Removing Lipemia in Serum/Plasma Samples: A Multicenter Study

Ann Lab Med. 2018 Nov;38(6):518-523. doi: 10.3343/alm.2018.38.6.518.

Abstract

Background: 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.

Methods: 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).

Results: 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.

Conclusions: 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.

Keywords: 1,1,2-trichlorotrifluoroethane; High-speed centrifugation; Interference; Lipemia; Lipid removal method; LipoClear.

Publication types

  • Comparative Study
  • Multicenter Study

MeSH terms

  • Alanine Transaminase / blood
  • Calcium / blood
  • Centrifugation
  • Creatinine / blood
  • Humans
  • Hyperlipidemias / blood*
  • Hyperlipidemias / pathology
  • Laboratories, Hospital
  • Lipids / isolation & purification*
  • Liquid-Liquid Extraction / methods*

Substances

  • Lipids
  • Creatinine
  • Alanine Transaminase
  • Calcium