422 Evaluation of Lipemia Interference in Immunoassays Using Native Patient Samples and Ultracentrifugation

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Abstract Introduction/Objective Lipemia, characterized by elevated lipid content in blood samples, can interfere with laboratory assays. Traditional interference studies often employ spiking with synthetic lipid emulsions like Intralipid; however, these may not accurately represent the complexity of native lipemic samples, which can vary in lipoprotein composition, including chylomicrons, LDL, and cholesterol. Ultracentrifugation is a recognized method for removing lipemic interference, yet its impact on various immunoassays using native samples requires further evaluation. Methods/Case Report We collected 20–26 patient serum samples exhibiting high lipemia indices (>3+) as determined by Beckman AU analyzers. These samples underwent analysis for free thyroxine (FT4), thyroid-stimulating hormone (TSH), high-sensitivity troponin, B-type natriuretic peptide (BNP), and prostate-specific antigen (PSA) using Siemens Atellica immunoassay systems. Post-ultracentrifugation, lipid indices were reassessed to confirm reduction (<3+), and the analytes were remeasured to assess changes attributable to lipemia removal. Results Post-ultracentrifugation, all samples demonstrated lipid indices below 3+, indicating effective lipemia reduction. Comparative analysis of pre- and post-ultracentrifugation results revealed that most analyte concentrations changed within ±20%, suggesting minimal interference from lipemia in these assays. Conclusion Our findings indicate that, in native patient samples with significant lipemia, the evaluated immunoassays for FT4, TSH, high-sensitivity troponin, BNP, and PSA are largely resilient to lipemic interference, with ultracentrifugation causing minimal changes in analyte levels. This suggests that, for these assays, lipemia may not require corrective measures in all cases; however, ultracentrifugation remains a reliable method for ensuring result accuracy when interference is suspected.

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