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Zheng C, Zhou W, Zhou R, Zhang H, Liang S, Zhang W, Li G, Zhang C, Gan W. The necessity for improving lipid testing reagents: A real world study. Clin Chim Acta 2023; 548:117529. [PMID: 37640131 DOI: 10.1016/j.cca.2023.117529] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 08/10/2023] [Accepted: 08/25/2023] [Indexed: 08/31/2023]
Abstract
BACKGROUND We investigated the interference of vitamin C (VitC), glycerol fructose, lipoprotein X (LpX) and lipemia on the analysis of serum lipids. METHODS Serum were collected from 44 patients with VitC infusion, serum lipid concentrations before and after VitC auto-oxidation were compared. Serum of 31 patients with glycerol fructose infusion were collected, triglycerides (TG) measured by glycerol blanking and non-blanking reagents were compared. Forty-four serum samples suspected to contain LpX were collected, LDL-C measured by reagents from five manufacturers were compared. Lipemia samples were collected, LDL-C measured using five different reagents were compared. The interference rate was considered unacceptable if it was greater than 1/2 total allowable error (TEa). RESULTS In patients with VitC infusion, the interference rates of TG and total cholesterol (TC) were -59% (-123%, -28%) and -15% (-21%, -11%), respectively. In patients with glycerol fructose infusion, the interference rate of TG was 13% (4%, 113%). LpX interference led to increased LDL-C results for most reagents. Lipemia caused great interference with LDL-C analysis. CONCLUSION VitC, glycerol fructose, LpX and lipemia significantly interfered with lipid assays. The reagent formulation should be improved to get reliable results.
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Affiliation(s)
- Chuan Zheng
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, China; Department of Clinical Laboratory, The First People's Hospital of Shuangliu District, Chengdu/West China (Airport) Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Weiyan Zhou
- National Center for Clinical Laboratories, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology, Beijing, China
| | - Ruyi Zhou
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - He Zhang
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Shanshan Liang
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Wen Zhang
- Department of Clinical Laboratory, The First People's Hospital of Shuangliu District, Chengdu/West China (Airport) Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Guixing Li
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Chuanbao Zhang
- National Center for Clinical Laboratories, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology, Beijing, China
| | - Wei Gan
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, China.
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Lefrère B, Sakka M, Fourati S, Levasseur A, Curis E, Cherfils C, Grès P, Guilbert Z, Lacorte JM, Chenevière C, Bittar R, Bonnefont-Rousselot D. Could the chylomicron marker apoB48 be of value in the diagnosis of chylous effusions? Clin Chim Acta 2023; 539:184-190. [PMID: 36463939 DOI: 10.1016/j.cca.2022.11.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 11/19/2022] [Accepted: 11/19/2022] [Indexed: 12/04/2022]
Abstract
BACKGROUND Chylous effusions such as chylothorax, chylopericardium and chylous ascites are marked by the abnormal presence of chylomicrons in serous membranes. These relatively rare situations are associated with high morbidity and mortality rates. Given that a macroscopic assessment of the fluid is insufficient, the current gold standard method for chylous effusion is the electrophoretic separation of lipoproteins. Serous effusions are most frequently assayed for triglycerides, with a diagnostic threshold varying between studies. The present study is the first to assess the value of the apolipoprotein B48, specific of the chylomicron, in the diagnosis of chylous effusions. METHODS A chemiluminescent sandwich enzyme immunoassay was used to measure levels of apoB48 in remnant samples of effusion fluid sent to our laboratory for chylomicron detection and lipid assays. The diagnostic values of apoB48 and triglyceride assays were compared with that of the gold standard method. RESULTS The triglyceride and apoB48 levels and the triglyceride/cholesterol ratio in the effusion fluid were significantly higher in patients with chylous effusion. The threshold values for apoB48 were respectively 2.45, 0.25 and 19.00 µg/mL for a maximal Youden index, a sensitivity > 95 %, and a specificity > 95 %. The apoB48 assay's diagnostic value might be at least as high as that of a triglyceride assay (area under the receiver operating characteristic curve [95 % confidence interval]: 0.84 [0.72, 0.96]) and 0.80 [0.67, 0.94], respectively). CONCLUSION ApoB48 appears to be a promising marker for the diagnosis of chylous effusions; the putative diagnostic improvement must be confirmed in larger studies.
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Affiliation(s)
- Bertrand Lefrère
- AP-HP, Hôpitaux Universitaires Pitié-Salpêtrière-Charles Foix, Service de Biochimie métabolique, Paris, France.
| | - Mehdi Sakka
- AP-HP, Hôpitaux Universitaires Pitié-Salpêtrière-Charles Foix, Service de Biochimie métabolique, Paris, France
| | - Salma Fourati
- AP-HP, Hôpitaux Universitaires Pitié-Salpêtrière-Charles Foix, Service de Biochimie endocrinienne et oncologique, Paris, France
| | - Antoine Levasseur
- AP-HP, Hôpitaux Universitaires Pitié-Salpêtrière-Charles Foix, Service de Biochimie métabolique, Paris, France
| | - Emmanuel Curis
- Université de Paris, INSERM UMR-S 1144, Optimisation Thérapeutique en Neuropsychopharmacologie OTeN, Paris F-75006, France; EA 7537 BioSTM, Faculté de Pharmacie, Université Paris Descartes, USPC, Paris 75006, France
| | - Corinne Cherfils
- AP-HP, Hôpitaux Universitaires Pitié-Salpêtrière-Charles Foix, Service de Biochimie métabolique, Paris, France
| | - Pierre Grès
- AP-HP, Hôpitaux Universitaires Pitié-Salpêtrière-Charles Foix, Service de Biochimie métabolique, Paris, France
| | - Zoé Guilbert
- AP-HP, Hôpitaux Universitaires Pitié-Salpêtrière-Charles Foix, Service de Biochimie métabolique, Paris, France
| | - Jean-Marc Lacorte
- AP-HP, Hôpitaux Universitaires Pitié-Salpêtrière-Charles Foix, Service de Biochimie endocrinienne et oncologique, Paris, France; AP-HP, Hôpital Pitié-Salpêtrière, Unité de recherche sur les maladies cardiovasculaires et métaboliques, UMR 1166 ICAN, Sorbonne Université, Inserm, Paris, France
| | - Cristina Chenevière
- AP-HP, Hôpitaux Universitaires Pitié-Salpêtrière-Charles Foix, Service de Biochimie endocrinienne et oncologique, Paris, France
| | - Randa Bittar
- AP-HP, Hôpitaux Universitaires Pitié-Salpêtrière-Charles Foix, Service de Biochimie métabolique, Paris, France; AP-HP, Hôpital Pitié-Salpêtrière, Unité de recherche sur les maladies cardiovasculaires et métaboliques, UMR 1166 ICAN, Sorbonne Université, Inserm, Paris, France
| | - Dominique Bonnefont-Rousselot
- AP-HP, Hôpitaux Universitaires Pitié-Salpêtrière-Charles Foix, Service de Biochimie métabolique, Paris, France; UFR de Pharmacie, Université Paris Cité; CNRS, Inserm, UTCBS, Paris, France
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Wieczorek E, Ćwiklińska A, Jankowski M. Hypertriglyceridemia, a causal risk factor for atherosclerosis, and its laboratory assessment. Clin Chem Lab Med 2022; 60:1145-1159. [PMID: 35687325 DOI: 10.1515/cclm-2022-0189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 04/29/2022] [Indexed: 11/15/2022]
Abstract
Epidemiological and clinical studies show a causal association between serum triglyceride (TG) level, the number of triglyceride-rich lipoproteins (TRLs) and their remnants, and the increased risk of atherosclerosis and cardiovascular disease (CVD) development. In light of current guidelines for dyslipidemia management, the laboratory parameters reflecting TRL content are recommended as part of the routine lipid analysis process and used for CVD risk assessment, especially in people with hypertriglyceridemia (HTG), diabetes mellitus, obesity and low levels of low-density lipoprotein cholesterol (LDL-C), in which high residual CVD risk is observed. The basic routinely available laboratory parameters related with TRL are serum TG and non-high-density lipoprotein cholesterol (non-HDL-C) levels, but there are also other biomarkers related to TRL metabolism, the determination of which can be helpful in identifying the basis of HTG development or assessing CVD risk or can be the target of pharmacological intervention. In this review, we present the currently available laboratory parameters related to HTG. We summarise their link with TRL metabolism and HTG development, the determination methods as well as their clinical significance, the target values and interpretation of the results in relation to the current dyslipidemia guidelines.
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Affiliation(s)
- Ewa Wieczorek
- Department of Clinical Chemistry, Faculty of Pharmacy, Medical University of Gdańsk, Gdańsk, Poland
| | - Agnieszka Ćwiklińska
- Department of Clinical Chemistry, Faculty of Pharmacy, Medical University of Gdańsk, Gdańsk, Poland
| | - Maciej Jankowski
- Department of Clinical Chemistry, Faculty of Pharmacy, Medical University of Gdańsk, Gdańsk, Poland
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