Assessment of a point-of-care test for measurement of blood triglyceride levels for rapid detection of equid hypertriglyceridaemia

Abstract

This project investigated the clinical value of a human whole blood point-of-care (POC) triglyceride (TG) measurement device to determine equid blood TG concentrations. Equid plasma TG measurements were determined in a commercial laboratory and also using whole blood and plasma on the POC device from equid patients with TG concentrations from within the normal range to severely hypertriglyceridaemic. Results were compared between methods using the Bland-Altman method for validation. Seventy-four samples were collected: 35 from inappetent or starved equid patients (considered 'at-risk' of developing hypertriglyceridaemia) and 39 from equids eating with a normal appetite. The POC device readable range is 0.8-6.86mmol/l; high readings were diluted and measurements repeated and calculated. Inappetent/starved patients had a higher risk of developing raised plasma triglycerides (OR 16.8, 95% CI 4.8-58.4, P<0.0001) than the appetent ones with 34% (12/35) having mildly increased TG and 31% (11/35) having moderately to severely increased TG concentrations. In comparison, there were no severely hypertriglyceridaemic patients, one moderately increased and 3/39 (8%) mildly elevated TG patients in the appetent group. In the readable range, using whole blood, the POC device had excellent agreement with the laboratory (mean difference -0.59). However, accuracy varied with TG concentration and the POC instrument overestimated TG values, particularly when TG values were above the POC device's range. For a given value in the readable range of the POC device, multiplication of the POC value by a factor of 0.77 (whole blood) and 0.72 (plasma) provides an estimation of the laboratory TG value. Whole blood TG readings below the POC instrument's range were reliably low. The POC device reliably predicted TG values in a clinical setting. Use of this device provides rapid, easy to perform, reliable assessment of blood TG concentration in equids at risk of developing hypertriglyceridaemia. © 2012 EVJ Ltd.