Evaluation of glycosylated hemoglobin and glycolsylated albumin levels in forensic autopsies

Abstract

There may be difficulties in determining causes of sudden, unexpected deaths in medico-legal practice. It is known that sudden, unexpected deaths may result from diabetes mellitus and its complications. However, there is an ongoing debate on whether many parameters recommended to diagnose post-mortem diabetes mellitus are reliable. The aim of this study was to determine whether glycosylated haemoglobin (HbA1c) and glyscosylated albumin (fructosamine) measures could be used to diagnose post-mortem diabetes mellitus in forensic autopsies and to contribute to limited data on the issue reported in the literature. Method: We obtained blood and vitreous humor specimens from 146 decedents aged over 18 years and exposed to forensic autopsies. Results: The mean age of the cases was 46 ± 16.39 years (min 19yrs, max 85yrs) and 87.7% of the cases were male. HbA1c and fructosamine levels were higher than the standard values in 51 and 9 cases respectively. Of six cases with a history of diabetes mellitus, one had high fructosamine levels and five had high HbA1c levels. Fructosamine and HbA1c levels were high in three and 20 deaths from natural causes respectively and 12 of these deaths were caused by cardiovascular disorders. There was no significant relation between causes of deaths and HbA1c and fructosamine levels. Conclusion: The results of this study will contribute to the limited data on diabetes mellitus in sudden, unexpected deaths. It can be suggested that measurements of HbA1c and fructosamine levels should be included in routine autopsy protocols.