ANALYTE: Albumin serum/ plasma
DESCRIPTION: Albumin is a protein made by the liver that keeps fluid from leaking out of blood vessels, nourishes tissues, and transports hormones, vitamins, drugs, and substances like calcium throughout the body.

CLINICAL SIGNIFICANCE: Albumin level is a general indicator of nutritional status and used to assess liver and kidney function.
REFERENCE INTERVALS FOR ADULTS: 3.5-5.2 g/dl
CLINICAL INTERPRETATION:

INCREASE IN:  Dehydration.

DECREASE IN:  Starvation, burns, kidney disease, liver disease.

ANALYTE: Alkaline phosphatase (ALP)
DESCRIPTION: An enzyme found in many tissues, especially Liver, bone, intestine and kidney.
CLINICAL SIGNIFICANCE: Assess to detect bone disease and liver disease
REFERENCE INTERVALS FOR ADULTS: 98-279 U/L.

CLINICAL INTERPRETATION:

INCREASE IN: Liver disease, bone disease and periods of bone growth

DECREASE IN: Low phosphate, hypothyroidism, pernicious anemia

ANALYTE: Allergy screening
DESCRIPTION: Eighty common allergens are screened for
CLINICAL SIGNIFICANCE: Person with signs or symptoms that suggest an allergy to one or more  substances
REFERENCE INTERVALS FOR ADULTS: Negative /Positive.
CLINICAL INTERPRETATION:

POSITIVE: Indicates that the person likely has an allergy

NEGATIVE: Indicate that a person probably does not have a true allergy.

ANALYTE: Alpha-fetoprotein (AFP)
DESCRIPTION: Alpha-fetoprotein (AFP) is a glycoprotein that is produced in early fetal life by the liver and by a variety of tumors including hepatocellular carcinoma, hepatoblastoma, and non seminomatous germ cell tumors of the ovary and testis.

CLINICAL SIGNIFICANCE: Intended only as an adjunct to diagnose and monitor therapy for certain cancers of the liver, testicles, or ovaries. For pregnant women, to assess the risk of having a baby with certain chromosomal disorders, such as Down syndrome (trisomy 21) or Edwards syndrome (trisomy 18), or open neural tube defects.

REFERENCE INTERVALS FOR ADULTS: - <7.22 IU/mL.
 

CLINICAL INTERPRETATION:

INCREASE IN: Liver cancer, cancer of the ovary, germ cell tumor of the testicles, cirrhosis, hepatitis, other cancers such as stomach, colon, lung, breast, and lymphoma.

DECREASE IN: NA

ANALYTE: Amylase
DESCRIPTION: Digestive enzyme secreted by salivary and pancreatic glands responsible for digestion of carbohydrates.
CLINICAL SIGNIFICANCE: To diagnose and monitor pancreatitis other disorders that may involve the pancreas.
REFERENCE INTERVALS FOR ADULTS: < 85 U/L
CLINICAL INTERPRETATION:

INCREASE IN: Acute pancreatitis, blocked pancreatic ducts.

DECREASE IN: kidney disease, toxemia of pregnancy

ANALYTE: Anti DNA antibody
DESCRIPTION: Detects presence of antibodies to native or double stranded DNA
CLINICAL SIGNIFICANCE: Help diagnose lupus (systemic lupus erythematosus, SLE) in a person who has a positive result on a test for antinuclear antibody (ANA).
REFERENCE INTERVALS FOR ADULTS: Negative/Borderline/Positive.

CLINICAL INTERPRETATION:

POSITIVE: Lupus Nephritis, rheumatoid arthritis, SLE.

ANALYTE: Anti mullerian hormone
DESCRIPTION: Hormone produced by reproductive tissues, including the testicles in males and the ovaries in females

CLINICAL SIGNIFICANCE: Assessing ovarian status, including ovarian reserve and ovarian responsiveness, as part of an evaluation for infertility and assisted reproduction protocols such as in vitro fertilization.
REFERENCE INTERVALS FOR ADULTS: Needs clinical correlation
CLINICAL INTERPRETATION: - 0.8 - 12.6 ng/ml.

INCREASE IN:  Polycystic ovarian syndrome (PCOS), Granulosa cell tumors of the ovary, increased or excessive responsiveness to IVF.

DECREASE IN: onset of menopause, low ovarian reserve.

ANALYTE:  Anti Nuclear Antibody (ANA)
DESCRIPTION: Antibodies against nuclear components of its own cells.
CLINICAL SIGNIFICANCE: Suspicion of autoimmune disease
REFERENCE INTERVALS FOR ADULTS: Negative/Borderline/Positive.

CLINICAL INTERPRETATION:

POSITIVE:  SLE, Drug-induced lupus, Sjögren syndrome, Scleroderma

ANALYTE: Antistreptolysin O (ASO)
DESCRIPTION: An antibody to Streptolysin O, a toxin made by the Group A streptococcus bacteria.
CLINICAL SIGNIFICANCE: Detect a recent streptococcal infection in a patient who has symptoms that may be due to an illness caused by a previous streptococcal infection. REFERENCE INTERVALS FOR ADULTS:  Cutoff: <200 IU/mL
CLINICAL INTERPRETATION: -

INCREASE IN: Recent strep infection.

DECREASE IN: NA

ANALYTE: Anti thrombin III
DESCRIPTION: Inactivates thrombin and other coagulation factors.
CLINICAL SIGNIFICANCE: Hypercoagulability
REFERENCE INTERVALS FOR ADULTS: 80-120%
CLINICAL INTERPRETATION:

INCREASE IN: Vitamin K deficiency

DECREASE IN: Cirrhosis, congenital anti thrombin III deficiency, DVT, DIC.

ANALYTE: Apolipoprotein A-I
DESCRIPTION: Protein portion of HDL
CLINICAL SIGNIFICANCE: Cardiac risk assessment.
REFERENCE INTERVALS FOR ADULTS: Male 94-178 mg/dl; Female 101-199 mg/dl
CLINICAL   INTERPRETATION:

INCREASE IN: Estrogen therapy, alcohol consumption, pregnancy

DECREASE IN:  Smoking, Chronic kidney disease, Uncontrolled diabetes.

ANALYTE: Apolipoprotein B
DESCRIPTION: Protein portion of VLDL and LDL
CLINICAL SIGNIFICANCE: Cardiac risk assessment

REFERENCE INTERVALS FOR ADULTS: Male 63-133 mg/dl; Female 60-126 mg/dl

CLINICAL INTERPRETATION
INCREASE IN:  Diabetes, Hypothyroidism, Nephrotic syndrome.

DECREASE IN:  Hyperthyroidism, Malnutrition, certain medications.

ANALYTE: Beta-human chorionic gonadotropin (β- HCG)
DESCRIPTION: Β-HCG is a protein produced in the placenta during pregnancy.

CLINICAL SIGNIFICANCE: Confirms pregnancy, aids in the diagnosis of gestational trophoblastic disease (GTD), testicular tumors, ovarian germ cell tumors, teratomas, and other human chorionic gonadotropin (hCG)-secreting tumors.
REFERENCE INTERVALS FOR ADULTS:

NON-PREGNANT FEMALES: < 5.0 mIU/ml
DURING NORMAL PREGNANCY: -

 1st WEEK: 10 - 30 mIU/ml
2nd WEEK: 30 - 100 mIU/ml

 3rd WEEK: 100 - 1,000 mIU/ml
4th WEEK: 1,000 - 10,000 mIU/ml

2nd & 3rd MONTH: 30,000 - 100,000 mIU/ml
2nd TRIMESTER: 10,000 -30,000 mIU/ml

3rd TRIMESTER: 5,000 - 15,000 mIU/ml
CLINICAL INTERPRETATION:

INCREASE IN: Pregnancy, testicular tumors, ovarian germ cell tumors, teratomas.

DECREASE IN: NA

ANALYTE: Bilirubin Total
DESCRIPTION: Breakdown product of hemoglobin. Excreted by the liver into the bile.
CLINICAL SIGNIFICANCE: To assess liver function
REFERENCE INTERVALS FOR ADULTS: 0.1-1.2 mg/dl
CLINICAL INTERPRETATION:

INCREASE IN: Hepatitis, cirrhosis, hemolytic disease and obstruction of biliary or hepatic ducts.

DECREASE IN: NA.

ANALYTE: Bilirubin Direct (Conjugated bilirubin)
DESCRIPTION: The conjugated form is water-soluble, made in the liver and excreted in the blood.
CLINICAL SIGNIFICANCE: To test the liver's ability to conjugate bilirubin and excrete it.
REFERENCE INTERVALS FOR ADULTS: <0.3 mg/dl
CLINICAL INTERPRETATION:

INCREASE IN: Obstruction of biliary or hepatic ducts, and in hereditary conditions like Dubin-Johnson syndrome

DECREASE IN: NA.

ANALYTE: Bilirubin Indirect (Unconjugated bilirubin)
DESCRIPTION: The unconjugated form is fat-soluble and the product of hemoglobin breakdown.
CLINICAL SIGNIFICANCE: To assess liver function

REFERENCE INTERVALS FOR ADULTS: 0.1-1.0 mg/dl
CLINICAL INTERPRETATION:

INCREASE IN: Hereditary conditions like Gilbert's disease and Crigler-Najjar syndrome, hemolytic disease.

DECREASE IN: NA.

ANALYTE: Cytoplasmic- Antineutrophil cytoplasmic antibodies (C-ANCA)
DESCRIPTION: Antineutrophil cytoplasmic antibodies (ANCA) are autoantibodies produced by a person's immune system that mistakenly target and attack proteins within the person's neutrophils.
CLINICAL SIGNIFICANCE:  Evaluating patients suspected of having autoimmune vasculitis

REFERENCE INTERVALS FOR ADULTS: Negative/Positive.
CLINICAL INTERPRETATION:

POSITIVE: Wegener granulomatosis, Glomerulonephritis, inflammatory bowel disease, polyarthritis nodosa

ANALYTE: Calcium
DESCRIPTION: Mineral required for bone formation and for blood clotting and important in nerve and muscle function.
CLINICAL SIGNIFICANCE: A blood calcium test is ordered to screen for, diagnose, and monitor a range of conditions relating to the bones, heart, nerves, kidneys, teeth and if a person has symptoms of a parathyroid disorder.
REFERENCE INTERVALS FOR ADULTS: 8.6-10.3 mg/dl
CLINICAL  INTERPRETATION:

INCREASE IN: Hyperparathyroidism, some cancers, excess vitamin D intake

DECREASE IN: Hypoparathyroidism, vitamin D deficiency, chronic kidney disease, pancreatitis.

ANALYTE: Calprotectin
DESCRIPTION: Protein occurring in large amount in neutrophil granulocytes.
CLINICAL SIGNIFICANCE: Fecal calprotectin is measured to detect bowl inflammation severity.
REFERENCE INTERVALS FOR ADULTS: Negative
CLINICAL INTERPRETATION:

POSITIVE:  Inflammatory bowel disease, bacterial infections.

ANALYTE: Cancer Antigen 125 (CA-125)
DESCRIPTION: Protein that is glycoprotein antigen normally expressed in tissues derived from coelomic epithelia (ovary, fallopian tube, peritoneum, pleura, pericardium, colon, kidney, stomach)

CLINICAL SIGNIFICANCE: Confirm diagnosis, Monitor treatment and Determine recurrence of Ovarian Cancer.
 REFERENCE INTERVALS FOR ADULTS: - 0-35 U/mL.
CLINICAL INTERPRETATION: -

INCREASE IN: Ovarian cancer, nonovarian malignancies including cervical, liver, pancreatic, lung, colon, stomach, biliary tract, uterine, fallopian tube, breast, and endometrial carcinomas, benign conditions including cirrhosis, hepatitis, endometriosis, first trimester pregnancy, ovarian cysts, and pelvic inflammatory disease

ANALYTE: Cancer Antigen 15-3 (CA 15-3)
DESCRIPTION: Protein that is produced by normal breast cells.

CLINICAL SIGNIFICANCE: To monitor the response to treatment of breast cancer and to help watch for recurrence of the disease
REFERENCE INTERVALS FOR ADULTS: - <35 U/ml.
CLINICAL INTERPRETATION: -

INCREASE IN: Breast cancer, cancer of the lung, pancreas, ovary, prostate, and colon, benign conditions including cirrhosis, hepatitis, and benign breast disorders.

ANALYTE: Total Carbon dioxide/ Bicarbonate
DESCRIPTION: Major anion that buffers blood to physiologic pH of 7.4
CLINICAL SIGNIFICANCE: - As part of an electrolyte panel to identify or monitor an electrolyte imbalance or acid-base (pH) imbalance

REFERENCE INTERVALS FOR ADULTS: 22-28 mEq/L
CLINICAL INTERPRETATION:

INCREASE IN: Metabolic alkalosis, Severe, prolonged vomiting and/or diarrhea, Lung diseases, including COPD, Cushing syndrome, Conn syndrome

DECREASE IN: Metabolic acidosis, Addison disease, Chronic diarrhea, Diabetic ketoacidosis

ANALYTE: Carcinoembryonic antigen (CEA)
DESCRIPTION: Carcinoembryonic antigen (CEA) is a glycoprotein normally found in embryonic entodermal epithelium.
CLINICAL SIGNIFICANCE: Monitor treatment and Determine recurrence of colon cancer.
REFERENCE INTERVALS FOR ADULTS: 0-5 ng/ml.
CLINICA  INTERPRETATION: -

INCREASE IN: Colon cancer, medullary thyroid cancer and cancers of the rectum, lung, breast, liver, pancreas, stomach, and ovaries, Non malignant diseases like Ulcerative colitis, Crohn’s disease, Diverticulitis, Peptic ulcer, Chronic pancreatitis, Cirrhosis, Chronic active hepatitis, Ostructive jaundice, Alcoholic liver disease.

ANALYTE: Ceruloplasmin
DESCRIPTION: Protein that binds and transports copper
CLINICAL SIGNIFICANCE: Measured along with serum and or urine copper concentrations to test for disease of copper metabolism like Wilson's disease
REFERENCE INTERVALS FOR ADULTS: 18-45 mg/dl
CLINICAL INTERPRETATION:

INCREASE IN: Copper toxicity.

DECREASE IN: Wilson's disease, copper deficiency, Menkes disease.

ANALYTE: Chloride (Clꜚ)
DESCRIPTION: Major extracellular anion helps regulate the amount of fluid in the body and maintain the acid-base balance.

CLINICAL SIGNIFICANCE - Suspected acidosis or alkalosis

 REFERENCE INTERVALS FOR ADULTS: 98-107 mmol/L
CLINICAL INTERPRETATION:

INCREASE IN: Dehydration, Cushing syndrome, kidney disease

DECREASE IN: Low blood sodium, vomiting, congestive heart failure.

ANALYTE: Cholesterol Total
DESCRIPTION: Important steroid lipid made by the liver and used for production of steroid hormones and cell walls.
CLINICAL SIGNIFICANCE: High cholesterol has been implicated as a risk factor for coronary artery disease.
REFERENCE INTERVALS FOR ADULTS: <200 mg/dl (Desirable)
CLINICAL INTERPRETATION:

INCREASE IN:   Diet high in saturated fat, physically inactive, overweight or obese, smoking, hypothyroidism, uncontrolled diabetes, kidney disease, some inherited conditions.

DECREASE IN: Liver disease, starvation, hyperthyroidism, adrenal insufficiency abetalipoproteinemia, hypobetalipoproteinemia

ANALYTE: Complement C3
DESCRIPTION: Central protein to all complement activation pathway
CLINICAL SIGNIFICANCE: - Unexplained inflammation or edema or symptoms of an autoimmune disorder
REFERENCE INTERVALS FOR ADULTS: 83-177 mg/dl
CLINICAL INTERPRETATION: -

INCREASE IN: Cancer, Ulcerative colitis, Thyroiditis, Acute myocardial infarction, Sarcoidosis.

DECREASE IN: Autoimmune diseases, kidney disease including glomerulonephritis, Cirrhosis, Hepatitis, Recurrent microbial infections, septicemia

ANALYTE: Complement C4
DESCRIPTION: Protein that functions with antigen antibody complexes to activate the complement system.
CLINICAL SIGNIFICANCE: - unexplained inflammation or edema or symptoms of an autoimmune disorder
REFERENCE INTERVALS FOR ADULTS: 29-68 mg/dl
CLINICAL   INTERPRETATION: -

INCREASE IN: Cancer, Ulcerative colitis, Thyroiditis, Acute myocardial infarction, Sarcoidosis.

DECREASE IN: Autoimmune diseases, kidney disease including glomerulonephritis, Cirrhosis, Hepatitis, Recurrent microbial infections.

ANALYTE: Creatine Kinase (CK)
DESCRIPTION: Muscle enzyme. Different forms of the enzyme are specific for different kind of tissue.
CLINICAL SIGNIFICANCE: Indicator of muscle damage.
REFERENCE INTERVALS FOR ADULTS: Male 25-130 U/L Female 10-115 U/L
CLINICAL   INTERPRETATION:

INCREASE IN: Muscle damage, extreme exercise, trauma

DECREASE IN: People with very low muscle mass.

ANALYTE: Creatinine
DESCRIPTION: A waste product from the muscle breakdown of a compound called creatine. Creatinine is excreted into urine by the kidney
CLINICAL SIGNIFICANCE: To evaluate kidney function and monitor therapy for kidney disease. Creatinine may be measured in blood, urine or both to evaluate kidney function
REFERENCE INTERVALS FOR ADULTS: Male 0.7-1.3 mg/dl Female 0.6-1.1 mg/dl
CLINICAL INTERPRETATION:

INCREASE IN: Kidney dysfunction which may be due to a variety of different causes such as drug toxicity, poorly controlled diabetes or inadequate blood flow through the kidneys as seen with shock or congestive heart failure

DECREASE IN: Decreased muscle mass.

ANALYTE: CSF protein
DESCRIPTION: Protein in cerebrospinal fluid; components are similar to those in blood plasma
CLINICAL SIGNIFICANCE: Used to investigate possible disease of the central nervous system
REFERENCE INTERVALS FOR ADULTS: 12-60 mg/dl
CLINICAL INTERPRETATION:

INCREASE IN: Meningitis, tumor of brain or spinal cord, multiple sclerosis, Guillain-Barre syndrome

DECREASE IN: NA.

ANALYTE: C-Reactive Protein (CRP)
DESCRIPTION: CRP is a protein produced in response to infection or inflammatory processes
CLINICAL SIGNIFICANCE: To evaluate the severity of inflammatory diseases like rheumatoid arthritis or inflammatory bowel disease
REFERENCE INTERVALS FOR ADULTS: - <5 mg/l.
CLINICAL INTERPRETATION: -

INCREASE IN: Inflammation, bacterial infection

DECREASE IN: NA.

ANALYTE: Cystatin C
DESCRIPTION: A protein mainly used as a biomarker of kidney function
CLINICAL SIGNIFICANCE: To assess kidney function
REFERENCE INTERVALS FOR ADULTS: Young adult: <0.70 mg/ml Elderly adults: <0.85 mg/ml
CLINICAL INTERPRETATION:

INCREASE IN: Acute renal failure, chronic renal failure, diabetic nephropathy and infections

DECREASE IN: NA

ANALYTE: D-dimer
DESCRIPTION: D-dimer is a breakdown product of blood clots called fibrin degradation products.
CLINICAL SIGNIFICANCE: To determine if blood clots have formed in the circulation, especially DVT. D-dimer is not normally detected in blood.
REFERENCE INTERVALS FOR ADULTS: - <0.5 mg/L.
CLINICAL INTERPRETATION: -

INCREASE IN: venous thromboembolism (VTE), disseminated intravascular coagulation (DIC), surgery, trauma, infection, heart attack, and some cancers or conditions in which fibrin is not cleared normally, such as liver disease

DECREASE IN: NA.

ANALYTE: Estrogen
DESCRIPTION: A female hormone, produced by the ovaries that triggers ovulation.
CLINICAL SIGNIFICANCE: To evaluate causes of infertility and to assess menopause.
REFERENCE INTERVALS FOR ADULTS: Reference values differ with the menstrual cycle phase. Lower values are seen after menopause.

CLINICAL INTERPRETATION:

INCREASE IN:

In Female: Early (precocious) puberty, Tumors of the ovary or adrenal glands, Hyperthyroidism Cirrhosis

In Male: Enlarged breasts (gynecomastia), Tumors of the testicles (testicular cancer) or adrenal glands, Delayed puberty.

DECREASE IN: Turner syndrome, hypopituitarism, female hypogonadism, menopause

ANALYTE: Ferritin
DESCRIPTION: Iron storage protein found primarily inside cells.
CLINICAL SIGNIFICANCE: Ferritin is often tested along with iron and transferring to assess iron status.
REFERENCE INTERVALS FOR ADULTS: Male 20-250 µg/L Female 10-120µg/L
CLINICAL INTERPRETATION:

INCREASE IN: Iron overload, inflammation, multiple blood transfusions, chronic illness.

DECREASE IN: Iron deficiency.

ANALYTE: Fibrinogen
DESCRIPTION: Fibrinogen is a soluble protein that is converted by clotting factors into insoluble fibrin threads that stabilize a clot at a site of injury, protecting the site until it heals.
CLINICAL SIGNIFICANCE: To determine if enough fibrinogen is present for normal blood clotting.

REFERENCE INTERVALS FOR ADULTS: -
CLINICAL INTERPRETATION: -

INCREASE IN: Cancer, Coronary heart disease, myocardial infarction, Stroke, Inflammatory disorders, Trauma, Cigarette smoking, Pregnancy, Peripheral artery disease.

DECREASE IN: End-stage liver disease, severe malnutrition

ANALYTE: Folic acid/ Folate.
DESCRIPTION: Needed for red blood cell function and important for cell division, especially needed in pregnancy for the developing fetus.
CLINICAL SIGNIFICANCE: Measured with Vitamin B12 to determine the cause of macrocytic anemia, and to monitor therapy for low folate.
REFERENCE INTERVALS FOR ADULTS: 3-20 ng/ml
CLINICAL INTERPRETATION:

INCREASE IN: Pernicious anemia 

DECREASE IN: Malabsorption, Decreased folate intake, Alcohol use, Advanced age, Poor dietary intake.

ANALYTE: Gamma Glutamyl-transferase (GGT)
DESCRIPTION: Present in liver and some other tissue.

CLINICAL SIGNIFICANCE: Assess liver disease or damage
REFERENCE INTERVALS FOR ADULTS: Male 2-30 U/L Female 1-24 U/L
CLINICAL INTERPRETATION:

INCREASE IN: Biliary obstruction, alcoholic liver disease

DECREASE IN: NA

ANALYTE: Globulins
DESCRIPTION: Proteins that help in transport and also assist in the blood in clotting.

CLINICAL SIGNIFICANCE: Provides an overall assessment of circulating Immunoglobulins

CLINICAL INTERPRETATION:

INCREASE IN: Infections, multiple myeloma, autoimmunity diseases such as lupus or collagen diseases, chronic inflammatory diseases such as syphilis, waldenstrom's macroglobulinemia, liver disease, Rheumatoid arthritis, ulcerative colitis, carcinoid syndrome, kidney disease.

DECREASE IN: Renal disease, hepatic dysfunction, celiac disease, inflammatory bowel disease (IBD), acute hemolytic anemia, agammaglobulinemia and hypogammaglobulinemia.

ANALYTE: Glucose
DESCRIPTION: A major source of energy for many tissues- regulated by hormones, such as insulin, cortisol and glucagon
CLINICAL SIGNIFICANCE: For diagnosis and monitoring diabetes (high blood glucose reflecting insulin deficiency or insulin resistance); in critical care setting to test metabolic state
REFERENCE INTERVALS FOR ADULTS: Target fasting value 74-106 mg/dl
CLINICAL INTERPRETATION:

INCREASE IN: Diabetes, Cushing's disease, stress

DECREASE IN: Insulin excess, starvation, adrenal insufficiency.

ANALYTE: HbA1c, Glycated hemoglobin
DESCRIPTION: Hemoglobin molecule with a glucose molecule covalently bound in it.
CLINICAL SIGNIFICANCE: In diabetics, gives a good estimate of glucose control over a 3 months period

 REFERENCE INTERVALS FOR ADULTS: Non diabetic 4-6% Diabetic good control <7%
CLINICAL INTERPRETATION: -

INCREASE IN: Diabetes.

DECREASE IN: NA.

ANALYTE: High sensitivity C-Reactive Protein (hs CRP)
DESCRIPTION: Measures CRP at concentrations seen in absence of illness or flare-ups of inflammatory diseases.
CLINICAL SIGNIFICANCE: Usually measured with a lipid panel to evaluate cardiovascular risk, related to levels of inflammation in arteries associated with atherosclerotic plaque.
REFERENCE INTERVALS FOR ADULTS: American Heart Association considers average risk to be hs CRP of 1.0-3.0 mg/L
CLINICAL INTERPRETATION:

HIGH LEVEL: Predictive of an increased risk of a future heart attack, stroke, sudden cardiac death, and/or peripheral arterial disease.

ANALYTE: High Density Lipoprotein (HDL)
DESCRIPTION: HDL removes excess cholesterol from tissue for disposal. Elevated HDL has been found to protect against coronary artery disease.
CLINICAL SIGNIFICANCE: Part of cardiovascular risk profile
REFERENCE INTERVALS FOR ADULTS: >40 mg/dl
CLINICAL INTERPRETATION:

INCREASE IN: Hormone replacement therapy, chronic liver disease

DECREASE IN: Tangier disease, cholestatic liver disease.

ANALYTE: IgA
DESCRIPTION: Protects mucous membranes, found in saliva, tears and sweat. About 10-15% of serum immunoglobulins are IgA
CLINICAL SIGNIFICANCE:- Detection or monitoring of monoclonal gammopathies and immune deficiencies
REFERENCE INTERVALS FOR ADULTS: 113-563 mg/dl
CLINICAL  INTERPRETATION: -

INCREASE IN: Monoclonal gammopathies such as multiple myeloma, primary systemic amyloidosis, monoclonal gammopathy of undetermined significance

DECREASE IN: Primary or secondary immune deficiencies.

ANALYTE: IgG
DESCRIPTION: IgG makes up about 75- 80% of total serum immunoglobulins. IgG confers long term immunity.
CLINICAL SIGNIFICANCE: - Detection or monitoring of monoclonal gammopathies and immune deficiencies
REFERENCE INTERVALS FOR ADULTS: 800-1801 mg/dl
CLINICAL INTERPRETATION: - INCREASE IN: Chronic Infection, Multiple sclerosis.

DECREASE IN: Immunodeficiency, combined immunodeficiency, ataxia telangiectasia, and other primary and acquired immunodeficiency diseases.

ANALYTE: IgM
DESCRIPTION: IgM is the largest immunoglobulin in size and is the first to form in response to an infection. It comprises 10-15% of the circulating immunoglobulins.
CLINICAL SIGNIFICANCE: - Detection or monitoring of monoclonal gammopathies and immune deficiencies
REFERENCE INTERVALS FOR ADULTS: 54-222 mg/dl
CLINICAL INTERPRETATION: - INCREASE IN: Polyclonal immunoglobulin production, macroglobulinemia

DECREASE IN: Primary or secondary immune deficiencies

ANALYTE: IgE
DESCRIPTION: It is present primarily in the skin and mucous membranes and is believed to function in response to environmental antigens and to play a role in allergic reactions
CLINICAL SIGNIFICANCE: Assess allergic conditions.

REFERENCE INTERVALS FOR ADULTS: <100 IU/ml.

CLINICAL INTERPRETATION:

INCREASE IN: Allergic disease, Infections, inflammatory diseases, and malignancies.

DECREASE IN: NA.

ANALYTE: Low Density Lipoprotein (LDL) cholesterol
DESCRIPTION: LDL carries cholesterol from the liver to peripheral tissue. LDL contributes to formation of plaques that clog arteries and lead to coronary heart disease
CLINICAL SIGNIFICANCE: Part of cardiovascular risk profile
REFERENCE INTERVALS FOR ADULTS: <130 mg/dl
CLINICAL INTERPRETATION:

INCREASE IN: High saturated fat diets, inherited disorders of cholesterol metabolism.

DECREASE IN: High fiber intake, drug treatment, inherited lipoprotein deficiency, hyperthyroidism, infection, inflammation, or cirrhosis

ANALYTE: Lactate Dehydrogenase (LDH)
DESCRIPTION: Widely distributed in tissue like heat, lung, liver, kidney, skeletal muscle.
CLINICAL SIGNIFICANCE: General indicator of tissue damage.
REFERENCE INTERVALS FOR ADULTS: 100-190 U/L

CLINICAL INTERPRETATION:

INCREASE IN: Heart attack, liver disease, lung disease, trauma, acute kidney disease, Testicular cancer, lymphoma or other cancers.

DECREASE IN: NA.

ANALYTE: Lactic acid
DESCRIPTION: This metabolite is released from muscle under conditions of anaerobic energy production. If high amount are released into the blood, it can disrupt acid/base balance.
CLINICAL SIGNIFICANCE: To evaluate symptoms that suggest poor oxygen delivery to tissue such as shortness of breath and muscle weakness; to evaluate patients in shock, congestive heart failure or coma
REFERENCE INTERVALS FOR ADULTS: 4.5-19.8 mg/dl
CLINICAL INTERPRETATION:

INCREASE IN: Shock, muscle fatigue, diabetic ketoacidosis, tissue hypoxia, severe infections like meningitis

DECREASE IN: NA.

ANALYTE: Lipase
DESCRIPTION: Digestive enzyme secreted by pancreas and salivary glands responsible for breakdown of triglyceride.
CLINICAL SIGNIFICANCE: To diagnose pancreatitis.
REFERENCE INTERVALS FOR ADULTS: 31-186 U/L
CLINICAL INTERPRETATION:

INCREASE IN: Acute or chronic pancreatitis or other pancreatic disease.

DECREASE IN: NA.

ANALYTE: Magnesium
DESCRIPTION: Essential mineral for enzymes, especially those converting energy for muscle function. Also important in bone structure.
CLINICAL SIGNIFICANCE: Assess symptoms of muscle problems, like weakness, twitching, cramping, or cardiac arrhythmias, kidney disorder or uncontrolled diabetes.
REFERENCE INTERVALS FOR ADULTS: 1.6-2.6 mg/dl
CLINICAL  INTERPRETATION:

INCREASE IN: Renal disease, severe dehydration Hyperparathyroidism, Hypothyroidism

DECREASE IN: Malabsorption, diarrhea, alcoholism, Uncontrolled diabetes, Hypoparathyroidism

ANALYTE: Microalbumin/ Urine albumin.
DESCRIPTION: Albumin is too large to escape from plasma into urine. Its presence in urine signals a problem with the glomerular filtration system of the kidney.
CLINICAL SIGNIFICANCE: Used to monitor kidney function and to screen for early stages of kidney dysfunction in diabetics or people with high blood pressure.
REFERENCE INTERVALS FOR ADULTS: < 30 mg/L

CLINICAL INTERPRETATION:

INCREASE IN: Kidney disease.

DECREASE IN: NA.

ANALYTE: NT-pro BNP

DESCRIPTION: Comes from a protein made in heart cells called pro-BNP. Pro-BNP is cleaved to form BNP which helps regulate blood volume, and an inactive peptide called NT-proBNP
CLINICAL SIGNIFICANCE: Tests for either BNP or NT-proBNP are used to detect and evaluate cardiac failure
REFERENCE INTERVALS FOR ADULTS: < 300 pg/ml.

CLINICAL INTERPRETATION: -

INCREASE IN: Heart failure.

DECREASE IN: NA.

ANALYTE: Occult Blood
DESCRIPTION: Hidden blood loss from stool
CLINICAL SIGNIFICANCE: To detect blood loss of 5 ml per day or more through the GI system
REFERENCE INTERVALS FOR ADULTS: Negative
CLINICAL INTERPRETATION:

INCREASE IN: Presence suggests anal fissure, hemorrhoids, inflammatory bowel disease and colorectal cancer

DECREASE IN: NA.

ANALYTE: Phosphorus (Phosphate)
DESCRIPTION: Mineral important in bone metabolism, energy production and nerve and muscle function.
CLINICAL SIGNIFICANCE: Measured along with other analytes to help diagnose problems with calcium metabolism.
REFERENCE INTERVALS FOR ADULTS: 2.7-4.5 mg/dl
CLINICAL INTERPRETATION:

INCREASE IN: Renal insufficiency, vitamin D overdose, high phosphate intake.

DECREASE IN: Overuse of diuretics or antacids, hyperparathyroidism.

ANALYTE: Potassium
DESCRIPTION: Major intracellular cation responsible for muscle contraction and maintenance of normal heart rate.
CLINICAL SIGNIFICANCE: - May be used to help diagnose and/or monitor kidney disease
REFERENCE INTERVALS FOR ADULTS: 3.5-5.1 mmol/L
CLINICAL INTERPRETATION:

INCREASE IN: Shock, circulatory failure, renal disease, Addison disease, diabetes, potassium sparing diuretics.

DECREASE IN: GI loss (vomiting and diarrhea), diuretic use, Conn syndrome (hyperaldosteronism)

ANALYTE: Prostate Specific Antigen (PSA)
DESCRIPTION: Protein produced primarily by cells in the prostate
CLINICAL SIGNIFICANCE: Screening, diagnosis and monitoring therapy for prostate cancer.
REFERENCE INTERVALS FOR ADULTS:-
CLINICAL INTERPRETATION:-

INCREASE IN: Prostate cancer, benign prostate hyperplasia, inflammation of the prostate.

DECREASE IN: NA.

ANALYTE: Protein C
DESCRIPTION: Proteins in the blood that help regulate blood clot formation
CLINICAL SIGNIFICANCE: Evaluation of patients with recurrent thrombosis
REFERENCE INTERVALS FOR ADULTS: 60-150%
CLINICAL INTERPRETATION:

INCREASE IN: NA

DECREASE IN: Cirrhosis, Vitamin K deficiency, DIC

ANALYTE: Protein S
DESCRIPTION: Cofactor to enhance anticoagulation function of Protein C
CLINICAL SIGNIFICANCE: Evaluation of patients with recurrent thrombosis
REFERENCE INTERVALS FOR ADULTS: 60-150%
CLINICAL INTERPRETATION:

INCREASE IN: NA.

DECREASE IN: Vitamin K deficiency, DIC, renal disease.

ANALYTE: Rheumatoid Factor (RF)
DESCRIPTION: Human IgM autoantibody that is increased in autoimmune diseases like rheumatoid arthritis
CLINICAL SIGNIFICANCE: Ordered as part of an evaluation of joint inflammation and pain to diagnose rheumatoid arthritis.
REFERENCE INTERVALS FOR ADULTS: < 40 IU/ml
CLINICAL INTERPRETATION: -

INCREASE IN: Rheumatoid arthritis, Sjögren syndrome, scleroderma, systemic lupus erythematosus (lupus), sarcoidosis, endocarditis, tuberculosis, syphilis

DECREASE IN: NA.

ANALYTE: SGOT/ Aspartate aminotransferase (AST)
DESCRIPTION: Widely present in tissue especially liver, heart and skeletal muscle.
CLINICAL SIGNIFICANCE: To assess liver disorders.
CLINICAL INTERPRETATION:

INCREASE IN: Liver disease, heart attack, trauma.

DECREASE IN: NA.

ANALYTE: SGPT/ Alanine aminotransferase (ALT)

DESCRIPTION: Enzyme found mostly in the cells of the liver and kidney

CLINICAL SIGNIFICANCE: To assess liver disease, more specific for liver disease than AST.
REFERENCE INTERVALS FOR ADULTS: Male 13-40 U/L Female 10-28 U/L
CLINICAL INTERPRETATION:

INCREASE IN: Hepatitis, cirrhosis, Reye's syndrome, hepatoma, monitor drug induced liver damage.

DECREASE IN: NA.

ANALYTE: Sodium
DESCRIPTION: Major extracellular cation responsible for maintaining fluid balance in circulation

CLINICAL SIGNIFICANCE: -
REFERENCE INTERVALS FOR ADULTS: 136-145 mmol/L
CLINICAL INTERPRETATION:

INCREASE IN: Dehydration, Cushing's syndrome, diabeted insipidus

DECREASE IN: GI loss (diarrhea and vomiting), Addison's disease, renal disease.

ANALYTE: Tacrolimus 
DESCRIPTION: An immunosuppressive drug that is used mainly after organ transplant to reduce the activity of the patient's immune system and so lower the risk of organ rejection. 
CLINICAL SIGNIFICANCE: To evaluate drug levels in transplant patients 
REFERENCE INTERVALS FOR ADULTS: As per duration of transplant.

ANALYTE: Testosterone total
DESCRIPTION: Hormone responsible for development of male secondary sex characteristics; in females it is converted to estradiol, the major female sex hormone.
CLINICAL SIGNIFICANCE: To evaluate infertility or erectile dysfunction in adult males. In boys, to investigate delayed puberty. Infemales, to investigate development of male traits (virilization)
REFERENCE INTERVALS FOR ADULTS: 240-870 ng/dl.

CLINICAL INTERPRETATION:

INCREASE IN: Testicular tumors, Use of androgens, Congenital adrenal hyperplasia,; In female: PCOS, Ovarian or adrenal gland tumor.

DECREASE IN: Hypothalamic or pituitary disease, testicular failure and infertility, Chronic disease, such as diabetes.

ANALYTE: Thyroid Stimulating Hormone (TSH)
DESCRIPTION: Made by the pituitary gland, it maintains stable amounts of thyroid hormones (T3 and T4) in the blood.
CLINICAL SIGNIFICANCE: To screen for or diagnose thyroid disorders; to monitor treatment of thyroid disease.
 REFERENCE INTERVALS FOR ADULTS: 0.4- 4.2 mIU/L
CLINICAL INTERPRETATION:

INCREASE IN: Hypothyroidism.

DECREASE IN: Hyperthyroidism.

ANALYTE: Thyroxine (T4) and triiodothyronine (T3)
DESCRIPTION: T4 is made by the thyroid gland and converted to T3 by the liver. These hormones control energy production (metabolic rate) in tissues.

CLINICAL SIGNIFICANCE: As follow up to an abnormal TSH test. Laboratory tests may measure either the total hormone or free hormone (not bound to protein)
REFERENCE INTERVALS FOR ADULTS:

FT3:  1.71-3.71 pg/ml

FT4:  0.70-1.48 ng/dl.

CLINICAL INTERPRETATION:

INCREASE IN: Hyperthyroidism

DECREASE IN: Hypothyroidism

ANALYTE: TORCH test
DESCRIPTION: Combination of infectious tests
CLINICAL SIGNIFICANCE: Screening test for conceiving mothers and newborn for possible congenital infection
REFERENCE INTERVALS: Negative
CLINICAL INTERPRETATION:

In neonates:

INCREASE IN:  IgM- congenital infection with the indicated virus

                             IgG- transfer of antibody from mother to new born (mother has had past infection)

ANALYTE:Total Iron Binding Capacity (TIBC)
DESCRIPTION: Maximum amount of iron that can be transported by the transferrin in blood.
CLINICAL SIGNIFICANCE: Tests iron status; describes amount of transferrin in terms of its iron transport capacity.
REFERENCE INTERVALS FOR ADULTS: 250-425 µg/dl
CLINICAL  INTERPRETATION:

INCREASE IN: Iron deficiency, pregnancy, acute and chronic blood loss, acute hepatitis DECREASE IN: Hypoproteinemia, Chronic illness, hemochromatosis.

ANALYTE: Total protein, serum/plasma
DESCRIPTION: Measures the amount of protein, primarily albumin and globulins, found in serum or plasma.
CLINICAL SIGNIFICANCE: Assess diseases involving the liver, kidney, or bone marrow, as well as other metabolic or nutritional disorders

REFERENCE INTERVALS FOR ADULTS: 6.4-8.3 g/dl
CLINICAL INTERPRETATION:

INCREASE IN: Dehydration, infections, some cancer like myelomas and lymphomas

DECREASE IN: Protein loss (from kidney or GI tract), liver disease, malnutrition

ANALYTE: Transferrin
DESCRIPTION: Primary protein for transport of iron; made by the liver.
CLINICAL SIGNIFICANCE: Test for iron status
REFERENCE INTERVALS FOR ADULTS: 215-380 mg/dl
CLINICAL INTERPRETATION:

INCREASE IN: Hemolytic anemia, pernicious anemia, hepatitis, hemochromatosis.

DECREASE IN: Iron deficiency, infections, liver disease

ANALYTE: Triglycerides
DESCRIPTION: Triglycerides are a form of fat and a major source of energy for the body
CLINICAL SIGNIFICANCE: Part of cardiovascular risk profile
REFERENCE INTERVALS FOR ADULTS: <250 mg/dl
CLINICAL INTERPRETATION:

INCREASE IN: Hypothyroidism, alcoholism, liver disease, uncontrolled diabetes

DECREASE IN: Abetalipoproteinaemia

ANALYTE: Troponin I
DESCRIPTION: Troponins are intracellular proteins found specially in heart muscle. They are released when there is damage to cardiac cells
CLINICAL SIGNIFICANCE: Diagnosis of heart attack (myocardial infarction, MI)
REFERENCE INTERVALS FOR ADULTS: NEGATIVE

CLINICAL INTERPRETATION: -

POSITIVE: Myocardial infarction, myocarditis, cardiomyopathy, congestive heart failure, severe infections and kidney disease

ANALYTE: Urinary neutrophil gelatinase-associated lipocalin

DESCRIPTION: A protein found in activated neutrophils and many other cells, like kidney tubular cells in response to injury.
CLINICAL SIGNIFICANCE: Acute kidney injury and chronic kidney disease
REFERENCE INTERVALS FOR ADULTS: Needs clinical correlation
CLINICAL INTERPRETATION: -

INCREASE IN:

DECREASE IN:

ANALYTE: Urea
DESCRIPTION: A waste product from protein breakdown formed by the liver and excreted by the kidney.
CLINICAL SIGNIFICANCE: To evaluate kidney function. REFERENCE INTERVALS FOR ADULTS: 20-40 mg/dl
CLINICAL INTERPRETATION:

INCREASE IN: Kidney dysfunction, stress, high protein diet

DECREASE IN: Low protein diet, liver disease

ANALYTE: Uric acid
DESCRIPTION: A waste product from breakdown of purines that is excreted by the kidneys.
CLINICAL SIGNIFICANCE: To evaluate joint inflammation that may be due to gout; often ordered to monitor uric acid production in patients undergoing chemotherapy or radiation therapy
REFERENCE INTERVALS FOR ADULTS: Male 3.5-7.2 mg/dl Female 2.6-6.0 mg/dl
CLINICAL INTERPRETATION:

INCREASE IN: Gout, kidney disease, leukemia

DECREASE IN: NA

ANALYTE: Urine protein
DESCRIPTION: Normally very little protein is found in urine.

CLINICAL SIGNIFICANCE: To evaluate kidney function.

REFERENCE INTERVALS FOR ADULTS: 50-80 mg/day
CLINICAL INTERPRETATION:

INCREASE IN: Kidney failure (nephrotic syndrome), diabetes, hypertension.

DECREASE IN: NA

ANALYTE: Very Low density Lipoprotein (VLDL) cholesterol
DESCRIPTION: Triglyceride-rich lipoprotein that is secreted by the liver and is the precursor to LDL
CLINICAL SIGNIFICANCE: Part of cardiovascular risk profile
REFERENCE INTERVALS FOR ADULTS: <30 mg/dl
CLINICAL  INTERPRETATION:

INCREASE IN: High saturated fat diets, inherited disorders of cholesterol metabolism

DECREASE IN: High fiber intake, drug treatment

ANALYTE: Vitamin B12
DESCRIPTION: Required for red blood cell function and important in nerve function.
CLINICAL SIGNIFICANCE: To identify a deficiency, help diagnose the cause of certain anemias, such as pernicious anemia, an autoimmune disease

REFERENCE INTERVALS FOR ADULTS: 200-835 pg/ml
CLINICAL INTERPRETATION:

INCREASE IN: Some leukemias

DECREASE IN: Malnutrition, malabsorption, pernicious anemia

ANALYTE: Vitamin D
DESCRIPTION: A vitamin synthesized by skin exposure to sunshine and is required for absorption of calcium and phosphorus by the intestinal tract
CLINICAL SIGNIFICANCE: Correlated with different clinical conditions
REFERENCE INTERVALS FOR ADULTS:

Deficient: < 20
Insufficient : 20 - 29
Sufficient : 30 - 100
Potential Toxicity : > 100

CLINICAL INTERPRETATION:

INCREASE IN:  Gastrointestinal symptoms (anorexia, nausea, vomiting, constipation). In infants- failure to thrive, mental retardation

DECREASE IN: anticonvulsants usage, diabetes mellitus, hypoparathyroidism, renal osteodystrophy, renal tubular acidosis