Ann Lab Med 2018; 38(6): 518-523  https://doi.org/10.3343/alm.2018.38.6.518
Removing Lipemia in Serum/Plasma Samples: A Multicenter Study
María-José Castro-Castro, Ph.D.1, Beatriz Candás-Estébanez, Ph.D.1, Margarita Esteban-Salán, Ph.D.2, Pilar Calmarza, Ph.D.3, Teresa Arrobas-Velilla, Ph.D.4, Carlos Romero-Román, Ph.D.5, Miguel Pocoví-Mieras, Ph.D.6, José-Ángel Aguilar-Doreste, Ph.D.7, on behalf of the Commission on Lipoprotein and Vascular Diseases, Sociedad Española de Química Clínica
1Clinical Laboratory, Bellvitge University Hospital, Barcelona, Spain; 2Biochemitry Service, Cruces University Hospital, Vizcaya, Spain; 3Laboratory of Clinical Biochemistry, Miguel Servet University Hospital, Zaragoza, Spain; 4Laboratory of Clinical Biochemistry, Virgen del Rocío University Hospital, Sevilla, Spain; 5Laboratory of Clinical Biochemistry, Albacete Hospital, Albacete, Spain; 6Department of Biochemistry and Molecular and Cellular Biology, University of Zaragoza, Zaragoza, Spain; 7Laboratory of Clinical Biochemistry, Gran Canaria Dr. Negrín University Hospital, Las Palmas de Gran Canaria, Spain
Corresponding author: María-José Castro-Castro
https://orcid.org/0000-0002-6080-3716
Bellvitge University Hospital, C/Feixa Llarga s/n, L’Hospitalet de Llobregat, Barcelona, C.P. 08907, Spain
Tel: +349-3260-7573
E-mail: mjcastro@bellvitgehospital.cat
Received: November 12, 2017; Revised: January 30, 2018; Accepted: June 20, 2018; Published online: November 1, 2018.
© Korean Society for Laboratory Medicine. All rights reserved.

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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 ifferences 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: Lipemia, Interference, Lipid removal method, High-speed centrifugation, LipoClear, 1,1,2-trichlorotrifluoroethane



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