Abstract
Introduction: Reference interval (RIs) is the range of values provided by laboratory scientists in a convenient and practical form to support clinician in interpreting observed values for diagnosis, treatment and monitoring of a disease. Laboratories in Nepal uses RIs, provided in the kit inserts by the manufacturers or from the scientific literature, established for western/European population. It is well known that population across the globe differs physiologically, genetically; race, ethnically, lifestyle, food habits and diet which have great impact on the reference values. Thus, it is inappropriate to use RIs that do not represent the local population. This approach highlights for establishing reference values in Nepalese population using the IFCC-CRIDL guidelines published in (C28-A3). Objectives: The objective of this study is to analyze blood lipids concentration in apparently healthy Nepalese population to set up reference values for total cholesterol (TC), triglycerides (TG), High Density Lipoprotein-cholesterol (HDL-C) and Low Density Lipoprotein-cholesterol (LDL-C) and compare with the internationally recommended values. Methods: Reference individuals selected from healthy volunteers according to the IFCC/C-RIDL protocol in (C28 –A3). Volunteers were requested to avoid excessive physical exertion/exercise/excessive eating and drinking and fast overnight for 10-12 hour. Blood samples were collected from 120 subjects from each five centers of the country between 7:00-10:00 am, serum were separated and refrigerated at -20 in a cryo-vials. Finally, 617 samples were transported to Yamaguchi University, Graduate School of Medicine, Ube, Japan for analysis in dry Ice and 30 parameters were measured by fully automated biochemistry analyzer, Beckman Coulter (BC480) in the clinical laboratory. Results: A reference interval for each parameter was calculated from the 95% reference intervals ranging from 2.5% and 97.5% percentiles and, arithmetic mean + 2 SD were also calculated. The 95% reference range for total cholesterol (2.53-6.14), triglyceride was(0.42-3.32),for HDL Cholesterol was (0.28-1.46), for LDL was(1.05-4.00) and for VLDL was (0.054-0.92) for Nepalese population. Conclusion: Nepalese clinicians can take into consideration of reference lipid values of this study for diagnosis, treatment and monitoring of disease.
 Int. J. Appl. Sci. Biotechnol. Vol 6(4): 366-372
Highlights
Reference interval (RIs) is the range of values provided by laboratory scientists in a convenient and practical form to support clinician in interpreting observed values for diagnosis, treatment and monitoring of a disease
The objective of this study was to analyze concentration of blood lipids in 532 apparently healthy Nepalese populations from around the country to set up reference values for Total Cholesterol, Triglycerides, HDL-Cholesterol and LDL-Cholesterol to compare these with the globally recommended reference intervals
A total of 617 reference individuals were selected from apparently healthy volunteers from community, colleges, hospitals, and clinical laboratories of five developmental region of Nepal, according to the International Federation of Clinical Chemistry (IFCC)/C-RIDL protocol in (C28 –A3). (27) The study design was approved by Nepal Health Research Council (NHRC), Institutional Review Board (IRB)
Summary
Reference interval (RIs) is the range of values provided by laboratory scientists in a convenient and practical form to support clinician in interpreting observed values for diagnosis, treatment and monitoring of a disease. Laboratories in Nepal uses RIs, provided in the kit inserts by the manufacturers or from the scientific literature, established for western/European population. It is inappropriate to use RIs that do not represent the local population This approach highlights for establishing reference values in Nepalese population using the IFCC-CRIDL guidelines published in (C28-A3). In 20th century the term "Reference Value "was first introduced by Ralph Grasbeck, Fellman and Nils-Erik Sarisin (Grasbeck and Saris, 1969) They published a paper entitled ‘Normal Values and Statistics’ as an initial study in the field of reference intervals (RIs) (Solberg, 1987). In spite of immense clinical importance of RVs, most laboratories across many developing countries including Nepal refers either from kit inserts provided by the manufacturers or from the scientific literature, which are based on Western/European population.
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