Domínguez Jiménez José Luis, Fernández Suárez Antonio
Department of Gastroenterology and Hepatology, Alto Guadalquivir Healthcare Agency, Alto Guadalquivir Hospital, Blas Infante Ave, Andújar, Jaén, 23740, Spain.
Department of Biotechnology, Alto Guadalquivir Healthcare Agency, Alto Guadalquivir Hospital, Andújar, Jaén, Spain.
Dig Dis Sci. 2016 Jan;61(1):208-14. doi: 10.1007/s10620-015-3851-1. Epub 2015 Aug 30.
The lactose tolerance test is a classic method for the study of lactose malabsorption. However, the methodology used has not been standardized, and this leads to differences in results.
The aim of this report was to analyze whether capillary blood glucose measurement is in agreement with venous blood glucose when performing lactose tolerance test.
This is a prospective study of consecutive patients with suspected lactose malabsorption who had lactose tolerance test performed in venous and capillary blood simultaneously, using a load of 50 g lactose. Agreement was measured using the concordance correlation coefficient of Lin (95 % CI) and Bland-Altman plots. The degree of agreement was measured using the Kappa index. A value of p < 0.05 was considered statistically significant.
Eighty-four patients (68 % women) were included. The concordance correlation coefficient showed very poor agreement between the two techniques: 0.68 (0.58-0.77), 0.72 (0.62-0.8), and 0.77 (0.69-0.83) for baseline, 30, and 60 min, respectively. The Bland-Altman plots showed that capillary blood glucose measurements result in higher levels than venous blood glucose measurements, with mean differences of 0.39, 0.77, and 1.1 mmol/L at baseline, 30, and 60 min, respectively. The degree of agreement was low, with a Kappa index of 0.59 (p < 0.001).
The test measured in venous blood is not in agreement with the measurement obtained from capillary blood. It is likely that the diagnostic accuracy attributed without distinction to lactose tolerance test in different studies for lactose malabsorption is incorrect, making it necessary to specify the analysis method.
乳糖耐量试验是研究乳糖吸收不良的经典方法。然而，所使用的方法尚未标准化，这导致了结果的差异。
本报告的目的是分析在进行乳糖耐量试验时，毛细血管血糖测量与静脉血糖测量是否一致。
这是一项对连续疑似乳糖吸收不良患者的前瞻性研究，这些患者同时使用50 g乳糖负荷进行静脉血和毛细血管血的乳糖耐量试验。使用Lin一致性相关系数（95%可信区间）和Bland-Altman图来衡量一致性。使用Kappa指数来衡量一致程度。p < 0.05的值被认为具有统计学意义。
纳入了84例患者（68%为女性）。一致性相关系数显示两种技术之间的一致性非常差：基线、30分钟和60分钟时分别为0.68（0.58 - 0.77）、0.72（0.62 - 0.8）和0.77（0.69 - 0.83）。Bland-Altman图显示，毛细血管血糖测量结果高于静脉血糖测量结果，基线、30分钟和60分钟时的平均差异分别为0.39、0.77和1.1 mmol/L。一致程度较低，Kappa指数为0.59（p < 0.001）。
静脉血测量的试验与毛细血管血测量结果不一致。在不同的乳糖吸收不良研究中，不加区分地将乳糖耐量试验的诊断准确性归因可能是不正确的，因此有必要明确分析方法。
