Influence of hemolysis on serum glucose determination according to CLSI EP7-A2

doi:10.3969/j.issn.1673-8640.2018.05.007

Abstract

Abstract:

Objective To evaluate the influence of hemolysis on serum glucose （Glu） determination by hexokinase（HK）assay. Methods The hemoglobin （Hb） was identified as an interfering substance by paired-difference experiment according to the Clinical and Laboratory Standards Institute （CLSI） EP7-A2 document. The correlation between Hb level and interference was evaluated by dose-effect experiment. Results Paired-difference experiment showed that Hb at 5 g/L could influence high-level and middle-level Glu determinations. Dose-effect experiment with 5 levels of Hb showed that there existed non-linear interference in Glu determination. The non-linear equations were Y=6.496+0.160 5X-0.013 10X² for middle-level Glu determination （r²=0.983） and Y=10.13+0.211 0X-0.017 83X² for high-level Glu determination （r²=0.973）. Conclusions There exists interference for Glu determination from hemolytic samples by HK assay. It should avoid hemolytic samples if necessary. If another sample is not available,the hemolysis degree and potential interference should be attached to the laboratory report sheets for clinical reference.

Key words: Glucose, Hexokinase assay, Hemolysis, Paired-difference experiment, Dose-effect experiment

CLC Number:

R446.1

SHEN Jianjiang, FU Buqing, ZHAO Chun, XU Tian. Influence of hemolysis on serum glucose determination according to CLSI EP7-A2[J]. Laboratory Medicine, 2018, 33(5): 404-406.

Figures/Tables 3

References 8

[1]	BONINI P,PLEBANI M,CERIOTTI F,et al.Errors in laboratory medicine[J]. Clin Chem,2002,48(5):691-698.
[2]	PLEBANI M,CARRARO P.Mistakes in a stat laboratory:types and frequency[J]. Clin Chem,1997,43(8 Pt 1):1348-1351.
[3]	Clinical and Laboratory Standards Institute. Interference testing in clinical chemistry[S]. EP7-A2,CLSI,2002.
[4]	中华医学会糖尿病学分会糖尿病慢性并发症调查组. 全国住院糖尿病患者慢性并发症及其相关危险因素10年回顾性调查分析[J]. 中国糖尿病杂志,2003,11(4):232-237.
[5]	邵文琦,孙林,王蓓丽,等. 上海地区糖化血红蛋白一致性计划研究进展[J]. 检验医学,2015,30(9):948-952.
[6]	LIPPI G,SALVAGNO G L,MONTAGNANA M,et al.Influence of hemolysis on routine clinical chemistry testing[J]. Clin Chem Lab Med,2006,44(3):311-316.
[7]	DA FONSECA-WOLLHEIM F. Haemoglobin interference in the bichromatic spectrophotometry of NAD(P)H at 340/380 nm[J]. Eur J Clin Chem Clin Biochem,1993,31(9):595-601.
[8]	HAWKINS R.Discrepancy between visual and spectrophotometric assessment of sample haemolysis[J]. Ann Clin Biochem,2002,39(Pt 5):521-522.

编号	Hb（g/L）	中浓度Glu（mmol/L）			高浓度Glu（mmol/L）
编号	Hb（g/L）	第1次	第2次	第3次	第1次	第2次	第3次
1	0.00	6.46	6.50	6.50	10.17	10.17	10.07
2	1.25	6.71	6.68	6.69	10.31	10.31	10.37
3	2.50	6.82	6.82	6.81	10.53	10.58	10.60
4	3.75	6.90	6.86	6.92	10.68	10.63	10.67
5	5.00	6.96	6.97	7.01	10.70	10.75	10.75

编号	Hb（g/L）	中浓度Glu（mmol/L）			高浓度Glu（mmol/L）
编号	Hb（g/L）	第1次	第2次	第3次	第1次	第2次	第3次
1	0.00	6.46	6.50	6.50	10.17	10.17	10.07
2	1.25	6.71	6.68	6.69	10.31	10.31	10.37
3	2.50	6.82	6.82	6.81	10.53	10.58	10.60
4	3.75	6.90	6.86	6.92	10.68	10.63	10.67
5	5.00	6.96	6.97	7.01	10.70	10.75	10.75

[1]	SUN Wenyuan, WANG Pan, CUI Liyan. Role of brown adipose tissue in insulin resistance and its research progress [J]. Laboratory Medicine, 2023, 38(3): 297-300.
[2]	WANG Xiaoyu, SEMIRE Ainiwaer, LI Shijun. Influence of specimen state on the accuracy of plasma Epstein-Barr virus DNA determination results [J]. Laboratory Medicine, 2022, 37(7): 615-617.
[3]	JI Wei, TIAN Guoli, ZHU Zhixing, ZHOU Zhuo, WANG Yanmin, ZHANG Xiaofen. Feasibility of indirect method to establish the cut-off value of neonatal G6PD screening in Shanghai [J]. Laboratory Medicine, 2022, 37(2): 112-116.
[4]	HU Senan, TAN Junfeng, PENG Chang, AI Honghong, LI Dan. Role of blood glucose variability in the prognosis of severe corona virus disease 2019 patients [J]. Laboratory Medicine, 2021, 36(4): 400-403.
[5]	CHEN Xingyu, DONG Feifei. Correlation between fasting blood glucose variability parameters and painful diabetic peripheral neuropathy [J]. Laboratory Medicine, 2021, 36(3): 285-291.
[6]	LI Dan, LIN Ping, JIN Weifeng, CHEN Shuzi, LI Ping, CHENG Xunjia. Correlation between glycolipid metabolism and lipopolysaccharide in patients with Alzheimer's disease [J]. Laboratory Medicine, 2020, 35(11): 1126-1129.
[7]	JIN Zhonggan, JU Yi, ZHANG Sujie, LI Qing, OU Yuanzhu, YU Xiaoxuan, SUN Hewei, FAN Xiaoyu, YU Keying. Preliminary study on the application of glucose reference method to determine the target value for EQA samples [J]. Laboratory Medicine, 2020, 35(11): 1190-1193.
[8]	WANG Zhiheng, YING Chunmei. Changes of CA125 in pregnancy and relationship with other biochemical indicators [J]. Laboratory Medicine, 2019, 34(8): 687-690.
[9]	WANG Qiang, LU Xiaolan, WANG Guangrong, CAI Yanjuan, DU Qin, ZHANG Maoxin, ZHANG Guoyuan, WANG Dongsheng. Influence of neonatal blood sample hemolysis on the determination of serum neuron-specific enolase and establishment of correction equation [J]. Laboratory Medicine, 2019, 34(1): 42-46.
[10]	YUAN Fengxi, XUE Xiongyan, CHEN Caifeng, LAI Yuehong, LIANG Yongyi, LI Yan, XIE Wenchun, YANG Shaojie, WU Yanjie. Influence of hemolysis on the results of plasma catecholamines and their metabolites by liquid chromatography-tandem mass spectrometry [J]. Laboratory Medicine, 2018, 33(12): 1103-1107.
[11]	TIAN Guoli, WANG Yanmin, ZHOU Zhuo, GUO Jing, XU Hongping, YAO Jing. Performance evaluation of automatic genetic screening processor for neonatal screening [J]. Laboratory Medicine, 2017, 32(7): 633-636.
[12]	ZHAO Wanhui, WANG Zejun, QI Lin, GENG Lili, ZHANG Lulu, LIU Yiqing, XU Rui. Determinations of anti-CCP antibody and anti-MCV antibody for the diagnosis of rheumatoid arthritis [J]. Laboratory Medicine, 2017, 32(11): 975-978.
[13]	XU Anping, JI Ling, CHEN Weidong, XIA Yong, YU Jing, ZHOU Yu, LI Lu. The applicability of glycated hemoglobin A_1c for patients with hemoglobin H disease [J]. Laboratory Medicine, 2016, 31(8): 667-670.
[14]	FENG Yuchen, FANG Qingqing, LIN Junping, XU Xiayu, ZHU Hui, SHEN Haili. The combined determination of GPI,anti-CCP antibody and RF for the diagnosis of rheumatoid arthritis [J]. Laboratory Medicine, 2016, 31(7): 567-570.
[15]	ZENG Jianqiong, WANG Guiping, CHENG Qinghong. Correlation between blood glucose in septicopyemia patients and their prognosis [J]. Laboratory Medicine, 2016, 31(2): 95-98.