Korean J Lab Med.  2009 Dec;29(6):524-528. 10.3343/kjlm.2009.29.6.524.

Effectiveness of Sodium Fluoride as a Glycolysis Inhibitor on Blood Glucose Measurement: Comparison of Blood Glucose using Specimens from the Korea National Health and Nutrition Examination Survey

Affiliations
  • 1Department of Laboratory Medicine, Soonchunhyang University Bucheon Hospital and Soonchunhyang University College of Medicine, Bucheon, Korea.
  • 2Department of Laboratory Medicine, Chung-Ang University College of Medicine, Seoul, Korea. chayoung@cau.ac.kr
  • 3Department of Laboratory Medicine, College of Medicine, Dongguk University, Goyang, Korea.
  • 4Department of Laboratory Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
  • 5Department of Laboratory Medicine, Konkuk University School of Medicine and Medical Center, Seoul, Korea.
  • 6Department of Laboratory Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
  • 7Department of Laboratory Medicine, National Cancer Center, Goyang, Korea.
  • 8Department of Laboratory Medicine, Inje University Seoul Paik Hospital, Seoul, Korea.
  • 9Department of Laboratory Medicine, Hallym University College of Medicine, Seoul, Korea.
  • 10Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Korea.
  • 11Division of Chronic Disease Surveillance, Korea Centers for Disease Control and Prevention, Seoul, Korea.
  • 12Neodin Medical Institute, Seoul, Korea.

Abstract

BACKGROUND
Accurate measurement of blood glucose concentrations is essential for defining diabetes, and the minimization of ex vivo glycolysis has been recommended. Recent guidelines advocate two kinds of methods for sample collection and processing: either the sodium fluoride (NaF) method or immediate refrigeration using a serum separation tube (SST). We investigated the difference between the two methods in measuring subsequent glucose concentrations using blood specimens from participants recruited for the fourth Korean National Health and Nutrition Examination Survey. METHODS: Paired venous blood samples were collected in an SST and a NaF tube from 1,103 men and women. SST serum was separated within 30 min, including standing for 15 min, and then refrigerated. The NaF samples were refrigerated, but not separated until immediately before analysis. We compared the blood glucose concentrations between the SST (SST glucose) and NaF (NaF glucose) methods. RESULTS: The mean SST glucose was significantly higher than NaF glucose (99.0 mg/dL vs 96.5 mg/dL, P<0.05). NaF glucose showed a negative mean bias of 2.6 mg/dL vs SST glucose but showed high correlation (R=0.9899). There was no significant correlation between the bias of blood glucose concentrations by two methods and the storage time of NaF glucose. CONCLUSIONS: The negative bias associated with the use of NaF tubes may significantly affect the prevalence of diabetes. Serum separation and refrigeration within 30 min after venous sampling is recommended over NaF method, not only to minimize the preanalytical impact on detecting diabetes but also to reduce sample volume and number of tubes.

Keyword

Glucose; Sodium fluoride; Glycolysis

MeSH Terms

Blood Glucose/*analysis
Blood Specimen Collection/*methods
Diabetes Mellitus/diagnosis
Female
Glycolysis/*drug effects
Humans
Male
Nutrition Surveys
Republic of Korea
Sodium Fluoride/*pharmacology
Specimen Handling

Figure

  • Fig. 1. (A) Linear regression analysis of NaF method on SST method for blood glucose concentrations (mg/dL). (B) Absolute difference plot showing blood glucose concentrations from NaF method minus SST method (Y axis) versus SST method (X axis). Abbreviations: NaF, sodium fluoride; SST, serum separation tube.


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Comparison of the Characteristics of Patients with diabetes as Diagnosed Using Three Different Tests
Jaehoon Choi, Ile Kyu Park
Lab Med Online. 2014;4(2):71-76.    doi: 10.3343/lmo.2014.4.2.71.


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