Influence of IgM-type M protein on determination results of apolipoprotein and lipoprotein and corrective measures

doi:10.3969/j.issn.1673-8640.2026.01.013

Abstract

Abstract:

Objective To evaluate the correction effects of pre-dilution method and polyethylene glycol（PEG） precipitation method on the interference of IgM-type M protein in serum on the determination results of apolipoproteins（apo） and lipoproteins. Methods The effects of pre-dilution method and PEG precipitation method on the determination results of apo A1，apo B，apo E，high-density lipoprotein cholesterol（HDL-C） and low-density lipoprotein cholesterol（LDL-C） in control serum samples were evaluated. The appropriate pre-dilution ratios and PEG6000 solution concentrations were screened，and their correction effects on the interference of M protein on the determination results of apo A1，apo B，apo E，HDL-C and LDL-C were evaluated. Results When the pre-dilution ratio was 1︰1，the determination results of apo A1，apo B，apo E，HDL-C and LDL-C in control serum samples were all within the allowable error range of internal quality control. When the PEG6000 solution concentrations were 2%，4% and 8%，the determination results of apo A1，apo B，apo E，HDL-C and LDL-C in control serum samples were all within the allowable error range. The consistency of the determination results of apo A1，apo B and apo E in 3 M protein-positive serum samples was poor at each dilution ratio of the pre-dilution method，but the determination results of HDL-C and LDL-C had good consistency. When the PEG6000 solution concentration was 8% in 3 M protein serum samples， the determination results were reliable. Conclusions The pre-dilution method can not eliminate the interference of M protein. The 8% PEG6000 solution can eliminate the interference of M protein on the determination results of apo A1，apo B，apo E，HDL-C and LDL-C，and it has no significant interference effect on the determination results of the same items in control serum samples，which is suitable for clinical promotion and application.

Key words: IgM-type M protein, Interference, Apolipoprotein, Pre-dilution method, Polyethylene glycol precipitation method

CLC Number:

R446.62

FAN Jiabao, ZHAO Meng, WU Xiaoling, XU Tao, ZHU Zhengqi, CHEN Mingliang, ZHAO Zhen. Influence of IgM-type M protein on determination results of apolipoprotein and lipoprotein and corrective measures[J]. Laboratory Medicine, 2026, 41(1): 73-77.

Figures/Tables 4

References 25

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血清样本	apo A1/ （ g·L^-1）	apo B/ （ g·L^-1）	apo E / （mg·L^-1）	HDL-C/ （mmol·L^-1）	LDL-C/ （mmol·L^-1）
患者1	—	—	29	1.27	1.82
患者2	0.52	—	—	1.61	1.45
患者3	1.80	—	—	2.06	1.92
对照	1.53	0.92	37	1.38	2.90

血清样本	apo A1/ （ g·L^-1）	apo B/ （ g·L^-1）	apo E / （mg·L^-1）	HDL-C/ （mmol·L^-1）	LDL-C/ （mmol·L^-1）
患者1	—	—	29	1.27	1.82
患者2	0.52	—	—	1.61	1.45
患者3	1.80	—	—	2.06	1.92
对照	1.53	0.92	37	1.38	2.90

方法	apo A1		apo B		apo E		HDL-C		LDL-C
方法	结果/（g·L^-1）	偏倚/ %	结果/（g·L^-1）	偏倚/ %	结果/（mg·L^-1）	偏倚/ %	结果/（mmol·L^-1）	偏倚/ %	结果/（mmol·L^-1）	偏倚/ %
预稀释法
H₂O稀释
1:1	1.48	-3.27	0.94	2.17	36	-2.70	1.48	7.25	3.00	3.45
1:2	1.44	-5.88	0.93	1.09	36	-2.70	1.53	10.87	3.03	4.48
1:3	1.34	-12.42	0.90	-2.17	36	-2.70	1.56	13.04	3.45	2.98
1:4	1.30	-15.03	0.90	-2.17	35	-5.41	1.55	12.32	2.98	2.76
1:9	0.90	-41.18	0.75	-18.48	30	-18.92	1.45	5.07	3.00	3.45
0.9%NaCl溶液稀释
1:1	1.52	-0.65	0.95	3.26	36	-2.70	1.46	5.80	3.02	4.14
1:2	1.46	-4.58	0.90	-2.17	36	2.70	1.52	10.14	2.99	3.10
1:3	1.32	-13.73	0.88	-4.35	32	-13.51	1.52	10.14	3.00	3.45
1:4	1.28	-16.34	0.90	-2.17	33	-10.81	1.53	10.87	2.98	2.76
1:9	0.85	-44.44	0.75	-18.48	20	-45.95	1.50	8.70	2.90	0.00
PEG沉淀法
2%	1.42	-7.84	0.92	0.00	34	-8.11	1.44	4.35	2.98	2.76
4%	1.39	-9.15	0.92	0.00	36	-2.70	1.43	3.62	3.01	3.79
8%	1.41	-7.84	0.87	5.43	37	0.00	1.42	2.90	2.92	0.69
16%	1.40	-8.50	—	—	14	-62.16	1.40	1.45	0.04	-98.62
20%	1.40	-8.50	—	—	12	-67.57	1.39	0.72	0.03	-98.97

方法	apo A1		apo B		apo E		HDL-C		LDL-C
方法	结果/（g·L^-1）	偏倚/ %	结果/（g·L^-1）	偏倚/ %	结果/（mg·L^-1）	偏倚/ %	结果/（mmol·L^-1）	偏倚/ %	结果/（mmol·L^-1）	偏倚/ %
预稀释法
H₂O稀释
1:1	1.48	-3.27	0.94	2.17	36	-2.70	1.48	7.25	3.00	3.45
1:2	1.44	-5.88	0.93	1.09	36	-2.70	1.53	10.87	3.03	4.48
1:3	1.34	-12.42	0.90	-2.17	36	-2.70	1.56	13.04	3.45	2.98
1:4	1.30	-15.03	0.90	-2.17	35	-5.41	1.55	12.32	2.98	2.76
1:9	0.90	-41.18	0.75	-18.48	30	-18.92	1.45	5.07	3.00	3.45
0.9%NaCl溶液稀释
1:1	1.52	-0.65	0.95	3.26	36	-2.70	1.46	5.80	3.02	4.14
1:2	1.46	-4.58	0.90	-2.17	36	2.70	1.52	10.14	2.99	3.10
1:3	1.32	-13.73	0.88	-4.35	32	-13.51	1.52	10.14	3.00	3.45
1:4	1.28	-16.34	0.90	-2.17	33	-10.81	1.53	10.87	2.98	2.76
1:9	0.85	-44.44	0.75	-18.48	20	-45.95	1.50	8.70	2.90	0.00
PEG沉淀法
2%	1.42	-7.84	0.92	0.00	34	-8.11	1.44	4.35	2.98	2.76
4%	1.39	-9.15	0.92	0.00	36	-2.70	1.43	3.62	3.01	3.79
8%	1.41	-7.84	0.87	5.43	37	0.00	1.42	2.90	2.92	0.69
16%	1.40	-8.50	—	—	14	-62.16	1.40	1.45	0.04	-98.62
20%	1.40	-8.50	—	—	12	-67.57	1.39	0.72	0.03	-98.97

稀释液	apo A1/ （g·L^-1）	apo B/ （g·L^-1）	apo E/ （mg·L^-1）	HDL-C/ （mmol·L^-1）	LDL-C/ （mmol·L^-1）
患者1
H₂O	—	—	32	0.84	1.78
0.9% NaCl	—	—	32	0.84	1.98
患者2
H₂O	0.50	—	—	0.88	1.42
0.9% NaCl	0.44	—	—	0.88	1.44
患者3
H₂O	1.94	—	—	2.06	2.08
0.9% NaCl	1.94	—	—	2.00	1.96