Clinical Biochemistry Tests

Alanine aminotransferase (ALT), also referred to as glutamic pyruvic transaminase (GPT), is an enzyme involved in amino acid metabolism. Significantly elevated levels of ALT in human serum can be detected in a variety of liver-related diseases, such as hepatitis, mononucleosis, and cirrhosis.

Assessing nutritional status. Albumin is the main serum protein in healthy individuals. Elevated serum albumin levels are usually the result of dehydration. Decreased albumin levels are observed in various conditions, such as kidney disease, liver disease, malabsorption, poor nutrition, severe burns, and infections.

Diagnosing and monitoring treatment of liver, bone, intestinal, and parathyroid diseases. A rise in the alkaline phosphatase occurs with all forms of cholestasis, particularly with obstructive jaundice. It is also elevated in diseases of the skeletal system, such as Paget disease, hyperparathyroidism, rickets, and osteomalacia, as well as with fractures and malignant tumors. 

The Amylase test is used as an adjunct in the diagnosis and management of pancreatitis (inflammation of the pancreas).

Measurement of ApoA-I is useful in identifying patients who are at high risk for coronary artery disease (CAD). ApoA levels are inversely related to the risk of premature CAD. The ratio of ApoB, as a main component of VLDL and LDL, to ApoA is effective in distinguishing individuals with or without ischemic heart disease. An increased ApoB/ApoA ratio at a young age constitutes a potential marker of CAD.

Assessment of cardiovascular risk. Follow-up studies in individuals with basic lipid measures inconsistent with risk factors or clinical presentation. The ratio of ApoB, as a main component of VLDL and LDL, to ApoA is effective in distinguishing individuals with or without ischemic heart disease. An increased ApoB/ApoA ratio at a young age constitutes a potential marker of CAD.

Diagnosing and monitoring liver disease, particularly diseases resulting in a destruction of hepatocytes. The highest concentrations of AST are found in the tissues of the heart, liver, muscles, and kidneys. Damage to these tissues can significantly increase AST levels in human serum.

Evaluation of jaundice and liver functions. Direct bilirubin increases in conditions that cause hepatic enlargement, hepatitis, cirrhosis, several inherited enzymatic deficiencies, as well as hereditary defects in tubular (canalicular) excretion.

Assessing liver function. Evaluating a wide range of diseases affecting the production, uptake, storage, metabolism, or excretion of bilirubin. Total bilirubin is increased in hepatitis, cirrhosis, hemolytic disorders, several inherited enzymatic deficiencies, and in conditions that cause hepatic obstruction. Quantitative determination of neonatal bilirubin is used to monitor diseases that cause jaundice in the newborn, mainly fetal erythroblastosis (also known as hemolytic disease of the newborn, or HDN).

Diagnosis and monitoring of a wide range of disorders including diseases of bone, kidney, parathyroid gland, or gastrointestinal tract.

Evaluation of water, electrolyte, and acid-base status

Measurement of serum cholesterol levels can be used as an indicator of liver function, biliary function, intestinal absorption, and thyroid function, as well as an indicator of predisposition to the development of coronary artery disease. Cholesterol levels constitute an important factor for the diagnosis and classification of hyperlipoproteinemias. Stress, age, sex, hormonal balance, and pregnancy affect normal cholesterol levels.

Measurement of serum creatinine is used for the diagnosis and monitoring of acute and chronic renal failure, the calculation of the glomerular filtration rate (GFR), and the assessment of patients undergoing hemodialysis.

CK (creatine kinase) is an enzyme found in muscles and the heart. Measuring CK, especially the CK-MB type, helps doctors detect and monitor heart attacks (acute myocardial infarction) because CK-MB is mostly found in heart muscle. It can also help identify certain muscle diseases. Tracking CK-MB over time shows how the heart is recovering after damage.

Creatine kinase (CK) testing is used to help diagnose and monitor conditions that affect the skeletal muscles, the heart, the central nervous system, and the thyroid.

CRP is used as a marker to indicate infections and inflammation, and to monitor how patients respond to medications or surgical procedures.

Diagnosing and monitoring hepatobiliary disease, it is currently the most sensitive enzymatic indicator of liver disease. An increase in GGT levels appears earlier and more pronounced compared to other liver enzymes in cases of obstructive jaundice and metastatic neoplasms.

Diagnosing and managing diabetes mellitus and other carbohydrate metabolism disorders including gestational diabetes, neonatal hypoglycemia, idiopathic hypoglycemia, and pancreatic islet cell carcinoma.

Evaluating the long-term control of blood glucose concentrations in patients with diabetes. Hemoglobin A1c measurements are used as an aid in the diagnosis of diabetes mellitus, for identifying patients who may be at risk of developing diabetes mellitus, and for monitoring long-term blood glucose control in individuals with diabetes mellitus. This assay is not useful in determining day-to-day glucose control and should not be used to replace daily home testing of blood glucose.

High-density lipoprotein cholesterol (HDL-C) is associated with lower risk of cardiovascular disease. Excess cholesterol is actively pumped into HDL to be carried in the blood circulation and cleared by the liver in a process known as reverse cholesterol transport. For these reasons, HDL-C is often referred to as "good" cholesterol. HDL-C is rarely measured in isolation and most often ordered along with total cholesterol and triglycerides. Measuring HDL-C and total cholesterol enables calculation of non-HDL cholesterol (total cholesterol-HDL-C). Non-HDL cholesterol is the combination of low-density lipoprotein cholesterol  and very-low density lipoprotein cholesterol. Non-HDL cholesterol is directly associated with risk for cardiovascular disease and referred to as "bad" cholesterol.

Aiding in the evaluation of iron deficiency and iron overload diseases in combination with total iron binding capacity and percent saturation. Assessment of acute iron poisoning.

Investigation of a variety of diseases involving the heart, liver, muscle, kidney, lung, and blood. LDH is not an exact marker, which is why it is used in combination with other markers for the diagnosis and management of patients.

Calculation of low-density lipoprotein cholesterol using total cholesterol, non-high-density lipoprotein (HDL) cholesterol, HDL cholesterol, and triglyceride concentrations . Managing atherosclerotic cardiovascular disease risk.

Cardiovascular disease risk refinement in patients with moderate or high risk based on conventional risk factors or patients with clinical suspicion of residual cardiovascular risk not identified by other lipid parameters. When present at high levels, it constitutes a major risk factor for the development of atherosclerosis and coronary artery disease, regardless of LDL cholesterol levels.