Serum delipidation but not high-speed centrifugation is effective in clearing lipemia interference in serum lipase activity measurement

Biljak, Vanja Radišić; Božičević, Sandra; Krhač, Maja; Radeljak, Andrea; Lovrenčić, Marijana Vučić

doi:10.1515/cclm-2015-1275

Cited by 3 publications

(2 citation statements)

References 4 publications

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“…The ability of high-speed centrifugation to correct or reduce some but not all lipemic interferences is similar to findings for human samples. 7,8,23 Our use of Intralipid may have exaggerated the effectiveness of high-speed centrifugation. The size of Intralipid particles overlaps with chylomicrons, rather than VLDL.…”

Section: Discussionmentioning

confidence: 99%

“…18 However, human studies suggest that the centrifugation speeds commonly used in veterinary medicine are insufficient to fully correct lipemic interferences and may introduce additional sources of error, such as depletion of hydrophobic analytes. 18,23 Although there is some evidence that non-polar solvents are more effective than centrifugation for removal of interference for specific analytes, 23 studies using human plasma reveal that a commercial polar solvent introduced bias for other analytes. 26 Similar studies have not been performed for veterinary samples.…”

Section: Introductionmentioning

confidence: 99%

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Effects of marked hypertriglyceridemia and lipid clearance techniques on canine biochemistry testing

2019

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Triglyceride concentrations in dogs with hyperlipidemic disorders can exceed concentrations used by assay manufacturers for interference testing. High-speed centrifugation or the polar solvent LipoClear reduce triglyceride concentrations, but efficacy requires evaluation in veterinary species. We determined the effect of marked hypertriglyceridemia on canine biochemistry testing; assessed the ability of high-speed centrifugation or LipoClear to correct lipemic interferences; and determined if LipoClear introduces inaccuracy into biochemistry assays. Fifteen pooled canine serum samples were aliquoted and spiked with equal volumes of water or Intralipid [triglyceride concentration 33.9 mmol/L (3,000 mg/dL)]. Intralipid aliquots underwent lipid removal by high-speed centrifugation or LipoClear treatment, and a water-spiked aliquot underwent LipoClear treatment. Biochemistry panels were performed using a Vitros 4600 chemistry analyzer. Results were compared by paired t-test or Wilcoxon test. Total observed errors were considered clinically acceptable if below veterinary allowable total error (TEa) guidelines. Statistically significant ( p ≤ 0.05) interferences were introduced by Intralipid for 15 of 15 analytes. Median observed error exceeded TEa for potassium and enzymatic carbon dioxide, neither of which were identified by the manufacturer as susceptible to lipemic interference. After centrifugation, median observed error exceeded TEa for potassium and chloride. LipoClear treatment resulted in median errors that exceeded TEa for total protein, chloride, and phosphorus. Given that severe lipemia can occur in dogs with primary or secondary hyperlipidemia, veterinary laboratories should perform their own interference testing at triglyceride concentrations relevant to their patient population and provide this information to clinicians to ensure optimal case management.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effects of marked hypertriglyceridemia and lipid clearance techniques on canine biochemistry testing

2019

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Filling accuracy and imprecision of commercial evacuated sodium citrate coagulation tubes

Lippi

Salvagno

Biljak³

et al. 2019

Scandinavian Journal of Clinical and Laboratory Investigation

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Methods to reduce lipemic interference in clinical chemistry tests: a systematic review and recommendations

Soh

Loh

Sethi

et al. 2021

Clinical Chemistry and Laboratory Medicine (CCLM)

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Objectives Lipemia is the presence of abnormally high lipoprotein concentrations in serum or plasma samples that can interfere with laboratory testing. There is little guidance available from manufacturers or professional bodies on processing lipemic samples to produce clinically acceptable results. This systematic review summarizes existing literature on the effectiveness of lipid removal techniques in reducing interference in clinical chemistry tests. Methods A PubMed search using terms relating to lipid removal from human samples for clinical chemistry tests produced 1,558 studies published between January 2010 and July 2021. 15 articles met the criteria for further analyses. Results A total of 66 analytes were investigated amongst the 15 studies, which showed highly heterogenous study designs. High-speed centrifugation was consistently effective for 13 analytes: albumin, alkaline phosphatase (ALP), alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin, creatine kinase (CK), creatinine (Jaffe method), gamma-glutamyl transferase (GGT), glucose (hexokinase-based method), lactate dehydrogenase (LDH), phosphate, potassium, and urea. Lipid-clearing agents were uniformly effective for seven analytes: ALT, AST, total bilirubin, CK, creatinine (Jaffe method), lipase, and urea. Mixed results were reported for the remaining analytes. Conclusions For some analytes, high-speed centrifugation and/or lipid-clearing agents can be used in place of ultracentrifugation. Harmonized protocols and acceptability criteria are required to allow pooled data analysis and interpretation of different lipemic interference studies.

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Serum delipidation but not high-speed centrifugation is effective in clearing lipemia interference in serum lipase activity measurement

Cited by 3 publications

References 4 publications

Effects of marked hypertriglyceridemia and lipid clearance techniques on canine biochemistry testing

Effects of marked hypertriglyceridemia and lipid clearance techniques on canine biochemistry testing

Filling accuracy and imprecision of commercial evacuated sodium citrate coagulation tubes

Methods to reduce lipemic interference in clinical chemistry tests: a systematic review and recommendations

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