Effects of lipemia on capillary serum protein electrophoresis in native ultra-lipemic material and intravenous lipid emulsion added sera

Objectives: This study aims to investigate the effect of natural ultralipemic material (NULM) and intravenous lipid emulsion (IVLE) on capillary serum protein electrophoresis (SPEP). Methods: NULM material was prepared from leftover patients' lipemic serum sample (triglyceride concentration > 2,000 mg/dL) pool by a refrigerated high-speed centrifuge, and IVLE Omegaven lipid emulsion (30%) was used. Serum pools for interference study were prepared from patient samples for which serum protein electrophoresis was studied as Normal SPEP and M Peak SPEP. For both types of lipemia (DULM and IVLE), five pools with triglyceride concentrations of similar to 4.52 mmol/L, similar to 7.91 mmol/L, similar to 14.69 mmol/L, similar to 21.47 mmol/L, and similar to 28.25 mmol/L were prepared. SPEP was studied in each pool with Sebia Capillarys Minicap. A repeated measure ANOVA test was used to determine the difference between the pools, and interferograms were used to evaluate the interference effect. Results: Interference was not detected in IVLE added Normal SPEP and M Peak SPEP pools, either % or concentrations of fractions. In NULM-added Normal SPEP and M Peak SPEP pools, significant positive interference in albumin % (p=0.002 and p < 0.001 respectively) and significant negative interference in gamma% (p < 0.001 and p=0.005 respectively) and M protein peak (p=0.002) fractions were detected. However, significant positive interference was seen only for albumin concentration fractions (p < 0.001 for both pools). Conclusions: It is vital to use NULM instead of IVLE solutions in lipemia interference studies for all laboratory tests, including CZE SPEP. The fractions concentration values calculated with the total protein concentration should be used for evaluating SPEP results.

Automated summary

This study investigates the effect of NULM and IVLE on SPEP. The results show significant interference in albumin and gamma fractions in NULM-added SPEP. Therefore, it is crucial to use NULM instead of IVLE solutions in laboratory tests and calculate fraction concentrations with total protein concentration for evaluating SPEP results.