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

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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.

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Abbreviations

LI:

Lactose intolerance

LM:

Lactose malabsorption

LHBT:

Lactose hydrogen breath test

LTT:

Lactose tolerance test

POCT:

Point-of-care testing

LFD:

Lactose-free diet

DM:

Diabetes mellitus

r c :

Concordance correlation coefficient of Lin

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Acknowledgments

We appreciate the tireless work of the nursing and medical consultation supporting staff, without which it would have been impossible to conduct this study.

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Authors and Affiliations

  1. Department of Gastroenterology and Hepatology, Alto Guadalquivir Healthcare Agency, Alto Guadalquivir Hospital, Blas Infante Ave, Andújar, Jaén, 23740, Spain

    José Luis Domínguez Jiménez

  2. Department of Biotechnology, Alto Guadalquivir Healthcare Agency, Alto Guadalquivir Hospital, Andújar, Jaén, Spain

    Antonio Fernández Suárez

Authors
  1. José Luis Domínguez Jiménez
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  2. Antonio Fernández Suárez
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Correspondence to José Luis Domínguez Jiménez.

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The protocol was approved by the institutional ethics committee, and informed consent was obtained from all patients.

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Domínguez Jiménez, J.L., Fernández Suárez, A. Correlation Between Capillary and Venous Blood Glucose in the Lactose Tolerance Test. Dig Dis Sci 61, 208–214 (2016). https://doi.org/10.1007/s10620-015-3851-1

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  • DOI: https://doi.org/10.1007/s10620-015-3851-1

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