Establishment of reference interval for serum protein electrophoresis of apparently healthy adults in Addis Ababa, Ethiopia

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Addis Abeba University


Background: Serum protein electrophoresis is a laboratory technique routinely employed for the identification of patients with multiple myeloma and other disorders of serum protein fractions. Even though, several factors affect reference intervals, company derived values are currently in use, and little or no data is available in resource limited setting countries like Ethiopia. Therefore, the current study will establish reference interval for serum protein fractions which serve as baseline data for the diagnosis, interpretation and monitoring of problems associated with serum proteins fractions in clinical laboratories. Objective: To establish reference interval for serum protein electrophoresis of apparently healthy adults in Addis Ababa, Ethiopia. Method: A cross-sectional study design was conducted on a total of 297 apparently healthy adults from April-October 2019 in four selected sub cities (Akaki, Kirkos, Arada, Yeka) of Addis Ababa, Ethiopia. Socio-demographic data were obtained from previously collected reference interval study data while laboratory analysis of collected samples was performed using Capillarys 2 Flex Piercing analyzer. Data was entered into Microsoft Excel and exported to SPSS version 23 and med-cal software for analysis. Data was explored and tested by Kolmogorov-Smirnov (K-S) and Shapiro-Wilk test of normality and Mann-Whitney test to check Partitions. For p≥0.05, the data was considered as normally distributed. Non-parametric method of reference range establishment was performed as per CLSI guideline EP28A3C. The lower and upper limits, including 95% distribution with 90% confidence intervals, were calculated. The results were expressed as percentages and absolute concentration and presented by tables accordingly. Result: The established RIs were: Albumin 53.83-64.59%, 52.24-63.55%; Alpha-1 globulin 3.04-5.40%, 3.44-5.60%; Alpha-2 globulin 8.0-12.67%, 8.44-12.87%; and Beta-1 globulin 5.017.38%, 5.14-7.86%. Moreover, Albumin to globulin ratio was 1.16-1.8, 1.09-1.74 for male and female, respectively. The combined RIs for Beta-2 globulin and Gamma globulin were 2.544.90% and 12.40-21.66%, respectively. Conclusion: The current study established reference interval for serum protein fractions and revealed gender specific differences in reference interval except for Beta-2 globulin and Gamma globulin.



Serum protein electrophoresis, reference interval, Addis Ababa, Ethiopia