Removing Lipemia in Serum/Plasma Samples: A Multicenter Study

• Published in: Annals of laboratory medicine 2018, 38(6), , pp.518-523
• Main Authors: Castro-Castro, María José, Candás-Estébanez, Beatriz, Esteban-Salán, Margarita, Calmarza, Pilar, Arrobas-Velilla, Teresa, Romero-Román, Carlos, Pocoví-Mieras, Miguel, Aguilar-Doreste, José Ángel
• Format: Article
• Language: English
• Subjects: Alanine Transaminase - blood; Calcium - blood; Centrifugation; Creatinine - blood; Humans; Hyperlipidemias - blood; Hyperlipidemias - pathology; Laboratories, Hospital; Lipids - isolation & purification; Liquid-Liquid Extraction - methods; Original; 병리학
• ISSN: 2234-3806; 2234-3814
• DOI: 10.3343/alm.2018.38.6.518

Lipemia, a significant source of analytical errors in clinical laboratory settings, should be removed prior to measuring biochemical parameters. We investigated whether lipemia in serum/plasma samples can be removed using a method that is easier and more practicable than ultracentrifugation, the current reference method. Seven hospital laboratories in Spain participated in this study. We first compared the effectiveness of ultracentrifugation (108,200×g) and high-speed centrifugation (10,000×g for 15 minutes) in removing lipemia. Second, we compared high-speed centrifugation with two liquid-liquid extraction methods-LipoClear (StatSpin, Norwood, USA), and 1,1,2-trichlorotrifluoroethane (Merck, Darmstadt, Germany). We assessed 14 biochemical parameters: serum/plasma concentrations of sodium ion, potassium ion, chloride ion, glucose, total protein, albumin, creatinine, urea, alkaline phosphatase, gamma-glutamyl transferase, alanine aminotransferase, aspartate-aminotransferase, calcium, and bilirubin. We analyzed whether the differences between lipemia removal methods exceeded the limit for clinically significant interference (LCSI). When ultracentrifugation and high-speed centrifugation were compared, no parameter had a difference that exceeded the LCSI. When high-speed centrifugation was compared with the two liquid-liquid extraction methods, we found differences exceeding the LCSI in protein, calcium, and aspartate aminotransferase in the comparison with 1,1,2-trichlorotrifluoroethane, and in protein, albumin, and calcium in the comparison with LipoClear. Differences in other parameters did not exceed the LCSI. High-speed centrifugation (10,000×g for 15 minutes) can be used instead of ultracentrifugation to remove lipemia in serum/plasma samples. LipoClear and 1,1,2-trichlorotrifluoroethane are unsuitable as they interfere with the measurement of certain parameters.