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La Rivista Italiana della Medicina di Laboratorio 2020 Marzo;16(1):26-33

DOI: 10.23736/S1825-859X.20.00052-3

Copyright © 2020 EDIZIONI MINERVA MEDICA

language: Italian

Lipemia: an overlooked interference? Some considerations and recommendations. Extra-analytical Variability Working Group of Italian Society for Clinical Pathology and Laboratory Medicine (GdS VEA SIPMeL)

Margherita MORANDINI ✉

Laboratorio Analisi, ASFO, Pordenone, Italia

Lipemia is the result of increased serum or plasma concentrations of lipoproteins, which may cause interference by many mechanisms, mainly light scattering, volume displacement, and absorption of hydrophobic analytes. The real frequency is heterogeneous in different populations and in different times, also depending on methods of detection (visual, by triglycerides concentration measurement, automatic L-index) and on non-standardized interference criteria. For demonstrating the Lipemia effects, two principal methods can be applied: on the sample by the determination of analytes before and after the lipids removal (by ultracentrifugation, high speed centrifugation, or extraction) or in the patients after intravenous emulsion lipid administration or after a standardized meal. The last one is the most physiologic method and demonstrated significant effects on common biochemical and hematological tests for moderate assumption of lipids. Significant effects were demonstrated also for hormones and drugs. Nevertheless, the Lipemia interference appears as an overlooked issue. Consequently, Laboratories must have more attention to the problem and a written procedure for identifying and treating the samples and managing the results in presence of Lipemia. Since the principal cause of Lipemia interference, at least in outpatients, is non-fasting blood sampling, guidelines must confirm the need of fasting state before blood sampling in every patients, except in some specific disease and setting (emergency, risk of hypoglycemia, pediatric patients, cardiovascular patients).

KEY WORDS: Lipemia; Analytical interferences; Fasting blood sampling