High-Speed Centrifugation Fails to Mitigate Severe Lipemic Interference in D-dimer Measurement

IF 2.3 4区医学 Q3 HEMATOLOGY

International Journal of Laboratory Hematology Pub Date : 2025-04-16 DOI:10.1111/ijlh.14479

Xiaoping Xu, Shuqian Cai, Junchi Xue, Junqi Wu

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引用次数: 0

Abstract

Objective

To evaluate the impact of varying lipid turbidity (LT) levels on D-dimer measurements after routine centrifugation (RC) and high-speed centrifugation (HC) in lipemic samples.

Methods

Lipemic samples (triglyceride > 1.7 mmol/L) were classified into four LT grades via HIL testing and visual inspection. Coagulation parameters (APTT, TT, FIB, PT-INR, and D-dimer) were compared between RC (2600 × g/10 min) and HC (10 000 × g/10 min) in 104 lipemic and 30 non-lipemic control samples.

Results

Significant differences (p < 0.05) were observed in all coagulation indices between RC and HC for lipemic samples. LT level was positively correlated with TG and total cholesterol (TC). Deviation rates for APTT, TT, FIB, and PT-INR were below 15%, while D-dimer deviation rates exceeded 50% in severe LT (grades 3–4). D-dimer levels in the lipid layer were significantly higher than those in the plasma layer (p < 0.05). HC failed to resolve interference in severely turbid samples, where D-dimer adhered to chylomicron-rich lipid fractions.

Conclusion

Contrary to CLSI recommendations, high-speed centrifugation (HC) significantly reduced D-dimer concentrations in the lower plasma layer of severely turbid specimens (e.g., type II hyperlipidemia), failing to mitigate turbidity interference. This discrepancy may lead to misdiagnosis of high-risk thrombotic conditions, such as pancreatitis. The upper lipid layer, predominantly composed of chylomicrons, exhibits a strong binding affinity with D-dimer, further complicating accurate measurement. Direct dilution, however, may resolve measurement failures in severe LT samples by maintaining analyte integrity while eliminating lipid interference.

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高速离心不能减轻严重的脂质干扰在d -二聚体测量。

目的：评价脂质浊度（LT）水平对常规离心（RC）和高速离心（HC）后血脂样品d -二聚体测定的影响。方法：脂质样品（甘油三酯> 1.7 mmol/L）通过HIL检测和目测分为4个LT等级。比较了104例脂血症对照和30例非脂血症对照的RC （2600 × g/10 min）和HC （10 000 × g/10 min）的凝血参数（APTT、TT、FIB、PT-INR和d -二聚体）。结论：与CLSI建议相反，高速离心（HC）显著降低了严重浑浊标本（如II型高脂血症）下血浆层d -二聚体浓度，未能减轻浑浊干扰。这种差异可能导致高风险血栓性疾病的误诊，如胰腺炎。主要由乳糜微粒组成的上层脂质层与d -二聚体具有很强的结合亲和力，这进一步使精确测量复杂化。然而，直接稀释可以通过保持分析物的完整性同时消除脂质干扰来解决严重LT样品的测量失败。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Laboratory Hematology 医学-血液学

CiteScore

4.50

自引率

6.70%

发文量

211

审稿时长

6-12 weeks

期刊介绍： The International Journal of Laboratory Hematology provides a forum for the communication of new developments, research topics and the practice of laboratory haematology. The journal publishes invited reviews, full length original articles, and correspondence. The International Journal of Laboratory Hematology is the official journal of the International Society for Laboratory Hematology, which addresses the following sub-disciplines: cellular analysis, flow cytometry, haemostasis and thrombosis, molecular diagnostics, haematology informatics, haemoglobinopathies, point of care testing, standards and guidelines. The journal was launched in 2006 as the successor to Clinical and Laboratory Hematology, which was first published in 1979. An active and positive editorial policy ensures that work of a high scientific standard is reported, in order to bridge the gap between practical and academic aspects of laboratory haematology.