Analyzer 26 SMA 26 Test Panel

An Amylase test determines the amount of amylase enzyme in your blood. This enzyme helps in the breakdown of complex dietary carbohydrates into simple carbohydrates for absorption. The digestion of carbohydrates begins in the mouth since the amylase is secreted by the salivary glands too. However, the majority of the amylase is produced by the pancreas and secreted into the duodenum of the small intestine. The amount of amylase in the blood rises either due to its increased secretion into the blood or decreased elimination by the kidneys. Higher levels of amylase for longer periods indicate pancreatic complications and need medical intervention.

The alkaline phosphatase, serum test measures the alkaline phosphatase levels in the blood. Alkaline phosphatase (ALP) is an enzyme which is found in various tissues throughout the body. The maximum concentrations of ALP are present in cells of bone and liver. Usually, raised levels of ALP are caused due to liver disease or bone disorders.

ALP is found in the liver on the cell edges that join to form bile ducts. The bile ducts are the tiny tubes which drain bile from the liver to the bowels. The bile juice formed is required by the small intestine to help digest fat in the diet.

ALP is produced by osteoblasts cells in the bone which are involved in bone formation. The various tissue types produce distinct forms of ALP which are known as isoenzymes.

The levels of ALP generally increase to a great extent if one or more bile ducts get blocked. The reason could be inflammation of the gallbladder which is known as cholecystitis or the presence of gallstones. The small amount of increase of ALP in the blood can be seen in liver cancer and cirrhosis. These high levels can also be observed if there is intake of medications toxic to the liver and hepatitis.

In conditions, where there is formation of excessive bones such as Paget’s disease one can also have increased levels of ALP. Along with that, higher blood ALP levels can be seen in children and adolescents, as they are in the growing stage and so are their bones.

Creatinine is a waste product which is produced by the muscles due to the breakdown of a compound called Creatine. During the cycle of energy production which is required to contract muscles, creatine is produced. Kidneys remove creatinine from the body by filtering it from the blood and then releasing it into the urine. This test measures the amount of creatinine in the blood.

The body produces creatine and creatinine at a relatively same rate. Since kidneys filter most of the creatinine from the blood and release it into the urine, the blood levels can be used as an indicator to know how well the kidneys are functioning. The amount of creatinine produced depends upon the size of the person as well as their muscle mass. That is why levels of creatinine are higher in men as compared to women and children.

Aspartate aminotransferase (AST) is an enzyme which is found in most of the body cells but mainly in the heart and liver. It is also present in kidneys and muscles but in smaller amounts. Normally, the levels of AST are low, but the levels rise when there is an injury to cells of the liver or muscle. 

The function of the liver is to process the nutrients of the body. It also produces bile which helps in digesting fats along with the production of other important proteins such as blood clotting factors and albumin. The liver breaks the potentially toxic substances into harmless products which can be used or eliminated by the body. 

The rise in levels of AST can be due to conditions causing liver damage such as hepatitis, drugs which are toxic to liver, cirrhosis, or alcoholism. The AST test is not specific for the liver. Its levels may also rise in conditions which affect other parts of the body.

This test is done with alanine aminotransferase (ALT) test. Both the enzymes are found in the liver and their levels rise in case of liver damage. The ratio of AST/ALT helps in differentiating between the causes of liver damage in case of injury to heart or muscle. 

The serum electrolyte test measures the following electrolytes:

• Sodium (Na+)

• Potassium (K+)

• Chloride (Cl-)

Electrolytes play an important role in a number of body functions like metabolism, neuromuscular functioning, maintaining hydration and pH (acid-base balance). Electrolytes also help in the entry of nutrients into the cells and removal of waste products from the cells. Electrolytes carry an electrical charge, either negative or positive and exist as dissolved salts in blood and body tissues. The Serum Electrolyte test measures the following important electrolytes:

Sodium (Na+)

Sodium is an essential body electrolyte which, along with potassium, chloride, bicarbonate, etc., helps to maintain the normal fluid and pH balance of the body. It is also vital for cellular metabolism, and in the activity of nerves and muscles and transmission of impulses between them. Sodium is present in all the body fluids. The highest concentration of sodium is found in blood and extracellular fluid.

Sodium is supplied to the body principally through dietary salt (sodium chloride or NaCl), and a small portion of sodium is absorbed through other food items. The required portion is absorbed by the body and the remaining is excreted by the kidneys through urine. The body maintains a very narrow range of sodium concentration by three mechanisms:

·         Secretion of hormones natriuretic peptides and aldosterone to control sodium elimination through urine

·         Secretion of antidiuretic hormone (ADH), also called Vasopressin, to control the volume of water eliminated through urine

·         Induction of thirst

Any disruption in the above mentioned mechanisms gives rise to an imbalance in the concentration of sodium in the blood to produce Hyponatremia (low blood sodium concentration), or Hypernatremia (high blood sodium concentration). Both these conditions produce a number of symptoms and may even lead to death.

Potassium (K+)

Potassium is one of the essential body electrolytes along with sodium, chloride, bicarbonate, etc. As an electrolyte, potassium helps to regulate the amount of fluids present in the body and to maintain a correct pH balance. It performs a vital role in cellular metabolism and transport of nutrients and waste products in and out of cells. It is also essential in the transmission of nerve impulses to muscles and muscle activity.

Sufficient amount of potassium required by the body is absorbed from dietary sources, and the remaining unabsorbed potassium is excreted by the kidneys. The hormone called aldosterone maintains the body potassium level within a small normal range. Aldosterone acts on the nephrons present in the kidneys and activates a sodium-potassium pump which helps the body to reabsorb sodium and excrete potassium. This helps to maintain the potassium concentration in the blood within its normal range. Deviation of potassium concentration from its normal range gives rise to Hyperkalemia (high potassium level in blood), or Hypokalemia (low potassium level in blood). Both these conditions may produce a number of symptoms, and may even be fatal if not controlled.

Chloride (Cl-)

Chloride is an essential mineral which acts as an electrolyte along with potassium, sodium, bicarbonate, etc. It helps to maintain the normal fluid and electrolyte balance in the body. It also acts as a buffer to help maintain the pH balance of the body. It also plays essential roles in metabolism. Chloride is used by the stomach to produce hydrochloric acid (HCl) for digestion. Chloride is present in every body fluid. The highest concentration of chloride is found in blood and extracellular fluid (fluid present outside the cells).

Most of the chloride is supplied to the body through dietary salt (sodium chloride or NaCl), and a small portion is absorbed through other food items. The required portion is absorbed by the body and the remaining is excreted by the kidneys through urine. The concentration of chloride in blood is maintained within a very narrow range by the body. Its increase or decrease is directly correlated with the sodium levels.

The Uric acid test measures the levels of uric acid in the blood. Uric acid is a nitrogenous compound produced by the metabolic breakdown of purine. Purines are nitrogenous bases in DNA forming parts of the structural framework of the cells. Breakdown of purines occurs when cells become old and die, forming uric acid. Uric acid is also formed from the metabolic breakdown of some types of food like red meat, seafood, beans, etc.

Most of the uric acid in the blood is filtered and eliminated by the kidneys and a small remaining amount in the stool. The concentration of uric acid in the blood can increase due to overproduction of uric acid or improper elimination of uric acid, and this condition is called Hyperuricemia. Hyperuricemia can also be caused due to cancer treatment by chemotherapy or radiotherapy. These treatment methods kill the cancer cells, which may leak the uric acid into the blood.

Excess uric acid can form crystals in the synovial fluid between the joints causing inflammation and pain. This condition is called gout and can severely damage the joints if left untreated. The Uric Acid Test can indicate the presence of gout, or risk of formation of gout. However, it is not a definitive test for gout. Confirmatory test for gout is performed by analysis of synovial fluid (joint fluid) for monosodium urate crystals. Chronic Hyperuricemia can cause the formation of tophi, which are hard lumpy deposits of uric acid crystals formed under the skin, in the joints, and at the top of the ears. Tophi cause severe damage to the joints and may compress nerves causing chronic pain and disfigurement. The excess uric acid may also deposit and crystallize in the kidneys causing kidney stones and acute renal failure.

Lactate dehydrogenase is an enzyme which plays an essential role in the production of energy from glucose. It is present in all the cells of the body, with the highest concentrations being in the cells of heart, lungs, muscles, liver, kidneys, and RBCs. Normally, only a small amount of the enzyme is found in the serum outside blood cells. However, in certain conditions of damage to the cells, lactate dehydrogenase is secreted out of the cells into the serum, where its concentration rises. Thus, the Serum Lactate Dehydrogenase Test is a nonspecific test that helps to determine the presence of conditions causing tissue damage somewhere in the body. Further tests are performed to identify the exact cause and location of these conditions.

The total lactate dehydrogenase in the body consists of five different forms of the enzymes (isoenzymes) named LDH-1 to LDH-5. The isoenzymes are present in different concentrations in different organs of the body. For example, LDH-1 and LDH-2 are most abundant in the cells of the heart, while LDH-5 is most abundant in the liver. Although the total LDH levels indicate tissue damage somewhere in the body, testing for the different isoenzymes can help identify the location of such damage.

Lactate dehydrogenase is also secreted into other body fluids in case of damage to the body tissues. It is also produced by bacteria and can be thus used to help identify bacterial meningitis.

Cholesterol is essential for life, as it is required by the body to work properly. It plays a role in the formation of cell membranes in all organs and tissues in the body. It is associated with the formation of hormones which are important for development, growth, and reproduction. It forms bile acids, which help to absorb nutrients from food. 

In the blood, a small amount of cholesterol circulates in the form of lipoproteins which contains protein, cholesterol, triglyceride, and phospholipid molecules. These are classified according to their density into HDL (high-density lipoproteins), LDL (low-density lipoproteins), and VLDL (very low-density lipoproteins). HDL cholesterol is also known as good cholesterol, as it carries excess cholesterol away for disposal while LDL cholesterol is also known as bad cholesterol, as it deposits cholesterol in tissues and organs. 

It is important to maintain and monitor the levels of cholesterol for a healthy lifestyle. The source of cholesterol is diet as well. If a person is taking too much of cholesterol-rich foods, it can cause a rise in levels of cholesterol in the blood. The amount of cholesterol which is not required by the body starts to deposit in the form of plaques on the walls of blood vessels. These plaques can narrow or block the blood vessels opening which can lead to the hardening of arteries known as atherosclerosis. Also, with an increase in cholesterol levels, there is an increased risk of various conditions such as heart disease and stroke. 

The Creatine Kinase Test measures the levels of Creatine Kinase in the blood. Creatine Kinase (CK) is an enzyme which is found in the brain, heart, skeletal muscle, and other tissues. In case of muscle damage, increased amounts of CK are released into the blood. 

In the blood, normally small amount of CK is present which comes from the skeletal muscles primarily. In case of any damage to the muscle or interference with the production of muscle, energy can lead to increased levels of CK. Also, these levels may rise if there is any change with the use of muscle energy. The examples of such conditions include strenuous exercise and myositis (inflammation of muscles). 

Muscle diseases (myopathies) such as muscle dystrophy can also lead to an increase in the levels of CK. However, significantly high levels of CK are observed in Rhabdomyolysis which there is an extreme breakdown of skeletal muscle tissue. 

The Phosphorus, Serum test is used to evaluate the level of phosphorus in your blood. Phosphorus is an inherent component of all living cells in the system and most, 85 percent, is located in the tissues of bones and teeth, while the remaining 15 percent is part of the blood and other soft tissues. Your body obtains its daily phosphorus requirements through dietary sources and under normal conditions, once the necessary amounts of phosphorus are absorbed by the cells and tissues, the remaining is eliminated via the urine.

Besides consuming a wholesome diet enriched with sufficient amounts of phosphorus, it is also important to ensure ample intake of calcium and vitamin D, to maintain overall health.

The Bilirubin (Total, Direct and Indirect) measures the amount of bilirubin present in the blood of a person. Bilirubin is an orange-yellow waste pigment produced by the normal breakdown of heme. The heme is a component of hemoglobin and is found in red blood cells. The liver processes the bilirubin and eliminates it from the body. 

The life span of red blood cells is about 120 days. The heme which is released from the hemoglobin is converted into bilirubin which is called unconjugated bilirubin. It is then carried to the liver by proteins, where it gets attached to sugars and becomes conjugated bilirubin. The conjugated bilirubin enters the bile from the liver and passes to the small intestine where it is broken down by the bacteria and further eliminated in the stool. These breakdown products of bilirubin are responsible for giving the characteristic brown color to the stool.

A healthy adult body produces approximately 250 - 350 mg of bilirubin daily. About 85% of bilirubin comes from damaged or degraded RBCs while the remaining amount comes from the bone marrow or liver. The small amount of unconjugated bilirubin is released in the blood normally, but conjugated bilirubin is not present in the blood. 

Both these forms of bilirubin can be measured or estimated and total bilirubin (sum of direct and indirect bilirubin) may be reported. In case there is an increase in levels of bilirubin, there will be yellowing of the skin and white of the eyes, giving the appearance of jaundice.  

Urea is a byproduct of protein metabolism. Proteins consumed in the diet are digested and converted into amino acids, which are utilized by the body. This metabolic process creates toxic byproduct ammonia. This byproduct is rapidly converted by the liver to form urea, which is less toxic and is transported relatively safely in blood. Following this, urea is transported by the blood to the kidneys. The kidneys then filter it out of the blood and excrete it out of the body in a solution called urine. This process continues and the body keeps producing and excreting urea, hence maintaining a low and steady level of urea in the blood.

The BUN test measures the amount of urea present in the urea. The levels of BUN test in the blood are affected due to impairment of kidney function, or due to large scale liver conditions. Primarily, BUN Test results are used to evaluate kidney functioning. Results are often interpreted together with results of Creatinine Tests that measure the levels of another metabolic waste (creatinine), which is also excreted in the urine.

The Protein Total, Serum Test measures the total amount of the various types of proteins in the serum. Proteins are known as building blocks of all cells and tissues. They are very important for the growth and development of the body. The proteins are responsible for forming the structural part of most of the organs and help in making up of enzymes and hormones which regulate the functions of the body.

In the blood, two classes of proteins are found which include albumin and globulin. Around 60% of the total protein is formed of albumin which is produced by the liver. Albumin works as a carrier protein for various small ions and molecules. It also acts as a source of amino acids for tissue metabolism and as the principal component which is involved in the maintenance of osmotic pressure.

The rest of the proteins present in the plasma are globulins which include enzymes, antibodies, carrier proteins, hormones, and various other types of proteins. In the blood, the protein total serum levels are relatively stable, which means that there is a fine balance in the loss and production of the protein molecules.

If this delicate balance is disturbed due to any illness or disease then this test is done to analyze the reason for it.

Alanine Transaminase test measures the levels of alanine transaminase in the blood.  Alanine Transaminase is an enzyme which is found in liver and kidney cells. However, this enzyme, in less quantity, can be found in the muscles and the heart. Its function is to convert alanine (an amino acid found in proteins) to pyruvate (intermediate in cellular energy production). 

Generally, these levels of alanine transaminase in the blood remain low in healthy individuals. However, if there is any damage to the liver, alanine transaminase is released in the blood. This process helps in early detection of any damage to the liver. 

The function of the liver is to process the nutrients of the body. It also produces bile which helps in digesting fats along with the production of other important proteins such as blood clotting factors and albumin. The liver breaks the potentially toxic substances into harmless products which can be used or eliminated by the body. 

This test is done with another liver enzyme, aspartate aminotransferase (AST) as a part of the liver panel. In case of damage to the liver, there is a sudden rise in levels of both enzymes. However, alanine transaminase is more specific for the liver. In some cases, it is possible that only one of them is increased. The AST/ALT ratio can be calculated to differentiate between various causes and severity of the liver injury. This can also help to distinguish whether the injury is from damage to the liver or heart or muscles.

Triglycerides test measures the levels of triglycerides in the blood.

Triglycerides are a type of body fat (lipid). Chemically, triglycerides consist of three ("tri-") molecules of fatty acid combined with a molecule of the alcohol glycerol ("-glyceride").

High levels of triglycerides in the blood have been linked to atherosclerosis which increases the risk of heart disease (Coronary Artery Disease), peripheral artery disease, stroke and kidney disease. Atherosclerosis is a disease in which plaque (made up of fat, cholesterol, calcium, and other substances) builds up inside the arteries (blood vessels) resulting in narrowing of the lumen. This restricts the flow of blood to the organs and other parts of the body. Signs and symptoms of atherosclerosis usually do not appear until severe or total blockage of the artery (blood vessel). Therefore, most people are not aware of atherosclerosis until they have a medical emergency, such as a heart attack or stroke.

Increased levels of triglycerides may also be seen in Metabolic syndrome (cluster of metabolic risk factors for cardiovascular disease, type 2 diabetes and stroke). Very high triglyceride levels can also cause inflammation of the pancreas (pancreatitis).

Triglycerides test is usually done as a part of lipid profile which includes other tests like cholesterol, HDL (High-density lipoprotein), LDL (Low-density lipoprotein), VLDL (Very low-density lipoprotein) also.