hyperglycemia is an indicator of diabetic derangement. Conventional biochemical parameters for postmortem diagnosis of antemortem hyperglycemic states are not sufficiently resistant to antemortem and postmortem non-diabetic influences or are suited only for long and medium-term assessment of diabetes control. In the search for other, more reliable, indices of immediately antemortem blood glucose levels, we investigated the value of glycosylation levels of serum proteins with very brief biologic half-lives: a) In vitro studies were performed on the glycosylation course of the short-lived serum proteins α1-antitrypsin (α1-AT) and haptoglobin (HP). b) Glycosylation levels were measured after purification of α1-AT and HP from sera of living and deceased non-diabetics and diabetics. c) The resistance of α1-AT and HP glycosylation levels to autolysis was investigated. Our studies revealed the following: 1) α1-AT and HP glycosylate considerably more rapidly than either albumin or hemoglobin. This rapid glycosylation, combined with the rapid turnover of both proteins, facilitates detection of short-term changes in glycemia. 2) α1-AT and HP glycosylation levels are autolysis-stable and can be assessed even after advanced hemolysis. 3) α1-AT and HP glycosylation levels appear to allow reliable ante- and postmortem discrimination between normoglycemic and hyperglycemic metabolic states. As a tool in the postmortem diagnosis of antemortem hyperglycemic states, α1-AT and HP glycosylation levels combine the advantages of a short-term parameter with resistance to non-diabetic influences.


    Author Information:

    Mehlan, G
    Physicians, Institut für Rechtsmedizin der Christian-Albrechts-Universität zu Kiel, Kiel,

    Ritz, S
    Physicians, Institut für Rechtsmedizin der Christian-Albrechts-Universität zu Kiel, Kiel,

    Martz, W
    Institut für Toxikologie, Hannover,


    Stock #: JFS13901J

    ISSN: 0022-1198

    DOI: 10.1520/JFS13901J

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    Title Postmortem Diagnosis of Diabetic Metabolic Derangement: Elevated α1-Antitrypsin and Haptoglobin Glycosylation Levels as an Index of Antemortem Hyperglycemia
    Symposium , 0000-00-00
    Committee E30