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 ∼4.52 mmol/L, ∼7.91 mmol/L, ∼14.69 mmol/L, ∼21.47 mmol/L, and ∼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.

Comparison of Martin and Friedewald equation for estimated LDL-C in adults.

OBJECTIVE: In this study, we aimed to compare the directly measured low-density lipoprotein cholesterol (LDL-C), Friedewald, and a new Martin LDL-C formula in the Turkish adult population. METHODS: A total of 1,558 patients between the ages of 18 and 65 years with a triglyceride level of <400 mg/dL were included in this study. Serum lipid profiles of all the patients were measured with Cobas 6000 c501 (Roche Diagnostic), and LDL-C concentrations were measured by a homogeneous direct method using reagents. [TC- (HDL-C+(TG/5)] and Martin [TC- (HDL-C+TG / new adjustable factor)] formulas were used to estimate LDL-C. RESULTS: The average age of the patients was 52.7±12.3 years. Of the 1,558 patients, 56% were women and 44% were men. The d-LDL-C, F-LDL-C, and M-LDL-C concentrations in all the patients were 148.6±39.8 mg/dL, 123.9±38.7 mg/dL, and 133.4±35.9 mg/dL, respectively. The mean difference between F-LDL-C and M-LDL-C concentrations according to d-LDL-C was 24.6±10.7 and 15.10±10.3, respectively. For comparing the scatter blot plot [estimated LDL-C(x) and d-LDL-C(y)] were calculated by the equations y=1.1665x+0 for Friedewald and y=1.1667x+0 for Martin. When compared to the d-LDL-C concentration, both the Friedewald and Martin formulas showed a strong correlation (r=0.963, r=0.968, respectively). The new adjustable factor mean of the Martin formula was 6.1±0.9. CONCLUSION: In our study, the Martin formula showed a relatively better separation. Although there was a strong correlation between the formulas and d-LDL-C, there was a negative bias for the two formulas. These formulas show a lower risk in the determination of the risk of coronary heart disease and in the planning of treatment strategies.

Comparison of Widely Used Biochemical Analytes in the Serum and Saliva Samples of Dialysis Patients.

BACKGROUND: The aim of this study is to determine whether the saliva analysis is an alternative to routine biochemical and immunoassay analyses in patients undergoing perito - neal dialysis (PD) or hemodialysis (HD). METHODS: Study group consisted of 40 healthy control, 44 PD and 44 HD patients. Routine biochemical analytes, thyroid stimulating hormone (TSH), free T3, free T4, vitamin B12, ferritin and folic acid were measured. RESULTS: Compared to pre-HD, urea, creatinine, uric acid, potassium levels were lower in post-HD, and calcium, magnesium, vitamin B12 levels were higher in post-HD both in saliva and serum. Positive correlations between saliva and serum were found for TSH and ferritin in control; urea, LDH, K in PD; urea, creatinine, alkaline phosphatase in pre-HD, and gamma-glutamyl transferase, iron, TSH in post-HD. There was a negative correlation only for creatine kinase and Mg in pre-HD and calcium in post-HD. In all groups, a positive correlation was found for urea, creatinine and a negative correlation was found for magnesium. CONCLUSIONS: Our study showed higher salivary urea and creatinine levels in patient groups, consistent with serum levels. Based on these results, salivary urea and creatinine levels may be useful in the evaluation of azotemia in dialysis patients.

Determination of reference range with the indirect method of the 25-hydroxyvitaminD3 test in the Balikesir region, Turkey.

BACKGROUND/AIM: The aim of this study is to determine the reference ranges of 25-hydroxyvitamin D3 (25(OH)vitD3) by an indirect method using data obtained from patients over the course of 3 years. MATERIALS AND METHODS: The 25(OH)vitD3 test results of the patients who applied to the medical biochemistry laboratory of Balikesir State Hospital between the years of 2010 and 2014 were analyzed. Patient data were retrospectively taken from the laboratory information system. The 25(OH)vitD3 levels of patients were examined after exclusion of outliers. Patients were divided into subgroups according to season, sex, and age. The central 95% reference intervals were calculated using a nonparametric method. RESULTS: Calculated reference intervals showed lower values than the recommended reference values of the manufacturer. In our study, 25(OH)vitD3 test results obtained for the reference values were 6.43-30.0 ng/mL for the percentile range of 2.5-97.5. For 25(OH)vitD3, the determined reference interval for our data was significantly different from the data provided by the manufacturer. CONCLUSION: This work should also be carried out in a healthy population. Data obtained from this study can be combined with the reference range determination studies for other regions in Turkey, and therefore it can contribute to the determination of the reference ranges of the Turkish community. This study is important for verification of the reference range recommended by the manufacturer.

Obesity with and without metabolic syndrome: do vitamin D and thyroid autoimmunity have a role?

AIMS: To investigate serum levels of thyroid stimulating hormone (TSH), anti-thyroid peroxidase antibody (TPO), and 25(OH)D in the presence or absence of metabolic syndrome in an obese population. METHODS: Data from a prospectively generated "Obesity Polyclinic" database that includes socio-demographic characteristics, anthropometric, and laboratory measurements of obese subjects were retrospectively analyzed. Subjects with body-mass index (BMI) ≥30kg/m(2) were eligible. After detailed analysis and exclusion of unavailable cases, subjects diagnosed with and without metabolic syndrome were compared for TSH, anti-TPO, and 25(OH)D. RESULTS: Of the study participants (n=548; men/women, 64/484), 277 were diagnosed with metabolic syndrome [Met-S (+)]. Met-S (+) patients had a higher mean BMI (36.4 vs. 32.3kg/m(2), p<.001) and percentage body fat (PBF) (39.2 vs. 35.3%, p<.001), but similar TSH (2.1 vs. 2.2mIU/mL, p=.759), anti-TPO (12 vs. 13IU/mL, p=.483), 25(OH)D (13.2 vs. 12.6ng/mL, p=.409), and calcium-phosphorus product (28.7 vs. 29.5mg/dL, p=0.275), compared to Met-S (-) subjects. When serum TSH, anti-TPO, and 25(OH)D levels were analyzed according to tertiles for comparisons of fasting plasma glucose, triglycerides, high-density lipoprotein cholesterol, BMI, and PBF, only 25(OH)D levels were negatively correlated with BMI and PBF. CONCLUSIONS: Although decreased 25(OH)D levels were related to the degree of obesity in obese subjects, serum 25(OH)D levels per se did not seem to be associated with metabolic syndrome. The prevalence of thyroid autoimmunity and hypothyroidism were high in this obese sample; however, neither serum TSH nor anti-TPO levels correlated with metabolic syndrome. Our findings did not support the hypothesis that thyroid autoimmunity and/or vitamin D status have a role in the development of metabolic disturbances in the obese population.