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Test Code Glucagon Glucagon, Plasma

Reporting Name

Glucagon, P

Useful For

Diagnosis and follow-up of glucagonomas and other glucagon-producing tumors

 

Assessing diabetic patients with problematic hyper- or hypoglycemic episodes (extremely limited utility)

 

Glucagon is routinely measured along with serum glucose, insulin, and C-peptide levels, during the mixed-meal test employed in the diagnostic workup of suspected postprandial hypoglycemia. However, it plays only a minor role in the interpretation of this test.


Specimen Required


Collection Container/Tube: Lavender top (EDTA)

Submission Container/Tube: Plastic vial

Specimen Volume: 2 mL

Collection Instructions:

1. Fasting

2. Pre-chill tube at 4° C before drawing the specimen.

3. Draw into the pre-chilled tube, and process as follows:

a. After drawing specimen, chill tube in wet ice for 10 minutes.

b. Centrifuge in a refrigerated centrifuge or in chilled centrifuge cup.

c. Immediately after centrifugation, remove plasma, place in a plastic transport vial (T465), and freeze.


Specimen Type

Plasma EDTA

Specimen Minimum Volume

0.45 mL

Specimen Stability Information

Specimen Type Temperature Time
Plasma EDTA Frozen 90 days

Day(s) and Time(s) Performed

Monday, Thursday; 10 a.m.

Seattle Children's Hospital Note:

TAT: 4 - 8 days

Performing Laboratory

Mayo Medical Laboratories in Rochester

Method Name

Immunoassay Following Extraction

Method Description

Big plasma glucagon (BPG), which is considered to be biologically inactive, is extracted using ethanol prior to assay of the specimen. This enables accurate measurement of the biologically active glucagon in the specimen.(Hendriks T: Radioimmunoassay of clinically meaningful components of circulating glucagon: removal of big plasma glucagon prior to assay. Clin Chim Acta 1984;140:301-307) Following ethanol extraction, glucagon reacts with an antiglucagon antibody that is attached to tiny polystyrene beads. After incubation and washing, a second detection antibody is added and attaches to any bead-bound glucagon, forming a sandwich assay. A streptavidin-phycoerythrin (SPE) tag binds to the glucagon-antibody complex. Laser-based fluorescent analysis of the resulting glucagon-antibody-SPE complex is performed on the Luminex 200 instrument.(Package insert: Human Endocrine LINCOplex Kit, HENDO-65K-Rev. 03/03/06)

Reference Values

≤6 hours: 100-650 pg/mL

1-2 days: 70-450 pg/mL

2-4 days: 100-650 pg/mL

4-14 days: declining gradually to adult levels

>14 days: ≤80 pg/mL (range based on 95% confidence limits)

 

Glucagon levels are inversely related to blood glucose levels at all ages. This is particularly pronounced at birth and shortly thereafter, until regular feeding patterns are established. This explains the higher levels immediately after birth, which then first fall as the glucagon release mobilizes the infant's glucose stores, then rise again as stores are depleted, finally normalizing towards adult levels as regular feeding patterns are established.

 

For SI unit Reference Values, see https://www.mayomedicallaboratories.com/order-tests/si-unit-conversion.html.

Test Classification

This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the U.S. Food and Drug Administration.

CPT Code Information

82943

LOINC Code Information

Test ID Test Order Name Order LOINC Value
GLP Glucagon, P 2338-2

 

Result ID Test Result Name Result LOINC Value
9358 Glucagon, P 2338-2

Reject Due To

Hemolysis

Mild OK; Gross reject

Lipemia

Mild OK; Gross OK

Icterus

Mild OK; Gross OK

Other

NA