Calprotectin levels are elevated in inflammation and cancer but are not helpful in differentiating between these disorders. In our series, calprotectin was not elevated in colonic polyps or adenomata. Calprotectin could be helpful as a screening method in a general gastroenterology population for inflammatory bowel disease and those with carcinoma, as well as assessing and monitoring disease activity in inflammatory bowel disease.
Four blood glucose reagent strips (BM-Test 1-44, Glucostix, Hypoguard GA, and Exactech), used in conjunction with measuring devices produced by the same manufacturer, were investigated with respect to the influence of haematocrit. The erythrocytes and plasma of fresh blood samples were separated, then remixed in different proportions to achieve a range of haematocrit values and the resulting specimens subjected to glucose assay. All the strip tests showed some influence of haematocrit, low haematocrits producing higher glucose results and vice versa, but some were much more affected than others. The Hypoguard GA was most affected and the BM-Test 1-44 least. In the worst case, glucose results differed by 49% from one end of the normal adult haematocrit range to the other.
To resolve whether haemoglobin A1c(HbA1c) levels in normal subjects increase with age, we measured HbA1c in 399 patients undergoing routine oral glucose tolerance test (OGTT). The OGTT results categorized the patients into 127 normal, 94 impaired glucose tolerance (IGT) and 178 diabetic. None of these groups showed a significant correlation between HbA1c and age and we cannot, therefore, see a need for age-specific reference ranges for HbA1c. Some of the confusion in the literature may have arisen from less rigorous categorization of subjects than we used, resulting in the inclusion of some individuals with IGT or diabetes in the 'normal' groups of other studies. The prevalence of such abnormality would be expected to be greater amongst older subjects, falsely suggesting a correlation between HbA1c and age, and we were able to demonstrate this with our own data when insufficiently rigorous criteria were applied for the selection of normal subjects.
SUMMARY. The HemoCue blood glucose analyser was investigated with particular respect to its susceptibility to influence by the haematocrit of the blood specimen. The red cells and plasma of fresh blood samples were separated and then recombined in proportions to give a range of haematocrit values and the resulting specimens assayed for glucose. The HemoCue exhibited no appreciable influence of haematocrit. The instrument was easy to use, stable and had good precision (CV 1'8%). However, results tended to be a little higher than those produced by a conventional laboratory analyser on whole blood and it is understood that the factory calibration of newer HemoCue instruments has been modified to correct for this.
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