An exploratory study; the gap between real reference interval and currently used reference interval of RBC AChE...

Area of Science:

• Biochemistry
• Toxicology
• Clinical Chemistry

Background:

• The existing reference interval (RI) for red blood cell acetylcholinesterase (RBC AChE) activity in South Korea was established using data from non-local populations.
• Organophosphate (OP) poisoning diagnosis relies on accurate RBC AChE activity measurements, necessitating region-specific reference intervals.

Purpose of the Study:

• To evaluate the transferability of the current RBC AChE RI for organophosphate poisoning in South Korea.
• To determine the actual RI, biological characteristics, and interindividual variation of RBC AChE activity within the South Korean population.

Main Methods:

• Retrospective data collection of RBC AChE activity from 782 patients using the modified Ellman's method.
• Analysis of clinical data for 195 patients exposed to OP to assess the correlation between RBC AChE activity deviation and clinical course.

Main Results:

• No significant difference in clinical course was observed based on the deviation of RBC AChE activity from the current RI in OP-exposed patients.
• RBC AChE activity showed associations with gender and smoking status, but not age or BMI, with a regression model explaining minimal variance.
• The established RI for RBC AChE activity in South Korea is 9,403-16,825 U/L, exhibiting 13.9% interindividual variation, which is wider than currently used intervals.

Conclusions:

• The current RI for RBC AChE activity is not transferable to the South Korean population due to significant interindividual variation and a wider range.
• Serial measurements of RBC AChE activity are recommended for diagnosing OP poisoning in South Korea, especially when pre-exposure values are unavailable.