Pichler M, Damberger A, Arnholdt T, Schwendenwein I, Gasteiner J, Drillich M, Iwersen M
University Clinic for Ruminants, Clinical Unit for Herd Health Management in Ruminants, Department for Farm Animals and Veterinary Public Health, University of Veterinary Medicine Vienna, 1210 Vienna, Austria.
Central Clinical Pathology Unit, Department for Pathobiology, University of Veterinary Medicine Vienna, 1210 Vienna, Austria.
J Dairy Sci. 2014 Dec;97(12):7538-46. doi: 10.3168/jds.2014-8198. Epub 2014 Oct 3.
The objective of this study was to evaluate the suitability of the electronic handheld devices FreeStyle Precision (FSP; Abbott Germany, Wiesbaden, Germany) and GlucoMen LX Plus (GML; A. Menarini GmbH, Vienna, Austria) for the measurement of β-hydroxybutyrate (BHBA) in whole blood in dairy goats. Additionally, glucose concentration was analyzed with the FSP device. For method comparison, the samples were also analyzed in the laboratory by standard methods, which served as the gold standard in our study. A further objective was to evaluate the agreement between samples obtained by minimal invasive venipuncture of an ear vein and measurements of whole blood samples from the jugular vein (vena jugularis). In total, 173 blood sample pairs collected from 28 goats were obtained from an ear vein and from the jugular vein. The Spearman correlation coefficients (rsp) for BHBA concentrations determined with the FSP or GML and the gold standard were 0.95 and 0.85 for the ear vein and 0.98 and 0.88 for the jugular vein, respectively. Bland-Altman plots of differences showed a positive bias of 0.12 (ear vein) and 0.21 (jugular vein) when determination was performed with the FSP and a negative bias of 0.21 (ear vein) and 0.24 (jugular vein) when using the GML. For the FSP, applying the adjusted thresholds determined by ROC analysis of 0.9 (ear vein) and 1.0 mmol/L (jugular vein) allowed to distinguish between healthy goats and animals with hyperketonemia with sensitivities (Se) and specificities (Sp) for samples from the ear vein of 0.98 and 0.85, and from the jugular vein of 0.99 and 0.94, respectively. For the GML, adjusted thresholds were 0.5 mmol/L for the ear vein (Se=0.94, Sp=0.75) and 0.6 mmol/L for the jugular vein (Se=0.88, Sp=0.91). Repeated analyses of defined whole blood samples showed average inter- and intraassay coefficients of variation of 6.6 and 7.3% for FSP, and of 35.6 and 35.4% for GML, respectively. Test characteristics for determining glucose concentration with the FSP compared with the gold standard were poor (ear vein: rsp=0.41; jugular vein: rsp=0.51), with low validity to distinguish between hypo- and normoglycemia (Se=0.71, Sp=0.66). The present study showed good test characteristics for the FSP and moderate for the GML device for determining BHBA concentrations in whole blood. Additionally the results demonstrate the suitability of testing BHBA concentration in a blood drop obtained from an ear vein. Based on the results of this study, the FSP device is not suitable to differentiate normo- from hypoglycemia in goats.
本研究的目的是评估电子手持设备FreeStyle Precision（FSP；德国威斯巴登雅培公司）和GlucoMen LX Plus（GML；奥地利维也纳A. Menarini有限公司）用于测定奶山羊全血中β-羟基丁酸（BHBA）的适用性。此外，还使用FSP设备分析了葡萄糖浓度。为进行方法比较，样本也在实验室采用标准方法进行分析，该标准方法在我们的研究中作为金标准。另一个目的是评估通过耳静脉微创静脉穿刺采集的样本与颈静脉全血样本测量结果之间的一致性。总共从28只山羊采集了173对血液样本，分别来自耳静脉和颈静脉。用FSP或GML测定的BHBA浓度与金标准之间的Spearman相关系数（rsp），耳静脉样本分别为0.95和0.85，颈静脉样本分别为0.98和0.88。差异的Bland-Altman图显示，使用FSP测定时，耳静脉有0.12的正偏差，颈静脉有0.21的正偏差；使用GML时，耳静脉有0.21的负偏差，颈静脉有0.24的负偏差。对于FSP，应用通过ROC分析确定的调整阈值，耳静脉为0.9 mmol/L，颈静脉为1.0 mmol/L，可区分健康山羊和患有酮血症的动物，耳静脉样本的敏感性（Se）和特异性（Sp）分别为0.98和0.85，颈静脉样本分别为0.99和0.94。对于GML，耳静脉的调整阈值为0.5 mmol/L（Se = 0.94，Sp = 0.75），颈静脉为0.6 mmol/L（Se = 0.88，Sp = 0.91）。对定义的全血样本进行重复分析显示，FSP的平均批间和批内变异系数分别为6.6%和7.3%，GML分别为35.6%和35.4%。与金标准相比，用FSP测定葡萄糖浓度的检测特性较差（耳静脉：rsp = 0.41；颈静脉：rsp = 0.51），区分低血糖和正常血糖的有效性较低（Se = 0.71，Sp = 0.66）。本研究表明，FSP测定全血中BHBA浓度的检测特性良好，GML设备的检测特性中等。此外，结果证明了检测耳静脉血滴中BHBA浓度的适用性。基于本研究结果，FSP设备不适用于区分山羊的正常血糖和低血糖。
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