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Published in: Digestive Diseases and Sciences 1/2016

01-01-2016 | Original Article

Correlation Between Capillary and Venous Blood Glucose in the Lactose Tolerance Test

Authors: José Luis Domínguez Jiménez, Antonio Fernández Suárez

Published in: Digestive Diseases and Sciences | Issue 1/2016

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Abstract

Background

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.

Aim

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.

Methods

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.

Results

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).

Conclusions

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.
Literature
1.
go back to reference Usai-Satta P, Scarpa M, Oppia F, Cabras F. Lactose malabsorption and intolerance: what should be the best clinical management? World J Gastrointest Pharmacol Ther. 2012;3:29–33.PubMedCentralCrossRefPubMed Usai-Satta P, Scarpa M, Oppia F, Cabras F. Lactose malabsorption and intolerance: what should be the best clinical management? World J Gastrointest Pharmacol Ther. 2012;3:29–33.PubMedCentralCrossRefPubMed
2.
go back to reference Scrimshaw NS, Murray EB. The acceptability of milk and milk products in populations with a high prevalence of lactose intolerance. Am J Clin Nutr. 1988;48:1079–1159.PubMed Scrimshaw NS, Murray EB. The acceptability of milk and milk products in populations with a high prevalence of lactose intolerance. Am J Clin Nutr. 1988;48:1079–1159.PubMed
3.
go back to reference Suarez FL, Savaiano DA, Levitt MD. A comparison of symptoms after the consumption of milk or lactose-hydrolyzed milk by people with self-reported severe lactose intolerance. N Engl J Med. 1995;333:1–4.CrossRefPubMed Suarez FL, Savaiano DA, Levitt MD. A comparison of symptoms after the consumption of milk or lactose-hydrolyzed milk by people with self-reported severe lactose intolerance. N Engl J Med. 1995;333:1–4.CrossRefPubMed
4.
go back to reference Johnson AO, Semenya JG, Buchowski MS, Enwonwu CO, Scrimshaw NS. Correlation of lactose maldigestion, lactose intolerance, and milk intolerance. Am J Clin Nutr. 1993;57:399–401.PubMed Johnson AO, Semenya JG, Buchowski MS, Enwonwu CO, Scrimshaw NS. Correlation of lactose maldigestion, lactose intolerance, and milk intolerance. Am J Clin Nutr. 1993;57:399–401.PubMed
5.
go back to reference Schirru E, Corona V, Usai-Satta P, et al. Genetic testing improves the diagnosis of adult type hypolactasia in the Mediterranean population of Sardinia. Eur J Clin Nutr. 2007;61:1220–1225.CrossRefPubMed Schirru E, Corona V, Usai-Satta P, et al. Genetic testing improves the diagnosis of adult type hypolactasia in the Mediterranean population of Sardinia. Eur J Clin Nutr. 2007;61:1220–1225.CrossRefPubMed
6.
go back to reference Hermida C, Guerra P, Martínez-Costa OH, et al. Phase I and phase IB clinical trials for the noninvasive evaluation of intestinal lactase with 4-galactosylxylose (gaxilose). J Clin Gastroenterol. 2013;47:501–508.CrossRefPubMed Hermida C, Guerra P, Martínez-Costa OH, et al. Phase I and phase IB clinical trials for the noninvasive evaluation of intestinal lactase with 4-galactosylxylose (gaxilose). J Clin Gastroenterol. 2013;47:501–508.CrossRefPubMed
7.
go back to reference Shaw A, Davies G. Lactose intolerance: problems in diagnosis and treatment. J Clin Gastroenterol. 1999;28:208–216.CrossRefPubMed Shaw A, Davies G. Lactose intolerance: problems in diagnosis and treatment. J Clin Gastroenterol. 1999;28:208–216.CrossRefPubMed
8.
go back to reference Domínguez Jiménez JL, Fernández Suárez A. Can we shorten the lactose tolerance test? Eur J Clin Nutr. 2014;68:106–108.CrossRefPubMed Domínguez Jiménez JL, Fernández Suárez A. Can we shorten the lactose tolerance test? Eur J Clin Nutr. 2014;68:106–108.CrossRefPubMed
9.
go back to reference Alexandre V, Davila AM, Bouchoucha M, et al. Agreement between indirect calorimetry and traditional tests of lactose malabsorption. Dig Liver Dis. 2013;45:727–732.CrossRefPubMed Alexandre V, Davila AM, Bouchoucha M, et al. Agreement between indirect calorimetry and traditional tests of lactose malabsorption. Dig Liver Dis. 2013;45:727–732.CrossRefPubMed
10.
go back to reference Babu J, Kumar S, Babu P, Prasad JH, Ghoshal UC. Frequency of lactose malabsorption among healthy southern and northern Indian populations by genetic analysis and lactose hydrogen breath and tolerance tests. Am J Clin Nutr. 2010;91:140–146.CrossRefPubMed Babu J, Kumar S, Babu P, Prasad JH, Ghoshal UC. Frequency of lactose malabsorption among healthy southern and northern Indian populations by genetic analysis and lactose hydrogen breath and tolerance tests. Am J Clin Nutr. 2010;91:140–146.CrossRefPubMed
11.
go back to reference Ghoshal UC, Kumar S, Misra A, Mittal B. Lactose malabsorption diagnosed by 50 g dose is inferior to assess clinical intolerance and to predict response to milk withdrawal than 25 g dose in an endemic area. J Gastroenterol Hepatol. 2013;28:1462–1468.CrossRefPubMed Ghoshal UC, Kumar S, Misra A, Mittal B. Lactose malabsorption diagnosed by 50 g dose is inferior to assess clinical intolerance and to predict response to milk withdrawal than 25 g dose in an endemic area. J Gastroenterol Hepatol. 2013;28:1462–1468.CrossRefPubMed
12.
go back to reference Plebani M. Does POCT reduce the risk of error in laboratory testing? Clin Chim Acta. 2009;404:59–64.CrossRefPubMed Plebani M. Does POCT reduce the risk of error in laboratory testing? Clin Chim Acta. 2009;404:59–64.CrossRefPubMed
15.
go back to reference Gambino R, Bruns DE. Stabilization of glucose in blood samples: out with the old, in with the new. Clin Chem Lab Med. 2013;51:1883–1885.CrossRefPubMed Gambino R, Bruns DE. Stabilization of glucose in blood samples: out with the old, in with the new. Clin Chem Lab Med. 2013;51:1883–1885.CrossRefPubMed
16.
go back to reference Lyon ME, Dubois JA, Fick GH, Lyon AW. Estimates of total analytical error in consumer and hospital glucometers contributed by hematocrit, maltose and ascorbate. J Diabetes Sci Technol. 2010;4:1479–1494.PubMedCentralCrossRefPubMed Lyon ME, Dubois JA, Fick GH, Lyon AW. Estimates of total analytical error in consumer and hospital glucometers contributed by hematocrit, maltose and ascorbate. J Diabetes Sci Technol. 2010;4:1479–1494.PubMedCentralCrossRefPubMed
17.
go back to reference Lin LI. A note on the concordance correlation coefficient. Biometrics. 2000;56:324–325.CrossRef Lin LI. A note on the concordance correlation coefficient. Biometrics. 2000;56:324–325.CrossRef
18.
go back to reference Corstjens AM, Ligtenberg JJ, van der Horst IC, et al. Accuracy and feasibility of point-of-care and continuous blood glucose analysis in critically ill ICU patients. Crit Care. 2006;10:R135.PubMedCentralCrossRefPubMed Corstjens AM, Ligtenberg JJ, van der Horst IC, et al. Accuracy and feasibility of point-of-care and continuous blood glucose analysis in critically ill ICU patients. Crit Care. 2006;10:R135.PubMedCentralCrossRefPubMed
19.
go back to reference Savoca R, Jaworek B, Huber AR. New “plasma referenced” POCT glucose monitoring systems-are they suitable for glucose monitoring and diagnosis of diabetes? Clin Chim Acta. 2006;372:199–201.CrossRefPubMed Savoca R, Jaworek B, Huber AR. New “plasma referenced” POCT glucose monitoring systems-are they suitable for glucose monitoring and diagnosis of diabetes? Clin Chim Acta. 2006;372:199–201.CrossRefPubMed
20.
go back to reference Akinbami F, Segal S, Schnipper JL, Stopfkuchen-Evans M, Mills J, Rogers SO. Tale of two sites: capillary versus arterial blood glucose testing in the operating room. Am J Surg. 2012;203:423–427.CrossRefPubMed Akinbami F, Segal S, Schnipper JL, Stopfkuchen-Evans M, Mills J, Rogers SO. Tale of two sites: capillary versus arterial blood glucose testing in the operating room. Am J Surg. 2012;203:423–427.CrossRefPubMed
21.
go back to reference Izquierdo F, Fatela D, Chueca MP. Detección de interferencias y otros errores en la medición de la glucemia en glucómetros portátiles. Recomendaciones 2012. Documentos de la SEQC. Comisión de Interferencias y Efectos de los Medicamentos. http://www.seqc.es. Accessed December 2012. Izquierdo F, Fatela D, Chueca MP. Detección de interferencias y otros errores en la medición de la glucemia en glucómetros portátiles. Recomendaciones 2012. Documentos de la SEQC. Comisión de Interferencias y Efectos de los Medicamentos. http://​www.​seqc.​es. Accessed December 2012.
23.
go back to reference Newcomer AD, McGill DB, Thomas PJ, Hofmann AF. Prospective comparison of indirect methods for detecting lactase deficiency. N Engl J Med. 1975;11:1232–1236.CrossRef Newcomer AD, McGill DB, Thomas PJ, Hofmann AF. Prospective comparison of indirect methods for detecting lactase deficiency. N Engl J Med. 1975;11:1232–1236.CrossRef
24.
go back to reference Hermans M, Brummer R, Ruijgers A, Stockbrügger RW. The relationship between lactose tolerance test results and symptoms of lactose intolerance. Am J Gastroenterol. 1997;92:981–984.PubMed Hermans M, Brummer R, Ruijgers A, Stockbrügger RW. The relationship between lactose tolerance test results and symptoms of lactose intolerance. Am J Gastroenterol. 1997;92:981–984.PubMed
25.
go back to reference Marton A, Xue X, Szilagyi A. Meta-analysis: the diagnostic accuracy of lactose breath hydrogen or lactose tolerance test for predicting the North European lactase polymorphism C/T-13910. Aliment Pharmacol Ther. 2012;35:429–440.CrossRefPubMed Marton A, Xue X, Szilagyi A. Meta-analysis: the diagnostic accuracy of lactose breath hydrogen or lactose tolerance test for predicting the North European lactase polymorphism C/T-13910. Aliment Pharmacol Ther. 2012;35:429–440.CrossRefPubMed
Metadata
Title
Correlation Between Capillary and Venous Blood Glucose in the Lactose Tolerance Test
Authors
José Luis Domínguez Jiménez
Antonio Fernández Suárez
Publication date
01-01-2016
Publisher
Springer US
Published in
Digestive Diseases and Sciences / Issue 1/2016
Print ISSN: 0163-2116
Electronic ISSN: 1573-2568
DOI
https://doi.org/10.1007/s10620-015-3851-1

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