A blood test for biochemistry: what it shows, the norm and interpretation. What does a biochemical blood test show: decoding, norm Decoding of a biochemical blood test for adults

Biochemical analysis blood - a method of laboratory diagnosis of the human body, which helps to evaluate the function of various internal organs. It is advisable to conduct such a study once a year as a preventive check.

Biochemistry is mandatory for infectious, inflammatory and somatic diseases of internal organs. It also allows you to assess the level of hormones, indicators of the inflammatory process and other parameters related to somatic diseases.

What is included in a detailed biochemical blood test, what indicators indicate health problems, why is biochemistry needed at all, how to properly prepare for it, take it on an empty stomach or not? The answers to all your questions are in this article.

There are rules for submitting research material. This ensures credibility the results obtained.

If biochemistry is carried out in order to monitor the dynamics of the disease, then such an analysis is best done in the same laboratory at the same time. This will increase the reliability of the compared indicators.

The procedure is performed by a laboratory nurse. She takes blood for biochemistry from the cubital vein, in cases where this is not possible, the sampling is carried out from other available peripheral veins.

The algorithm for taking (taking) blood for biochemical analysis is as follows:

1. A tourniquet is applied above the injection site.
2. Cleaning the puncture site with an antiseptic solution.
3. After filling the vein with blood (the patient clenches and unclenches his fist), a needle is inserted into the vessel.
4. After removing the tourniquet and removing the needle, the patient should keep the arm in a bent position for a while.

Necessarily need to follow the rules of hygiene medical personnel. This includes working with disposable gloves, using disposable syringes and test tubes, and using antiseptic solutions or alcohol wipes.

What it shows: characteristics of biochemistry points

Laboratory indicators that make up the biochemical analysis:

Normal levels in babies, men and women

Using these tables, you can decipher the results of a detailed biochemical blood test in adults or children and find deviations from the norm, the data are indicated by age and gender.

Deviation of indicators of a biochemical blood test from the established norms may indicate various pathologies.

Possible deviations of indicators: what they indicate

The results of the study in the diagnosis of the cardiovascular system

Biochemical analysis in the diagnosis of cardiovascular pathologies is used to confirm the data of physical and instrumental diagnostics. It allows you to determine the severity of the disease, as well as the current state of the heart and blood vessels.

special clinical significance when diagnosing cardiovascular pathologies, they have cholesterol and blood lipids, transferases and phosphatase, and indicators of electrolyte metabolism.

Lipid Spectrum Disorders is not a definition of any cardiovascular disease, but increases the risk of its occurrence. Therefore, when a change in the analyzes is detected, it is necessary to start taking drugs and introduce a diet that will correct these values.

Transferases- these are markers of such a serious pathology as a heart attack. Their number allows you to determine the stage and severity of the disease. This helps to choose the tactics of further therapy.

Also, these figures may be higher than normal in severe heart failure. And a change in the quantitative composition of electrolytes, in particular potassium and sodium, can affect.

Timely laboratory analysis allows clarify the diagnosis and determine the treatment regimen. If it is necessary to frequently monitor indicators, it should be taken into account that the amount of blood taken does not exceed the allowable annual value.

Blood chemistry- called the "king" of analyzes. Specialists often prescribe it to clarify the diagnosis of the patient, to control the treatment, its effectiveness.

Deciphering a biochemical blood test with an English (Latin) abbreviation begins with a comparison of the average statistical data of a healthy person. The norm depends on the age of the person, the gender of the patient and other factors. All these data are compared with the norms accepted in medicine for a healthy average person and an assessment is made of his state of immunity and the quality of metabolism in the body. Evaluate the work of the liver, kidneys, pancreas and other vital internal organs.

• Biochemistry of blood - obtained by cleaning the blood from formed elements: leukocytes, erythrocytes, platelets, etc. In the general analysis, these cells are of primary importance.

Biochemical blood test - the norm in the table with the decoding of the abbreviation

Latin (English) letters in biochemical blood tests

Video: Biochemical blood test - transcript, table and norm

Deciphering a biochemical blood test

Amylase

• Men 45 - 75 µmol/l
• Women 40 - 70 µmol/l

Features of preparation for the study: during the week before the test, do not take iron supplements, 1-2 days before the test, it is necessary to limit the intake of fatty food.

Normal saturation of transferrin with iron:

• in men - 25.6 - 48.6%,
• in women - 25.5 - 47.6%.

Physiological changes in YSL occur during a normal pregnancy (increase to 4500 mcg/l). In healthy children, VR decreases immediately after birth, then increases.

High rates indicate: iron deficiency anemia, oral contraceptives, liver damage (cirrhosis, hepatitis), frequent blood transfusions. Low levels of YBC are manifested: with a decrease in total protein in plasma (starvation, necrotic syndrome), iron deficiency in the body, chronic infections.

Bilirubin

Bilirubin in the analyzes depends on the age of the patients.

• Newborns up to 1 day - less than 34 µmol / l.
• Newborns from 1 to 2 days 24 - 149 µmol1 hzl.
• Newborns from 3 to 5 days 26 - 205 µmol/l.
• Adults up to 60 years 5 - 21 µmol/l.
• Adults age 60 to 90 3 - 19 µmol/l.
• People over 90 3 - 15 µmol/l.

Bilirubin is a component of bile, a yellow pigment, the breakdown of direct (bound) bilirubin and the death of red blood cells is formed.

What is AST and ALT

AST - astspartate aminotransferase (AST) is an enzyme found in various tissues such as liver, heart, kidney, muscle, and the like. Elevated levels of AST, as well as ALT, may indicate necrosis of liver cells. In chronic viral hepatitis, you need to monitor the ratio of AST / ALT, which is called the de Ritis ratio.

Elevated AST over ALT may indicate liver fibrosis in patients with chronic hepatitis or alcoholic, chemical liver damage. Elevated AST also speaks of cellular decay of liver tissues (necrosis of hepatocytes).

ALT - transcript

ALT (alanine aminotransferase) or ALT.

ALT is a special liver tissue enzyme that is released when it is diseased. When ALT biochemical analysis is elevated, they can talk about toxic or viral damage to liver tissues. With hepatitis C, B, A, this indicator must be monitored constantly, once a quarter or every six months. The level of ALT is judged on the degree of liver damage by hepatitis, however, with chronic forms the level of ALT may remain within the normal range, which does not exclude hidden liver damage. ALT is more fixed at diagnosis acute hepatitis.

• Read: diagnosis of hepatitis;

Glucose

Glucose in biochemical analysis:

• Up to 14 years - 3.33 - 5.65 mmol / l
• From 14 - 60 - 3.89 - 5.83
• From 60 - 70 - 4.44 - 6.38
• Over 70 years - 4.61 - 6.10 mmol / l

Glucose analysis is a very important indicator in the diagnosis of diabetes. Glucose is the energy of our body. It is in demand and intensively consumed during physical and mental stress, stressful conditions. A high rate indicates diabetes mellitus, adrenal tumors, thyrotoxicosis, Cushing's syndrome, acromegaly, gigantism, pancreatic cancer, pancreatitis, chronic kidney and liver diseases, cystic fibrosis.

Video: About blood test AST and ALT

Osteocalcin

Osteocalcin norm:

• men: 12.0 - 52.1 ng / ml,
• women - premenopause - 6.5 - 42.3 ng / ml.

postmenopausal - 5.4 - 59 ng / ml.

Osteocalcin (Osteocalcin, Bone Gla protein, BGP) is a sensitive marker of bone turnover. Used to diagnose osteoporosis.

High value: Paget's disease, rapid growth in adolescents, diffuse toxic goiter, bone metastases, bone softening, postmenopausal osteoporosis, chronic kidney failure;

Low osteocalcin: pregnancy, hypercortisolism (Itsenko-Cushing's disease and syndrome), hypoparathyroidism, somatotropin deficiency, cirrhosis of the liver, glucocorticoid therapy.

Triglycerides (fats)

Triglycerides 165mg% (1.65g/l). Triglycerides are prescribed for analysis for heart disease, strokes. As a factor in the formation of vascular atherosclerosis and coronary disease. Violation of lipid metabolism is not one of the reasons for the maturation of atherosclerosis. Therefore, lipid metabolism tests must be taken into account along with other factors. The indicators of fat metabolism are corrected with the help of diet and the use of drugs.

Decryption for C-reactive protein

C-reactive protein is an indicator of the acute phase of the inflammatory process, the most sensitive and fastest indicator of tissue damage. C-reactive protein is most often compared to the ESR erythrocyte sedimentation rate. Both indicators rise sharply at the onset of the disease, but CRP appears and disappears before ESR changes. With successful treatment, the level of CRP decreases over the next days, normalizing on days 6-10, while ESR decreases only after 2-4 weeks.

Such sensitivity can capture changes in CRP not only in acute conditions, but also chronic inflammation. A number of scientific works have shown that an increase in CRP, even in the concentration range of less than 10 mg / l in apparently healthy people, indicates an increased risk of developing atherosclerosis, as well as the first myocardial infarction, thromboembolism.

Uric acid

Uric acid is normally:

• Children under 12: 119 - 327 µmol/l
• Men 12 to 60 years old: 262 - 452 µmol/l
• Women from! 2 to 60: 137 - 393
• Men 60 to 90: 250 - 476
• Women 60 to 90: 208 - 434 µmol/l
• Men over 90: 208 - 494
• Women over 90: 131 - 458 µmol/l

The uric acid level indicates normal or not kidney function and a violation of their filtration. Uric acid is a metabolic product, (purine bases), which are part of proteins. Excreted from the body by the kidneys. Uric acid is a product of the metabolism of purine bases, which are part of complex proteins- nucleoproteins, and excreted from the body by the kidneys.

Rheumatoid factor

• negative - up to 25 IU / ml (international unit per milliliter)
• slightly elevated - 25-50 IU / ml
• elevated - 50-100 IU / ml
• significantly increased - more than 100 IU / ml

Rheumatoid factor is determined in patients with rheumatoid arthritis, as well as in patients with other inflammatory pathologies. Normally, rheumatoid factor is not detected by conventional methods.

Reasons for rejection: detection of rheumatoid factor - rheumatoid arthritis, systemic lupus erythematosus, Sjögren's syndrome, Waldenström's disease, Felty syndrome and Still syndrome (special forms of rheumatoid arthritis).

Iron

• Men: 10.7 - 30.4 µmol/l
• Women: 9 - 23.3 µmol/l

Iron is involved in the synthesis of hemoglobin. Indicates hematopoietic diseases and anemia. Approximately 4 g of iron is in the human body. Approximately 80% of the total amount of the substance is placed in the composition of hemoglobin, 25% of iron is in reserve, 10% is contained in the composition of myoglobin, 1% is stored in respiratory enzymes that catalyze the processes of cell respiration. Iron deficiency states (hyposiderosis, iron deficiency anemia) are one of the most common human ailments.

Potassium

• Up to 12 months 4.1 - 5.3
• 12 months - 14 years 3.4 - 4.7
• Over 14 years old 3.5 - 5.5

Potassium affects the functioning of many cells in the body, especially nerve and muscle cells. The biological role of potassium is great. Potassium promotes mental clarity, improves oxygen supply to the brain, helps to get rid of toxins, acts as an immunomodulator, helps reduce blood pressure and helps in the treatment of allergies.

Potassium, is in the cells, regulates water balance, normalizes the rhythm of the heart.

Increasing potassium levels

This phenomenon is called hyperkalemia and is a sign of the following disorders:

• cell damage (hemolysis - destruction of cells, severe starvation, convulsions, severe injuries, deep burns)
• dehydration
• acidosis
• acute renal failure (impaired excretion by the kidneys)
• adrenal insufficiency
• increase in the intake of potassium salts.

Usually potassium is increased due to the intake of antitumor, anti-inflammatory drugs and some other medicinal drugs. A decrease in potassium concentration (hypokalemia) begins with insufficient intake from food, increased losses in urine and feces, vomiting, diarrhea, the use of potassium-depleting diuretics, the use of steroid drugs, certain hormonal disorders, intravenous administration large volumes of fluid that does not contain potassium.

Deciphering the indicators of calcium in the blood:

• Newborn children: 1.05 - 1.37 mmol / l.
• Children from 1 year to 16 1.29 - 1.31 mmol / l
• Adults 1.17 - 1.29 mmol / l.

Calcium

• Normal calcium in an adult is from 2.15 to 1.5 mmol / l.

Among the nutrients contained in the body in the largest quantities, calcium ranks next after protein, fat and carbohydrates. Although 99 percent of all calcium is used for the needs of bones and teeth, the tasks of the remaining one percent are also extremely important.

An elevated calcium level, also known as hypercalcemia, means that there is too much calcium in the blood. Most of the human calcium is found in bones and teeth. A certain amount of calcium helps the body to work properly. Too much calcium damages the nerves, digestive tract, heart, and kidneys.

Sodium

The norm of sodium in the body (mmol / l):

• Newborns sodium rate: 133 - 146
• Babies under 1 goal: 139 - 146
• Children norm: 138 - 145
• Adults: 136 - 145 mmol / l.
• Adults over 90 within: 132 - 146.

Sodium is the main cation that neutralizes acids in the blood and lymph; in ruminants, sodium bicarbonate is the main integral part saliva. It regulates to an optimal level (pH 6.5-7) the actual acidity of the chyme in the pancreas.

Sodium chloride regulates osmotic pressure, activates the enzyme amylase, which destroys starch, accelerates the absorption of glucose in the intestine, and serves as a material for the formation of hydrochloric acid in gastric juice.

Chlorine

• Newborns up to 30 days: 98 - 113 mmol / l.
• Adults: 98 - 107
• Elderly patients over 90: 98 - 111 mmol / l.

Chlorine, like sodium, is found in plant foods in small amounts; Plants grown on saline soils are distinguished by a high content of chlorine. In the animal body, chlorine is concentrated in the gastric juice, blood, lymph, skin and subcutaneous tissue.

Magnesium

• the norm of magnesium for newborns is 0.62 - 0.91 mmol / l.
• For children from 5 months. up to 6 years 0.70 - 0.95
• Children aged 6 to 12: 0.70 - 0.86
• Adolescence norm from 12 to 20: 0 70 - 0 91
• Adults from 20 to 60 years old 0 66 - 1.07 mmol / l.
• Adults 60 to 90 within 0.66 - 0.99
• Adults over 90 years old 0.70 - 0.95 mmol/l

Magnesium, like potassium, calcium or sodium, belongs to electrolytes, ions with a positive or negative charge, each of which performs its own specific physiological function.

An increase in the norm of a biochemical blood test is observed in the following diseases:

• Renal failure (acute and chronic)
• Iatrogenic hypermagnesemia (an overdose of magnesium drugs or antacids)
• Diabetes,
• hypothyroidism,
• adrenal insufficiency,
• Addison's disease.
• tissue injury
• Systemic lupus erythematosus
• multiple myeloma

Despite the fact that magnesium is widely distributed in nature, its deficiency is found very often (approximately 50%), and Clinical signs Magnesium deficiencies are even more common.

Possible symptoms lack of magnesium: an inexplicable feeling of anxiety, stress, violation heart rate, muscle cramps (especially nocturnal calf muscle cramps), insomnia, depression, muscle twitching, tingling in the fingertips, dizziness, constant fatigue, migraine attacks.

Phosphorus

Phosphorus rate, mmol/l:

• Up to 2 years 1.45 -2.16
• 2 years - 12 years 1.45 - 1.78
• from 12 - to 60: 0.87 - 1.45
• Women over 60: 0.90 - 1.32
• Men over 60: 0.74 - 1.2

Determining the concentration of phosphorus is most often prescribed for disorders of calcium metabolism, since the ratio of the amount of calcium and inorganic phosphorus has the greatest diagnostic value.

An increase in the concentration of phosphorus is noted in renal failure, an overdose of vitamin D, insufficiency of the parathyroid glands, in some cases with multiple myeloma, and lipid metabolism disorders (lipid phosphorus).

The amount of acid-soluble phosphorus increases in all diseases accompanied by oxygen deficiency. A decrease in the concentration of phosphorus occurs when there is a deficiency of vitamin D, malabsorption in the intestines, rickets, hyperfunction of the parathyroid glands.

Vitamin B12

Vitamin B12 is normal in newborns - 160-1300 pg / ml, in adults - 100-700 pg / ml (average values ​​\u200b\u200bof 300-400 pg / ml).

Vitamin B12, also known as cobalamin, is found in the proteins of the regular diet. The process of absorption of vitamin B12 following five sets of measures that create the pancreas, duodenum, gastric juice and saliva.

Vitamin B12 is one of the B vitamins. It is the only vitamin that contains a metal - cobalt ion. It is because of cobalt that vitamin B12 is also called cobalamin. The cobalt ion in the vitamin B12 molecule is coordinated to the corrin heterocycle.

Vitamin B12 can exist in different forms. The most common form in human life is cyanocobalamin, obtained by chemical purification of the vitamin with cyanides.

Vitamin B12 can also exist in the form of hydroxycobalamin and in two coenzyme forms - methylcobalamin and adenosylcobalamin. The term pseudo-vitamin B12 refers to substances similar to this vitamin found in some living organisms, for example, in blue-green algae of the genus Spirulina. Such vitamin-like substances do not have a vitamin effect on the human body.

Folic acid

The norm of filic acid in the human body is 3 - 17 ng / ml.

Folic acid is our most significant deficiency. Folic acid is named after the Latin word folium, meaning leaf, because it was first isolated in a laboratory from spinach leaves. Folic acid belongs to the group of B vitamins. It is easily destroyed during cooking and is lost during the processing and preservation of vegetables and grain peeling.

Folic acid is a vital vitamin that helps prevent neural tube defects in an unborn child, such as spina bifida, when the spinal canal in a newborn remains open, with the spinal cord and nerves exposed, or anencephaly (congenital absence of the brain and spinal cord), hydrocephalus, cerebral hernia.

The neural tube develops very quickly after conception and forms the baby's spinal cord. Studies say that increasing the amount of folic acid that pregnant women take makes it possible in 70% of cases to avoid spinal cord fractures.

With a lack of folic acid, the process of formation of the placenta may be disrupted, and the likelihood of miscarriage increases.

Women who may become pregnant are advised to eat foods fortified with folic acid or take supplements in foods rich in folic acid to reduce the risk of certain serious birth defects. Having enough folic acid supplements in the months leading up to pregnancy is very important to prevent neural tube defects. It has been suggested taking 400 micrograms of synthetic folic acid daily from fortified foods or supplements. The folic acid equivalents APP in pregnant women is 600-800 mcg, twice the usual 400 mcg APP for women who are not pregnant.

Albumen

Albumin molecules are involved in the binding of water, so a drop in this indicator below 30 g / l causes the formation of edema. Elevated albumin practically does not occur and is associated with a decrease in plasma water content.

How to pass

Biochemical analysis is prescribed for:

• acute diseases of internal organs (liver, kidneys, pancreas)
• many different hereditary diseases,
• with beriberi,
• intoxication and many others.

Not infrequently, I prescribe an analysis to make an accurate diagnosis, when the doctor has doubts, if it is based only on the indications and symptoms of the patient himself. This analysis is often prescribed by a doctor to evaluate the effectiveness of the treatment of a particular disease.

Before taking the analysis, IT IS STRICTLY FORBIDDEN TO EAT ANY FOOD! Incorrect examination indicators can lead to incorrect diagnosis and, as a result, incorrect treatment. Biochemistry of blood shows a close relationship between the exchange of water and mineral salts in the body. The results of the examined blood taken 3-4 hours after breakfast will differ from those taken on an empty stomach; if it is taken 3-4 hours after lunch, then the indicators will differ even more.

Referring the patient for analysis, the doctor wants to know and evaluate the work of a particular organ. This makes it possible to determine the state of the endocrine system (hormones thyroid gland, adrenal glands, pituitary gland, male and female sex hormones), indicators of the immune status.

This study is used in various fields of medicine, such as urology, internal medicine, gastroenterology, cardiology, gynecology, and a number of others.

Blood chemistry- a laboratory research method that is used in all areas of medicine (therapy, gastroenterology, rheumatology, etc.) and reflects the functional state of various organs and systems.

Fence for biochemical analysis of blood carried out from a vein, on an empty stomach. Before the study, you do not need to eat, drink and take medications. In special cases, for example, if you need to take medication in the early morning, you should consult with your doctor, who will give more precise recommendations.

Such a study involves taking blood from a vein on an empty stomach. It is advisable not to take food or any liquids, except for water, 6-12 hours before the procedure. The accuracy and reliability of the results of the analysis is affected by whether the preparation for the biochemical blood test was correct and whether you followed the doctor's recommendations. Doctors advise doing a biochemical blood test in the morning and STRICTLY on an empty stomach.

Deadline for performing a biochemical blood test: 1 day, express method possible.

A biochemical blood test reveals the amount of the following indicators in the blood (decoding):

Carbohydrates. Blood chemistry

Carbohydrates- glucose, fructosamine.

Sugar (glucose)

The most common indicator of carbohydrate metabolism is blood sugar. Its short-term increase occurs during emotional arousal, stress reactions, pain attacks, after eating. Norm - 3.5-5.5 mmol / l (glucose tolerance test, sugar load test).With the help of this analysis, it is possible to identify diabetes. A persistent increase in blood sugar is also observed in other diseases of the endocrine glands. An increase in glucose levels indicates a violation of carbohydrate metabolism and indicates the development of diabetes mellitus. Glucose is a universal source of energy for cells, the main substance from which any cell of the human body receives energy for life. The body's need for energy, and therefore, for glucose, increases in parallel with physical and psychological stress under the influence of the stress hormone - adrenaline. It is also greater during growth, development, recovery (growth hormones, thyroid, adrenal glands). For the absorption of glucose by cells, a normal content of insulin, the hormone of the pancreas, is necessary. With its deficiency (diabetes mellitus), glucose cannot enter the cells, its level in the blood is increased, and the cells starve. An increase in glucose levels (hyperglycemia) is observed when:

• diabetes mellitus (due to insulin deficiency);
• physical or emotional stress (due to the release of adrenaline);
• thyrotoxicosis (due to increased thyroid function);
• pheochromocytoma - tumors of the adrenal glands that secrete adrenaline;
• acromegaly, gigantism (the content of growth hormone increases);
• Cushing's syndrome (increased levels of the adrenal hormone cortisol);
• diseases of the pancreas - such as pancreatitis, tumor, cystic fibrosis; ABOUT chronic diseases liver and kidneys.

A decrease in glucose levels (hypoglycemia) is characteristic of:

• fasting;
• insulin overdose;
• diseases of the pancreas (a tumor from cells that synthesize insulin);
• tumors (there is an excess consumption of glucose as an energy material by tumor cells);
• insufficiency of the function of the endocrine glands (adrenal glands, thyroid, pituitary).

It also happens:

• with severe poisoning with liver damage - for example, poisoning with alcohol, arsenic, chlorine, phosphorus compounds, salicylates, antihistamines;
• in conditions after gastrectomy, diseases of the stomach and intestines (malabsorption);
• with congenital insufficiency in children (galactosemia, Gierke's syndrome);
• in children born to mothers with diabetes;
• in premature babies.

FRUCTOZAMINE

Formed from blood albumin with a short-term increase in glucose levels - glycated albumin. It is used, in contrast to glycated 54 hemoglobin, for short-term monitoring of the condition of patients with diabetes mellitus (especially newborns), the effectiveness of treatment.

The norm of fructosamine: 205 - 285 µmol / l. Children have slightly lower levels of fructosamine than adults.

Pigments. Blood chemistry

Bilirubin

Of the indicators of pigment metabolism, bilirubin of various forms is most often determined - an orange-brown bile pigment, a breakdown product of hemoglobin. It is formed mainly in the liver, from where it enters the intestines with bile.

Such indicators of blood biochemistry as bilirubin allow us to determine possible cause jaundice and assess its severity. There are two types of this pigment in the blood - direct and indirect. characteristic feature most liver diseases is a sharp increase in the concentration of direct bilirubin, and with obstructive jaundice, it rises especially significantly. With hemolytic jaundice, the concentration of indirect bilirubin increases in the blood.

The norm of total bilirubin: 5-20 µmol / l.

With an increase above 27 µmol / l, jaundice begins. High levels can cause cancer or liver disease, hepatitis, poisoning or cirrhosis of the liver, gallstones, or vitamin B12 deficiency.

direct bilirubin

Norm of direct bilirubin: 0 - 3.4 µmol / l.

If direct bilirubin is higher than normal, then for the doctor these bilirubin indicators are a reason to make the following diagnosis:
acute viral or toxic hepatitis
infection of the liver caused by cytomegalovirus, secondary and tertiary syphilis
cholecystitis
jaundice in pregnancy
hypothyroidism in newborns.

Fats (lipids). Blood chemistry

Lipids - total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides.

In case of violation of fat metabolism, the content of lipids and their fractions in the blood increases: triglycerides, lipoproteins and cholesterol esters. The same indicators are important for assessing the functional abilities of the liver and kidneys in many diseases.

• obesity
• hepatitis;
• atherosclerosis;
• nephrosis;
• diabetes.

We will talk about one of the main lipids - cholesterol in a little more detail.

CHOLESTEROL

Lipids (fats) are substances necessary for a living organism. The main lipid that a person receives from food and from which their own lipids are then formed is cholesterol. It is part of cell membranes, maintains their strength. From it, 40 so-called steroid hormones are synthesized: hormones of the adrenal cortex that regulate water-salt and carbohydrate metabolism, adapting the body to new conditions; sex hormones.

Bile acids are formed from cholesterol, which are involved in the absorption of fats in the intestines.

From cholesterol in the skin under the influence of sunlight, vitamin D is synthesized, which is necessary for the absorption of calcium. If the integrity of the vascular wall is damaged and / or an excess of cholesterol in the blood, it is deposited on the wall and forms a cholesterol plaque. This condition is called vascular atherosclerosis: plaques narrow the lumen, interfere with blood flow, disrupt the smoothness of blood flow, increase blood clotting, and contribute to the formation of blood clots. Various complexes of lipids with proteins circulating in the blood are formed in the liver: high, low and very low density lipoproteins (HDL, LDL, VLDL); total cholesterol is divided between them.

Low and very low density lipoproteins are deposited in plaques and contribute to the progression of atherosclerosis. High-density lipoproteins, due to the presence of a special protein in them - apoprotein A1 - contribute to the "pulling" of cholesterol from plaques and play a protective role, stop atherosclerosis. To assess the risk of the condition, it is not the total level of total cholesterol that is important, but the analysis of the ratio of its fractions.

Norms of total cholesterol in the blood - 3.0-6.0 mmol / l.

Norms of HDL cholesterol for men - 0.7-1.73 mmol / l, for women, the level of blood cholesterol is normal - 0.86-2.28 mmol / l.

total cholesterol

An increase in its content can cause:

• genetic features (familial hyperlipoproteinemia);
• liver disease;
• hypothyroidism (underactive thyroid gland);
• alcoholism;
• ischemic heart disease (atherosclerosis);
• pregnancy;
• taking synthetic preparations of sex hormones (contraceptives).

A decrease in total cholesterol levels indicates:

• hyperthyroidism (excess thyroid function);
• impaired absorption of fats.

HDL cholesterol

Decrease may mean:

• decompensated diabetes mellitus;
• early atherosclerosis of the coronary arteries.

LDL cholesterol

• hypothyroidism;
• liver disease;
• pregnancy;

triglycerides

Another class of lipids that is not derived from cholesterol. An increase in triglycerides may indicate:

• genetic features of lipid metabolism;
• obesity;
• impaired glucose tolerance;
• liver disease (hepatitis, cirrhosis);
• alcoholism;
• ischemic heart disease;
• hypothyroidism;
• pregnancy;
• diabetes;
• taking drugs of sex hormones.

A decrease in the level of their content occurs with hyperthyroidism and malnutrition or absorption.

Norm of triglycerides

Water and mineral salts. Blood chemistry

A blood test shows a close relationship between the exchange of water and mineral salts in the body. Its dehydration develops with an intense loss of water and electrolytes through the gastrointestinal tract with indomitable vomiting, through the kidneys with increased diuresis, through the skin with heavy sweating.

Various disorders of water and mineral metabolism can be observed in severe forms of diabetes mellitus, with heart failure, cirrhosis of the liver. In a biochemical blood test, a change in the concentration of phosphorus, calcium indicates a violation of mineral metabolism, which occurs in kidney diseases, rickets, and some hormonal disorders.

Important indicators of a biochemical blood test are the content of potassium, sodium and chlorine. Let's talk about these elements and their meaning in more detail.

POTASSIUM, SODIUM, CHLORIDES

These important elements and chemical compounds provide the electrical properties of cell membranes. On different sides of the cell membrane, the difference in concentration and charge is specially maintained: there is more sodium and chlorides outside the cell, and potassium inside, but less than sodium outside. This creates a potential difference between the sides of the cell membrane - a resting charge that allows the cell to be alive and respond to nerve impulses, participating in the systemic activities of the body. Losing the charge, the cell drops out of the system, as it cannot perceive the commands of the brain. It turns out that sodium ions and chlorine ions are extracellular ions, while potassium ion is intracellular.

In addition to maintaining the resting potential, these ions are involved in the generation and conduction of a nerve impulse - the action potential. The regulation of mineral metabolism in the body (hormones of the adrenal cortex) is aimed at retaining sodium, which is not enough in natural food (without table salt) and removing potassium from the blood, where it enters when cells are destroyed. Ions, together with other solutes, hold fluid: cytoplasm inside cells, extracellular fluid in tissues, blood in blood vessels, regulating blood pressure and preventing the development of edema.

Chlorides play an important role in digestion - they are part of the gastric juice.

What does the change in the concentration of these substances mean?

Potassium

• cell damage (hemolysis - destruction of blood cells, severe starvation, convulsions, severe injuries);
• dehydration;
• acute renal failure (impaired excretion by the kidneys); ,
• adrenal insufficiency.

• chronic starvation (lack of potassium intake with food);
• prolonged vomiting, diarrhea (loss with intestinal juice);
• impaired renal function;
• excess hormones of the adrenal cortex (including taking dosage forms cortisone);
• cystic fibrosis.

Sodium

• excess salt intake;
• loss of extracellular fluid (profuse sweat, severe vomiting and diarrhea, increased urination in diabetes insipidus);
• increased function of the adrenal cortex;
• violation of the central regulation of water-salt metabolism (pathology of the hypothalamus, coma).

• element loss (abuse of diuretics, kidney pathology, adrenal insufficiency);
• decrease in concentration due to an increase in fluid volume (diabetes mellitus, chronic heart failure, liver cirrhosis, nephrotic syndrome, edema).

Norms of sodium in the blood (Sodium): 136 - 145 mmol / l.

Chlorine

• dehydration;
• acute renal failure;
• diabetes insipidus;
• poisoning with salicylates;
• increased function of the adrenal cortex.

• excessive sweating, vomiting, gastric lavage;
• increase in fluid volume.

The norm of chlorine in the blood serum is 98 - 107 mmol / l.

CALCIUM

Participates in the conduction of a nerve impulse, especially in the heart muscle. Like all ions, it retains fluid in the vascular bed, preventing the development of edema.

Calcium is essential for muscle contraction and blood clotting. It is part of the bone tissue and tooth enamel.

The level of calcium in the blood is regulated by parathyroid hormone and vitamin D. Parathyroid hormone increases the level of calcium in the blood, washing this element out of the bones, increasing its absorption in the intestines and delaying excretion by the kidneys.

• malignant tumors with bone lesions (metastases, myeloma, leukemia);
• sarcoidosis;
• excess vitamin D;
• dehydration.

• decreased thyroid function;
• vitamin D deficiency;
• chronic renal failure;
• magnesium deficiency;
• hypoalbuminemia.

The norm of calcium Ca in the blood: 2.15 - 2.50 mmol / l.

PHOSPHORUS, INORGANIC

An element that is part of nucleic acids, bone tissue and the main energy supply systems of the cell - ATP. The level of its content is regulated in parallel with the level of calcium content.

If the level of phosphorus is above normal, the following occurs:

• destruction of bone tissue (tumors, leukemia, sarcoidosis);
• excess accumulation of vitamin D;
• fracture healing;
• decreased function of the parathyroid glands.

Decreased phosphorus levels may indicate:

• lack of growth hormone;
• vitamin D deficiency;
• malabsorption, severe diarrhea, vomiting;
• hypercalcemia.

The norm of phosphorus in the blood

MAGNESIUM

calcium antagonist. Promotes muscle relaxation. Participates in protein synthesis. An increase in its content (hypermagnesemia) indicates the presence of one of the following conditions:

• dehydration;
• kidney failure;
• adrenal insufficiency;
• multiple myeloma.

• impaired intake and / or absorption of magnesium;
• acute pancreatitis;
• decreased function of the parathyroid gland;
• chronic alcoholism;
• pregnancy.

IRON

• hemolytic anemia (destruction of red blood cells and release of their contents into the cytoplasm);
• sickle cell anemia (hemoglobin pathology, erythrocytes are irregularly shaped and also destroyed);
• aplastic anemia (bone marrow pathology, red blood cells are not formed, and iron is not used);
• acute leukemia;
• overtreatment with iron preparations.

Decreased iron levels may indicate:

• iron deficiency anemia;
• hypothyroidism;
• malignant tumors;
• hidden bleeding (gastrointestinal, gynecological).

FOLATES

• folic acid deficiency;
• vitamin B12 deficiency;
• alcoholism;
• malnutrition;
• malabsorption.

Cyanocobalamin. Cobalamin. Vitamin B12. B12 deficiency anemia

Vitamin B12 (or cyanocobalamin, cobalamin) is a unique vitamin in the human body that contains essential mineral elements. A large amount of vitamin B12 is necessary for the spleen and kidneys, somewhat less is absorbed by the muscles. In addition, vitamin B12 is found in mother's milk.

Vitamin B12 deficiency leads to serious, dangerous consequences for health - B 12 deficiency anemia develops. Particularly susceptible to B12 anemia are vegetarians and dieters who have excluded eggs and dairy products from their diet.

With a lack of cyanocobalamin, changes occur in the cells of the bone marrow, oral cavity, tongue and gastrointestinal tract, which leads to impaired hematopoiesis, the appearance of symptoms of neurological disorders ( mental disorders, polyneuritis, spinal cord injury).

The norm of vitamin B 12: 180 - 900 pg / ml

Enzymes. Blood chemistry

To assess the functional state of the endocrine glands, the content of hormones in the blood is determined, to study the specific activity of organs - the content of enzymes, to diagnose hypovitaminosis - the content of vitamins.

In blood biochemistry, a violation of liver function is indicated by an increase in such indicators as ALT, ACT, PT, alkaline phosphatase, cholinesterase. When determining blood biochemistry, a change in the level of amylase indicates a pathology of the pancreas. An increase in the level of creatinine, determined by a biochemical blood test, is characteristic of renal failure. An increase in the concentration of CPK-MB, DCH indicates myocardial infarction.

Enzymes - alanine aminotransferase (AlAT), aspartate aminotransferase (AsAT), gamma-glutamyl transferase (Gamma-GT), amylase, pancreatic amylase, lactate, creatine kinase, lactate dehydrogenase (LDH), alkaline phosphatase, lipase, cholinesterase.

Alanine aminotransferase (AlAT)

It is an enzyme produced by the cells of the liver, skeletal muscle and heart.

An increase in the level of its content can be caused by:

• destruction of liver cells during necrosis, cirrhosis, jaundice, tumors, alcohol consumption;
• myocardial infarction;
• destruction of muscle tissue as a result of injuries, myositis, muscular dystrophy;
• burns;
• toxic effect on the liver of drugs (antibiotics, etc.).

The ALT norm (ALAT norm) - for women - up to 31 U / l, for men the ALT norm - up to 41 U / l.

ASPARTAMINOTRANSFERASE (AcAT)

An enzyme produced by heart, liver, skeletal muscle, and red blood cells. Its content can be increased if there are:

• damage to liver cells (hepatitis, toxic drug damage, alcohol, liver metastases);
• heart failure, myocardial infarction;
• burns, heat stroke.

The norm of AST in the blood - for women - up to 31 U / l, for men, the norm of AST - up to 41 U / l.

GAMMA-GLUTAMIL TRANSFERASE (GAMMA-GT)

This enzyme is produced by liver cells, as well as cells of the pancreas, prostate and thyroid glands.

If an increase in its content is detected, the body may have:

• liver diseases (alcoholism, hepatitis, cirrhosis, cancer);
• diseases of the pancreas (pancreatitis, diabetes mellitus);
• hyperthyroidism (hyperfunction of the thyroid gland);
• prostate cancer.

In the blood of a healthy person, the content of GT gamma is negligible. For women, the GGT norm is up to 32 U / l. For men - up to 49 U / l. In newborns, the norm of HT gamma is 2-4 times higher than in adults.

AMYLASE

The enzyme amylase is produced by cells of the pancreas and parotid salivary glands. If the level of its content rises, this means:

• pancreatitis (inflammation of the pancreas);
• parotitis (inflammation of the parotid salivary gland).

• pancreatic insufficiency;
• cystic fibrosis.

lactate

Lactic acid. It is formed in cells during respiration, especially in muscles. With a full supply of oxygen, it does not accumulate, but is destroyed to neutral products and excreted. Under conditions of hypoxia (lack of oxygen), it accumulates, causes a feeling of muscle fatigue, disrupts the process of tissue respiration.

• food intake;
• aspirin intoxication;
• administration of insulin;
• hypoxia (insufficient supply of oxygen to tissues: bleeding, heart failure, respiratory failure, anemia);
• infections (pyelonephritis);
• third trimester of pregnancy;
• chronic alcoholism.

creatine kinase

An increase in its content may be a sign of the following conditions:

• myocardial infarction;
• muscle damage (myopathy, myodystrophy, trauma, surgery, heart attacks);
• pregnancy;
• alcoholic delirium (delirious tremens);
• traumatic brain injury.

• small muscle mass;
• immobile lifestyle.

lactate dehydrogenase (LDH)

An intracellular enzyme found in all tissues of the body.

An increase in its content occurs when:

• destruction of blood cells (sickle cell, megaloblastic, hemolytic anemia);
• liver diseases (hepatitis, cirrhosis, obstructive jaundice);
• muscle damage (myocardial infarction);
• tumors, leukemia;
• damage to internal organs (kidney infarction, acute pancreatitis).

PHOSPHATASE ALKALINE

Enzyme formed in bone tissue, liver, intestines, placenta, lungs. The level of its content rises when:

• pregnancy;
• increased metabolism in bone tissue (rapid growth, fracture healing, rickets, hyperparathyroidism);
• bone diseases (osteogenic sarcoma, bone cancer metastases, multiple myeloma);
• liver disease, infectious mononucleosis.

• hypothyroidism (hypothyroidism);
• anemia (anemia);
• lack of vitamin C (scurvy), B12, zinc, magnesium;
• hypophosphatasemia.
  The norm of alkaline phosphatase in the blood of a woman is up to 240 U / l, men - up to 270 U / l. Alkaline phosphatase affects bone growth, so its content is higher in children than in adults.

CHOLINESTERASE

An enzyme produced in the liver. The primary use is to diagnose possible insecticide poisoning and assess liver function.

An increase in its content may indicate:

• hyperlipoproteinemia FV type;
• nephrosis;
• obesity
• breast cancer.

• poisoning with organophosphorus compounds;
• liver pathology (hepatitis, cirrhosis, liver metastases);
• dermatomyositis.

Such a decrease is also characteristic of the state after surgical operations.

Cholinesterase rate - 5300 - 12900 U / l

LIPASE

An enzyme that breaks down food fats. It is secreted by the pancreas. In pancreatitis, it is more sensitive and specific than amylase; in simple mumps, unlike amylase, it does not change.

• pancreatitis, tumors, pancreatic cysts;
• biliary colic;
• perforation of a hollow organ, intestinal obstruction, peritonitis.
  The norm of lipase for adults is 0 to 190 U / ml.

PROTEIN. Blood chemistry

Proteins are the main biochemical criterion of life. They are included in all anatomical structures(muscles, cell membranes), transport substances through the blood and into cells, accelerate the course of biochemical reactions in the body, recognize substances - their own or others and protect their own from others, regulate metabolism, keep fluid in the blood vessels and prevent it from leaving the tissues .

Squirrels - albumin, total protein, C-reactive protein, glycated hemoglobin, myoglobin, transferrin, ferritin, serum iron-binding capacity (IBC), rheumatoid factor.

total protein

Proteins are synthesized in the liver from food amino acids. Total blood protein consists of two fractions: albumins and globulins.

An increase in protein levels (hyperproteinemia) indicates the presence of:

• dehydration (burns, diarrhea, vomiting - a relative increase in protein concentration due to a decrease in fluid volume);
• multiple myeloma (excessive production of gamma globulins).

A decrease in protein levels is called hypoproteinemia and occurs when:

• starvation (full or only protein - strict vegetarianism, anorexia nervosa);
• intestinal diseases (malabsorption);
• nephrotic syndrome;
• blood loss;
• burns;
• tumors;
• chronic and acute inflammation;
• chronic liver failure (hepatitis, cirrhosis).

Norms of protein in the blood

Albumins

Albumins are one of two types of total protein; their main role is transport.

There is no true (absolute) hyperalbuminemia.

Relative occurs when the total volume of the liquid decreases (dehydration).

Decrease (hypoalbuminemia) coincides with signs of general hypoproteinemia.

The norm of albumin in the blood:

GLYCATED HEMOGLOBIN

It is formed from hemoglobin with a long-term elevated glucose level (hyperglycemia) - for at least 120 days (erythrocyte lifespan). It is used to assess the compensation of diabetes mellitus, long-term monitoring of the effectiveness of treatment.

The norm of hemoglobin, g / l - Men - 135-160, Women - 120-140.

APOBELOC A1

Protective factor against atherosclerosis. The normal level of its content in the blood serum depends on age and gender.

An increase in the level of apoprotein A1 is observed with:

• weight loss;
• physical load.

• genetic features of lipid metabolism;
• early atherosclerosis of coronary vessels;
• uncompensated diabetes mellitus;
• smoking;
• food rich in carbohydrates and fats.

APOBELOC V

risk factor for atherosclerosis. Normal serum levels vary by sex and age.

An increase in the level of apoprotein B occurs when:

• alcohol abuse;
• taking drugs of steroid hormones (anabolics, glucocorticoids);
• early atherosclerosis of the coronary vessels;
• liver diseases;
• pregnancy;
• diabetes mellitus;
• hypothyroidism.

A decrease in its content is caused by:

• diet low in cholesterol;
• hyperthyroidism;
• genetic features of lipid metabolism;
• weight loss;
• acute stress (severe illness, burns).
  APO-B content in the blood plasma - 0.8-1.1 g / l.

MYOGLOBIN

The protein in muscle tissue is responsible for its respiration.

An increase in its content occurs under the following conditions:

• myocardial infarction;
• uremia (renal failure);
• muscle strain (sports, electropulse therapy, convulsions);
• injuries, burns.

A decrease in the level of myoglobin causes autoimmune conditions when autoantibodies against myoglobin are produced; this happens with polymyositis, rheumatoid arthritis, myasthenia gravis.

The norm of myoglobin, mcg / l - women 12-76, men 19-92.

Creatine Kinase MB

One of the fractions of total creatine kinase.

An increase in its level indicates:

• acute myocardial infarction;
• acute skeletal muscle injury.
  Norms of creatine kinase MB in the blood - 0-24 U / l

troponin 1

Specific contractile protein of the heart muscle. The increase in its content is caused by:

• myocardial infarction;
• ischemic heart disease.
  Normal content of Troponin I: 0.00 - 0.07 ng / ml.

FERRITIN

The protein, which contains iron in the depot, stocking up for the future. By its level, one can judge the sufficiency of iron stores in the body. An increase in ferritin may indicate:

• excess iron (certain liver disease);
• acute leukemia;
• inflammatory process.

A decrease in the level of this protein means a deficiency in the body of iron.

The norm of ferritin in the blood for adult men is 20 - 250 mcg / l. For women, the norm of a blood test for ferritin is 10 - 120 mcg / l.

Transferrin

Transferrin is a protein in blood plasma, the main carrier of iron.

Saturation of transferrin occurs due to its synthesis in the liver and depends on the iron content in the body. With the help of transferrin analysis, the functional state of the liver can be assessed.

Elevated transferrin is a symptom of iron deficiency (precedes the development of iron deficiency anemia for several days or months). The increase in transferrin occurs due to the use of estrogens and oral contraceptives.

Reduced serum transferrin is a reason for the doctor to make the following diagnosis: chronic inflammatory processes, hemochromatosis, cirrhosis of the liver,
burns, malignant tumors, excess iron.

An increase in transferrin in the blood also occurs as a result of the intake of androgens and glucocorticoids.

The norm of transferrin in blood serum is 2.0-4.0 g/l. The content of transferrin in women is 10% higher, the level of transferrin increases during pregnancy and decreases in the elderly.

Low molecular weight nitrogenous substances. Blood chemistry

low molecular weight nitrogenous substances - creatinine, uric acid, urea.

UREA

A product of protein metabolism that is excreted by the kidneys. Part of the urea remains in the blood.

If the urea content in the blood is increased, this indicates one of the following pathological processes:

• impaired renal function;
• obstruction urinary tract;
• increased protein content in food;
• increased protein degradation (burns, acute myocardial infarction).

In the case of a decrease in the level of urea in the body, the following may occur:

• protein starvation;
• excess protein intake (pregnancy, acromegaly);
• malabsorption.
  The norm of urea in children under 14 years old is 1.8-6.4 mmol / l, in adults - 2.5-6.4 mmol / l. In people over 60 years of age, the norm of urea in the blood is 2.9-7.5 mmol / l.

creatinine

Creatinine, like urea, is a product of protein metabolism excreted by the kidneys. Unlike the content of urea, the content of creatinine depends not only on the level of protein content, but on the intensity of its metabolism. Thus, with acromegaly and gigantism (increased protein synthesis), the level of its content increases, in contrast to the level of urea. Otherwise, the reasons for changing the level of its content are the same as for urea.

The norm of creatinine in the blood of a woman: 53-97 µmol / l, men - 62-115 µmol / l. For children under 1 year of age, the normal level of creatinine is 18–35 µmol/l, from 1 to 14 years old it is 27–62 µmol/l.

URIC ACID

Uric acid is a metabolic product of nucleic acids excreted from the body by the kidneys.

• gout, as there is a violation of the exchange of nucleic acids;
• renal failure;
• multiple myeloma;
• toxicosis of pregnant women;
• eating food rich in nucleic acids (liver, kidneys);
• hard physical work.

• Wilson's disease — Konovalov;
• Fanconi syndrome;
• a diet poor in nucleic acids.

The norm of uric acid for children under 14 years old is 120 - 320 µmol / l, for adult women - 150 - 350 µmol / l. For adult men, the normal level of uric acid is 210 - 420 µmol / l.

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A biochemical blood test in adults has significant differences in norms with a similar analysis in children. The metabolism of a child's body is significantly different from that of an adult. Only after hormonal changes in adolescence, the child's body in its functioning begins to approach the parameters of an adult's work. Completion of the formation of the human body ends on average by 25 years.

What is a biochemical blood test?

Biochemistry is a modern science that has a close relationship with medicine. This science began its rise at the beginning of the 20th century, its goal is to explore life from the standpoint of chemistry, biology and physics. The first serious studies of biochemistry related to medicine related to the study of vitamins and coenzymes in the vital activity of the human body.

The apogee of the development of medical biochemistry was the emergence of numerous types of testing based on the knowledge of this science: biochemical blood test (BAC), lipidogram, coagulogram, enzyme immunoassay.

Attention! There are three types of biochemical blood test: a) general therapeutic - 5-10 parameters; b) advanced - more than 10 parameters; c) highly specialized - one parameter is considered with all isoforms, if any.

How is LHC different from other types of medical research?

People often do not understand the difference between biochemical and clinical blood tests, and it is very significant: LHC examines biochemical compounds (proteins, enzymes, low molecular weight nitrogenous compounds, carbohydrates, lipids); a clinical blood test is aimed at studying the uniform composition of the blood (leukocytes, granulocytes, eosinophils, platelets, erythrocytes).

On the pages of an Internet forum they ask: “Why is there no WBC parameter among the results of my biochemical blood test?”. We answer: this English abbreviation means the parameter of a clinical blood test “leukocytes”, it cannot be in the LHC, because it is not a biochemical compound, but blood cells are its uniform part.

Preparing for the LHC

To ensure the laboratory purity of the LHC results, a number of important requirements must be met before analysis. They are important because the violation of any point may cause the need for re-analysis. BAC is not made for free - the average price of a general therapeutic form of BAC in Russia is 2500-3000 rubles, which is a lot. Therefore, a person who is going to take an analysis should carefully read these recommendations:

• The analysis is given in the morning on an empty stomach. You should not eat after 18 pm - maximum unsweetened tea with unsweetened cookies.
• One day before the analysis procedure, you can not eat a lot of sweet, fried, smoked, drink alcohol, smoke, expose the body to significant physical exertion.
• The analysis is not done immediately if the patient came from the heat and shows signs of physical fatigue.

Attention! To avoid confusion in the results of the LHC, it is necessary to visit the same laboratory.

Table of norms for a biochemical blood test in adults with an extended list of values

Deciphering the results of the LHC online is impossible without knowing the norms of each parameter. Tabular indicators are arranged as follows: on the left - the name of the parameter, on the right - the norm. Values ​​that fit within the numerical limits of the norm will be considered normal. Anything below or above the norm will mean pathology.

Deciphering the results of a biochemical blood test in adults

The decoding of the analysis is of interest to any person who receives a form of a biochemical test without any explanation. The values ​​​​of the tests can be explained by the doctor, but this does not happen immediately. There is one reason that patients are especially afraid of - medical confidentiality.

For example, test data is not deciphered to the patient in cases where the diagnosis may be life-threatening. This is justified from the point of view of medical ethics.

Polypeptides

Proteins are the most important building block of the human body. Performs such basic functions as:

• The function of building material - protein is part of all tissues of the human body. Most of the protein is found in the muscles.
• Transport function - the protein carries trace elements and nutrients throughout the body, for example, the hemoglobin polypeptide carries oxygen in the blood.
• Protective function - the body defends itself against antigens with the help of globulin proteins.
• The energy source is a reserve source of energy in the human body, the body burns protein only in exceptional cases, for example, during prolonged fasting.

Carbohydrates

Carbohydrates are the number one source of energy in the human body. An analysis for the presence of carbohydrates is necessary to determine the dangerous pathology - "diabetes mellitus". Blood sugar measures the amount of glucose in the body. To create a more complete picture of diabetes, to accurately determine its type and type, the severity of the pathology, a fraction of glycoproteins is considered - glycated hemoglobin, C-peptide, fructosamine. Lactate, a breakdown product of lactic acid, is a parameter that can be used to determine the development of diabetes insipidus.

Low molecular weight nitrogenous substances (slags)

Purine derivatives

Uric acid is the last step in the biochemical transformation of purine nitrogenous compounds under the influence of xanthine oxidase from xanthine.

An increased level of this substance in the body can be caused by kidney disease, alcoholism, poisoning with salts of heavy metals (lead, bismuth, arsenic), starvation, and blood diseases. Lack of uric acid can be the result of hereditary diseases, AIDS, cancer, burns, diabetes.

Lipids

Lipids (fats) are an important part of the human body. They perform the functions of an energy source (second in importance after carbohydrates), protection (protect the body from harmful substances), building material (cell walls are made of fats). Deciphering the values ​​in the table:

Pigments

The life span of red cells (erythrocytes) in the body is 3-6 months. When red blood cells die, the toxin "bilirubin" is formed. The body uses albumin to remove bilirubin from the blood - this is unbound bilirubin. When it enters the liver, bilirubin "binds" and becomes safe.

The parameter "total bilirubin" means the sum of bound and unbound bilirubin contained in the blood. The presence of unbound bilirubin in the blood above the norm will mean pathological processes in the liver of various etiologies. Also, the cause of an increase in the content of unbound bilirubin in the blood can be injuries and diseases of the blood.

Enzymes

Attention! Enzymes should not be equated with enzymes, which are often referred to as "enzymes" - what is correct from a chemical point of view looks different in clinical practice. For ease of understanding, we can assume that enzymes are substances in the blood, and enzyme enzymes are substances in the gastrointestinal tract.

vitamins

trace elements

Attention! This part of the article is devoted to deciphering the results of biochemical analysis in adults - the determination of an increased or decreased level of each BAC parameter is carried out using a table of norms!

Update: December 2018

A biochemical blood test is one of the most popular methods for doctors and patients. If you learn to “read” this analysis correctly, you can identify more early stages such serious pathologies as acute and chronic renal failure, diabetes mellitus, viral hepatitis and malignant tumors and completely stop their development.

How to prepare before taking blood for biochemical analysis?

The nurse draws blood from the patient for a couple of minutes, this procedure does not cause any particular discomfort. Biochemical examination, like any other, requires preparation and compliance with a number of simple requirements:

• blood must be taken strictly on an empty stomach;
• dinner the day before should not contain strong tea and coffee, and fatty foods and alcohol should not be consumed for 2-3 days;
• for 24 hours, you should refrain from any thermal procedures (bath, sauna) and heavy physical exertion;
• tests are taken early in the morning, first of all, before medical procedures (droppers, injections, radiography);
• when the patient came to the laboratory, before taking blood, it is advisable for him to sit for 10-15 minutes, catch his breath and calm down;
• to determine the exact level of blood sugar, the patient does not need to brush his teeth, drink tea or coffee in the morning before the analysis; even if your “morning starts with coffee”, you should refrain from it;
• it is also not advisable to take before blood sampling hormonal preparations, antibiotics, diuretics and other medicines;
• two weeks before the test, you need to stop drinking medications that reduce the concentration of lipids in the blood (see);
• if it is necessary to repeat the examination, the analysis must be taken at the same time of day, in the same laboratory.

Table of biochemical blood analysis with decoding

Total protein and its fractions

Protein plays a very important role in the body, it is involved in the construction of new cells, the formation of humoral immunity and the transfer of substances. Usually proteins consist of 20 basic amino acids, although they may include vitamins, inorganic substances (metals), carbohydrate and lipid residues.

The liquid part of the blood contains about 165 different proteins, which differ in structure and role in the body. All proteins are divided into three categories or fractions: albumins, globulins (α 1 , α 2 , β, γ) and fibrinogen. Since proteins are produced mostly in the liver, their content reflects the synthetic function of this organ.

A decrease in total protein is called hypoproteinemia (see). This condition occurs when:

• protein starvation (vegetarianism, protein-free diet);
• increased excretion of it in the urine (, proteinuria of pregnant women);
• loss of blood (heavy menstruation,);
• burns, especially with blistering;
• accumulation of plasma in the abdominal cavity (ascites), pleural cavity (exudative pleurisy), pericardium (exudative pericarditis);
• malignant neoplasms ( , );
• violation of protein formation (hepatitis,);
• long-term treatment with glucocorticosteroids;
• reduced absorption of substances (enteritis, colitis, celiac disease, pancreatitis).

An increase in total protein is called hyperproteinemia, this condition can be relative and absolute. A relative increase in proteins occurs with the loss of the liquid part of the plasma (cholera, repeated vomiting). An absolute increase in protein occurs during inflammatory processes (due to globulins), multiple myeloma. Physical labor and a change in the position of the body changes the concentration of this substance by 10%.

The main reasons for the change in the concentrations of protein fractions

Protein fractions are: albumins, globulins and fibrinogen. Fibrinogen is not determined in the biochemical analysis. This protein reflects the process of blood clotting. It is defined in such an analysis as .

Indicators of nitrogen metabolism

In the body, in addition to building cells, their constant decay occurs, accompanied by the accumulation of nitrogenous bases. These toxic substances are formed in the liver and excreted by the kidneys. Therefore, an increase in blood slags can indicate both a decrease in the work of the kidneys and liver, and excessive breakdown of proteins. The main indicators of nitrogen metabolism include:

• urea and creatinine
• less often, residual nitrogen, creatine, uric acid, ammonia, indican and others are determined.

Why does the level of blood slags change?

blood glucose

Glucose is the main indicator of carbohydrate metabolism. This substance is the main energy product that enters the cell; it is from glucose and oxygen that the cell receives fuel for further life.

Glucose enters the blood after a meal, then enters the liver, where it is utilized in the form of glycogen. These processes are controlled by pancreatic hormones - insulin and glucagon (see).

• The lack of glucose in the blood is called
• Excess - hyperglycemia.

What causes fluctuations in blood glucose levels?

Violation of pigment metabolism

There are specific colored proteins in the human body. Usually these are peptides that contain some metal (iron, copper). These include: hemoglobin, ceruloplasmin, myoglobin, cytochrome and others. The end product of the breakdown of such proteins is bilirubin and its fractions. What happens to bilirubin in the body?

When an erythrocyte ends its existence in the spleen, its heme disintegrates. Due to biliverdin reductase, bilirubin is formed, called indirect or free. This variant of bilirubin is toxic to the whole body, and primarily to the brain. But due to the fact that it quickly binds to blood albumin, the body is not poisoned. But with hepatitis, cirrhosis of the liver, it is high, because it does not bind to glucuronic acid.

Further in the liver cells, indirect bilirubin binds to glucuronic acid (turning into bound or direct, non-toxic), its indicators are high only with biliary dyskinesia, with (see). In analyzes, direct bilirubin rises when liver cells are damaged (for example, with hepatitis).

Bilirubin then enters the bile, which is transported from the hepatic ducts to gallbladder and then into the lumen of the duodenum. Here, urobilinogen is formed from bilirubin, which is absorbed from small intestine into the blood and, getting into the kidneys, stains the urine yellow. The rest, which reaches the large intestine, becomes stercobilin under the action of bacterial enzymes and stains the feces.

Why does jaundice occur?

There are three mechanisms:

• increased breakdown of hemoglobin and other pigment proteins (hemolytic anemia, snake bites, pathological hyperfunction of the spleen) - indirect bilirubin is formed in such huge quantities that the liver simply does not have time to process and remove it;
• liver diseases (hepatitis, cirrhosis, neoplasms) - the pigment is formed in a normal volume, but liver cells affected by the disease cannot perform their function;
• violation of the outflow of bile (cholecystitis, cholelithiasis, acute cholangitis, tumors of the head of the pancreas) - due to compression of the biliary tract, bile does not enter the intestine, but accumulates in the liver, causing the destruction of its cells and the flow of bilirubin back into the blood.

All three conditions are very dangerous for human health, they require immediate medical attention.

Indications for the study of bilirubin and its fractions:

• hepatitis (viral, toxic);
• liver tumors;
• cirrhosis of the liver;
• increased breakdown of red blood cells (hemolytic anemia);
• appearance of jaundice.

Indicators of lipid metabolism or cholesterol levels

Lipids play an important role in cell life. They are involved in the construction of the cell wall, the formation of bile, many hormones (male and female sex hormones, corticosteroids) and vitamin D. Fatty acids are a source of energy for organs and tissues.

All fats in the human body are divided into 3 categories:

• triglycerides or neutral fats;
• total cholesterol and its fractions;
• phospholipids.

Lipids are present in the blood as:

• chylomicrons - contain mainly triglycerides;
• high-density lipoproteins (HDL) - contain 50% protein, 30% phospholipids and 20% cholesterol;
• low density lipoproteins (LDL) - contain 20% protein, 20% phospholipids, 10% triglycerides and 50% cholesterol;
• very low density lipoproteins (VLDL) - are formed during the breakdown of LDL, include a large amount of cholesterol.

The greatest clinical value in the analysis has total cholesterol, LDL, HDL and triglycerides (see). When taking blood, it should be remembered that violation of the rules of preparation and the use of fatty foods can lead to significant errors in the results of the analysis.

What causes a violation of lipid metabolism and what can it lead to?

The degree of increase in cholesterol in the blood:

• 5.2-6.5 mmol / l - a slight degree of increase in the substance, a risk zone for atherosclerosis;
• 6.5-8.0 mmol / l - a moderate increase, which is corrected by the diet;
• over 8.0 mmol / l - a high level of a substance requiring drug intervention.

Depending on the change in lipid metabolism, 5 clinical syndromes, the so-called dyslipoproteinemias, are distinguished (1,2,3,4,5). These pathological conditions are harbingers of serious illnesses, such as diabetes mellitus and others.

Blood enzymes

Enzymes are special proteins that speed up chemical reactions in the body. The main blood enzymes include: alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (AP), gamma-glutamyl transferase (GGT), creatine kinase (CK) and α-amylase.

All these substances are contained inside the cells of the liver, pancreas, muscles, heart and other organs. Their content in the blood is very small, therefore enzymes are measured in special international units: U / l. Let's consider each enzyme separately.

Alanine aminotransferase and aspartate aminotransferase

These enzymes ensure the transfer of two amino acids in chemical reactions: aspartate and alanine. AST and ALT are found in large quantities in the tissues of the liver, heart muscle, and skeletal muscles. Their increase in the blood indicates the destruction of the cells of these organs, and the higher the level of enzymes, the more cells died.

Alkaline phosphatase

This enzyme is responsible for the cleavage of phosphoric acid from chemical compounds and the transport of phosphorus within the cell. ALP has two forms: hepatic and bone. Reasons for an increase in the enzyme:

Γ-glutamyltransferase

GGT is involved in fat metabolism by transporting cholesterol and triglycerides within the cell. The largest amount of the enzyme is found in the liver, prostate, kidneys, pancreas. Its activity in the blood increases with:

• the above liver diseases;
• alcohol intoxication;
• diabetes mellitus;
• infectious mononucleosis;
• heart failure.

Creatine kinase

CK is involved in the transformation of creatine and the maintenance of energy metabolism in the cell. It has 3 subtypes:

• MM (enzyme located in muscle tissue)
• MV (located in the heart muscle)
• BB (in the brain).

Blood electrolytes

Potassium and sodium are the most important electrolytes in the blood. It would seem that these are just trace elements, and their content in the body is scanty. In fact, it is difficult to imagine at least one organ or chemical process that would do without them.

Potassium

The trace element plays an important role in enzymatic processes and metabolism. Its main function is to carry out electrical impulses in the heart. Fluctuations in potassium levels are very bad for the myocardium.

The state when potassium is elevated is called hyperkalemia, and when it is low - hypokalemia. What threatens the increase in potassium?

• violation of sensitivity;
• arrhythmias (atrial fibrillation, intracardiac blockade);
• slowing of the pulse;
• drop in blood pressure;

Such threatening conditions can occur with an increase in the trace element above 7.15 mmol / l.

A drop in potassium levels below 3.05 mmol / l also poses a threat to the body. The main symptoms of element deficiency include:

• nausea;
• vomit;
• muscle weakness;
• difficulty breathing;
• involuntary excretion of urine and feces;
• heart weakness.

Sodium

Sodium is not directly involved in metabolism. Its complete is complete in the extracellular fluid. Its main function is to maintain osmotic pressure and pH. Sodium excretion occurs in the urine and is controlled by the adrenal cortex hormone aldosterone.

An increase in a trace element is called hypernatremia, and a decrease is called hyponatremia.

How does sodium metabolism disorder manifest itself?

In conclusion, I would like to give the readers of this article advice: each laboratory, whether private or public, has its own set of reagents, its own computers. Therefore, the performance standards can vary significantly. When the laboratory assistant gives you the results of the tests, be sure to make sure that the standards are written on the form. Only in this way will you be able to understand whether there are changes in your analyzes or not.