Basis of Clinical Chemistry

8/4/2019 Basis of Clinical Chemistry

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March, 2006 Fuji Photo Film 1

Basis of Clinical Chemistry

To understanding for clinicalbiochemistry test.


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Sample

BloodSerum; without fibrinogensupernatant after coagulation

Plasma; with fibrinogensupernatant with anticoagulant

Blood cells; RBC, WBC, Platelet,

Lymphocytes


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Constituents of blood

Hematocrit;Ratio of Blood cells/volume

Plasma(with Fibrinogen)

Blood cells

Hematocrit(uncoagulated)

Blood cellsBlood cells+Fibrin

Serum(without Fibrinogen)

Blood cells

(coagulated)

Without

anticoagulants

With

anticoagulants


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Various parameters in blood

Major biochemical parameters

Chemical substrates,Proteins,Electrolytes,Enzymes


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Glucose (GLU)

Blood sugarGlucose increase after meal.

Unit; mg/dL,

mmol/L

Nutrient

IncreaseDiabetes

DecreaseHypoglycemiaIt is very dangerous.


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Blood Urea Nitrogen BUN) Unit; mg/dL (mmol/L)

Metabolite of amino acids.

Urea is synthesized by liver.Urea is excreted to urine from kidney.

Urea is not poisonous.

DecreaseLiver failure

IncreaseRenal failure


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Creatinine (CRE)

Unit; mg/dL (mmol/L)

Dehydrates of creatineCreatine is sysnthesized from amino

acid by liver and kidney.Creatine is nutrient in muscle.Creatinine is excreted to urine fromkidney.

Creatinine is not poisonous.

IncreaseRenal failure


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Ammonia (NH3)

Unit; mg/dL (nitrogen) (mmol/L)

Ammonia is very poisonous to brain.

Ammonia causes;low body temperature, weak pulse,coma

IncreaseHeavy Liver failure


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Uric acid (UA)

Metabolite of nucleic acid or purinebody. Both are included in food.


Uric acid is excreted to urine fromkidney.Uric acid is quite unsoluble in water.

Increasegout (only human)


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Total cholesterol (TCHO)

A kind of lipids in body.Ester form which is combined with fattyacid. The another form is free cholesterol.

Unit; mg/dL (mmol/L) Basic constituent of cell membrane.

Raw material of steroid hormone or bileacid.

Increase; Meal, Diabetes, Hypothyroidism,Cussings syndrome


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Triglycerides (TG)

LipidNutrient


Increase; Meal, Diabetes

Decrease; Starvation, Hypothyroidism,Acute pancreatitis


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Total bilirubin (TBIL)Direct bilirubin (DBIL)

Yellow dye in bileBilirubin is made from red blood cell.

a-bil; unconjugatedb-bil; monoconjugatedg-bil; diconjugated directd-bil; combines with albumin


Increase; Jaundice


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Calcium (Ca)

Bone, teeth


Important for neurotransmittance Free calcium and combined with

albumin

Increase; Lymphoma

Decrease; Hypoparathyroidism, Renalfailure


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Inorganic phosphorus (IP)

Mediator of acid-base balance


Increase; Hypoparathyroidism, Renalfailure

Decrease; Malignant tumor, Diabetes,Hyperparathyroidism


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Total Protein (TP)Albumin (ALB)

Unit; g/dL (g/L)

Various proteins in blood.

Albumin, Globulin etc. Albumin is nutrient.

Globulin is not simple protein.Many kind of Globulins. a, b, g

Globulin is carrier of iron or lipid,anti-body for immunity, coagulation


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Sodium (Na)

Modulator of osmotic pressure inbody.

Unit; mEq/L (mmol/L) Increase; Diabetes insipidus,

Diabetes mellitus, Dehydration

Decrease; Diarrhea, Vomiting,Diabetes mellitus


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g-Glutamic transpeptidase (GGT)

Marker of hepatobiliary disease.

Unit; U/L (mkat/L)

1 U/L = 0.0167 mkat/L Increase; Cholestatic hepatitis (liver

disease)


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Glutamic-oxaloacetic transaminase/Aspartate aminotransferase (GOT/AST)

Marker of hepatitis, muscle disease

Unit; U/L (mkat/L)

1 U/L = 0.0167 mkat/L Increase; Hepatocyte necrosis,

Muscle necrosis, haemolysis


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Glutamic-pyruvic transaminase/Alanine aminotransferase (GPT/ALT)

Marker of hepatitis

Unit; U/L (mkat/L)

1 U/L = 0.0167 mkat/L Increase; Hepatocyte damage or

necrosis


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Creatine phosphokinase (CPK)Creatine kinase

Marker of muscle disease, centralnervous system.

Unit; U/L (mkat/L)1 U/L = 0.0167 mkat/L

Increase; Muscle damage or necrosis,Central nervous damage


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Alkaline phophatase (ALP)

Marker of hepatobiliary disease.

Unit; U/L (mkat/L)

1 U/L = 0.0167 mkat/L Increase; Cholestatic hepatitis (liver

disease), Adrenocortical hormoneliver damage, Bone growth


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Amylase (AMYL)

Marker of pancreas.

Unit; U/L (mkat/L)1 U/L = 0.0167 mkat/L

Increase; Pancreatic inflammationand necrosis, Pancreatic ductobstruction, Decreased renal

excretion, Uremia, Increasedabsorption due to upper intestinalinflammation


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Potassium (K)

Major cation intracellular fluid.Concentration is not so high as Na.

Unit; mEq/L (mmol/L) Increase; Renal failure, Acidosis,

Release from red blood cell.

Decrease; Diarrhea, Vomiting,Diuretic, Alkalosis


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Chloride (Cl)

Highest concentration anion in blood.Usually, concentration of Cl changeswith Na.

Unit; mEq/L (mmol/L)

Increase; Dehydration, Renal tubularacidosis

Decrease; Vomiting, Metabolicacidosis


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Basis of Clinical Chemistry