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Comparison of fasting and postprandial levels of commonly used biochemical and hematological parameters

Yıl 2019, , 66 - 71, 01.08.2019
https://doi.org/10.25000/acem.541810

Öz

Aim: Physicians and
patients may have varying preferences for optimal blood analysis time. We aimed
to determine the tendency for the optimal blood analysis time of the physicians
and patients and also to determine the difference in some commonly used
biochemical and hematological parameters, between fasting and food intake.

Methods: Questionnaire and cross-sectional designs were used. The doctors and patients
were conducted to a survey about the appropriate time for blood tests before
the study. 112 patients were included in study. Blood samples were collected
after 8-10 hours of fasting and 2 hours after 600-700 calories lunch. Blood
creatinine, alanine aminotransferase, sodium, glucose, calcium, albumin, total
cholesterol, triglyceride, HDL, LDL, alkaline phosphatase, total bilirubin, lactate
dehydrogenase, complete blood count, erythrocyte sedimentation rate, prothrombin
time and TSH were studied and the values were compared.

Results: In our
survey, 75% of patients (54 patients in the outpatient clinic and 98 patients
in the blood collection unit, a total of 152) and 77% of doctors were thinking
that fasting was the appropriate time for blood tests. There were significant
increase in glucose (p<0.01), triglyceride (p<0.01) and platelets (p=0.035)
and significant decrease in sodium (p=0.01) after the food intake. There was no
statistically significant difference in the other parameters.







Conclusion: The
majority of physicians and patients had the opinion that blood tests should be
given in fasting. Although there were significant differences in glucose, triglyceride, thrombocyte and sodium levels in our study, thrombocyte and sodium differences
may not exhibit any clinical importance. Notwithstanding, high postprandial
levels of glucose and triglyceride are valuable indicators for cardiovascular
disease and diabetes risk. 

Kaynakça

  • 1. Kackov S, Simundic AM, Gatti-Drnic A. Are patients well informed about the fasting requirements for laboratory blood testing? Biochemia medica. 2013;23:326-31. 2. Adcock DM. Collection, transport, and processing of blood specimens for testing plasma-based coagulation assays and molecular hemostasis assays; approved guideline-fifth edition. January 2008. Available from: https://clsi.org/media/1399/h21a5_sample.pdf
  • 3. Complete blood count (CBC). Mayo Clinic Web site. 2017 [cited 2017 July 20]. Available from: http://www. mayoclinic.org/tests-procedures/complete-blood-count/basics/howyou-prepare/prc-20014088. .
  • 4. Nordestgaard BG, Hilsted L, Stender S. [Plasma lipids in non-fasting patients and signal values of laboratory results]. Ugeskr Laeger. 2009;171:1093.
  • 5. Miller M, Stone NJ, Ballantyne C, Bittner V, Criqui MH, Ginsberg HN, et al. Triglycerides and cardiovascular disease: a scientific statement from the American Heart Association. Circulation. 2011;123:2292-333.
  • 6. Rabar S, Harker M, O'Flynn N, Wierzbicki AS. Lipid modification and cardiovascular risk assessment for the primary and secondary prevention of cardiovascular disease: summary of updated NICE guidance. BMJ. 2014;349:g4356.
  • 7. Nordestgaard BG, Langsted A, Mora S, Kolovou G, Baum H, Bruckert E, et al. Fasting is not routinely required for determination of a lipid profile: clinical and laboratory implications including flagging at desirable concentration cut-points—a joint consensus statement from the European Atherosclerosis Society and European Federation of Clinical Chemistry and Laboratory Medicine. Eur Heart J. 2016;37:1944-58.
  • 8. [Diler A, Sert S, Aybek H, Yılmaztürk G. Klinik laboratuarlarda toplam laboratuar performansının değerlendirilmesi: Normalize OPSpec Grafikleri, Altı Sigma ve Hasta Test Sonuçları]. Türk Biyokimya Dergisi 2005;30:296-305.
  • 9. Flanagin A, Fontanarosa PB, DeAngelis CD. Authorship for research groups. JAMA. 2002;288:3166-8. 10. Emekli Dİ, Güçlü K, Turna G, İlanbey B, Nar R, Çiçek EA. Klinik Laboratuvarlarda Analitik Süreç Değerlendirilmesi: Altı Sigma Metodolojisi. Türk Klinik Biyokimya Dergisi. 2016;14:79-86.
  • 11. Standards of medical care in diabetes—2015 abridged for primary care providers. Clin Diabetes. 2015;33:97-111.
  • 12. Masharani U, German M. Pancreatic hormones and diabetes mellitus. In: Gardner DG, Shoback D, editors. Greenspan’s basic & clinical endocrinology. New York: McGraw-Hill; 2011.pp.612-17.
  • 13. Ranganath LR. The entero-insular axis: implications for human metabolism. Clin Chem Lab Med. 2008;46:43-56.
  • 14. Adams SH, Newman JW. Metabolomics: applications in type 2 diabetes mellitus and insulin resistance. In: DeFronzo RA, Ferrannini E, Alberti KGMM, Zimmet P, Alberti G, editors. International Textbook of Diabetes Mellitus. John Wiley & Sons; 2015.pp.275-82.
  • 15. Nathan DM. Long-term complications of diabetes mellitus. New Eng J Med. 1993;328:1676-85.
  • 16. Leiter LA, Ceriello A, Davidson JA, Hanefeld M, Monnier L, Owens DR, et al. Postprandial glucose regulation: New data and new implications. Clin Ther. 2005;27 Suppl B:S42-S56.
  • 17. Stein EA, Myers GL. National cholesterol education program recommendations for triglycerides measurement: executive summary. The National Cholesterol Education Program Working Group on Lipoprotein Measurement. Clin Chem. 1995;41:1421-6.
  • 18. Ferreira AC, Peter AA, Mendez AJ, Jimenez JJ, Mauro LM, Chirinos JA, et al. Postprandial hypertriglyceridemia increases circulating levels of endothelial cell microparticles. Circulation. 2004;11:3599-603.
  • 19. Plumelle D, Lombard E, Nicolay A, Portugal H. Influence of diet and sample collection time on 77 laboratory tests on healthy adults. Clin Biochem. 2014;47:31-7.
  • 20. Sarwar N, Danesh J, Eiriksdottir G, Sigurdsson G, Wareham N, Bingham S, et al. Triglycerides and the risk of coronary heart disease: 10,158 incident cases among 262,525 participants in 29 Western prospective studies. Circulation. 2007;115:450-8.
  • 21. Patel A, Barzi F, Jamrozik K, Lam TH, Ueshima H, Whitlock G, et al. Serum triglycerides as a risk factor for cardiovascular diseases in the Asia-Pacific region. Circulation. 2004;110:2678-86.
  • 22. Kolovou GD, Anagnostopoulou KK, Daskalopoulou SS, Mikhailidis DP, Cokkinos DV. Clinical relevance of postprandial lipaemia. Curr Med Chem. 2005;12:1931-45.
  • 23. Bansal S, Buring JE, Rifai N, Mora S, Sacks FM, Ridker PM. Fasting compared with nonfasting triglycerides and risk of cardiovascular events in women. JAMA. 2007;298:309-16.
  • 24. Freiberg JJ, Tybjaerg-Hansen A, Jensen JS, Nordestgaard BG. Nonfasting triglycerides and risk of ischemic stroke in the general population. JAMA. 2008;300:2142-52.
  • 25. Varbo A, Nordestgaard BG. Nonfasting Triglycerides, Low-Density Lipoprotein Cholesterol, and Heart Failure Risk: Two Cohort Studies of 113 554 Individuals. Arterioscler Thromb Vasc Biol. 2018;38:464-72.
  • 26. Ginsberg HN, Karmally W, Siddiqui M, Holleran S, Tall AR, Rumsey SC, et al. A dose-response study of the effects of dietary cholesterol on fasting and postprandial lipid and lipoprotein metabolism in healthy young men. Arterioscler Thromb. 1994;14:576-86.
  • 27. Doran B, Guo Y, Xu J, Weintraub H, Mora S, Maron DJ, et al. Prognostic value of fasting versus nonfasting low-density lipoprotein cholesterol levels on long-term mortality: insight from the National Health and Nutrition Examination Survey III (NHANES-III). Circulation. 2014;130:546-53.
  • 28. Jellinger PS, Handelsman Y, Rosenblit PD, Bloomgarden ZT, Fonseca VA, Garber AJ, et al. American Association of Clinical Endocrinologists and American College of Endocrinology guidelines for management of dyslipidemia and prevention of cardiovascular disease. Endocr Pract. 2017;23 Suppl 2:1-87.
  • 29. Sothern RB, Vesely DL, Kanabrocki EL, Bremner FW, Third JL, McCormick JB, et al. Circadian relationships between circulating atrial natriuretic peptides and serum sodium and chloride in healthy humans. Am J Nephrol. 1996;16:462-70.
  • 30. Lippi G, Lima-Oliveira G, Salvagno GL, Montagnana M, Gelati M, Picheth G, et al. Influence of a light meal on routine haematological tests. Blood Transfus. 2010;8:94-9.
  • 31. Van Oostrom A, Sijmonsma T, Rabelink T, Van Asbeck B, Cabezas MC. Postprandial leukocyte increase in healthy subjects. Metabolism. 2003;52:199-202.
  • 32. Wiens L, Lutze G, Luley C, Westphal S. Platelet count and platelet activation: impact of a fat meal and day time. Platelets. 2007;18:171-3.
  • 33. Bremner WF, Sothern RB, Kanabrocki EL, Ryan M, McCormick JB, Dawson S, et al. Relation between circadian patterns in levels of circulating lipoprotein(a), fibrinogen, platelets, and related lipid variables in men. Am Heart J. 2000;139:164-73.

Sık kullanılan biyokimyasal ve hematolojik parametrelerin açlık ve postprandiyal düzeylerinin karşılaştırılması

Yıl 2019, , 66 - 71, 01.08.2019
https://doi.org/10.25000/acem.541810

Öz

Amaç: Hekimler ve
hastaların kan tahlili verme zamanı tercihleri değişiklik gösterebilmektedir. Çalışmamızda
anketler ile hekim ve hastaların eğilimlerini belirlemeyi ve günümüzde sık
kullanılan bazı biyokimyasal ve hematolojik tetkiklerde açlık ve tokluk
arasında farklılık olup olmadığını tespit etmeyi amaçladık.

Materyal-metod:
Anket ve kesitsel dizayn birlikte kullanıldı. Çalışmaya başlamadan önce
doktorlara ve hastalara kan tahlilleri için uygun kan verme zamanı konusunda
anket yapıldı. Çalışmaya toplam 112 hasta alındı. Bu hastalarda 8-10 saatlik
açlık sonrası ve 600-700 kalorilik öğle yemeğinden 2 saat sonra kan alındı.
Alınan kanlardan kreatinin, alanin aminotransferaz, sodyum, glukoz, kalsiyum,
albumin, total kolesterol, trigliserid, HDL, LDL, alkalen fosfataz, total
bilirubin, laktat dehidrogenaz, hemogram, sedimentasyon, protrombiz zamanı ve
TSH çalışıldı ve değerleri karşılaştırıldı.

Bulgular: Çalışmamızın
anket evresinde; hastaların %75’i (54 poliklinik hastası ve 98 kan alma
birimine gelen hasta olmak üzere toplam 152), doktorların % 77’si tetkiklerin
aç karna yapılması gerektiğini düşünmekteydiler. Çalışılan kanların sonucunda
glukoz (p<0.01), trigliserid (p<0.01) ve trombositlerde (p=0.035)
toklukta istatistiksel olarak anlamlı artış, sodyumda (p=0.01) ise toklukta
anlamlı azalma tespit edildi. Diğer parametrelerde açlık ve tokluk arasında
istatistiksel olarak anlamlı farklılık bulunmadı.







Sonuç: Doktor ve hastaların
büyük çoğunluğu kan tetkiklerinin açlıkta verilmesi gerektiği görüşündedir.
Çalışmamızda glukoz, trigliserid, trombosit ve sodyumda anlamlı farklılık
tespit edilse de, trombosit ve sodyum düzeyindeki farklılık klinik önem
arzetmeyecek seviyelerdeydi. Toklukta tespit edilen yüksek glukoz ve
trigliserid düzeyleri kardiovasküler hastalık ve diyabet riski için kıymetli
göstergelerdir. 

Kaynakça

  • 1. Kackov S, Simundic AM, Gatti-Drnic A. Are patients well informed about the fasting requirements for laboratory blood testing? Biochemia medica. 2013;23:326-31. 2. Adcock DM. Collection, transport, and processing of blood specimens for testing plasma-based coagulation assays and molecular hemostasis assays; approved guideline-fifth edition. January 2008. Available from: https://clsi.org/media/1399/h21a5_sample.pdf
  • 3. Complete blood count (CBC). Mayo Clinic Web site. 2017 [cited 2017 July 20]. Available from: http://www. mayoclinic.org/tests-procedures/complete-blood-count/basics/howyou-prepare/prc-20014088. .
  • 4. Nordestgaard BG, Hilsted L, Stender S. [Plasma lipids in non-fasting patients and signal values of laboratory results]. Ugeskr Laeger. 2009;171:1093.
  • 5. Miller M, Stone NJ, Ballantyne C, Bittner V, Criqui MH, Ginsberg HN, et al. Triglycerides and cardiovascular disease: a scientific statement from the American Heart Association. Circulation. 2011;123:2292-333.
  • 6. Rabar S, Harker M, O'Flynn N, Wierzbicki AS. Lipid modification and cardiovascular risk assessment for the primary and secondary prevention of cardiovascular disease: summary of updated NICE guidance. BMJ. 2014;349:g4356.
  • 7. Nordestgaard BG, Langsted A, Mora S, Kolovou G, Baum H, Bruckert E, et al. Fasting is not routinely required for determination of a lipid profile: clinical and laboratory implications including flagging at desirable concentration cut-points—a joint consensus statement from the European Atherosclerosis Society and European Federation of Clinical Chemistry and Laboratory Medicine. Eur Heart J. 2016;37:1944-58.
  • 8. [Diler A, Sert S, Aybek H, Yılmaztürk G. Klinik laboratuarlarda toplam laboratuar performansının değerlendirilmesi: Normalize OPSpec Grafikleri, Altı Sigma ve Hasta Test Sonuçları]. Türk Biyokimya Dergisi 2005;30:296-305.
  • 9. Flanagin A, Fontanarosa PB, DeAngelis CD. Authorship for research groups. JAMA. 2002;288:3166-8. 10. Emekli Dİ, Güçlü K, Turna G, İlanbey B, Nar R, Çiçek EA. Klinik Laboratuvarlarda Analitik Süreç Değerlendirilmesi: Altı Sigma Metodolojisi. Türk Klinik Biyokimya Dergisi. 2016;14:79-86.
  • 11. Standards of medical care in diabetes—2015 abridged for primary care providers. Clin Diabetes. 2015;33:97-111.
  • 12. Masharani U, German M. Pancreatic hormones and diabetes mellitus. In: Gardner DG, Shoback D, editors. Greenspan’s basic & clinical endocrinology. New York: McGraw-Hill; 2011.pp.612-17.
  • 13. Ranganath LR. The entero-insular axis: implications for human metabolism. Clin Chem Lab Med. 2008;46:43-56.
  • 14. Adams SH, Newman JW. Metabolomics: applications in type 2 diabetes mellitus and insulin resistance. In: DeFronzo RA, Ferrannini E, Alberti KGMM, Zimmet P, Alberti G, editors. International Textbook of Diabetes Mellitus. John Wiley & Sons; 2015.pp.275-82.
  • 15. Nathan DM. Long-term complications of diabetes mellitus. New Eng J Med. 1993;328:1676-85.
  • 16. Leiter LA, Ceriello A, Davidson JA, Hanefeld M, Monnier L, Owens DR, et al. Postprandial glucose regulation: New data and new implications. Clin Ther. 2005;27 Suppl B:S42-S56.
  • 17. Stein EA, Myers GL. National cholesterol education program recommendations for triglycerides measurement: executive summary. The National Cholesterol Education Program Working Group on Lipoprotein Measurement. Clin Chem. 1995;41:1421-6.
  • 18. Ferreira AC, Peter AA, Mendez AJ, Jimenez JJ, Mauro LM, Chirinos JA, et al. Postprandial hypertriglyceridemia increases circulating levels of endothelial cell microparticles. Circulation. 2004;11:3599-603.
  • 19. Plumelle D, Lombard E, Nicolay A, Portugal H. Influence of diet and sample collection time on 77 laboratory tests on healthy adults. Clin Biochem. 2014;47:31-7.
  • 20. Sarwar N, Danesh J, Eiriksdottir G, Sigurdsson G, Wareham N, Bingham S, et al. Triglycerides and the risk of coronary heart disease: 10,158 incident cases among 262,525 participants in 29 Western prospective studies. Circulation. 2007;115:450-8.
  • 21. Patel A, Barzi F, Jamrozik K, Lam TH, Ueshima H, Whitlock G, et al. Serum triglycerides as a risk factor for cardiovascular diseases in the Asia-Pacific region. Circulation. 2004;110:2678-86.
  • 22. Kolovou GD, Anagnostopoulou KK, Daskalopoulou SS, Mikhailidis DP, Cokkinos DV. Clinical relevance of postprandial lipaemia. Curr Med Chem. 2005;12:1931-45.
  • 23. Bansal S, Buring JE, Rifai N, Mora S, Sacks FM, Ridker PM. Fasting compared with nonfasting triglycerides and risk of cardiovascular events in women. JAMA. 2007;298:309-16.
  • 24. Freiberg JJ, Tybjaerg-Hansen A, Jensen JS, Nordestgaard BG. Nonfasting triglycerides and risk of ischemic stroke in the general population. JAMA. 2008;300:2142-52.
  • 25. Varbo A, Nordestgaard BG. Nonfasting Triglycerides, Low-Density Lipoprotein Cholesterol, and Heart Failure Risk: Two Cohort Studies of 113 554 Individuals. Arterioscler Thromb Vasc Biol. 2018;38:464-72.
  • 26. Ginsberg HN, Karmally W, Siddiqui M, Holleran S, Tall AR, Rumsey SC, et al. A dose-response study of the effects of dietary cholesterol on fasting and postprandial lipid and lipoprotein metabolism in healthy young men. Arterioscler Thromb. 1994;14:576-86.
  • 27. Doran B, Guo Y, Xu J, Weintraub H, Mora S, Maron DJ, et al. Prognostic value of fasting versus nonfasting low-density lipoprotein cholesterol levels on long-term mortality: insight from the National Health and Nutrition Examination Survey III (NHANES-III). Circulation. 2014;130:546-53.
  • 28. Jellinger PS, Handelsman Y, Rosenblit PD, Bloomgarden ZT, Fonseca VA, Garber AJ, et al. American Association of Clinical Endocrinologists and American College of Endocrinology guidelines for management of dyslipidemia and prevention of cardiovascular disease. Endocr Pract. 2017;23 Suppl 2:1-87.
  • 29. Sothern RB, Vesely DL, Kanabrocki EL, Bremner FW, Third JL, McCormick JB, et al. Circadian relationships between circulating atrial natriuretic peptides and serum sodium and chloride in healthy humans. Am J Nephrol. 1996;16:462-70.
  • 30. Lippi G, Lima-Oliveira G, Salvagno GL, Montagnana M, Gelati M, Picheth G, et al. Influence of a light meal on routine haematological tests. Blood Transfus. 2010;8:94-9.
  • 31. Van Oostrom A, Sijmonsma T, Rabelink T, Van Asbeck B, Cabezas MC. Postprandial leukocyte increase in healthy subjects. Metabolism. 2003;52:199-202.
  • 32. Wiens L, Lutze G, Luley C, Westphal S. Platelet count and platelet activation: impact of a fat meal and day time. Platelets. 2007;18:171-3.
  • 33. Bremner WF, Sothern RB, Kanabrocki EL, Ryan M, McCormick JB, Dawson S, et al. Relation between circadian patterns in levels of circulating lipoprotein(a), fibrinogen, platelets, and related lipid variables in men. Am Heart J. 2000;139:164-73.
Toplam 31 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular İç Hastalıkları
Bölüm Orjinal Makale
Yazarlar

Elif Turan 0000-0002-8228-6932

Recep Tunç Bu kişi benim

Yaşar Turan 0000-0002-2796-899X

Yayımlanma Tarihi 1 Ağustos 2019
Yayımlandığı Sayı Yıl 2019

Kaynak Göster

Vancouver Turan E, Tunç R, Turan Y. Comparison of fasting and postprandial levels of commonly used biochemical and hematological parameters. Arch Clin Exp Med. 2019;4(2):66-71.