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Interpretation of Folate Results in Hemolytic Plasma Samples: A Practical Approach

Annals of Laboratory Medicine 2021년 41권 5호 p.485 ~ 488
Minovic Isidor, Dikkeschei Lambert D., Vos Michel J., Kootstra-Ros Jenny E.,
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 ( Minovic Isidor ) - University of Groningen University Medical Center Groningen Department of Laboratory Medicine
 ( Dikkeschei Lambert D. ) - Isala Department of Laboratory Medicine
 ( Vos Michel J. ) - University of Groningen University Medical Center Groningen Department of Laboratory Medicine
 ( Kootstra-Ros Jenny E. ) - University of Groningen University Medical Center Groningen Department of Laboratory Medicine

Abstract


Folate analysis in plasma is affected by hemolysis, which can lead to biased results. However, the degree of hemolysis that is considered acceptable is unclear. We explored the relationship between folate concentration and degree of hemolysis. Heparin plasma samples (N=77, hemolysis index ≤10 μmol/L) were spiked with increasing amounts of corresponding patient-specific hemolysate. Subsequently, the folate concentration and hemolysis index were measured using two Roche Cobas platforms, and their incremental relationship was investigated. The folate concentration ranged from 2.9 to 30.9 nmol/L with a median (interquartile range) of 11.4 (8.6-19.1) nmol/L. The linear relationship between the increments in folate concentration and hemolysis index was approximated by the function y=1.86x+1.56 (R2=0.996), where x represents the laboratory-specific critical difference in folate concentration, which can be calculated from the analytical variation of the employed folate assay(s), and y represents the hemolysis threshold. The hemolysis threshold did not significantly differ between the tertiles of plasma folate concentration (P=0.10). In conclusion, we have provided an evidence-based approach that can be used to reliably interpret folate concentrations in hemolytic samples, independent of the patient’s folate status.

키워드

Folate; Hemolysis; Hemolysis index; Relationship

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