Accessible Requires Authentication Published by De Gruyter December 22, 2015

Glucose is stable during prolonged storage in un-centrifuged Greiner tubes with liquid citrate buffer, but not in serum and NaF/KOx tubes

Gordana Juricic, Ana Bakliza, Andrea Saracevic, Lara Milevoj Kopcinovic, Sanja Dobrijevic, Sandra Drmic and Ana-Maria Simundic

Abstract

Background: Delayed sample processing can affect accurate glucose measurement. Our aim was to investigate the stability of glucose in samples collected in serum, sodium fluoride/potassium oxalate (NaF/KOx) and Glucomedics tubes processed according to different controlled pre-centrifugation delays (up to 180 min after venipuncture) in order to simulate prolonged sample transport between venipuncture and centrifugation.

Methods: Samples were collected from healthy volunteers (n=80) into either serum or NaF/KOx and Glucomedics tubes. Glucose concentration was measured in samples centrifuged immediately after venipuncture and compared with tubes processed with a delay of 60, 120 and 180 min prior to centrifugation. Differences between baseline and respective delayed centrifugation glucose value for each tube type were tested using the paired t-test. Mean bias calculated for each tube type and delay protocol was compared to recommended quality specifications for glucose (2.2%).

Results: Glucose concentrations measured in all three delayed tube types were lower in comparison to respective baseline glucose concentrations measured in immediately processed tube (p<0.001). The highest decrease in glucose was observed in serum tubes in all specified time points (p<0.001), while glucose was most stable in Glucomedics tubes (p<0.001). The decrease in glucose observed for serum and NaF/KOx tubes was clinically significant at all specified time points while the bias for Glucomedics tubes did not exceed the criteria even with a centrifugation delay of 180 min.

Conclusions: Glucose stability in un-centrifuged Glucomedics tubes is much superior to serum and NaF/KOx tubes. Glucomedics tubes can be left un-centrifuged for up to 3 h without affecting glucose concentration.


Corresponding author: Gordana Juricic, Department of Laboratory Diagnostics, General Hospital Pula, Aldo Negri 6, Pula, Croatia, Phone: +385 98 908 5506, E-mail:

Acknowledgments

We thank Marija Culjak for her technical skills in performing all venipunctures.

Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

Research funding: This study was supported by the Ministry of Science, Education, and Sports, Republic of Croatia (project number: 134-1340227-0200).

Employment or leadership: None declared.

Honorarium: None declared.

Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

References

1. Beastall GH. The modernisation of pathology and laboratory medicine in the UK: networking into the future. Clin Biochem Rev 2008;29:3–10. Search in Google Scholar

2. Lippi G, Simundic AM. Laboratory networking and sample quality: a still relevant issue for patient safety. Clin Chem Lab Med 2012;50:1703–5. Search in Google Scholar

3. Uchida K, Matuse R, Toyoda E, Okuda S, Tomita S. A new method of inhibiting gycolysis in blood samples. Clin Chim Acta 1988;172:1–8. Search in Google Scholar

4. Gambino R, Piscitelli J, Ackattupathil TA, Theriault JL, Andrin RD, Sanfilippo ML, et al. Acidification of blood is superior to sodium fluoride alone as an inhibitor of glycolysis. Clin Chem 2009;55:1019–21. Search in Google Scholar

5. del Pino IG, Constanso I, Mourín LV, Safont CB, Vázquez PR. Citric/citrate buffer: an effective antiglycolytic agent. Clin Chem Lab Med 2013;51:1943–9. Search in Google Scholar

6. Szoke D, Valente C, Panteghini M. Better blood collection tubes for plasma glucose: ready for prime time? Clin Chem Lab Med 2014;52:e87–9. Search in Google Scholar

7. Fobker M. Stability of glucose in plasma with different anticoagulants. Clin Chem Lab Med 2014;52:1057–60. Search in Google Scholar

8. Dimeski G, Yow KS, Brown NN. What is the most suitable blood collection tube for glucose estimation? Ann Clin Biochem 2014;52:270–5. Search in Google Scholar

9. Yagmur E, van Helden J, Koch A, Jadem J, Tacke F, Trautwein C. Effective inhibition of glycolysis in venous whole blood and plasma samples. Available at: http://dx.doi.org/10.1515/labmed-2013-0028. Accessed 1 March 2015. Search in Google Scholar

10. van den Berg SA, Thelen MH, Salden LP, van Thiel SW, Boonen KJ. It takes acid, rather than ice, to freeze glucose. Scientific Reports 5, Article number: 8875, doi:10.1038/srep08875. Accessed 1 March 2015. Search in Google Scholar

11. Juricic G, Milevoj Kopcinovic L, Saracevic A, Bakliza A, Simundic AM. Liquid citrate acidification introduces significant glucose bias and leads to misclassification of patients with diabetes. Available at: http://dx.doi.org/10.1515/cclm-2015-0358. Accessed 3 July 2015. Search in Google Scholar

12. Sacks DB, Arnold M, Bakris GL, Bruns DE, Horvath AR, Kirkman MS, et al. Guidelines and recommendations for laboratory analysis in the diagnosis and management of diabetes mellitus. Diabetes Care 2011;34:e61–99. Search in Google Scholar

13. Chan AY, Swaminathan R, Cockram KS. Effectiveness of sodium fluoride as a preservative of glucose in blood. Clin Chem 1989;35:315–7. Search in Google Scholar

14. Waring WS, Evans LE, Kirkpatrick CT. Glycolysis inhibitors negatively bias blood glucose measurements: potential impact on the reported prevalence of diabetes mellitus. J Clin Pathol 2007;60:820–3. Search in Google Scholar

15. Turchiano M, Nguyen C, Fierman A, Lifshitz M, Convit A. Impact of blood sample collection and processing methods on glucose levels in community outreach studies. Available at: http://dx.doi.org/10.1155/2013/256151. Accessed 29 August 2014. Search in Google Scholar

16. Chan H, Lunt H, Thompson H, Heenan HF, Frampton CM, Florkowski CM. Plasma glucose measurement in diabetes: impact and implications of variations in sample collection procedures with a focus on the first hour after sample collection. Clin Chem Lab Med 2014;52:1061–8. Search in Google Scholar

17. Narayan S. The preanalytic phase. An important component of laboratory medicine. Am J Clin Pathol 2000;113:429–52. Search in Google Scholar

18. Fernandez L, Jee P, Klein MJ, Fisher P, Perkins SL, Brooks SP. A comparison of glucose concentrations in paired specimens collected in serum separator and fluoride/potassium oxalate blood collections tubes under survey ‘field’ conditions. Clin Biochem 2013;46:285–8. Search in Google Scholar

19. Nikolac N, Supak-Smolcic V, Simundic AM, Celap I. Croatian Society of Medical Biochemistry and Laboratory Medicine: national recommendations for venous blood sampling. Biochem Med 2013;23:242–54. Search in Google Scholar

20. Evacuated blood collection system for in vitro diagnostic use. Greiner Bio-One, Kremsmünster, Austria. 980200 Rev.15, 12-2013. Search in Google Scholar

21. Harboe M. A method for determination of hemoglobin in plasma by near-ultraviolet spectrophotometry. Scand J Clin Lab Invest 1959;11:66–70. Search in Google Scholar

22. Noe DA, Weedn V, Bell WR. Direct spectrophotometry of serum hemoglobin: an Allen correction compared with a three-wavelength polychromatic analysis. Clin Chem 1984;30: 627–30. Search in Google Scholar

23. Bowen RA, Remaley AT. Interferences from blood collection tube components on clinical chemistry assays. Biochemia Medica 2014;24:31–44. Search in Google Scholar

24. Package insert for Glucose on the Architect c Systems and the Aeroset system; Abbott Laboratories; January 2010; REF 3L82-21 and 3L82-41. Search in Google Scholar

Received: 2015-7-31
Accepted: 2015-11-19
Published Online: 2015-12-22
Published in Print: 2016-3-1

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