Why is a blood test prescribed for biochemistry. What does a biochemical blood test show: decoding, norm Causes of lipid metabolism disorders

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

What is a biochemical blood test?

Biochemistry - modern science closely related to 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 life. 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 parameter clinical analysis blood "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.
• The 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.

LHC indicator		Normal in the blood
Polypeptides
total protein		63-87 g/l
Albumins		40-50 g/l
Globulins	alpha 1	2.0‑2.4 g/l
	alpha 2	in men 1.51‑3.50 g/l; in women 1.74‑4.20 g/l.
	beta	2.20-4.0 g/l
	gamma	10.5 g/l
Haptoglobin		0.8-2.7 g/l
Hemopexin		0.50‑1.2 g/l
myoglobin		in men 19-92 mcg / l; in women 12-76 mcg / l.
Rheumatoid factor		Up to 10 U / ml.
C-reactive protein		Up to 0.5 mg/l.
Transferrin		2.0 - 4.0 g / l (for a woman during gestation, the values ​​\u200b\u200bare higher, for a person over 60 years old - lower).
ferritin		in men 20-250 mcg / l; in women 10-120 mcg /.
ceruloplasmin		150.0-600.0 mg/l.
		26.85 - 41.2 µmol/l
Carbohydrates
Glucose		3.5-6.2 mmol/l
Glycated hemoglobin		until 6%
Fructosamine		up to 280.0 mmol/l
lactate		0.5–2.2 mmol/l
C-peptide		1.1–5.0 ng/ml.
low molecular weight nitrogenous substances
Urea		2.55-8.31 mmol/l
Creatinine		men - 62-124 µmol / l; women - 44-97 µmol / l.
Purine derivatives
Uric acid		men - 0.12-0.43 mmol / l; women - 0.24-0.54 mmol / l.
Lipids
total cholesterol		3.1-5.2 mmol/l
Low density lipoproteins (LDL)		3.8 mmol/l
High density lipoproteins (HDL)		men 1.6 mmol/l; women 1.4 mmol/l.
Triglycerides		0.14-1.82 mmol/l
Atherogenic coefficient		less than 3 mmol/l
Pigments
total bilirubin		8.49-20.58 µmol/l
Indirect (unbound) bilirubin		4.5-17.1 µmol/l
Direct (bound) bilirubin		2.2-5.1 µmol/l
Enzymes
A-amylase		up to 110 U/l
Alanine aminotransferase (ALT)		up to 38 U/l
		up to 42 U/l
		men - up to 33.5 U / l; women - up to 48.6 U / l.
		men - 11-50 U / l; women - 7-32 U / l.
Acid phosphatase (AP)		men - 0-5.5 U / l; women - 0-6.5 U / l.
Creatine kinase (CK)		up to 180 U/l
Lactate dehydrogenase (LDH)		120-240 U/l.
Lipase		0-417 U/l.
Cholinesterase		men - 5800-14600 U / l; women - 5860-11800 U / l.
Alkaline phosphatase (AP)		up to 260 U/l
vitamins
Vitamin A		0.30-1.20 mg/l
Vitamin B 1		70-180 nmol/l
Vitamin B 2		5-50 nmol/l
Vitamin B 6		20-125 nmol/l
Vitamin D		30-80 ng/ml
Vitamin E		5.5-18.0 mg/l
Vitamin C		0.4-2.0 mg/dl
trace elements
Iron		in men - 11.64-30.43 µmol / l; in women - 8.95-30.43 µmol / l.
Potassium		3.6-5.4 mmol/l
Calcium		2.0-2.8 mmol/l
Magnesium		0.65-1.1 mmol/l
Sodium		134-150 mmol/l
Phosphorus		0.65-1.3 mmol/l
Chlorine		95.0-110.0 mmol/l
Zinc		11-18 µmol/l

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.

Protein and its fractions		Possible reason for the increase	Possible reason for the decline
total protein		there is a lot of protein in the diet; oncological diseases; diseases of the genitourinary system complicated by sepsis; blood sepsis, sepsis of internal organs.	there are few protein products in the diet, diseases of the genitourinary system, oncological diseases, hepatitis, blood loss, pregnancy, burn injuries of the body.
Albumins		body dehydration, blood diseases, oncological diseases, burns and sepsis, diabetes, infectious diseases, rheumatoid arthritis, systemic lupus erythematosus, multiple myeloma, vomiting, diarrhea, hemoconcentration, nephritis.	anasarca, pregnancy, hyperhydration, atrophy muscle tissue, anemia, blood loss, gastric ulcer and duodenum(with bleeding), oncological diseases, hepatitis, pulmonary edema, blood diseases.
Globulins	alpha	glomerulonephritis, dermatomyositis, nephrosis, rheumatoid arthritis, sepsis, scleroderma.	anasarca, muscle tissue atrophy, anemia, gestation, blood loss, oncological diseases, hepatitis, blood diseases.
	beta	atherosclerosis, hypothyroidism, nephrosis, diabetes mellitus, gastric and duodenal ulcers (with bleeding).
	gamma	allergies, helminthic invasion, infectious diseases, scleroderma, dermatomyositis, rheumatoid arthritis, burns.
Haptoglobin		hemolysis in vivo, cholecystitis, steroid treatment.	hemolysis in vivo, liver disease, deficiency folic acid, enlarged spleen, nephrosis.
Hemopexin		nephrosis, diabetes.	oncological diseases, hepatitis, blood diseases.
myoglobin		myocardial infarction, renal failure, inflammatory processes in muscle tissue, muscle tissue injuries, burns of various etiologies.	rheumatoid arthritis, myositis and polymyositis, myasthenia gravis.
ceruloplasmin		infectious diseases, cirrhosis of the liver, hepatitis, schizophrenia, oncological diseases.	alimentary anemia, unbalanced diet.
Rheumatoid factor		the presence of this protein in the blood indicates the development of rheumatism, autoimmune diseases.
C-reactive protein		the presence of this protein in the blood indicates the development of sepsis in the blood and in the internal organs.
ferritin		excess iron, hepatitis, leukemia, breast cancer, infectious diseases.	iron deficiency, iron deficiency anemia, during female monthly cycles, autoimmune hepatitis, third trimester of gestation.
Transferrin		oncological diseases, inflammatory processes of various etiologies, burns, excess iron, cirrhosis of the liver.
Serum iron-binding capacity (IBC)		iron deficiency, iron deficiency anemia, autoimmune hepatitis, third trimester of gestation.	excess iron, hepatitis, leukemia, breast cancer, infectious diseases, inflammatory processes of various etiologies, burns, cirrhosis of the liver.

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 damage, 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:

Lipid name	Possible reason for the increase	Possible reason for the decline
total cholesterol
LDL	change of seasons (higher in winter than in spring), blood diseases (hypertension, angina pectoris), menstruation, gestation, physical inactivity, cancer, cholecystitis, viral hepatitis, an improperly balanced diet (an abundance of fatty foods).	change of seasons (lower in spring than in autumn and winter), well-balanced diet, hyperdynamia.
HDL	HDL breaks down LDL (bad cholesterol), if it is low, LDL becomes larger and pathological processes that depend on the amount of LDL are aggravated; if enough - LDL does not harm the body.
Triglycerides	the parameter is needed to clarify data on LDL and HDL

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

Enzyme name	Possible reason for the increase	Possible reason for the decline
A-amylase	alcoholism, taking tetracycline antibiotics, taking steroids, acute pancreatitis, pancreatic cancer, viral hepatitis, mumps, kidney failure.	preeclampsia, myocardial infarction, pancreatic necrosis, thyrotoxicosis.
Alanine aminotransferase (ALT)	myocardial infarction, skeletal muscle injury.	skeletal muscle atrophy, hereditary diseases, anemia, prolonged starvation.
Aspartate aminotransferase (AST)	hepatitis, liver cirrhosis, liver carcinoma.
Gamma-glutamyltransferase (GGT)	rheumatoid arthritis, liver diseases, oncological diseases of the liver, pancreas and prostate; myocardial infarction, diabetes mellitus, alcoholism, hyperthyroidism.	There are no pathological reasons for the decrease in GGT.
Gamma-glutamyl transpeptidase (GGTP)	alcoholism, liver carcinoma, hyperthyroidism, pancreatitis, pancreatic cancer, diabetes mellitus, pyelonephritis, glomerulonephritis, prostate cancer, viral hepatitis, toxic hepatitis (including alcohol), cholelithiasis.	decompensated cirrhosis of the liver, hypothyroidism.
Acid phosphatase (AP)	lack of calcium and phosphorus in the body, hepatitis, regeneration bone tissue, cytomegalovirus infection, toxic injury liver, infectious mononucleosis, osteosarcoma.	osteoporosis, vitamin D excess, anemia, dysfunction thyroid gland, starvation, vitamin C deficiency.
Creatine kinase (CK)	schizophrenia, manic-depressive psychosis, gangrene, myocardial infarction, myositis, hypothyroidism, encephalitis.	There are no pathological reasons for the decrease in CC.
Lactate dehydrogenase (LDH)	injuries, blood diseases, liver diseases, anemia of various types, lesions of the endocrine glands.	there are no pathological reasons for the decrease in LDH.
Lipase	pancreatitis, intestinal infarction, peritonitis, long-term use of barbiturates and analgesics, obesity grades 3 and 4, cirrhosis of the liver, gestation, intestinal obstruction, mumps, diabetes mellitus, cholecystitis.	pancreatic dysfunction, cystic fibrosis, excess triglycerides in the blood.
Cholinesterase	obesity 3 and 4 degrees, alcoholism, breast cancer, arterial hypertension, tetanus, neurosis, gestation, diabetes mellitus.	third trimester of pregnancy, liver disease, blood transfusion, cancer, myocardial infarction, decreased blood albumin.
Alkaline phosphatase (AP)	multiple myeloma, lymphogranulomatosis, hepatitis, bone tissue regeneration, cytomegalovirus infection, toxic liver damage, osteosarcoma.	osteoporosis, excess vitamin D, anemia, thyroid dysfunction, starvation, scurvy.

Attention! Enzymes should not be identified with enzymes, which are often called "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

Vitamin	Excess	Flaw
A	headache, nausea, vomiting, drowsiness, hyperemia skin face, thinning of the skin, sporadic pruritus.	problems with vision at dusk, the condition of the skin worsens - the skin becomes dry, rough, painful; brittle nails, conjunctivitis.
B1	weakness, nausea, urge to vomit, dizziness, palpitations, swelling of the face, numbness of the extremities; in severe hypervitaminosis, pulmonary edema, convulsions, involuntary urination, loss of consciousness, and death may occur.	disappears appetite, problems with intestinal motility, frequent constipation, fatigue, nervousness and irritability, sleep problems.
B2	tingling of the fingertips, burning in the joints, blockage of the renal channels, diarrhea and accumulation of fluid in the body, fatty liver.	conjunctivitis, inflammation of the mucous membranes, itching and pain in the eyes, drying out and cracking of the lips, hair begins to fall out.
B6	allergic reactions	there are dermatitis, a tendency to arthritis, myositis, atherosclerosis and liver disease, excitability, nervousness, irascibility, lack of sleep.
D	irritability, muscle spasms, vascular calcification, nausea, vomiting, lack of appetite, xerostomia, weight loss, increased blood pressure, fatigue, constipation, acidosis.	fatigue, lethargy, lethargy, osteoporosis, liver disease, increased risk of infectious diseases.
E	deterioration of the general condition of the body, violation of sexual function (from apathy to increased desire).	muscle weakness and lethargy, male infertility, endocrine and mental disorders.
WITH	autoimmune diseases, the risk of developing cancer of the red and white blood.	the strength of immunity decreases, weakness, lethargy, increased fatigue.

trace elements

The name of the microelement	What is it needed for	Pathologies associated with a deficiency (-) or an excess (+) of a microelement in human blood
(Ca)	ensures the growth of bone tissue, cleanses the cells of toxins.	liver disease (+, -), bone disease (-), osteoporosis (-), muscle pain (+, -).
(Na)		fainting (-), loss of activity (-), drowsiness (-), thirst (+).
(I)	influence on the growth, development and metabolism of the body.	fatigue, headache, depression, pathological laziness, irritability and irritability (-), weakening memory and intelligence (-), poisoning, weakness, allergies (+).
(K)	affects the functioning of the heart.	hypotension (-), hypertension (+).
(P)	helps the body absorb calcium, a participant in energy metabolism, an integral part of biomolecules, is important for the functioning of the organs of the higher nervous system.	poor memory (-), osteoporosis (+, -), muscle anemia (-), muscle pain (+, -), rickets (-), liver disease (+, -).
(Mg)	takes part in the regulation of the cardiovascular system.	heart disease (+, -), myocardial infarction (-), vascular disease (+, -), convulsions (-).
(Fe)	helps in the composition of the hemoglobin protein to oxidize chemical elements and compounds in the human body.	iron deficiency anemia (-), toxic hepatitis (+).
(Cl)	affects cellular water exchange.	alkaline gastritis (-), acid gastritis (+), anemia (+, -), impaired kidney function (+, -).
(Zn)	affects the functioning of the immune system and male potency, is important for the production of pancreatic secretions.	poor potency in men (-), delayed sexual development (-), autoimmune diseases (+).

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!

Blood chemistry - laboratory method study, which is used in all areas of medicine (therapy, gastroenterology, rheumatology, etc.) and reflects the functional state various bodies 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 carbohydrate metabolism is the blood sugar level. 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, diabetes mellitus can be detected. 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; O chronic diseases liver and kidneys.

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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

Pigments- bilirubin, total bilirubin, direct bilirubin.

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 liver cancer or disease, hepatitis, liver poisoning or cirrhosis, gallstone disease, 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.

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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).

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A decrease in total cholesterol levels indicates:

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

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HDL cholesterol

Decrease may mean:

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

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LDL cholesterol

• hypothyroidism;
• liver disease;
• pregnancy;

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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.

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

Norm of triglycerides

Age	Triglyceride level, mmol/l
	Men	Women

Water and mineral salts. Blood chemistry

Inorganic substances and vitamins - iron, potassium, calcium, sodium, chlorine, magnesium, phosphorus, vitamin B12, folic acid.

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 arterial pressure 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.

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• 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.

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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).

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

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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.

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

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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.

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

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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.

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Decreased phosphorus levels may indicate:

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

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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.

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

class="we"> The norm of magnesium in the blood plasma for adults is 0.65 - 1.05 mmol / l.

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.

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Decreased iron levels may indicate:

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

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FOLATES

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

class="we"> The norm of folic acid in the blood serum is 3 - 17 ng / ml.

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 damage).

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 kidney 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.).

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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.

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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.

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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).

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• pancreatic insufficiency;
• cystic fibrosis.

class="we"> The norm of alpha-amylase in the blood (diastase norm) is 28-100 U / l. Norms of pancreatic amylase - from 0 to 50 U / l.

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.

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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.

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• small muscle mass;
• immobile lifestyle.

class="we"> Norms of creatine kinase MB in the blood - 0-24 U / l.

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).

class="we"> The LDH norm for newborns is up to 2000 U / l. In children under 2 years of age, LDH activity is still high - 430 U / l, from 2 to 12 - 295 U / l. For children over 12 years of age and in adults, the LDH norm is 250 U / l.

PHOSPHATASE ALKALINE

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

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

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• 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.

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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.

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

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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.

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PROTEIN. Blood chemistry

Proteins are the main biochemical criterion of life. They are part of all anatomical structures (muscles, cell membranes), carry 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 strangers, regulate metabolism, retain fluid in the blood vessels and do not allow it to go into the fabric.

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).

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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).

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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

Formed from hemoglobin elevated level glucose (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 sex.

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

• weight loss;
• physical load.

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

class="we"> Normal levels of apoA1 in the hemoplasm are different for men and women: 1.1-2.05 and 1.25-2.15 g/l

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.

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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.

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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.

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A decrease in the level of myoglobin causes autoimmune conditions when autoantibodies against myoglobin are produced; it 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 infarction myocardium;
• acute skeletal muscle injury.
  Norms of creatine kinase MB in the blood - 0-24 U / l

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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.

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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.

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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).

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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.

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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 old normal level creatinine - 18-35 µmol/l, from one year to 14 years - 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.

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

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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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This analysis is necessary for a clear diagnosis of the current state of the body, including not only the work of organs, but also control over ongoing physical and chemical processes. It is prescribed in half of the cases of visiting a doctor with any disease - these are one of the most popular and sought-after tests in the world.

When is it appointed?

A biochemical blood test is prescribed for any transferred somatic or infectious diseases, diseases associated with disruption of the above organs, as well as an additional control of the body's work during regular / prescribed / emergency diagnostics of the patient's health.

How is it carried out?

The process of biochemical blood analysis can be divided into two stages

Preliminaries

Twelve hours before the analysis, it is necessary to completely refuse food, tea, juices, coffee, alcohol and milk, you can only use pure water. If you use any of the above list, then the biochemical analysis itself will most likely not be correct.

Blood sampling

Taking samples for analysis is carried out sitting or lying down. At the same time, a strong tourniquet is placed above the elbow, and the place of the future puncture is carefully treated with antiseptics. A needle is inserted into a vein in the crook of the elbow, and the specialist takes blood in the required amount. The collected material is poured into a test tube, after which it is sent to a biochemical laboratory. Primary test results can be obtained the next day after blood donation.

Indicators and norms. Deciphering the results.

Biochemical analysis allows you to find out the following parameters and levels:

Below you can find a table with normal indicators results of a biochemical blood test.

Different laboratories can conduct a biochemical blood test in accordance with excellent methodological manuals, use other units for measuring the concentrations of elements, therefore, when interpreting the results yourself, be sure to pay attention to this.

Useful video

Update: December 2018

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

Indicator	Norm
total protein	63-87 g/l
Protein fractions: albumins globulins (α 1 , α 2 , β, γ)	35-45 g/l 21.2-34.9 g/l
Urea	2.5-8.3 mmol/l
Creatinine	women 44-97 micromoles per liter men 62-124
	In men - 0.12-0.43 mmol / l In women - 0.24-0.54 mmol / l
Glucose	3.5-6.2 mmol per liter
total cholesterol	3.3-5.8 mmol/l
LDL	less than 3 mmol per liter
HDL	women greater than or equal to 1.2 mmol per liter men 1 mmol per liter
Triglycerides	less than 1.7 mmol per liter
total bilirubin	8.49-20.58 µmol/l
direct bilirubin	2.2-5.1 µmol/l
Alanine aminotransferase (ALT)	Up to 38 U/l
Aspartate aminotransferase (AST)	Up to 42 U/l
Alkaline phosphatase (AP)	Up to 260 U/l
Gamma-glutamyltransferase (GGT)	In men - up to 33.5 U / l In women - up to 48.6 U / l
Creatine kinase (CK)	Up to 180 U/l
	up to 110 E per liter
Sodium	130-155 mmol/l
Potassium	3.35-5.35 mmol/l

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 .

Albumins	Globulins
Increasing the indicator fluid loss in infectious diseases () burn disease	Α-globulins: acute purulent inflammatory processes; burns in the recovery phase; nephrotic syndrome in glomerulonephritis. β-globulins: hyperlipoproteinemia (atherosclerosis, diabetes mellitus); nephrotic syndrome; an ulcer in the stomach and intestines that bleeds; Γ-globulins: viral and bacterial infections; systemic connective tissue diseases (scleroderma, dermatomyositis, rheumatoid arthritis); burns; allergies; helminthic invasion.
Level reduction in newborns due to underdevelopment of liver cells; during pregnancy; pulmonary edema; malignant neoplasms; liver disease; bleeding; accumulation of plasma in body cavities (anasarca)

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?

Reasons for the increase	Reasons for the decline
Urea acute and chronic glomerulonephritis, pyelonephritis; nephrosclerosis; poisoning with mercury salts, dichloroethane, ethylene glycol; crash syndrome (syndrome of prolonged squeezing); arterial hypertension; polycystic kidney disease; kidney tuberculosis; acute and chronic renal failure	after administration of glucose; increased urine output (polyuria); after hemodialysis; starvation; decreased metabolism; hypothyroidism
Creatinine acute and chronic renal failure; hyperthyroidism; acromegaly; decompensated diabetes mellitus; intestinal obstruction; muscular dystrophy; extensive burns
Uric acid gout; leukemia; B-12 deficiency anemia; Wakez disease; acute infections; liver disease; severe form of diabetes; skin pathologies (dermatitis, pemphigus); barbiturate poisoning, carbon monoxide poisoning

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?

hypoglycemia	hyperglycemia
prolonged fasting; violation of the absorption of carbohydrates (colitis, enteritis, dumping syndrome); chronic hepatic pathologies; hypothyroidism; hypopituitarism; overdose of insulin or oral hypoglycemic drugs (diabeton, glibenclamide, etc.); meningitis (tuberculous, purulent, cryptococcal); encephalitis, meningoencephalitis; insuloma; sarcoidosis	DIABETES 1 and 2 types thyrotoxicosis; pituitary tumors; neoplasms of the adrenal cortex; pheochromocytoma; treatment with glucocorticoids; epilepsy; trauma and brain tumors; carbon monoxide poisoning; psycho-emotional arousal

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. end product 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 the 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?

	Why is it declining
total cholesterol myxedema; diabetes; pregnancy; familial combined hyperlipidemia; cholelithiasis; and prostate; glomerulonephritis; alcoholism; hypertonic disease; myocardial infarction; cardiac ischemia	malignant tumors of the liver; cirrhosis of the liver; rheumatoid arthritis; starvation; malabsorption of substances; chronic obstructive pulmonary disease
Triglycerides viral hepatitis; alcoholism; alcoholic cirrhosis of the liver; biliary (biliary) cirrhosis of the liver; cholelithiasis; acute and chronic pancreatitis; chronic renal failure; hypertonic disease; myocardial infarction; cardiac ischemia; pregnancy; thrombosis of cerebral vessels; hypothyroidism; diabetes; gout; Down syndrome; acute intermittent porphyria	chronic obstructive pulmonary disease; hyperfunction of the thyroid and parathyroid glands; malnutrition; malabsorption

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 dyslipoproteinemia (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, 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 conduct 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.

One of the most important components modern medicine These are laboratory studies. Among the most frequently performed and demanded types of such diagnostics, a blood test for biochemistry is distinguished. It allows you to learn about the state of almost all processes occurring in the human body, provides detailed information about health. The difficulty lies only in, because the reliability of the results depends on this.

Diagnostic task

First of all, you should understand what it is and why it is needed.

The task of blood biochemistry is to determine the ratio of certain components in human blood, created as a result of certain types of metabolism.

To get samples do . To conduct a biochemical blood test, you need a transparent, liquid part of the blood - plasma, so the blood must go through the process of sedimentation and centrifugation.

In the process of a blood test for plasma biochemistry, the following indicators are revealed:

• Protein metabolism: total protein and its structure, albumin and globulin content, as well as nitrogenous components: residual nitrogen, creatinine,;
• Pigment metabolism: bilirubin and its fractions (direct or indirect)
• Serum enzymes, which include alanine aminotransferase (ALAT), glutamate oxaloacetate transaminase (AST), alpha-amylase, alkaline phosphatase.
• Lipid metabolism, including neutral fats, cholesterol, lipoproteins of various densities.
• Electrolytes: magnesium, potassium, chlorine, sodium and calcium.

Indications can be completely different. It is mandatory to carry out, for example, in the pathology of internal organs, oncological and inflammatory diseases.

It is not necessary to include all of these indicators in the study at once. The need for certain indications in the analysis is established by the doctor and depends on the patient himself and his condition. The ability to remove unnecessary can significantly reduce the cost of conducting a study, while not affecting the quality of the result.

Protein molecules play a very important role in the human body, they are part of cell membranes, they are responsible for the transport of nutrients, they are the basis.

In the table below, you can see what the result of certain indicators of protein metabolism shows.

Protein metabolism index	Norm	Pathological changes
total protein	70-90 g/l	Hypoproteinemia. In this state, the level of proteins in the body is below normal. Hyperproteinemia. In this condition, total plasma protein is above normal. Dysproteinemia. The ratio between the levels of albumin and globulins is disturbed.
Albumins	56,5-66,5%	Gopoalbuminemia. The albumin value obtained during the studies is below normal. Hyperalbuminemia. The albumin index obtained during the studies exceeds the norm.
Globulins	33,5-43,5%	Hypoglobulinemia/hyperglobulinemia is the detected level of globulins (either in general or certain types of them) below/above the normal level.
Creatinine	50-115 mmol/l	Of practical interest is an increase in the level of creatinine in the blood.
Urea	4.2-8.3 mmol/l	Of practical interest is the increase in the level of urea in the blood.

Not all parameters of fat metabolism usually bring benefits from the level of lipid metabolism. The diagnosis of the dynamics of vascular atherosclerosis is quite relevant, so many of these “useful” indicators are associated precisely with cholesterol metabolism.

Can be the basis for development coronary disease heart, stroke and heart attack, which leads to problems with blood vessels lower extremities and branches of the aorta, so the indicator has great importance while researching.

The decoding of the indicators is given in the table below:

Indicator	Norm	Variants of deviation from the norm
Cholesterol	Less than 4.1 mmol/l	Raise this indicator in serum means a violation of lipid metabolism, which can be the result of metabolic syndrome, obesity, diabetes mellitus and can cause the progression of vascular atherosclerosis. A decrease in cholesterol is also very unfavorable and threatens to disrupt the synthesis of steroid and sex hormones in the body.
low density lipoproteins	Less than 2.2 mmol/l	An increase in this indicator may be the cause of the spread of atherosclerotic vascular lesions, for the reason that LDL transport cholesterol from the liver to the vessels.
high density lipoproteins	0.9-1.9 mol/l	The compounds are responsible for the transfer of cholesterol from blood vessels to the liver and tissues. From a practical point of view, it is of interest to reduce their level in the analysis of plasma for biochemistry. If one is detected, this indicates the possibility of an atherosclerotic process in the vascular walls.

The electrolyte composition of the blood

Electrolytes, as well as calcium, chlorine, potassium and magnesium ions, are something without which the cells of the human body cannot exist and perform their function. Therefore, according to the results of a biochemical blood test, one can judge the general condition of the cells and possible complications.

The norm of the electrolyte composition of the blood in the table:

Indicator	Norm	Pathology
Potassium	3.3-5.5 mmol/l	They are intracellular ions. Exceeding the norm of these indicators (hyperkalemia or hypermagnesemia) indicates kidney failure or decaying muscle tissue, which can occur with severe burns, injuries, pancreatic necrosis. Excessive amounts of these electrolytes can lead to abnormal heart rhythms, as well as cardiac arrest in diastole. The lack of these ions in plasma (hypokalemia, hypomagnesemia) is usually a consequence of peritonitis, dehydration, intestinal obstruction, infectious diarrhea and vomiting, overdose of diuretics. The health risks are no different from those of hyperkalemia and hypermagnesemia.
Magnesium	0.7-1.2 mmol/l
Sodium	135-152 mmol/l	These are intracellular ions, and they are responsible for the osmotic pressure inside the cell, as well as in the space between them. A decrease in their level is usually caused by a violation of the water and electrolyte balance and dehydration against the background of various serious illnesses. In this case, there is a risk of a violation of the excitability of nerve tissues and the heart, which can cause it to stop in systole.
Chlorine	95-110 mmol/l
Calcium	2.2-2.75 mmol/l	It is the main ion responsible for the stabilization of cell membranes, bone strength and muscle contraction. If the level of this indicator is below the norm, this can reveal rickets, hypothyroidism and a lack of food intake in the patient. There is a threat of muscle weakness, arrhythmia, osteoporosis. An increased calcium content is a sign of hyperfunction of the parathyroid glands, as well as pancreatic necrosis.

A blood test for biochemistry is a very useful and informative study that can reveal various diseases, the nature of violations of the work of many organs and obtain extended data on the physical processes in the body. Correct decryption biochemistry results are a decisive moment in making a diagnosis and determining further actions.