Plasmapheresis for hypertriglyceridemia: The association between blood viscosity and triglyceride clearance rate

J Clin Lab Anal. 2019 Feb;33(2):e22688. doi: 10.1002/jcla.22688. Epub 2018 Oct 15.

Abstract

Objectives: Several factors in double filtration plasmapheresis (DFPP) were associated with triglyceride (TG) clearance rate. This study examines whether baseline whole blood viscosity was a predictor for efficient TG removal.

Methods: Adult subjects who receiving DFPP for hyperlipidemia in Taoyuan General Hospital from January 2015 to March 2018 were classified into efficient and inefficient TG removal according to TG removal rate ≥50% vs <50%. TG removal rate was defined as following formula: (pre-apheresis TG- post-apheresis TG)/pre-apheresis TG. Whole blood viscosity (WBV) was estimated by following equation: WBV = 0.12 × hematocrit +0.17 × (total protein -2.07). Univariate linear regression was used to assess the association between TG removal rate and WBV. Odds ratios (ORs) and 95% confidence interval (95%CI) for associations between variables and efficient TG removal were evaluated by logistic regression model to including univariate and multivariate adjustment.

Results: From a total of 66 subjects receiving DFPP, 37 subjects reached efficient TG removal. The difference in pre-apheresis TG levels, hematocrit, and WBV between efficient vs. inefficient TG removal groups was 4.1 vs 6.7 mmol/L; 43.1% vs 39.5%; and 6.0cP vs 5.cP (Ps <0.05). After multivariate adjustment, WBC was a significant predictor for efficient TG removal (ORs and 95% CI were 3.192 (1.300-7.838), P < 0.05). The correlation between WBV and extraction of TG was significant (r = -0.255, P = 0.039).

Conclusion: Hyperviscosity reduced the efficiency of TG removal in those receiving DFPP.

Keywords: double filtration plasmapheresis; hematocrit; removal rate; triglyceride; viscosity.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Blood Viscosity / physiology*
  • Female
  • Hematocrit
  • Humans
  • Hypertriglyceridemia* / blood
  • Hypertriglyceridemia* / epidemiology
  • Hypertriglyceridemia* / therapy
  • Male
  • Middle Aged
  • Plasmapheresis*
  • Retrospective Studies
  • Triglycerides / blood*

Substances

  • Triglycerides