Colagiuri S, Sandbaek A, Carstensen B, Christensen J, Glumer C, Lauritzen T, Borch-Johnsen K
Department of Endocrinology and Diabetes, Prince of Wales Hospital, Randwick, Australia.
Diabet Med. 2003 Nov;20(11):953-6. doi: 10.1046/j.1464-5491.2003.01048.x.
Diabetes and glucose intolerance are diagnosed by measurement of glucose in blood. Glucose is usually measured as venous plasma or capillary whole blood and diagnostic criteria frequently provide equivalence estimates for these two methods. This study examined the relationship between glucose measured in capillary and venous samples collected at random, fasting and 2 h after oral glucose.
Simultaneous measurements of venous plasma and capillary blood glucose were performed on random samples in 609 people, fasting samples in 685 people, and 2 h after oral glucose samples in 463 people. Separate capillary and venous samples were collected each time. A variance component model was used to construct conversion algorithms between venous and capillary results.
The relationship between venous and capillary glucose values varied, with venous plasma being higher than capillary blood for random and fasting samples but lower for sampling 2 h after oral glucose. Discrepancies were observed between measured capillary blood values and the published WHO capillary blood equivalence values for venous plasma values for all except a fasting venous value of 7.0 mmol/l. For example, for a fasting venous plasma glucose of 6.1 mmol/l the WHO equivalent value is 5.6 mmol/l, while the measured value was 5.2 mmol/l, and for a 2-h venous plasma glucose of 11.1 mmol/l the WHO value is 11.1 mmol/l, while the measured result was 11.7 mmol/l.
These results highlight the difficulty in equating glucose levels from one sampling and measuring procedure to another, and raise uncertainties about current published equivalence values which could lead to misclassifications in glucose tolerance status.
糖尿病和葡萄糖耐量异常通过测量血液中的葡萄糖来诊断。葡萄糖通常作为静脉血浆或毛细血管全血进行测量,诊断标准经常提供这两种方法的等效性估计。本研究调查了随机、空腹及口服葡萄糖2小时后采集的毛细血管和静脉样本中所测葡萄糖之间的关系。
对609人的随机样本、685人的空腹样本以及463人的口服葡萄糖2小时后的样本同时进行静脉血浆和毛细血管血糖测量。每次分别采集毛细血管和静脉样本。采用方差成分模型构建静脉和毛细血管测量结果之间的转换算法。
静脉和毛细血管葡萄糖值之间的关系各不相同,随机和空腹样本中静脉血浆高于毛细血管血,但口服葡萄糖2小时后采样时静脉血浆低于毛细血管血。除了空腹静脉值为7.0 mmol/l外,所有测量的毛细血管血值与已公布的世界卫生组织(WHO)静脉血浆值的毛细血管血等效值之间均存在差异。例如,空腹静脉血浆葡萄糖为6.1 mmol/l时,WHO等效值为5.6 mmol/l,而测量值为5.2 mmol/l;口服葡萄糖2小时后静脉血浆葡萄糖为11.1 mmol/l时,WHO值为11.1 mmol/l,而测量结果为11.7 mmol/l。
这些结果凸显了将一种采样和测量程序的葡萄糖水平与另一种进行等同的困难,并引发了对当前已公布的等效值的不确定性,这可能导致葡萄糖耐量状态的错误分类。