PERBEDAAN KADAR GLUKOSA DARAH MENGGUNAKAN PLASMA EDTA DENGAN PLASMA NaF DALAM PENUNDAAN WAKTU PEMERIKSAAN
Keywords:
Glukosa Darah, Plasma EDTA, Plasma NaFAbstract
ABSTRACT
The reliability of glucose testing is influenced not only by the analytical method but also by how specimens are maintained before analysis. Delayed testing may allow changes in glucose concentration to occur, making the choice of plasma type and specimen handling important components of preanalytical control. This study compared glucose concentrations in EDTA and NaF plasma following examination delays of 0, 4, and 8 hours. The test materials consisted of 24 blood samples collected from Prolanis patients at Klinik Alamanda and processed at Laboratorium Bakti Analisa, Surabaya. Plasma was separated from blood cells immediately after centrifugation, followed by glucose measurement using the GOD-PAP method. The mean glucose concentrations in EDTA plasma were 247.75, 245.00, and 243.50 mg/dL, respectively, whereas those in NaF plasma were 252.00, 250.50, and 244.25 mg/dL at the corresponding observation intervals. Analysis using the Kruskal-Wallis test yielded p=0.972, indicating no statistically significant difference in glucose concentrations among the compared conditions. Descriptively, both plasma types exhibited relatively similar changes during the examination delay. These findings indicate that, after plasma separation from blood cells, changes in glucose concentration remained relatively limited in both plasma types throughout the observation period, highlighting plasma separation as an important aspect of specimen management when immediate analysis is not feasible.
ABSTRAK
Keandalan hasil pemeriksaan glukosa tidak hanya ditentukan oleh metode analitik, tetapi juga oleh bagaimana spesimen dipertahankan sebelum dianalisis. Penundaan pemeriksaan dapat membuka peluang terjadinya perubahan kadar glukosa, sehingga pemilihan jenis plasma dan penanganan spesimen menjadi bagian penting dalam pengendalian pra-analitik. Penelitian ini membandingkan kadar glukosa pada plasma EDTA dan plasma NaF setelah penundaan pemeriksaan selama 0, 4, dan 8 jam. Bahan uji berasal dari 24 sampel darah pasien Prolanis Klinik Alamanda yang diproses di Laboratorium Bakti Analisa Surabaya; plasma dipisahkan dari sel darah segera setelah sentrifugasi, kemudian kadar glukosa ditentukan menggunakan metode GOD-PAP. Rerata kadar glukosa plasma EDTA berturut-turut sebesar 247,75; 245,00; dan 243,50 mg/dL, sedangkan plasma NaF sebesar 252,00; 250,50; dan 244,25 mg/dL pada interval pengamatan yang sama. Analisis menggunakan uji Kruskal-Wallis menghasilkan p=0,972, sehingga tidak ditemukan perbedaan kadar glukosa yang bermakna antara kondisi yang dibandingkan. Secara deskriptif, kedua jenis plasma memperlihatkan kecenderungan perubahan kadar yang relatif serupa selama penundaan. Temuan ini menunjukkan bahwa setelah plasma dipisahkan dari sel darah, perubahan kadar glukosa pada kedua jenis plasma dalam rentang pengamatan relatif terbatas, sehingga pemisahan plasma menjadi aspek penting dalam pengelolaan spesimen ketika pemeriksaan tidak dilakukan segera.
Downloads
References
Alcantara, J. C., Alharbi, B., Almotairi, Y., Alam, M. J., Muddathir, A. R. M., & Alshaghdali, K. (2022). Analysis of preanalytical errors in a clinical chemistry laboratory: A 2-year study. Medicine, 101(27), e29853. https://doi.org/10.1097/MD.0000000000029853
Braunberger, R. C., Martinez, M., & Grenache, D. G. (2021). Stability of plasma glucose in whole blood samples collected in sodium fluoride tube vs. sodium heparin plasma separator tubes. https://digitalrepository.unm.edu/hsc_qips/46
Cadamuro, J., & Simundic, A. M. (2023). The preanalytical phase—from an instrument-centred to a patient-centred laboratory medicine. Clinical Chemistry and Laboratory Medicine, 61(5), 732–740. https://doi.org/10.1515/cclm-2022-1036
Chaudhry, R., & Varacallo, M. A. (2023). Biochemistry, glycolysis. StatPearls Publishing.
Dharmasena, I. A., Siriwardhana, D., & Attanayake, A. P. (2021). Effect of sample volume variation and delay in analysis on plasma glucose concentration in Sri Lankan healthy adults. Scientifica, 2021, 6061206. https://doi.org/10.1155/2021/6061206
Dibbasey, M., Umukoro, S., & Bojang, A. (2024). Comparative and stability study of glucose concentrations measured in both sodium fluoride and serum separator tubes. Practical Laboratory Medicine, 39, e00360. https://www.sciencedirect.com/science/article/pii/S2352551724000064
Illana, F. J., García-Osuna, Á., Sospedra, M., Ferrer, R., Martínez-Brú, C., & Guiñón, L. (2024). Quality assurance of add-on testing in plasma samples: Stability limit for 29 biochemical analytes. Biochemia Medica, 34(2). https://doi.org/10.11613/BM.2024.020704
Indrawati, Y. (2023). Dasar-dasar teknik laboratorium medik. Kementerian Pendidikan, Kebudayaan, Riset, dan Teknologi.
Islam, M. N., Lyons, C., Griffin, T. P., Hamon, S., Dunne, F. P., & O’Shea, P. M. (2024). Maintaining glucose integrity ex vivo: Impact of preanalytical specimen handling. Annals of Clinical Biochemistry, 61(2), 133–142. https://doi.org/10.1177/00045632231199374
Kang, P., Wolf, C. E., Thomas, V. L., Melanson, S. E., & Tolan, N. V. (2026). Preanalytic considerations for preventing in vitro glycolysis: Practical recommendations for fasting and glucose tolerance testing. Diabetes Care, 49(2), e24–e25. https://doi.org/10.2337/dc25-2197
Khasanah, N. A. H., Lidiatama, N. G., Yuniati, N. I., & Husen, F. (2026). The effect of delayed examination and storage conditions on plasma glucose levels: Pengaruh variasi waktu penundaan pemeriksaan dan kondisi penyimpanan terhadap kadar glukosa plasma. Medicra (Journal of Medical Laboratory Science/Technology), 9(1), 62–68. https://doi.org/10.21070/medicra.v9i1.1831
Mulyani, E., Pangesti, I., & Farabi, M. F. (2023). Perbedaan kadar glukosa darah sewaktu menggunakan antikoagulan ethylene diamine tetra-acetic acid (EDTA) dan natrium fluorida (NaF) dengan variasi penundaan waktu pemeriksaan pada siswa SMK Semesta Bumiayu. Jurnal Ilmiah Kefarmasian, 5(2). https://doi.org/10.36760/jp.v5i2.322
Nakanga, W. P., Balungi, P., Niwaha, A. J., Shields, B. M., Hughes, P., Andrews, R. C., McDonald, T. J., Nyirenda, M. J., & Hattersley, A. T. (2022). Alternative pre-analytic sample handling techniques for glucose measurement in the absence of fluoride tubes in low resource settings. PLOS ONE, 17(2), e0264432. https://doi.org/10.1371/journal.pone.0264432
Nevraumont, A., Deltombe, M., & Bayart, J. L. (2024). How pre-analytical conditions impact glucose measurement and (gestational) diabetes diagnosis: A real-world stability study and a call for harmonization. Clinica Chimica Acta, 562, 119875. https://www.sciencedirect.com/science/article/abs/pii/S0009898124021284
Nisa, A. K., Sukeksi, A., & Mukaromah, A. H. (2020). Perbedaan kadar glukosa pada plasma EDTA dan NaF dengan variasi penundaan pemeriksaan. Universitas Muhammadiyah Semarang. http://repository.unimus.ac.id/id/eprint/4394
Nordin, N., Ab Rahim, S. N., Wan Omar, W. F. A., Zulkarnain, S., Sinha, S., Kumar, S., & Haque, M. (2024). Preanalytical errors in clinical laboratory testing at a glance: Source and control measures. Cureus, 16(3). https://doi.org/10.7759/cureus.57243
Sacks, D. B., Arnold, M., Bakris, G. L., Bruns, D. E., Horvath, A. R., Lernmark, Å., Kirkman, M. S., & others. (2023). Guidelines and recommendations for laboratory analysis in the diagnosis and management of diabetes mellitus. Clinical Chemistry, 69(8), 808–868. https://doi.org/10.1093/clinchem/hvad080
Sitanggang, F. T., Fione, V. R., Romaidha, I., Wilankrisna, L. A., Sari, N. I. P., Yuliandari, P., Fajri, H., Dewiyuliana, Putri, S. K., Sakdiah, S., Sitompul, A. J., Lestari, W. S., Simanjuntak, N. R., Wasilah, S. Z., & Novilla, A. (2024). Bunga rampai hematologi. Media Pustaka INDO. http://repository.stikesbcm.ac.id/id/eprint/599
Sugito, S., Djohan, H., Tumpuk, S., Sidiq, A. V., & Agum, D. (2025). Pre-analytical stability of fasting blood glucose: A comparison between immediate analysis and two-hour room temperature storage. Jurnal Laboratorium Khatulistiwa, 9(1), 69–75. https://doi.org/10.30602/jlk.v9i1.2138
Vercruysse, K., Lambrecht, S., & Oyaert, M. (2022). Total lab automation: Sample stability of clinical chemistry parameters in an automated storage and retrieval module. Clinical Chemistry and Laboratory Medicine, 60(1), 52–59. https://doi.org/10.1515/cclm-2021-0866
Warade, J. P. (2024). Study of glucose specimen integrity in various blood collection tubes over a period of 24 hours. International Journal of Research in Medical Sciences, 12(12), 4563–4567. https://doi.org/10.18203/2320-6012.ijrms20243707
Zhou, J., Fabros, A., Lam, S. J., Coro, A., Selvaratnam, R., Brinc, D., & Di Meo, A. (2024). The stability of 65 biochemistry analytes in plasma, serum, and whole blood. Clinical Chemistry and Laboratory Medicine, 62(8), 1557–1569. https://doi.org/10.1515/cclm-2023-1192
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2027 Arfi Amiratus Sholikhah, Edy Haryanto, Ratno Tri Utomo, Anik Handayati
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
CC Attribution-NonCommercial-ShareAlike 4.0
