Authors : Ajay Rajput, Puneet Saxena
DOI : 10.18231/j.ijcbr.2019.093
Volume : 6
Issue : 4
Year : 2019
Page No : 442-446
Introduction: Very often in clinical biochemistry laboratory, lipemic samples are encountered which
causes analytical interference in measurement of various biochemistry parameters. In routine practice,
8 to 10 hours of fasting is advised to overcome interference caused by lipemia. To minimize lipemic
interference ultracentrifugation, high speed centrifugation, lipid clearing agent, dilution with normal saline
or sample blanking can be used. Out of these, u ltracentrifugation is likely to cause least interference as
there is minimal exposure to additional chemicals.
Aims and Objectives: Aims and objectives of the study were to, identify lipemic samples, analyze
liver function test in lipemic samples before ultracentrifugation, perform ultracentrifugation, analyze
same analytes after ultracentrifugation and compare the results for any significant statistical and clinical
difference.
Materials and Methods: From 50 lipemic samples, 2 aliquots were prepared each having 500 microliter
of serum. One aliquot was used to perform liver function test. Second aliquot was further subjected
to the ultracentrifugation after which the same biochemical parameters were performed. Comparison of
results obtained, was done by paired Student’s t-test in Microsoft Office 2007 to assess statically significant
difference. Ratio of (lipemic bias in relation to ultracentrifuge samples) to (Biological Variation, CLIA
acceptability criteria and laboratory CV %) were also calculated to see whether the difference is clinically
significant or not.
Results: Statistically significant difference between lipemic and ultracentrifuge samples was observed
in alkaline phosphatase, alanine transaminase, total bilirubin, albumin and total protein while only total
bilirubin, total protein and alanine transaminase showed clinically significant difference.
Conclusions: Ultracentrifugation results in statistically significant difference in results obtained for all
parameters of liver function test but clinically significant interference was observed in total bilirubin, total
protein and alanine transaminase. For these examinations, ultracentrifugation can be useful to remove
lipemic interference.
Keywords: Clinical chemistry, Interferences, Lipemia, Liver function test, Ultracentrifugation.