Zhang Lei, Ran Yaqiong, Zhu Yan, Zhen Qianna
Clinical Laboratory, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Department of Endocrinology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Lab Med. 2021 Mar 15;52(2):197-201. doi: 10.1093/labmed/lmaa051.
Sodium fluoride (NaF) has been applied to inhibit glycolysis in venous specimens for decades. However, it has had little effect on the rate of glycolysis in the first 1 to 2 hours, resulting in a decrease of glucose, so a more efficient method is needed. Recently, we discovered that WZB117, a specific Glut1 inhibitor, restricts glycolysis by inhibiting the passive sugar transport of human red blood cells and cancer cells. The purpose of this study was to evaluate the results of intravenous blood glucose determination after the addition of WZB117.
Venous specimens from 40 pairs of healthy volunteers were collected for several days and placed in tubes containing NaF plus EDTA-disodium (Na2) without WZB117 (the A group); citric acid, trisodium citrate, and EDTA-Na2 without WZB117 (B group); and NaF plus EDTA-Na2 with WZB117 (C group). The glucose concentration was measured after venipuncture and compared with test tubes treated for 1 hour, 2 hours, and 3 hours before centrifugation. Glucose level was determined by the hexokinase method. The paired t-test was used to examine differences in glucose values at baseline and at different time points. The number of misdiagnoses and the misdiagnosis rate were calculated at 2 diagnostic stages: high risk of diabetes (glucose level of 6.1 mmol/L) and diagnosis of diabetes (glucose level of 7.0 mmol/L).
Glucose levels decreased by 1.0% at 1 hour and by 2.1% at 3 hours in the C group tubes and simultaneously decreased by 1.7% at 1 hour and by 2.5% at 3 hours in the B group tubes. In contrast, glucose levels decreased by 4.1% at 1 hour and by 6.3% at 3 hours in the A group tubes. There was a statistically significant difference in glucose levels measured in the A group tubes and B group tubes at 1 hour, 2 hours, and 3 hours. The misdiagnosis rate of clinical diagnosis in diabetes was highest in the A group tubes (7.0‰ at 1 hour, 0.1‰ at 3 hours at 7.0 mmol/L point; 14.6‰ at 1 hour, 0.4‰ at 3 hours at 6.1 mmol/L point) and lowest in the C group tubes (2.95‰ at 1 hour, 0‰ at 3 hours at 7.0 mmol/L point; 4.8‰ at 1 hour, 0.1‰ at 3 hours at 6.1 mmol/L point).
The tube addition of WZB117 is more suitable for minimizing glycolysis and has no effect on glucose levels even if specimens are left uncentrifuged for up to 3 hours.
几十年来，氟化钠（NaF）一直被用于抑制静脉血标本中的糖酵解。然而，它在最初1至2小时内对糖酵解速率影响甚微，导致葡萄糖减少，因此需要一种更有效的方法。最近，我们发现WZB117，一种特异性的葡萄糖转运蛋白1（Glut1）抑制剂，通过抑制人红细胞和癌细胞的被动糖转运来限制糖酵解。本研究的目的是评估添加WZB117后静脉血糖测定的结果。
连续数天收集40对健康志愿者的静脉血标本，分别置于不含WZB117的含NaF加乙二胺四乙酸二钠（Na₂）的试管中（A组）；不含WZB117的柠檬酸、柠檬酸钠和乙二胺四乙酸钠（EDTA-Na₂）的试管中（B组）；以及含WZB117的NaF加乙二胺四乙酸钠（EDTA-Na₂）的试管中（C组）。静脉穿刺后测量葡萄糖浓度，并与离心前处理1小时、第2小时和第3小时的试管进行比较。采用己糖激酶法测定葡萄糖水平。配对t检验用于检验基线和不同时间点葡萄糖值的差异。在两个诊断阶段计算误诊数和误诊率：糖尿病高风险（葡萄糖水平为6.1 mmol/L）和糖尿病诊断（葡萄糖水平为7.0 mmol/L）。
C组试管中葡萄糖水平在1小时时下降1.0%，在3小时时下降2.1%；同时，B组试管中葡萄糖水平在1小时时下降1.7%，在3小时时下降2.5%。相比之下，A组试管中葡萄糖水平在1小时时下降4.1%，在3小时时下降6.3%。A组试管和B组试管在1小时、2小时和3小时测量的葡萄糖水平存在统计学显著差异。糖尿病临床诊断的误诊率在A组试管中最高（在葡萄糖水平为7.0 mmol/L时，1小时为7.0‰，3小时为0.1‰；在葡萄糖水平为6.1 mmol/L时，1小时为14.6‰，3小时为0.4‰），在C组试管中最低（在葡萄糖水平为7.0 mmol/L时，1小时为2.95‰，3小时为0‰；在葡萄糖水平为6.1 mmol/L时，1小时为4.8‰，3小时为0.1‰）。
添加WZB117的试管更适合于最大限度地减少糖酵解，即使标本未离心长达3小时，对葡萄糖水平也无影响。
