Prime Health Package-2

The kidneys are a pair of bean-shaped organs located on either side of the spinal column in the abdomen towards the back. The kidneys perform a number of important functions. The most important of these is that they filter the blood and separate the waste products generated out of regular metabolic activities of the body, primarily urea. Following the separation, the kidneys excrete the waste products out of the body through urine. They help in maintaining the normal pH level and water balance of the body. The kidneys also play essential roles in the synthesis of Vitamin D and Red Blood Cells (RBCs).

The Kidney Function Test includes the following tests to monitor kidney function:

·  Blood Urea Nitrogen (BUN)/ Urea:

Blood Urea Nitrogen is a test to measure the amount of urea nitrogen present in the blood. Urea is a nitrogenous by-product of the metabolism of protein, and its level in blood serves as an indication of the amount of nitrogen present in blood as urea. In simpler terms, BUN is the measure of the amount of nitrogen present in blood in the form of urea. High BUN levels in the blood can be caused as a result of kidney diseases, dehydration and obstruction in the urinary tract due to kidney stones, prostate gland enlargement, etc.

Urea test measures the level of urea in the blood. Urea is a final waste product formed from the breakdown of proteins. Urea is filtered out of the blood by the kidneys to excrete excess nitrogen present in the blood through urine. Excess of urea in blood is called uremia and can be caused by a number of conditions including kidney diseases.

·  Uric Acid:

This test measures the level of uric acid in the blood. Uric acid is a waste product formed from the breakdown of purines, which are essential building blocks of DNA. It is also produced by the metabolism of proteinaceous food, especially red meat. Uric acid is excreted from the body by the kidneys through urine and a small portion through stool. The uric acid test indicates the level of uric acid in the blood and serves as an indirect estimation of the proper functioning of the kidneys.

The presence of excess amounts of uric acid in the blood is called hyperuricemia, and causes gout due to the accumulation of uric acid crystals in the synovial fluid between joints. Hyperuricemia also causes the formation of hard lumps of uric acid crystals called tophi under the skin and at the top of the ears. Uric acid crystals can also accumulate in the kidneys and cause kidney stones.

·  Creatinine:

This test measures the level of Creatinine in blood. Creatinine is a waste product formed from the normal breakdown of muscles in the body. Creatinine is almost completely excreted by the kidneys, so their levels in the blood serve as an indication of kidney function.

Excess creatinine in the blood can be found due to decreased elimination from the kidneys as well as due to increased creatinine production by muscular breakdown, eating cooked meat, protein supplements, etc.

·  BUN/Creatinine Ratio:

BUN/Creatinine Ratio compares the levels of nitrogen as urea in blood to the levels of creatinine in the blood. This ratio serves as a more accurate representation of kidney function. It is also used to check for dehydration since the BUN level increases in dehydration while creatinine levels remain the same. Low BUN to creatinine ratio can be caused due to a low protein diet, liver cirrhosis, rhabdomyolysis (muscle disease), syndrome of inappropriate antidiuretic hormone secretion (SIADH) as well as during pregnancy.

LFT measures the level of liver enzymes, proteins, and bilirubin in the blood.

The liver is a wedge-shaped organ located in the right upper part of the abdomen. The liver helps in the synthesis of certain proteins, produces bile (an alkaline compound which helps in the breakdown of fat), process the bilirubin (a yellowish substance produced from the breakdown of hemoglobin) and helps in removing ammonia and other toxins (harmful substances) from the body. It plays an important role in the metabolism of fats, protein, and carbohydrates. It stores glycogen, vitamins, and minerals as well as helps in the metabolism (breakdown) of certain drugs.

Many diseases affect the health of the liver like hepatitis A, hepatitis B, hepatitis C, alcoholic hepatitis, autoimmune hepatitis, cirrhosis, non-alcoholic fatty liver disease (NAFLD), bile duct obstruction, liver or bile duct cancer and many others. Liver function can also be affected by various risk factors like alcohol abuse, certain drugs, sedentary lifestyle, and obesity. Regular monitoring of liver function is essential for early detection of any liver abnormality.

LFT is a group of tests that measure the levels of Aspartate Aminotransferase (AST), Alanine Aminotransferase (ALT), Alkaline Phosphatase (ALP), Total protein, Bilirubin and Gamma Glutamyltransferase (GGT) in blood. Each component has its own significance and helps to understand a particular aspect of the liver function.

Alanine Aminotransferase (ALT)

 Alanine Aminotransferase (ALT) is an enzyme and this test measures the level of this enzyme in the blood. ALT is also known as serum glutamic-pyruvic transaminase (SGPT) and is mainly found in the liver, but also in smaller amounts in the kidneys, heart, pancreas and muscles. This enzyme is released into the bloodstream in case of liver disease or damage leading to increased ALT blood levels, a specific indicator of liver injury. However, this test cannot determine the extent or severity of the liver damage.

Aspartate Aminotransferase (AST)

This test measures the level of the enzyme AST in your blood. It is also known as serum glutamic-oxaloacetic transaminase (SGOT). AST is found in the liver and is released in the blood in large amounts in case of any liver injury. AST levels are usually measured along with ALT as AST is not specific for liver (also found in the heart, skeletal muscle and other organs). Your doctor may also recommend an ALT/AST ratio to help in the diagnosis.

Alkaline phosphatase (ALP)

This test measures the blood levels of the enzyme ALP which is found in the liver (one of the main source), bile ducts, bones, intestine, pancreas and kidney. ALP helps to break down proteins in the body. Diseases that mainly harm or damage the cells of the liver and bile duct, leading to overproduction and release of this enzyme into the bloodstream. This causes increased blood ALP levels.

Total Serum Protein

This test measures the total amount of protein in the blood, which includes two major types of proteins: albumin and globulin. The test report mentions separate results for total protein, albumin, globulin and albumin/globulin ratio (A/G ratio).

The level of proteins in the blood indicates the biosynthetic capacity of the liver. Hepatocytes (liver cells) are unable to synthesize this protein in certain liver diseases leading to a fall in protein levels in the blood.

Albumin is synthesized only in the liver. It helps to transports minerals, enzymes, hormones, bilirubin and some medicines throughout your body. It prevents the fluid from leaking out of your blood vessels into the tissues.

Globulin is synthesized in the liver and by the cells of the immune system. It plays a key role in fighting infections and transports many enzymes, hormones, minerals and some medicines in the body.

Bilirubin

This test measures the amount of bilirubin in the blood. Bilirubin is a waste product formed by the breakdown of red blood cells and is processed by the liver.

Bilirubin blood test report includes separate values for direct (conjugated) bilirubin, indirect (unconjugated) bilirubin, and total bilirubin.

When heme is released from the hemoglobin, it is converted to bilirubin. This is called unconjugated (indirect) bilirubin which is carried to the liver by some proteins.

In the liver, bilirubin gets attached (conjugated) to modified sugars (glucuronic acid) and form conjugated (direct) bilirubin.

Both these forms can be measured or estimated by laboratory tests, and a total bilirubin result (includes both direct and indirect bilirubin) is also measured.

A damaged liver can’t properly process bilirubin, leading to abnormally high levels of bilirubin in the blood. Increased unconjugated bilirubin in the blood results due to its overproduction or improper uptake by the liver. Increased conjugated bilirubin results can be seen in diseases that reduce the rate of secretion of conjugated bilirubin into the bile or the flow of bile into the intestine resulting in a backward flow of conjugated bilirubin into the blood.

Gamma-glutamyltransferase (GGT)

This test measures the level of the enzyme GGT in your blood which is present in large amounts in the liver. It is a transport molecule and it helps the liver to metabolize many drugs and toxins. GGT is a very sensitive test for detecting any liver disease especially due to alcohol abuse and is also one of the first enzymes to rise in patients with bile duct obstruction like tumor or stones.

The ESR test measures the rate at which red blood cells (erythrocytes) settle (sediment) at the bottom of a tube that contains a blood sample in one hour. The test result is expressed in millimeters per hour (mm/hr).

In the presence of inflammation, certain proteins mainly fibrinogen increase in blood. This high proportion of fibrinogen in the blood causes the red blood cells to form a stack (rouleaux formation) which settle quickly due to their high density.

The ESR test is a non-specific measure of inflammation. An ESR can be affected by conditions other than inflammation also. Although a high ESR can detect the presence of inflammation, it cannot provide any information regarding the cause and site of inflammation. Hence, an ESR test is done along with other tests.

IgE test measures the amount of IgE (immunoglobulin E) in the blood. It is an antibody produced by the immune system in response to danger. Normally, it is present in very small amounts in the blood. It belongs to the class of immunoglobulins which include five types of immunoglobulins:  IgA, IgG, IgM, IgD, and IgE. 

Immunoglobulins are produced by plasma cells (specific immune cells) when the body recognizes bacteria, viruses, other microorganisms or any other unknown substances as harmful foreign antigens to the immune system. 

The production of IgE is seen in cases of response to allergens such as asthma and response to parasitic infections. Other allergens can include plant pollen, eggs, peanuts, bee venom, strawberries, and other allergens substances. 

These IgE antibodies, once produced, bind to white blood cells and lead to the release of substances like histamine. This further causes constriction of bronchi in the lungs in allergic or asthmatic persons. Other signs and symptoms which can develop in these patients include running nose, skin itching, itchy eyes. 

The severity of the reaction depends upon the body’s exposure to allergens which can be observed from mild reddening and itching of skin to problems in breathing (respiratory distress) to vomiting and diarrhea to conditions of shock. 

Blood is made up of different types of cells suspended in a fluid called plasma. These include erythrocytes or red blood cells, leukocytes or white blood cells, and platelets. Blood cells are produced by the hematopoietic cells in bone marrow and are then released into circulation. RBCs carry oxygen to the tissues, platelets help in blood clotting at a site of injury, and leukocytes form a part of the immune system of the body. WBCs are of five primary types: neutrophils, basophils, eosinophils, monocytes, and lymphocytes. Lymphocytes are further of three types: B-Lymphocytes, T-Lymphocytes, and natural killer (NK) cells. Neutrophils, basophils, eosinophils are collectively called granulocytes since they contain granules in cytoplasm.

Depending on various factors like age, gender, health condition, environmental factors, etc., varying amounts of different types of WBCs circulate in the blood. The bone marrow increases the production of WBCs in response to an infection or inflammation anywhere in the body. These WBCs are called to the site by a series of chemical signals, where they work to treat the condition. During this time, the total leukocyte count remains high in blood. Once the infection or inflammation subsides, WBC production by bone marrow decreases and WBC count in circulation falls back to normal levels. A continuously elevated WBC count may thus be an indication of a chronic condition that is not resolving naturally and might need urgent attention.

Apart from an infection or inflammation, WBC count in blood can also be affected by other conditions like disorders of the immune system, autoimmune conditions, cancer, etc. WBC count may be higher or lower than normal in these cases.

WBC count test serves as an indication of a condition affecting the body. Further tests are performed to confirm a particular condition and direct treatment.

Calcium (Ca) Test measures the levels of calcium in blood. Calcium is essential for body processes including cell signaling, blood clotting, contraction of muscles, and functioning of nerves. It plays a crucial role in the formation and maintenance of healthy bones. Deficiency of calcium results in Osteoporosis, a disease in which the bones lose their density and become soft and fragile, causing them to fracture very easily.

About 99% of the total amount of calcium received by the body is bound as calcium complex in bones, and the remaining 1% lies in blood circulation. Of the amount of calcium circulating in the blood, about half remains bound to albumin protein or other ions and are metabolically inactive, while the remaining half remains free and metabolically active. Blood Calcium tests can be of two types: Total Calcium Test used to measure the total calcium concentration in blood including both the free and bound forms, and Ionized Calcium Test used to measure the concentration of only the metabolically active form.

Calcium levels in the blood are maintained within a very narrow range by a number of mechanisms. Deviation from the normal range of calcium concentration causes Hypocalcemia (low levels of calcium), or Hypercalcemia (excess of calcium). Both these conditions impact normal body processes in the short term and may give rise to other conditions in the long term.

A blood calcium test cannot be used to check for a lack of calcium in your diet or for osteoporosis (loss of calcium from bones) as the body can have normal calcium levels even in case of dietary deficiency of Calcium. The body can augment mild calcium deficiency by releasing the calcium stored in bones.

The Thyroid Profile Free Test measures the levels of the following three hormones in the blood:
Thyroid Stimulating Hormone (TSH)
Thyroxine (T4) - Free
TriIodothyronine (T3) - Free

The thyroid gland (a small, butterfly-shaped gland located in front of the neck) secretes the following hormones:
Triiodothyronine (T3)
Thyroxine (T4)
Thyroid Stimulating Hormone (TSH) is a hormone secreted into the blood by Pituitary gland (a gland present in the brain). It directs thyroid gland to produce and release the thyroid hormones (T3 & T4) into the blood. The iodine from the food stimulates the thyroid gland to make the thyroid hormones.
The thyroid hormones regulates the growth and metabolism of the body. If the thyroid gland produces very high amounts of these hormones (T3 and T4), you may experience symptoms of weight loss, rapid heartbeat, tremors, sweating, anxiety, increased sensitivity towards heat, etc. and this is known as Hyperthyroidism.
The decreased production of thyroid hormones (T3 and T4) results in Hypothyroidism which may cause weight gain, fatigue, slow heart rate, increased sensitivity towards cold, depression, dry and thin hair, etc.
There is a feedback system in the body to maintain stable amounts of the thyroid hormones (T3 and T4) in the blood. When the levels of thyroid hormones decrease, the pituitary gland is stimulated to release TSH. High TSH in turn increases the release of T3 and T4 hormones from the thyroid gland and vice-versa.
T3 and T4 circulate in the blood in two forms:
1) Bound form - It is bound to proteins present in blood and this prevents it from entering the body tissues. The three main proteins in the blood that the thyroid hormones are bound to are albumin, transthyretin and Thyroxine-binding globulin (TBG), also called Thyroid hormone Binding Globulin (THBG).
2) Free form - It enters the body tissues where it is needed.
The total T3 or total T4 includes both the bound and the free forms circulating within the blood. Hence, thyroid hormones can be measured as Free T3, Total T3, Free T4 and Total T4.
The Thyroid Profile Free Test measures the free forms of T3 and T4 i.e. FT3 and FT4 along with TSH.

The hemoglobin test measures the amount of hemoglobin in the blood.

Hemoglobin (Hb) is a protein found in red blood cells (RBCs) that carries oxygen from the lungs to the body tissues, and to exchange the oxygen for carbon dioxide. Hemoglobin then carries the carbon dioxide back to the lungs and where it is exchanged for oxygen. Iron is an essential part of hemoglobin. Most blood cells, including red blood cells, are produced regularly in your bone marrow (present within the cavities of many of large bones). To produce hemoglobin and red blood cells, your body needs iron, vitamin B12, folate and other nutrients from the foods you eat.

A decrease in hemoglobin concentration in blood results in anemia. Anemia is a blood disorder characterized by a decrease in the total amount of red blood cells (RBCs) or hemoglobin in the blood or a lowered ability of the blood to carry oxygen to body organs and tissues. Anemia is the most common blood disorder, affecting about a third of the global population and can cause symptoms like tiredness (fatigue), weakness, shortness of breath etc.

The hemoglobin test is usually performed as a part of complete blood count (CBC) test.

CRP Test measures the levels of CRP in blood to detect the presence of an inflammation or to monitor the treatment and progress of an inflammatory condition. C-reactive Protein or CRP is an acute phase reactant protein which is produced and secreted by the liver in response to an inflammation in the body, which may be caused by tissue injury, infection, or autoimmune diseases. CRP levels increase in patients with trauma, heart attack, autoimmune diseases, bacterial infections, sepsis, post surgery, cancer, etc. CRP levels are often increased before the onset of other symptoms of inflammation such as pain, fever, etc. CRP levels in blood fall as the inflammation subsides.

It is a non-specific test. It can neither diagnose a condition by itself nor can it determine the location of a particular inflammation or disease. Other tests along with physical examination are performed to diagnose a particular condition and determine the location.

A variant of the CRP test is the High Sensitivity C-reactive Protein Test (hs-CRP) which is more sensitive for CRP levels and can detect blood CRP levels at a lower concentration than the standard CRP Test. The hs-CRP Test is performed usually to determine the risk of development of cardiovascular diseases in otherwise healthy individuals.

Glycosylated Hemoglobin Test measures the percentage of glycosylated hemoglobin in blood which reflects the average blood glucose over a period of past two to three months (8 - 12 weeks).

Hemoglobin is the protein found in Red Blood Cells and is responsible for transporting oxygen. Of the different types of hemoglobin, Hemoglobin A is predominant. With the elevation of blood sugar levels, some glucose binds spontaneously to Hemoglobin A (this binding is called Glycosylation or Glycation) and remains bound for the complete lifetime of the RBC, which is 120 days normally. Higher the level of glucose in the blood, greater is the amount of it binding to Hemoglobin A. Hemoglobin A1c is the dominant form of Glycated Hemoglobin. As RBCs die and are replaced, Hemoglobin A1c is cleared and slowly replaced with non-glycosylated hemoglobin. Measurement of HbA1c level over a period of time gives an indication of the level of glucose in the blood over the specified period of time. This helps in the diagnosis of Diabetes and is useful for monitoring the effectiveness of measures taken to reduce blood sugar levels.

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. 

Magnesium is a mineral micronutrient which plays essential roles in body processes including enzyme functions, energy production by metabolism, contraction of muscles, and nerve functioning. It also helps in the metabolism of calcium and hence helps in the maintenance of healthy bones. Magnesium is supplied to the body from dietary sources and is absorbed in the small intestine and colon. It is subsequently absorbed into the bones and tissues. Only about 1% of the total amount of magnesium absorbed remains in the blood within a narrow normal range. The normal range of magnesium concentration is maintained in the body by utilizing the amount absorbed from food and excreting the excess through urination.

Deviation from the normal range of magnesium concentration causes Hypomagnesia (shortage of magnesium), or Hypermagnesia (excess of magnesium). Both these conditions impact normal body processes in the short term and may give rise to other conditions in the long term.

A low ferritin level, indicates iron deficiency, while an excess build up of ferritin can be suggestive of a condition called hemochromatosis that can cause organ and tissue damage. Higher than the normal levels can also indicate other serious medical conditions such as liver disease and cancer.

Iron is an essential micronutrient that is required by the body in trace amounts. It plays an essential role in the formation and functioning of red blood cells or RBCs. RBCs transport oxygen from the lungs to other body tissues.

Ferritin is stored in the liver, spleen, bone marrow, and skeletal muscles. When iron levels in the blood drop, it is recovered from these stored iron reserves.

Iron deficiency may occur due to insufficient dietary consumption of iron, excessive loss of blood from injuries, bleeding during periods, during pregnancy, etc. Iron deficiency could also be because of diseases like Celiac disease which prevent absorption of nutrients from food.

 Increased ferritin levels in the blood may occur due to excess iron consumption through diet or iron supplements, multiple blood transfusions within a short duration, liver damage, alcoholism, or due to conditions like hemochromatosis where the body absorbs excessive iron from food. 

Ferritin Test is performed in combination with other iron measurement tests like Iron Test, Total Iron Binding Capacity (TIBC) Test, and Unsaturated Iron Binding Capacity (UIBC) Test. The results are interpreted accordingly.

It gives us a measure of one of the components of the white blood cells , called Neutrophils. While all white blood cells help your body fight infections, neutrophils are important for fighting against bacterial infection.

The absolute eosinophil count measures the number of eosinophils present in the blood. Eosinophils, a  type of white blood cells, helps in fighting the disease. These come into action for are said to be linked with certain infections and allergic diseases. The eosinophils are produced and mature in the bone marrow. They usually take about 8 days to mature and then are moved to blood vessels.

The eosinophils have varied functions which include the physiological role in organ formation such as the development of post-gestational mammary gland. Other functions include its movement to the areas of inflammation, trapping substances, killing cells, bactericidal and anti-parasitic activity. It also helps the treatment of immediate allergic reactions and modulation of inflammatory responses.

Vitamin B12 is a part of B complex of vitamins. Vitamin B12 is also called as Cobalamin. It is a water soluble vitamin. Vitamin B12 plays an important role in formation of normal red blood cells, repair of tissues, DNA synthesis and genetic material in cells. It is not produced in the body and has to be taken in diet. The diet sources include red meat, fish, milk, poultry, yoghurt, eggs, fortified cereals, breads and other grain products. It can also be taken in the form of Vitamin B12 tablets or multivitamin pills. The deficiency of Vitamin B12 results in macrocytic anemia (size of red blood cells larger than normal).

Megaloblastic anemia is a type of macrocytic anemia, in which large size red blood cells called as macrocytes are produced. These red blood cells are fewer in number. There is a decrease in white blood cell count and platelet count. Megaloblastic anemia occurs due to acquired deficiency of Vitamin B12. The reason can be an inadequate dietary intake of Vitamin B12 or any problem in the absorption of Vitamin B12 from the intestines.

In case of problem in the absorption of Vitamin B12 from intestines, it is known as Pernicious anemia. It occurs due to lack of intrinsic factor which is present in secretions of the stomach.

Vitamin B12 is also important for nerve health and is taken as a nutritional supplement for the treatment of nerve damage.

Vitamin B12 binds with intrinsic factor (protein secreted by cells in the stomach). After binding, a complex is formed which is absorbed by the small intestine. In case of any disease interfering in this process can cause weakening of absorption of Vitamin B12.   

The platelet count measures the number of platelets present in the blood. Platelets are also known as thrombocytes which are tiny fragments of cells. These are formed from large cells which are found in the bone marrow known as megakaryocytes. After the platelets are formed, they are released into the blood circulation.

Whenever there is an injury to a tissue or blood vessel, bleeding starts. At this point, platelets help in stopping the bleeding in three ways:

• The platelets will adhere to the injury site

• The platelets will accumulate at the injury site 

• The platelets will release chemical compounds which stimulate gathering of other platelets

With these steps, a loose platelet connection forms at the site of injury. This process is known as primary hemostasis. The activated platelets start to support the coagulation cascade which involves a series of steps that includes the sequential activation of clotting factors. This process is known as secondary hemostasis which results in the formation of fibrin strands that knit through the loose platelet connection to form a fibrin net. After that, the connection is compressed to form a stable clot so that it remains in place until the injury heals. Once the injury is healed, other factors come into play and break it down so that it gets removed. 

In case the platelets are not sufficient in number or are not functioning properly, a stable clot might not form. These unstable clots can result in an increased risk of excessive bleeding. 

The Vitamin B9 test measures the levels of Vitamin B9 in the blood. Vitamin B9 also known as folate is a part of the B complex of vitamins. It is important for the formation of normal red blood cells, tissue and cell repair, and synthesis of DNA. This vitamin cannot be produced in the body, and hence it has to be taken in the diet. 

Folate is the naturally occurring form of the vitamin, while folic acid is referred to as a supplement which is added to food and drinks. This vitamin is found in food sources such as green leafy vegetables, citrus fruits, peas, dry beans, yeast, and liver. Apart from these food sources, Vitamin B9 can be found in fortified cereals (in which minerals are added), bread, and other grain products.

The deficiency of Vitamin B9 can lead to macrocytic anemia in which the size of red blood cells becomes larger than normal. Such type of macrocytic anemia includes Megaloblastic anemia which is characterized by the production of fewer but larger red blood cells. These red blood cells are known as macrocytes. Along with this, white blood cells may also get reduced and low platelet count can be seen.

Vitamin B9 is important for cell division such as in the case of developing a fetus. The deficiency of this vitamin during early pregnancy can expose the growing fetus to the risk of neural tube defects such as spina bifida. 

The cause of Vitamin B9 deficiency can be due to not taking supplements or diet rich in Vitamin B9, inadequate absorption of this vitamin or at the time of pregnancy when the requirement of this vitamin increases.

The Lipid Profile Test typically measures the levels of total cholesterol, HDL cholesterol, LDL cholesterol, and triglycerides. Other results that may be reported include VLDL cholesterol, non-HDL cholesterol, and total cholesterol to HDL cholesterol ratio.

Lipids are fatty acids which store energy for the body and play essential roles in cellular structure and cell signaling. Cholesterols and triglycerides are essential lipids, carried in the blood by lipoprotein particles made up of cholesterol, triglycerides, proteins and phospholipid molecules. The lipoprotein particles are classified according to their densities into High Density Lipoproteins (HDL), Low Density Lipoproteins (LDL), and Very Low Density Lipoproteins (VLDL).

Cholesterol is a fat-like substance formed in the liver, as well as obtained from dietary sources. It is found in all the cells and is an essential part of the structural framework of the cells apart from performing various vital body processes. However, excess cholesterol is harmful. Increased cholesterol in blood can cause it to get deposited on the inner walls of the blood vessels forming plaque.

Triglycerides are the commonest type of fat in the body. Triglycerides are obtained from dietary sources and form the stored fat in adipose tissues. Increase in triglyceride concentration can also give rise to cardiovascular diseases.

High Density Lipoproteins or HDLs are high density particles which help to reduce the chances of cardiovascular diseases by picking up and carrying lipoprotein particles of lower density to the liver for disposal.

Low Density Lipoproteins or LDLs are lipoprotein particles of low density which carry cholesterol to the tissues. Cholesterol carried by LDLs easily comes out of blood and get deposited on the inner walls of the blood vessels, increasing the chances of cardiovascular diseases.

Very Low Density Lipoproteins or VLDLs are lipoprotein particles of very low density which carry triglycerides to the tissues. Excess triglycerides in blood causes increase in VLDL particles which in turn again increases the chance of developing cardiovascular diseases.

Plaque deposition makes the lumen of the blood vessels narrower thereby preventing proper flow of blood and may stop the flow completely. Excessive plaque deposition can also cause the arteries to harden, giving rise to a condition called Atherosclerosis. Improper flow of blood prevents the supply of nutrients and oxygen to the vital organs and may cause heart attack or stroke.

Glucose - Fasting Blood Test is done to measure the levels of glucose in blood during period of fasting.

Glucose is the main source of energy for body. Carbohydrates consumed in the diet are broken down in the body to glucose, which is absorbed by the intestines and transported by the blood to various organs. The cells of these organs utilize the glucose to produce energy when required, and the excess is stored either as glycogen in the liver for short-term storage or in fat tissues as triglycerides for long-term storage. The uptake, utilization, and storage of glucose after it is absorbed in the intestines is facilitated by the hormone- insulin which is secreted by the pancreas. Insulin influences the transport of glucose to the organs like heart, brain, working muscles, etc. It also directs storage of excess glucose. The action of insulin reduces sugar levels in the blood.

After a meal, sugar levels increase in blood and insulin is secreted in response to reduce sugar levels until it becomes normal. If glucose levels fall too low in blood, another pancreatic hormone called glucagon is released, which directs the liver to convert stored glycogen into glucose and releases it into the blood. The insulin and glucagon hormones create a feedback mechanism to keep blood glucose levels within the normal range. Imbalance in their activity causes an excess or shortage of blood sugar.

Glucose - Fasting blood Test helps to determine if the body is able to utilize or store glucose efficiently. High levels of sugar in blood indicates diabetes or resistance to insulin. Type 1 Diabetes is caused when insulin is not produced or produced in very little quantity. Type 2 Diabetes is caused when insulin produced is not utilized effectively by the body. In both these cases, blood sugar level rises, while cells are deprived of nutrition.

About 99% of the total amount of calcium received by the body is bound as calcium complex in bones, and the remaining 1% lies in blood circulation. Of the amount of calcium circulating in the blood, about half remains bound to albumin protein or other ions and are metabolically inactive, while the remaining half remains free and metabolically active. Blood Calcium tests can be of two types: Total Calcium Test, used to measure the total calcium concentration in blood, including both the free and bound forms, and Ionized Calcium Test, used to measure the concentration of only the metabolically active form. Ionized calcium provides a more physiologically accurate assessment of calcium, especially in the presence of high protein concentrations, hyperparathyroidism and hypoparathyroidism.