Frequency and causes of lipemia interference of clinical chemistry laboratory tests
Objectives: 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. Design and methods: Retrospective study was done on the data from the core clinical laboratory at an acad...
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doaj-dfb26166530c4144a18aa6a8a6c52bce2020-11-25T00:47:50ZengElsevierPractical Laboratory Medicine2352-55172017-08-01819Frequency and causes of lipemia interference of clinical chemistry laboratory testsSandhya Mainali0Scott R. Davis1Matthew D. Krasowski2Carver College of Medicine, University of Iowa, 451 Newton Road, Iowa City, IA 52242, USADepartment of Pathology, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA 52242, USADepartment of Pathology, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA 52242, USA; Correspondence to: University of Iowa Hospitals and Clinics, Department of Pathology, 200 Hawkins Drive C-671 GH, Iowa City, IA 52242.Objectives: 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. Design and methods: 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 2000 mg/dL. We also determined the relationship between lipemia and hemolysis. Results: 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 (>2000 mg/dL) was diabetes mellitus (64%, mainly type 2) and hyperlipidemia (16.9%). The frequency of hemolysis increased with increasing lipemic index. Conclusions: 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. Keywords: Clinical chemistry tests, Hyperlipidemias, Intravenous fat emulsions, Intravenous infusions, Parenteral nutrition, Propofolhttp://www.sciencedirect.com/science/article/pii/S2352551716300348 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Sandhya Mainali Scott R. Davis Matthew D. Krasowski |
spellingShingle |
Sandhya Mainali Scott R. Davis Matthew D. Krasowski Frequency and causes of lipemia interference of clinical chemistry laboratory tests Practical Laboratory Medicine |
author_facet |
Sandhya Mainali Scott R. Davis Matthew D. Krasowski |
author_sort |
Sandhya Mainali |
title |
Frequency and causes of lipemia interference of clinical chemistry laboratory tests |
title_short |
Frequency and causes of lipemia interference of clinical chemistry laboratory tests |
title_full |
Frequency and causes of lipemia interference of clinical chemistry laboratory tests |
title_fullStr |
Frequency and causes of lipemia interference of clinical chemistry laboratory tests |
title_full_unstemmed |
Frequency and causes of lipemia interference of clinical chemistry laboratory tests |
title_sort |
frequency and causes of lipemia interference of clinical chemistry laboratory tests |
publisher |
Elsevier |
series |
Practical Laboratory Medicine |
issn |
2352-5517 |
publishDate |
2017-08-01 |
description |
Objectives: 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. Design and methods: 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 2000 mg/dL. We also determined the relationship between lipemia and hemolysis. Results: 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 (>2000 mg/dL) was diabetes mellitus (64%, mainly type 2) and hyperlipidemia (16.9%). The frequency of hemolysis increased with increasing lipemic index. Conclusions: 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. Keywords: Clinical chemistry tests, Hyperlipidemias, Intravenous fat emulsions, Intravenous infusions, Parenteral nutrition, Propofol |
url |
http://www.sciencedirect.com/science/article/pii/S2352551716300348 |
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