The metabolic syndrome (MetS) is a worldwide public health concern and is characterized by having three or more of these risk factors: high blood glucose (Glc), increased waist circumference (WC), high blood pressure (BP), reduced serum high-density lipoprotein (HDL) and increased serum triglycerides (TG). As certain rural regions lack the required infrastructure for optimal medical care, mobile diagnostics using point-of-care analyzers could help by identifying people at risk for MetS. PURPOSE: Test the reliability and validity of MetS risk factor analysis using point-of-care analyzers in a mobile examination unit.
METHODS: Fifty participants (18 test-retest; 52±7 y; 170±10 cm; 80±19 kg) were enrolled in the study. Agreement of Glc, HDL and TG of three point-of-care analyzers (A, B, C) against a reference lab (REF) were analyzed by Bland-Altman (bias, Limits of Agreement (LoA)) and McNemar’s test (MN). Further, MetS diagnosis by the mobile setup was tested for inter-session reliability by Spearman’s rho and test-retest variability (TRV%).
RESULTS: The range of systematic bias was for Glc -21 to -8 mg/dl, for TG -90 to 3 mg/dl and for HDL -8 to 9 mg/dl. Device C was excluded from further analyses due to missing values. Device A was chosen for additional analysis based on smallest bias and LoA (Glc: -8 [LoA -27 to 11] mg/dl; TG: 3 [LoA -40 to 46] mg/dl; HDL: -3 [LoA -16 to 11] mg/dl) and best agreement of MetS diagnosis with REF (MN: A vs. REF: p>.05; B vs. REF: p<.05). Test-retest analysis for risk factor classification and MetS diagnosis was performed in a mobile examination unit using device A. No inter-session differences for risk factor and MetS diagnosis were shown (MN day 1 vs. 2: p>.05). Spearman’s rho and TRV for risk factors were: TG: r =.734 (p<.05); 3.3%; HDL: r =.893 (p<.05); 6.8%; Glc, r =.076; 1.9%; systolic BP: r =.372; 1.7%; diastolic BP: r =.457; 3.3% and WC: r =.950 (p<.05); 1.1%.
CONCLUSIONS: The mobile setup showed no inter-session difference in MetS diagnosis. TRV was low for all risk factors and test-retest reliability was acceptable for TG, good for HDL and excellent for WC. Inter-session variations in Glc and BP did not influence the overall risk factor classification and MetS diagnosis. A mobile setup using a point-of-care analyzer for blood analysis is a valid and reliable method for a near-to-home MetS screening.