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Biological variation of serum cholinesterase activity in healthy subjects

  • Emiş Deniz Akbulut ORCID logo und Müjgan Ercan ORCID logo EMAIL logo
Veröffentlicht/Copyright: 24. April 2025
Clinical Chemistry and Laboratory Medicine (CCLM)
Aus der Zeitschrift Clinical Chemistry and Laboratory Medicine (CCLM) Band 63 Heft 9

Abstract

Objectives

Serum cholinesterase (ChE) 3.1.1.8 is measured to assess exposure to organophosphorus pesticides and determine deficiency related to prolonged apnea after the induction of anesthesia with certain drugs and less often as an indicator of liver function. Biological variation (BV) is an accepted endogenous source that contributes to the total variation in laboratory medicine. No data on the BV of serum ChE have been found in the European Federation of Clinical Chemistry and Laboratory Medicine BV database. Thus, this study aimed to contribute to the data on BV of serum ChE activity.

Methods

Detailed inclusion and exclusion criteria were used for the enrollment of 20 (10 women and 10 men, 8–10 weeks) ostensibly healthy volunteers from Turkey. The serum ChE activity was measured on Roche Cobas c501. Statistical analyses included the detection of outliers, control for the normality of distribution, checking steady-state condition, assessment for homogeneity, subgroup analysis, analysis of variance with 95 % confidence intervals, and estimation of analytical performance specifications (APS).

Results

After exclusion, 332 results were included in the study. The within-subject BV of men (3.5 % [2.9–4.2 %]) was lower than that of women (4.8 % [4.1–5.8 %]). Between-subject BV of men and women were 15.9 % [10.5–32.4 %] and 12.3 % [8.4–22.6 %], respectively. The index of individuality was 0.18 and reference change value (RCV) was +9.1 %/−8.3 %. The calculated desirable APS for imprecision and bias were 1.7 and 3.2 %, respectively.

Conclusions

We believe that this study will contribute to the BV data on serum ChE activity. The prominent individuality of serum ChE activity favors the use of RCV instead of population-based reference intervals for more reliable follow-up.

Keywords: serum cholinesterase; biological variation; index of individuality; reference change value; analytical performance specifications
Corresponding author: Müjgan Ercan, Department of Medical Biochemistry, Afyonkarahisar Health Sciences University, Afyonkarahisar Health Application and Research Center, 2078 Street, No 3/4, Afyonkarahisar, Turkiye, E-mail:

Acknowledgments

We would like to thank all the volunteers included in this study.

  1. Research ethics: The Ethical Approval was provided by Afyonkarahisar Health Sciences University Hospital, Afyonkarahisar, Turkey (approval No.: 2022/3).

  2. Informed consent: Informed consent was obtained from all individuals included in this study.

  3. Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  4. Use of Large Language Models, AI and Machine Learning Tools: None declared.

  5. Conflict of interest: The authors state no conflict of interest.

  6. Research funding: None declared.

  7. Data availability: The raw data can be obtained on request from the corresponding author.

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Received: 2025-02-28
Accepted: 2025-04-15
Published Online: 2025-04-24
Published in Print: 2025-08-26

© 2025 Walter de Gruyter GmbH, Berlin/Boston

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https://doi.org/10.1515/cclm-2025-0240
Schlagwörter für diesen Artikel
serum cholinesterase; biological variation; index of individuality; reference change value; analytical performance specifications

Artikel in diesem Heft

  1. Frontmatter
  2. Editorial
  3. Macroprolactinaemia – some progress but still an ongoing problem
  4. Review
  5. Understanding the circulating forms of cardiac troponin: insights for clinical practice
  6. Opinion Papers
  7. New insights in preanalytical quality
  8. IFCC recommendations for internal quality control practice: a missed opportunity
  9. Genetics and Molecular Diagnostics
  10. Evaluation of error detection and treatment recommendations in nucleic acid test reports using ChatGPT models
  11. General Clinical Chemistry and Laboratory Medicine
  12. Pre-analytical phase errors constitute the vast majority of errors in clinical laboratory testing
  13. Improving the efficiency of quality control in clinical laboratory with an integrated PBRTQC system based on patient risk
  14. IgA-type macroprolactin among 130 patients with macroprolactinemia
  15. Prevalence and re-evaluation of macroprolactinemia in hyperprolactinemic patients: a retrospective study in the Turkish population
  16. Defining dried blood spot diameter: implications for measurement and specimen rejection rates
  17. Screening primary aldosteronism by plasma aldosterone-to-angiotensin II ratio
  18. Assessment of serum free light chain measurements in a large Chinese chronic kidney disease cohort: a multicenter real-world study
  19. Beyond the Hydrashift assay: the utility of isoelectric focusing for therapeutic antibody and paraprotein detection
  20. Direct screening and quantification of monoclonal immunoglobulins in serum using MALDI-TOF mass spectrometry without antibody enrichment
  21. Effect of long-term frozen storage on stability of kappa free light chain index
  22. Impact of renal function impairment on kappa free light chain index
  23. Standardization challenges in antipsychotic drug monitoring: insights from a national survey in Chinese TDM practices
  24. Potential coeliac disease in children: a single-center experience
  25. Vitamin D metabolome in preterm infants: insights into postnatal metabolism
  26. Candidate Reference Measurement Procedures and Materials
  27. Development of commutable candidate certified reference materials from protein solutions: concept and application to human insulin
  28. Reference Values and Biological Variations
  29. Biological variation of serum cholinesterase activity in healthy subjects
  30. Hematology and Coagulation
  31. Diagnostic performance of morphological analysis and red blood cell parameter-based algorithms in the routine laboratory screening of heterozygous haemoglobinopathies
  32. Cancer Diagnostics
  33. Promising protein biomarkers for early gastric cancer: clinical performance of combined detection
  34. Infectious Diseases
  35. The accuracy of presepsin in diagnosing neonatal late-onset sepsis in critically ill neonates: a prospective study
  36. Corrigendum
  37. The Unholy Grail of cancer screening: or is it just about the Benjamins?
  38. Letters to the Editor
  39. Analytical validation of hemolysis detection on GEM Premier 7000
  40. Reconciling reference ranges and clinical decision limits: the case of thyroid stimulating hormone
  41. Contradictory definitions give rise to demands for a right to unambiguous definitions
  42. Biomarkers to measure the need and the effectiveness of therapeutic supplementation: a critical issue
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