Frequency and causes of lipemia interference of clinical chemistry laboratory tests

Sandhya Mainali; Scott R Davis; Matthew D Krasowski

doi:10.1016/j.plabm.2017.02.001

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Frequency and causes of lipemia interference of clinical chemistry laboratory tests

Journal article

Open access

Peer reviewed

Frequency and causes of lipemia interference of clinical chemistry laboratory tests

Sandhya Mainali, Scott R Davis and Matthew D Krasowski

Practical laboratory medicine, Vol.8, pp.1-9

08/2017

DOI: 10.1016/j.plabm.2017.02.001

PMCID: PMC5575408

PMID: 28856220

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Abstract

The aims of this study were to identify the causes of severe lipemia in an academic medical center patient population and to determine the relationship between lipemia and hemolysis. Retrospective study was done on the data from the core clinical laboratory at an academic medical center. Lipemic indices were available for all chemistry specimens analyzed over a 16-month period (n=552,029 specimens) and for serum/plasma triglycerides concentrations ordered for clinical purposes over a 16-year period (n=393,085 specimens). Analysis was performed on Roche Diagnostics cobas 8000 analyzers. Extensive chart review was done for all specimens with lipemic index greater than 500 (severely lipemic) and for all specimens with serum/plasma triglycerides greater than 2000mg/dL. We also determined the relationship between lipemia and hemolysis. The most frequent suspected causes of very high lipemic index (>500) were found to be lipid-containing intravenous infusions (54.4% of total; fat emulsions for parenteral nutrition – 47%; propofol −7.4%) and diabetes mellitus (25% of total, mainly type 2). The most frequent suspected causes of very elevated serum/plasma triglycerides (>2000mg/dL) was diabetes mellitus (64%, mainly type 2) and hyperlipidemia (16.9%). The frequency of hemolysis increased with increasing lipemic index. Intravenous lipid infusions and type 2 diabetes were the most common causes of severe lipemia in this study at an academic medical center. Given that iatrogenic factors are the most common cause of severe lipemia, education and intervention may be helpful in reducing frequency of severe lipemia in patient specimens. •Intravenous lipids and type 2 diabetes were most common causes of severe lipemia.•The frequency of hemolysis increased with increasing lipemic index.•Diabetes type 2 was the most common cause of extreme hypertriglyceridemia.•Education and intervention may be helpful in reducing frequency of lipemia.

Hyperlipidemias

Parenteral nutrition

Intravenous fat emulsions

Propofol

Clinical chemistry tests

Intravenous infusions

Details

Title: Subtitle: Frequency and causes of lipemia interference of clinical chemistry laboratory tests
Creators: Sandhya Mainali - Carver College of Medicine, University of Iowa, 451 Newton Road, Iowa City, IA 52242, USA
Scott R Davis - Department of Pathology, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA 52242, USA
Matthew D Krasowski - Department of Pathology, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA 52242, USA
Resource Type: Journal article
Publication Details: Practical laboratory medicine, Vol.8, pp.1-9
DOI: 10.1016/j.plabm.2017.02.001
PMID: 28856220
PMCID: PMC5575408
NLM abbreviation: Pract Lab Med
ISSN: 2352-5517
eISSN: 2352-5517
Publisher: Elsevier B.V
Language: English
Date published: 08/2017
Academic Unit: Pathology
Record Identifier: 9984047736202771

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