Journal Information
Journal ID (publisher-id): BM
Journal ID (nlm-ta): Biochem Med (Zagreb)
Title: Biochemia Medica
Abbreviated Title: Biochem. Med. (Zagreb)
ISSN (print): 1330-0962
ISSN (electronic): 1846-7482
Publisher: Croatian Society of Medical Biochemistry and Laboratory Medicine
Article Information
Copyright statement: Copyright Croatian Society of Medical Biochemistry and Laboratory Medicine
Copyright: 2024, Copyright Croatian Society of Medical Biochemistry and Laboratory Medicine
License (https://creativecommons.org/licenses/by/4.0/):
This is an open-access article distributed under the terms of the Creative Commons Attribution (CC BY) 4.0 License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Date received: 14 October 2023
Date accepted: 16 January 2024
Publication date: 15 April 2024
Publication date: 15 June 2024
Volume: 34
Issue: 2
Electronic Location Identifier: 020701
Publisher ID: bm-34-2-020701
DOI: 10.11613/BM.2024.020701
Comparison of lipemia interference created with native lipemic material and intravenous lipid emulsion in emergency laboratory tests
Hatice Sürer[2]
Serkan Bolat[3]
Mehmet Şeneş[2]
Doğan Yücel[4]
[1] Medical Biochemistry, Ministry of Health Pursaklar State Hospital, Ankara, Turkey
[2] Medical Biochemistry, University of Health Sciences Ankara Training and Research Hospital, Ankara, Turkey
[3] Department of Medical Biochemistry, Sivas Cumhuriyet University, Sivas, Turkey
[4] Department of Medical Biochemistry, Lokman Hekim University, Ankara, Turkey
Author notes:
[*] Corresponding author: emel_colak26@hotmail.com
Authorship contributions
EÇS: wrote the manuscript, designed the study, performed the sample collection and analysis, performed the statistical analysis, critically revised the manuscript. DY: designed the study, critically revised the manuscript. MŞ: designed the study, performed the sample collection and analysis, performed the statistical analysis, critically revised the manuscript. HS: designed the study, performed the sample collection and analysis, critically revised the manuscript. S Bolat: performed the statistical analysis, critically revised the manuscript. All authors have accepted responsibility for the entire content of the submitted manuscript and approved submission.
• After hemolysis and icterus, lipemia is one of the most common errors encountered in the preanalytical phase
• Mimicking lipemia is more challenging than other interference types because of the heterogenous property of lipids
• Intravenous lipid emulsions are not sufficient for mimicking lipemia
• Since almost all companies use intravenous lipid emulsion in lipemia interference studies, the results of these studies must be interpreted carefully by the laboratory experts
Introduction
This study aimed to investigate the effects of lipemia on clinical chemistry and coagulation parameters in native ultralipemic (NULM) and intravenous lipid emulsion (IVLE) spiked samples.
Materials and methods
The evaluation of biochemistry (photometric, ion-selective electrode, immunoturbidimetric method), cardiac (electrochemiluminescence immunoassay method) and coagulation (the viscosity-based mechanical method for prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen and the immunoturbidimetric method for D-dimer) parameters were conducted. In addition to the main pools, five pools were prepared for both types of lipemia, each with triglyceride (TG) concentrations of approximately 2.8, 5.7, 11.3, 17.0 and 22.6 mmol/L. All parameters’ mean differences (MD%) were presented as interferographs and compared with the desirable specification for the inaccuracy (bias%). Data were also evaluated by repeated measures of ANOVA.
Results
Prothrombin time and APTT showed no clinically relevant interference in IVLE-added pools but were negatively affected in NULM pools
(P < 0.001 in both parameters). For biochemistry, the most striking difference was seen for CRP; it is up to 134 MD% value with NULM (P < 0.001) at the highest TG concentration, whereas it was up to - 2.49 MD% value with IVLE (P = 0.009). Albumin was affected negatively upward of 5.7 mmol/L TG with IVLE, while there was no effect for NULM. Creatinine displayed significant positive interferences with NULM starting at the lowest TG concentration (P = 0.028). There was no clinically relevant interference in cardiac markers for both lipemia types.
Keywords: lipemia; intravenous lipid emulsions; interference; clinical chemistry tests; preanalytical phase
