School of Animal and Veterinary Sciences, Charles Sturt University, Locked Bag 588, Boorooma Street, Wagga Wagga, NSW, 2678, Australia; Rainbow Equine Hospital, Old Malton, Malton, North Yorkshire, YO17 6SG, UK.
School of Animal and Veterinary Sciences, Charles Sturt University, Locked Bag 588, Boorooma Street, Wagga Wagga, NSW, 2678, Australia; Royal (Dick) School of Veterinary Studies and Roslin Institute, University of Edinburgh, Roslin, Midlothian, EH25 9RG, UK.
Vet J. 2019 Oct;252:105359. doi: 10.1016/j.tvjl.2019.105359. Epub 2019 Aug 23.
Point-of-care glucometry is used commonly in clinical and research settings; however, accuracy and precision of this method are concerns. The objectives of this study were to determine the accuracy of glucometry in adult horses and the precision of duplicate measurements. Blood samples were collected from 62 horses into one plain syringe, one EDTA tube and three fluoride oxalate (FO) tubes. Immediately after collection, glucose concentrations in whole blood were determined, in duplicate, by glucometry from the syringe (plain whole blood [WB] group), EDTA tube (EDTA group) and one FO tube (FO group). One FO sample was used to measure plasma glucose concentration by a laboratory chemistry analyser (LAB group) ≤1 h after collection. The third FO tube was used to measure plasma glucose concentration by glucometry after 3 h storage (FO3hr group). Adequate precision was present for all groups (coefficient of variation: 0.7-3.5%) except WB (5.5-9.4%). Between groups, correlations were significant (P < 0.05; except for WB-EDTA), varied with group comparison, and tended to be lowest for comparisons involving WB. Mean bias was lowest for WB-LAB and greatest for FO-LAB and FO3hr-LAB; however, the limits of agreement were ≥4.65 mmol/L for WB-LAB and ≤2.75 mmol/L for most other comparisons. For the glucometer used, performance was influenced by sample type: WB was unsuitable, while FO or EDTA samples resulted in adequate precision and accuracy, provided under-estimation of glucose concentrations is accounted for by using method-specific reference ranges. Glucometer performance and optimal sample type(s) should be determined prior to use in horses.
即时床旁血糖检测常用于临床和研究环境中；然而，这种方法的准确性和精密度仍存在争议。本研究旨在确定即时床旁血糖检测在成年马中的准确性，以及重复测量的精密度。从 62 匹马中采集血液样本至一支普通注射器、一支 EDTA 管和三支氟草酸（FO）管中。采集后即刻，采用即时床旁血糖检测仪分别从注射器（普通全血[WB]组）、EDTA 管（EDTA 组）和一支 FO 管（FO 组）中重复检测全血葡萄糖浓度。采集后 1 小时内，从一支 FO 样本中抽取血样，用实验室化学分析仪（LAB 组）检测血浆葡萄糖浓度。3 小时储存后，从第三支 FO 管抽取血样，用即时床旁血糖检测仪（FO3hr 组）检测血浆葡萄糖浓度。除 WB 组（5.5-9.4%）外，所有组别的精密度均符合要求（变异系数：0.7-3.5%）。组间相关性具有统计学意义（P < 0.05；除 WB-EDTA 外），且与组间比较有关，WB 组间比较的相关性最低。WB-LAB 组的平均偏差最低，FO-LAB 和 FO3hr-LAB 组的平均偏差最大；然而，WB-LAB 的允许误差范围为≥4.65 mmol/L，而大多数其他比较的允许误差范围为≤2.75 mmol/L。对于所使用的血糖仪，样本类型会影响其性能：WB 不适合，而 FO 或 EDTA 样本可获得足够的精密度和准确性，但需考虑使用特定方法的参考范围来校正葡萄糖浓度的低估。在马匹中使用前，应确定血糖仪的性能和最佳样本类型。
