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Long-term stability of glucose: glycolysis inhibitor vs. gel barrier tubes

  • Theresa Winter EMAIL logo , Anke Hannemann , Juliane Suchsland , Matthias Nauck and Astrid Petersmann
Published/Copyright: March 12, 2018
Clinical Chemistry and Laboratory Medicine (CCLM)
From the journal Clinical Chemistry and Laboratory Medicine (CCLM) Volume 56 Issue 8

Abstract

Background:

Measuring the glucose concentration in whole blood samples is critical due to unsatisfactory glycolysis inhibition. Previous studies showed that Terumo tubes were superior, but they were taken off the European market in 2016 and alternatives were required. This initiated the present evaluation of glucose stability in five available tube types.

Methods:

Venous blood samples were collected from 61 healthy volunteers to test tubes supplied by Terumo (two sets), Greiner FC-Mix, BD FX-Mixture and BD serum. After sampling, the contents were thoroughly mixed and centrifuged within an hour. The glucose concentrations were determined and the samples resuspended except for BD serum tubes (gel barrier). The first 30 samples were stored at room temperature and the remaining 31 at 4°C. After 24, 48, 72 and 96 h, all tubes were (re)centrifuged, and glucose concentration measurements were repeated.

Results:

Changes in glucose concentrations over time differed significantly between the investigated tube types and to a certain extent between the two storing conditions. Glycolysis was most evident in the BD FX-mixture tubes. Good glucose stability was observed in samples retrieved form BD serum and Greiner tubes. The stability in both Terumo tubes was comparable to that in other studies. Although Greiner and both Terumo tubes are supposed to contain the same glycolysis inhibitor, glucose stability differed between these tubes.

Conclusions:

We showed that Greiner is an acceptable alternative to Terumo and that glucose in serum that was rapidly separated from corpuscles by a gel barrier is stable for an extended time.

Keywords: glucose; glycolysis; minimal difference; plasma; stability
Corresponding author: Dr. rer. nat. Theresa Winter, Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Ferdinand-Sauerbruch-Str., 17475 Greifswald, Germany, Phone: +49 3834 865541

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

  2. Research funding: None declared.

  3. Employment or leadership: None declared.

  4. Honorarium: None declared.

  5. 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. 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. Clin Chem 2011;57:e1–47.10.1373/clinchem.2010.161596Search in Google Scholar

2. Bowen RA, Remaley AT. Interferences from blood collection tube components on clinical chemistry assays. Biochemia Med 2014;24:31–44.10.11613/BM.2014.006Search in Google Scholar

3. 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;55:1019–21.10.1373/clinchem.2008.121707Search in Google Scholar

4. Gambino R. Sodium fluoride: an ineffective inhibitor of glycolysis. Ann Clin Biochem 2013;50(Pt 1):3–5.10.1258/acb.2012.012135Search in Google Scholar

5. 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. J Environ Public Health 2013;2013:256151.10.1155/2013/256151Search in Google Scholar

6. Li G, Cabanero M, Wang Z, Wang H, Huang T, Alexis H, et al. Comparison of glucose determinations on blood samples collected in three types of tubes. Ann Clin Lab Sci 2013;43:278–84.Search in Google Scholar

7. Stahl M, Jorgensen LG, Hyltoft Petersen P, Brandslund I, de Fine Olivarius N, Borch-Johnsen K. Optimization of preanalytical conditions and analysis of plasma glucose. 1. Impact of the new WHO and ADA recommendations on diagnosis of diabetes mellitus. Scand J Clin Lab Invest 2001;61:169–79.10.1080/003655101300133612Search in Google Scholar

8. Winter T, Greiser A, Nauck M, Petersmann A. Long-term stability of glucose: 96-h study using Terumo Glycaemia tubes. Clin Chem Lab Med 2016;54:407–10.10.1515/cclm-2015-0548Search in Google Scholar

9. Bonetti G, Carta M, Montagnana M, Lo Cascio C, Bonfigli AR, Mosca A, et al. Effectiveness of citrate buffer-fluoride mixture in Terumo tubes as an inhibitor of in vitro glycolysis. Biochem Med (Zagreb) 2016;26:68–76.10.11613/BM.2016.006Search in Google Scholar

10. Peake MJ, Bruns DE, Sacks DB, Horvath AR. It’s time for a better blood collection tube to improve the reliability of glucose results. Diabetes Care 2013;36:e2.10.2337/dc12-1312Search in Google Scholar

11. Uchida K, Matuse R, Toyoda E, Okuda S, Tomita S. A new method of inhibiting glycolysis in blood samples. Clin Chim Acta 1988;172:101–8.10.1016/0009-8981(88)90125-8Search in Google Scholar

12. van den Berg SA, Thelen MH, Salden LP, van Thiel SW, Boonen KJ. It takes acid, rather than ice, to freeze glucose. Sci Rep 2015;5:8875.10.1038/srep08875Search in Google Scholar PubMed PubMed Central

13. del Pino IG, Constanso I, Mourin LV, Safont CB, Vazquez PR. Citric/citrate buffer: an effective antiglycolytic agent. Clin Chem Lab Med 2013;51:1943–9.10.1515/cclm-2012-0735Search in Google Scholar PubMed

14. Lima-Oliveira G, Lippi G, Salvagno GL, Picheth G, Guidi GC. Laboratory diagnostics and quality of blood collection. J Med Biochem 2015;34:288–94.10.2478/jomb-2014-0043Search in Google Scholar PubMed PubMed Central

15. von Meyer A, Cadamuro J, Streichert T, Gurr E, Fiedler GM, Leichtle A, et al. Standard operating procedure for peripheral venous blood sampling. Laboratoriumsmedizin 2017;41: 333–40.10.1515/labmed-2017-0127Search in Google Scholar

16. Revision of the “Guideline of the German Medical Association on Quality Assurance in Medical Laboratory Examinations – Rili-BAEK” (unauthorized translation). Laboratoriumsmedizin 2015;39:26–69.10.1515/labmed-2014-0046Search in Google Scholar

17. Institute CaLS. Expression of Measurement Uncertainty in Laboratory Medicine; Approved Guideline: Clinical and Laboratory Standards Institute (CLSI), 940 West Valley Road, Suite 1400, Wayne, Pennsylvania 19087 USA; 2012.Search in Google Scholar

18. Müller-Wieland D, Petersmann A, Nauck M, Heinemann L, Kerner W, Müller UA, et al. DGG Praxisempfehlung, Definition, Klassifikation und Diagnostik des Diabetes mellitus. Diabetologie 2016;11(Suppl. 2):78–81.10.1055/s-0042-115159Search in Google Scholar

19. Petersmann A, Kallner A, Preez H, Thein E, Dressel A. Diagnosis of late presenting subarachnoid hemorrhage: comparison of methods for cerebrospinal fluid ferritin. Scand J Clin Lab Invest 2014;74:524–6.10.3109/00365513.2014.913187Search in Google Scholar PubMed

20. van der Hagen EA, Fokkert MJ, Kleefman AM, Thelen MH, van den Berg SA, Slingerland RJ. Technical and clinical validation of the Greiner FC-Mix glycaemia tube. Clin Chem Lab Med 2017;28:1530–6.10.1515/cclm-2016-0944Search in Google Scholar PubMed

21. Dimeski G, Yow KS, Brown NN. Evaluation of the accuracy of the Greiner Bio-One FC Mix Glucose tube. Clin Chem Lab Med 2017;55:e96–8.10.1515/cclm-2016-0611Search in Google Scholar PubMed

22. Bonetti G, Carta M. The new Greiner FC-Mix tubes equal the old Terumo ones and are useful as glucose stabilizer after prolonged storage of samples. Biochem Med (Zagreb) 2017;27:030901.10.11613/BM.2017.030901Search in Google Scholar PubMed PubMed Central

23. Juricic G, Kopcinovic LM, Saracevic A, Bakliza A, Simundic AM. Liquid citrate acidification introduces significant glucose bias and leads to misclassification of patients with diabetes. Clin Chem Lab Med 2016;54:363–71.10.1515/cclm-2015-0358Search in Google Scholar PubMed

24. van der Hagen EA, Kleefman AM, Thelen MH, van den Berg SA. Normalisation issues in glucose measurements using phlebotomy tubes with liquid additives. Clin Chem Lab Med 2017;55:e1–3.10.1515/cclm-2016-0225Search in Google Scholar PubMed

25. Jones I, Bottiger AK. Methaemoglobin does not interfere with the analysis of glucose in Terumo Venosafe Glycaemia tubes. Scand J Clin Lab Invest 2013;73:189–91.10.3109/00365513.2012.744463Search in Google Scholar PubMed

26. Juricic G, Saracevic A, Kopcinovic LM, Bakliza A, Simundic AM. The evidence for clinically significant bias in plasma glucose between liquid and lyophilized citrate buffer additive. Clin Biochem 2016;49:1402–5.10.1016/j.clinbiochem.2016.03.006Search in Google Scholar PubMed

27. Pasqualetti S, Braga F, Panteghini M. Pre-analytical and analytical aspects affecting clinical reliability of plasma glucose results. Clin Biochem 2017;50:587–94.10.1016/j.clinbiochem.2017.03.009Search in Google Scholar PubMed

28. Carey R, Lunt H, Heenan HF, Frampton CM, Florkowski CM. Collection tubes containing citrate stabiliser over-estimate plasma glucose, when compared to other samples undergoing immediate plasma separation. Clin Biochem 2016;49:1406–11.10.1016/j.clinbiochem.2016.05.017Search in Google Scholar PubMed

29. Juricic G, Bakliza A, Saracevic A, Kopcinovic LM, Dobrijevic S, Drmic S, et al. Glucose is stable during prolonged storage in un-centrifuged Greiner tubes with liquid citrate buffer, but not in serum and NaF/KOx tubes. Clin Chem Lab Med 2016;54:411–8.10.1515/cclm-2015-0746Search in Google Scholar PubMed

30. Roccaforte V, Daves M, Platzgummer S, Lippi G. The impact of different sample matrices in delayed measurement of glucose. Clin Biochem 2016;49:1412–5.10.1016/j.clinbiochem.2016.08.015Search in Google Scholar PubMed

31. Kang JG, Park CY, Ihm SH, Park SW. A potential issue with screening prediabetes or diabetes using serum glucose: a delay in diagnosis. Diabetes Metab J 2016;40:414–7.10.4093/dmj.2016.40.5.414Search in Google Scholar PubMed PubMed Central

32. Kim HS. Blood glucose measurement: is serum equal to plasma? Diabetes Metab J 2016;40:365–6.10.4093/dmj.2016.40.5.365Search in Google Scholar PubMed PubMed Central

Received: 2017-09-24
Accepted: 2018-01-28
Published Online: 2018-03-12
Published in Print: 2018-07-26

©2018 Walter de Gruyter GmbH, Berlin/Boston

Articles in the same Issue

  1. Frontmatter
  2. Editorials
  3. Procalcitonin for diagnosing and monitoring bacterial infections: for or against?
  4. Is it time to abandon the Nobel Prize?
  5. In Memoriam
  6. Norbert Tietz, 13th November 1926–23rd May 2018
  7. Reviews
  8. Procalcitonin guidance in patients with lower respiratory tract infections: a systematic review and meta-analysis
  9. Telomere biology and age-related diseases
  10. Opinion Paper
  11. Procalcitonin-guided antibiotic therapy: an expert consensus
  12. Genetics and Molecular Diagnostics
  13. mRNA expression profile in peripheral blood mononuclear cells based on ADRB1 Ser49Gly and Arg389Gly polymorphisms in essential hypertension — a case-control pilot investigation in South Indian population
  14. General Clinical Chemistry and Laboratory Medicine
  15. External quality assessment schemes for glucose measurements in Germany: factors for successful participation, analytical performance and medical impact
  16. Long-term stability of glucose: glycolysis inhibitor vs. gel barrier tubes
  17. Observational studies on macroprolactin in a routine clinical laboratory
  18. Anti-streptavidin IgG antibody interference in anti-cyclic citrullinated peptide (CCP) IgG antibody assays is a rare but important cause of false-positive anti-CCP results
  19. Point-of-care creatinine testing for kidney function measurement prior to contrast-enhanced diagnostic imaging: evaluation of the performance of three systems for clinical utility
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  22. Lupus anticoagulant testing using two parallel methods detects additional cases and predicts persistent positivity
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  25. Within-subject and between-subject biological variation estimates of 21 hematological parameters in 30 healthy subjects
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  27. Cancer Diagnostics
  28. Serum carbohydrate sulfotransferase 7 in lung cancer and non-malignant pulmonary inflammations
  29. Cardiovascular Diseases
  30. Clinical performance of a new point-of-care cardiac troponin I test
  31. Diabetes
  32. Testing for HbA1c, in addition to the oral glucose tolerance test, in screening for abnormal glucose regulation helps to reveal patients with early β-cell function impairment
  33. Effects of common hemoglobin variants on HbA1c measurements in China: results for α- and β-globin variants measured by six methods
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  35. Serum procalcitonin concentration within 2 days postoperatively accurately predicts outcome after liver resection
  36. Predictive value of serum gelsolin and Gc globulin in sepsis – a pilot study
  37. Cerebrospinal fluid free light chains as diagnostic biomarker in neuroborreliosis
  38. Letter to the Editor
  39. Glucose and total protein: unacceptable interference on Jaffe creatinine assays in patients
  40. Interference of glucose and total protein on Jaffe-based creatinine methods: mind the covolume
  41. Interference of glucose and total protein on Jaffe based creatinine methods: mind the covolume – reply
  42. Measuring procalcitonin to overcome heterophilic-antibody-induced spurious hypercalcitoninemia
  43. Paraprotein interference in the diagnosis of hepatitis C infection
  44. Timeo apis mellifera and dona ferens: bee sting-induced Kounis syndrome
  45. Bacterial contamination of reusable venipuncture tourniquets in tertiary-care hospital
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  47. Early adjustment of antimicrobial therapy after PCR/electrospray ionization mass spectrometry-based pathogen detection in critically ill patients with suspected sepsis
  48. Thromboelastometry reveals similar hemostatic properties of purified fibrinogen and a mixture of purified cryoprecipitate protein components
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https://doi.org/10.1515/cclm-2017-0860
Keywords for this article
glucose; glycolysis; minimal difference; plasma; stability

Articles in the same Issue

  1. Frontmatter
  2. Editorials
  3. Procalcitonin for diagnosing and monitoring bacterial infections: for or against?
  4. Is it time to abandon the Nobel Prize?
  5. In Memoriam
  6. Norbert Tietz, 13th November 1926–23rd May 2018
  7. Reviews
  8. Procalcitonin guidance in patients with lower respiratory tract infections: a systematic review and meta-analysis
  9. Telomere biology and age-related diseases
  10. Opinion Paper
  11. Procalcitonin-guided antibiotic therapy: an expert consensus
  12. Genetics and Molecular Diagnostics
  13. mRNA expression profile in peripheral blood mononuclear cells based on ADRB1 Ser49Gly and Arg389Gly polymorphisms in essential hypertension — a case-control pilot investigation in South Indian population
  14. General Clinical Chemistry and Laboratory Medicine
  15. External quality assessment schemes for glucose measurements in Germany: factors for successful participation, analytical performance and medical impact
  16. Long-term stability of glucose: glycolysis inhibitor vs. gel barrier tubes
  17. Observational studies on macroprolactin in a routine clinical laboratory
  18. Anti-streptavidin IgG antibody interference in anti-cyclic citrullinated peptide (CCP) IgG antibody assays is a rare but important cause of false-positive anti-CCP results
  19. Point-of-care creatinine testing for kidney function measurement prior to contrast-enhanced diagnostic imaging: evaluation of the performance of three systems for clinical utility
  20. Hematology and Coagulation
  21. Analytical performance of an automated volumetric flow cytometer for quantitation of T, B and natural killer lymphocytes
  22. Lupus anticoagulant testing using two parallel methods detects additional cases and predicts persistent positivity
  23. Reference Values and Biological Variations
  24. Within-subject biological variation of activated partial thromboplastin time, prothrombin time, fibrinogen, factor VIII and von Willebrand factor in pregnant women
  25. Within-subject and between-subject biological variation estimates of 21 hematological parameters in 30 healthy subjects
  26. Immunoglobulin G (IgG) and IgG subclass reference intervals in children, using Optilite® reagents
  27. Cancer Diagnostics
  28. Serum carbohydrate sulfotransferase 7 in lung cancer and non-malignant pulmonary inflammations
  29. Cardiovascular Diseases
  30. Clinical performance of a new point-of-care cardiac troponin I test
  31. Diabetes
  32. Testing for HbA1c, in addition to the oral glucose tolerance test, in screening for abnormal glucose regulation helps to reveal patients with early β-cell function impairment
  33. Effects of common hemoglobin variants on HbA1c measurements in China: results for α- and β-globin variants measured by six methods
  34. Infectious Diseases
  35. Serum procalcitonin concentration within 2 days postoperatively accurately predicts outcome after liver resection
  36. Predictive value of serum gelsolin and Gc globulin in sepsis – a pilot study
  37. Cerebrospinal fluid free light chains as diagnostic biomarker in neuroborreliosis
  38. Letter to the Editor
  39. Glucose and total protein: unacceptable interference on Jaffe creatinine assays in patients
  40. Interference of glucose and total protein on Jaffe-based creatinine methods: mind the covolume
  41. Interference of glucose and total protein on Jaffe based creatinine methods: mind the covolume – reply
  42. Measuring procalcitonin to overcome heterophilic-antibody-induced spurious hypercalcitoninemia
  43. Paraprotein interference in the diagnosis of hepatitis C infection
  44. Timeo apis mellifera and dona ferens: bee sting-induced Kounis syndrome
  45. Bacterial contamination of reusable venipuncture tourniquets in tertiary-care hospital
  46. Detection of EDTA-induced pseudo-leukopenia using automated hematology analyzer with VCS technology
  47. Early adjustment of antimicrobial therapy after PCR/electrospray ionization mass spectrometry-based pathogen detection in critically ill patients with suspected sepsis
  48. Thromboelastometry reveals similar hemostatic properties of purified fibrinogen and a mixture of purified cryoprecipitate protein components
  49. Bicarbonate interference on cobas 6000 c501 chloride ion-selective electrodes
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