CC BY-NC-ND 4.0 · J Lab Physicians 2023; 15(02): 269-275
DOI: 10.1055/s-0042-1758664
Original Article

Evaluating Interference of Lipemia on Routine Clinical Biochemical Tests

Subramaniam ArulVijayaVani
1   Department of Biochemistry, Jawaharlal Institute of Postgraduate Medical Education and Research, Karaikal, Puducherry, India
Palani Selvam Mohanraj
2   Department of Biochemistry, All India Institute of Medical Sciences, Gorakhpur, Uttar Pradesh, India
Rajagambeeram Reeta
3   Department of Biochemistry, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth, Puducherry, India
› Author Affiliations


Objective Lipemia is an important cause of preanalytical errors in laboratory results. They affect the specimen integrity and trustworthiness of laboratory results. The present study was to assess the impact of lipemia on routine clinical chemistry analytes.

Methods Anonymous leftover serum samples with normal levels of routine biochemical parameters were pooled. Twenty such pooled serum samples were used for the study. The samples were spiked with commercially available intralipid solution (20%) to produce lipemic concentrations of 0, 400 (mild, 20 μL), 1,000 (moderate, 50 μL), and 2,000 mg/dL (severe, 100 μL). Glucose, renal function test, electrolytes, and liver function test were estimated in all the samples. Baseline data without the effect of interference was considered as true value and percentage bias for the spiked samples was calculated. Interference was considered significant if the interference bias percentage exceeded 10%.

Result Parameters like glucose, urea, creatinine, direct bilirubin, sodium, potassium, and chloride showed negative interference at mild and moderate lipemic concentration and positive interference at severe lipemic concentration. Parameters like aspartate transaminase (AST) and alanine transaminase (ALT) showed negative interference at mild and positive interference at moderate and severe lipemic concentration. Whereas uric acid, total protein, albumin, total bilirubin, alkaline phosphatase, gamma-glutamyl transferase, calcium, magnesium, and phosphorous showed positive interference at all concentrations. Significant interference (> 10%) was shown for magnesium (mild lipemia), albumin, direct bilirubin, ALT, and AST at moderate lipemic concentration. All parameters showed significant interference at severe lipemic concentration.

Conclusion All the study parameters are affected by lipemic interference at varying levels. Laboratory-specific data regarding lipemic interference at various concentrations on the clinical biochemistry parameters is needed.

Authors' Contributions

S.A. contributed to the design of the study and analysis of the samples. P.S.M. contributed to the design of the study and statistical analysis. R.R. contributed to the design of the study and expert guidelines.

Publication History

Article published online:
05 December 2022

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