Validation of Finger-Prick Testing of Fasting Blood Glucose, Total Cholesterol, and HbA1c in Adolescents

Abstract

This study compared finger-prick testing of fasting blood glucose, total cholesterol, and glycated hemoglobin (HbA1c) with venous blood method in the screening of Jamaican adolescents in a school setting. Subjects, aged 14 to 18 years, were selected from grades 9 to 12, in 10 randomly selected high schools on the island. Capillary whole blood was tested for fasting blood glucose using the Accu-Chek Advantage Blood Glucose Monitor (Roche Diagnostics, Auckland, New Zealand). The Accutrend GCT Cholesterol Monitor (Roche Diagnostics, Mannheim, Germany) was used for measuring total cholesterol. HbA1c was tested using the NycoCard (Axis-Shield, Oslo, Norway). Finger-prick testing was compared to venous blood using standard laboratory procedures for all 3 tests. A total of 59 students participated, whose mean age was 15.6 (1.2) years. Mean fasting blood glucose finger-prick values (92.88 ± 11.97 mg/dL) was not significantly different (P > 0.05) from venous values (95.24 [10.27] mg/dL). Mean venous value of total cholesterol (157.9 [30.0] mg/dL) was significantly higher (P < 0.01) than finger-prick (145.8 [21.6] mg/dL). Mean venous HbA1c (5.40% [0.81%]) was significantly lower (P < 0.01) than finger-prick (6.08% [1.5%]). Percentage bias between the 2 methods met the reference standards for fasting blood glucose and total cholesterol but not for HbA1c. Bland-Altman tests of agreement between the 2 methods indicated good agreement for all 3 tests. Finger-prick testing of fasting blood glucose compared favorably with venous testing and may be used for screening this population. The Bland Altman tests indicated that finger-prick testing of fasting blood glucose, total cholesterol, and HbA1c may be used for the screening of adolescents in a high school setting.