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KMID : 1100820230130010013
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Laboratory Medicine Online
2023 Volume.13 No. 1 p.13 ~ p.21
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The negative role of Vitamin C in total cholesterol and triglycerides tests
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Ko You-Keun
Lee Hyun-Seung
Lee Kyung-Hoon
Song Jung-Han
Park Hyung-Doo
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Abstract
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Background: This study aimed to determine the cause of low total cholesterol and triglyceride levels based on the Trinder reaction by reviewing cases of negative interference.
Methods: We analyzed the results of total cholesterol and triglyceride tests performed over 19 months. Sixty-three test results from 48 patients showing abnormally low total cholesterol or triglyceride levels were included. Lipid profile (total cholesterol, triglyceride, HDL-cholesterol, and LDL-cholesterol) was evaluated with Roche Diagnostics (Germany) and Sekisui Medical (Japan) reagents by using Cobas c702 analyzer (Roche). In vitro lipid profile tests were also determined using both above reagents for serum spiked with nine different concentrations of vitamin C.
Results: Total cholesterol and triglyceride levels measured using Roche reagents (without ascorbate oxidase) were significantly lower than those using Sekisui reagents containing ascorbate oxidase respectively. HDL-cholesterol and LDL-cholesterol levels showed no significant difference between the two company reagents. Malignancy was diagnosed in 83% of the patients, and the patients have the possibility of receiving high-dose vitamin C therapy. In addition, 27% of the patients were diagnosed with chronic kidney disease. At the level of 25.0 mg/dL vitamin C to the serum, total cholesterol and triglyceride levels, measured using Roche reagents, reduced by 27% and 95%, respectively, but were rarely reduced when using Sekisui reagents.
Conclusions: When negative interference is suspected in the total cholesterol or triglyceride of patients, the specimens need to be retested with the reagent containing ascorbate oxidase, and the patient’s medical record should be reviewed thoroughly.
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KEYWORD
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Ascorbic acid, Ascorbate oxidase, Analytic interference, Cholesterol, Enzymatic assays, Triglycerides
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