Glycated nail proteins: a new approach for detecting diabetes in developing countries

Abstract

Abstractobjective To assess glycation of nail proteins as a tool in the diagnosis of diabetes. methods Glycation of nail proteins was assessed using a modified photometric nitroblue tetrazolium-based assay, which provides information about average glucose values of the last 6-9 months. Analysis is possible on 10 mg of nail clippings with a within-run coefficient of variation (CV) of 11%. The analyte is extremely stable. The reference range for glycated nail protein (0.55-3.60 lmol/g nail) increases upon ageing.results In diabetics (n = 112), values for glycated nail protein are significantly higher (median: 4.07 lmol/g nail, IQR: 2.37-6.89 lmol/g nail, P < 0.0001) than in non-diabetics (n = 116). ROC analysis shows an AUC of 0.848 (specificity 93.1%; sensitivity 68.9%).conclusion This affordable method is a simple alternative for diagnosing diabetes in remote areas as the pre-analytical phase (including all processes from the time a laboratory request is made by a physician until the sample is ready for testing) is extremely robust.

Glycation of Nail Proteins: From Basic Biochemical Findings to a Representative Marker for Diabetic Glycation-Associated Target Organ Damage

“…In sub-Saharan Africa, the assessment of glycated proteins in human finger nails may be a useful marker for monitoring of diabetes in comparison with the classic glycemia markers [measurement of plasma glucose concentration, oral glucose tolerance test (OGTT) and determination of HbA1c] due to a less critical preanalytical phase and low reagent costs [1]. However to the best of our knowledge, the nature and formation of glycated nail proteins are still poorly understood.…”

The presence of fructosamine in human aortic valves is associated with valve stiffness

“…The concentration of fructosamine in the aortic valve was determined on each valve specimen according to Kishabongo et al 3. About 20 mg of aortic valve fragments, selected from random regions of the human aortic valves, was transferred into a standard 10 mm cuvette.…”

What Do Your Fingernails Say About You? Can They Indicate That You Have Diabetes?

“…The investigators cautioned against harvesting toenails for diagnostic purposes because of the risk of causing a diabetic foot wound to develop from the clipping procedure. 5 This year the same group reported a study comparing the amount of glycation of fingernail proteins with the amount of glycation of eye lens proteins. They studied a cohort of 216 subjects (29% of whom had type 2 diabetes) who underwent cataract excisions and provided an eye lens protein and produced fingernail clilppings.…”

“…4 Last year a team from the Republic of the Congo and Belgium reported that the measurement of glycation in fingernail proteins offers a new approach for actually detecting diabetes. 5 This year the same team also reported that a measurement of glycation in fingernail proteins is a marker of glycation-associated target organ damage. 6 They clipped fingernail pieces from 128 volunteers (approximately half of whom had diabetes) into 2-3 mm pieces.…”

“…Receiver operator curve analysis demonstrated an area under the curve of 0.848 with a 95% confidence interval of 0.795-0.891 and a cutoff point of 3.14 micromole per gram of nail and specificity and sensitivity of 93.1% and 68.9%, respectively (see Figure 1). 5 The investigators concluded that their test provided information about the period that the nail was exposed to extracellular fluid glucose. The increased glycation content with age was attributed to slower growth of nails with aging.…”