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Individualized correction of insulin measurement in hemolyzed serum samples

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Abstract

Insulin measurement plays a key role in the investigation of patients with hypoglycemia, subtype classification of diabetes mellitus, insulin resistance, and impaired beta cell function. However, even slight hemolysis can negatively affect insulin measurement due to RBC insulin-degrading enzyme (IDE). Here, we derived and validated an individualized correction equation in an attempt to eliminate the effects of hemolysis on insulin measurement. The effects of hemolysis on insulin measurement were studied by adding lysed self-RBCs to serum. A correction equation was derived, accounting for both percentage and exposure time of hemolysis. The performance of this individualized correction was evaluated in intentionally hemolyzed samples. Insulin concentration decreased with increasing percentage and exposure time of hemolysis. Based on the effects of hemolysis on insulin measurement of 17 donors (baseline insulin concentrations ranged from 156 to 2119 pmol/L), the individualized hemolysis correction equation was derived: INScorr = INSmeas/(0.705lgHbplasma/Hbserum − 0.001Time − 0.612). This equation can revert insulin concentrations of the intentionally hemolyzed samples to values that were statistically not different from the corresponding insulin baseline concentrations (p = 0.1564). Hemolysis could lead to a negative interference on insulin measurement; by individualized hemolysis correction equation for insulin measurement, we can correct and report reliable serum insulin results for a wide range of degrees of sample hemolysis. This correction would increase diagnostic accuracy, reduce inappropriate therapeutic decisions, and improve patient satisfaction with care.

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Acknowledgements

This work was supported by the National Natural Science Foundation of China (81302531), by the Natural Science Foundation of Jiangsu Province of China (BK20131018), by the Talents Planning of Six Summit Fields of Jiangsu Province (2013-WSN-037), by the National Key Clinical Department of Laboratory Medicine of China in Nanjing, by the Key laboratory for Laboratory Medicine of Jiangsu Province (XK201114), and by the Priority Academic Program Development of Jiangsu Higher Education Institutions. Special thanks to Dr. Hong Wang, Dr. Li Gao, Dr. Lixuan Liu, and Dr. Jian Liu for the measurement of hemoglobin concentration and discussion.

Author contributions

Conceived and designed the experiments: Zhi-Qi Wu and Hua-Guo Xu. Performed the experiments: Zhi-Qi Wu, Ju Lu, Huanhuan Chen and Hua-Guo Xu. Analyzed the data: Zhi-Qi Wu, Ju Lu, Huanhuan Chen, Wensen Chen and Hua-Guo Xu. Wrote the paper: Hua-Guo Xu.

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Authors and Affiliations

  1. Department of Laboratory Medicine, The First Affiliated Hospital of Nanjing Medical University, 300 Guang Zhou Road, Nanjing, Jiangsu Province, 210029, China

    Zhi-Qi Wu, Ju Lu, Huanhuan Chen & Hua-Guo Xu

  2. Department of Infection Control and Hospital Epidemiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, China

    Wensen Chen

Authors
  1. Zhi-Qi Wu
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  2. Ju Lu
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  3. Huanhuan Chen
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  4. Wensen Chen
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  5. Hua-Guo Xu
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Corresponding author

Correspondence to Hua-Guo Xu.

Ethics declarations

This study was approved by the ethics committee of the First Affiliated Hospital of Nanjing Medical University. Participants provide their written informed consent to participate in this study. We have complied with the World Medical Association Declaration of Helsinki regarding ethical conduct of research involving human subjects.

Conflict of interest

The authors declare that they have no conflict of interest.

Additional information

Zhi-Qi Wu, Ju Lu, and Huanhuan Chen contributed equally to this work.

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Wu, ZQ., Lu, J., Chen, H. et al. Individualized correction of insulin measurement in hemolyzed serum samples. Immunol Res 65, 605–608 (2017). https://doi.org/10.1007/s12026-016-8878-7

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  • DOI: https://doi.org/10.1007/s12026-016-8878-7

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