Clinical Biochemistry: Plasma Proteins

Hypoglycemia (Blood Glucose < 60 mg/dL)

• Causes: Over dosage of insulin, Hypothyroidism, Addison disease, Decrease secretion of growth hormone, Inborn errors of metabolism, Galactosemia, Hereditary fructose intolerance, Glycogen storage diseases, Insulinoma (tumor of pancreas with excess secretion of insulin)

Lipid Profile

• When to request lipid profile analysis: Routine investigation for adults, hypertensive, diabetic patients, and cardiac patients
• Triacylglycerol (Normal value: Less than 150 mg/dl or 1.7 mmol/L)
• Causes of Hypertriglyceridaemia: Diabetes mellitus (type 2), Obesity, Excess alcohol, Renal disease, Liver disease, Genetic
• Cholesterol (Normal serum cholesterol: Less than 200 mg/dL or 5.2 mmol/L)
• Causes of Hypercholesterolemia: Diabetes Mellitus, Hypothyroidism, Obstructive jaundice, Nephrotic syndrome, Genetic
• High Density Lipoprotein-Cholesterol (HDL-C) (Normal: 40-60mg/dL)
• Low Density Lipoprotein-Cholesterol (LDL-C) (Normal: Calculated from total cholesterol, Triacylglycerol, and HDL-C)

Plasma Protein

• When to request plasma protein analysis: Edema, Ascites, Bone pain, especially in back, ribs, long bones, and shoulder
• Normal Values: Total protein: 6-8 g/dl, Albumin: 3.5-5 g/dl, Albumin to globulin ratio (A/G ratio): more than 1
• Causes of Hypoproteinemia (total plasma protein < 5g/dl): Severe malnutrition, Malabsorption, Kidney disease (nephrotic syndrome), Chronic liver disease, Severe burns
• Causes of Hyperproteinemia (total plasma protein > 8g/dl): Multiple myeloma (around 15g/dl)

Glucose

• When to request glucose analysis: Polyuria, Polyphagia, Polydipsia, Recurrent infections, Symptoms of hypoglycemia (attacks of sweating, tremors, fainting)
• Normal value: Fasting blood glucose level: 70-110 mg/dL (3.8-6.1 mmol/L)
• Causes of Hyperglycemia (fasting blood glucose > 110 mg/dL): Diabetes mellitus (Fasting blood glucose > 126mg/dL), Secondary diabetes, Hyperthyroidism, Cushing's syndrome, Acromegaly