【Pathology】Laboratory Values

1. Albumin (ALB) 血清白蛋白

• Normal range: 3.4–5.4 g/dL
• Function: 
• Maintain the osmotic pressure of the blood compartment
• Provide nourishment of the tissues
• Transport hormones, vitamins, drugs, and other substances such as calcium throughout the body
• Low: May have malnutrition, liver disease or an inflammatory disease.
• High: Maybe caused by dehydration, acute infections, burns, and stress from surgery or a heart attack.
• Disease: Hypoalbuminemia, Albuminuria

2. Alkaline phosphatase (ALP &ALKP) 碱性磷酸酶 

• Normal range: 20–140 IU/L
• Function:
• Protect intestinal tract against bacteria
• Aid in digestion, breakdown fats and some B vitamins
• Promote bone formation
• Low: Indicate a deficiency in zinc and magnesium
• High: May indicate bone, liver, or bile duct disease
• Disease: Hypophosphatasia (HPP)--affect bone & teeth, Hepatitis

3. Bicarbonate 碳酸氢盐

• Normal range: 23–30 mM
• Function: Maintain the body's acid-base (pH) balance. 
• Low: 酸
• Is making too much acid
• Isn't getting rid of enough acid
• Doesn't have enough base to offset a normal amount of acid
• High: 碱
• too many alkali-producing bicarbonate ions
• too few acid-producing hydrogen ions
• Both low & high----having trouble maintaining its acid-base balance, eg
• Failing to remove carbon dioxide through the lungs or the kidneys 
• An electrolyte imbalance, particularly a deficiency of potassium.
• Disease: Metabolic acidosis, Metabolic alkalosis

4. Bilirubin 胆红素

• Normal range: 
• Bilirubin, direct (conjugated): <0.3 mg/dL
• Bilirubin, indirect (unconjugated): 0.1–1.0 mg/dL
• Bilirubin, total: 0.1–1.2 mg/dL
• Function: 
• gives solid waste products (feces) their characteristic colour.
• protect cells against lipid peroxidation (Antioxidant)
• Low: 
• usually not a concern, mostly side effect of a medication (aspirin) or having too much coffee
• High:
• Bilirubin, direct (conjugated):
• Cholestasis 
• Genetic disorders – Dubin johnson syndrome and rotor’s syndrome 
• Bilirubin, indirect (unconjugated):
• Hemolytic anemia. This means your body is getting rid of too many red blood cells.
• Genetic disorders – crigler najjar and gilbert’s syndrome
• Neonatal jaundice/physiological jaundice
• Bilirubin, total:
• Intrahepatic /liver disorder
• Disease: Diseases (Low), Diseases (High)

*Difference between direct and indirect Bilirubin:

5. Blood Urea Nitrogen (BUN) 血尿素氮

• Normal range: 8–23 mg/dL
• Function: determine kidneys function
• Urea nitrogen is a waste product that’s created in the liver when the body breaks down proteins. 
• Low: Low protein diet, may have
• Liver disease
• Malnutrition 
• Overhydration (having too much fluid)
• High: high protein diet, may have
• Dehydration
• Urinary tract obstruction (blockage from being able to pee)
• Congestive heart failure
• Disease: Diabetes (High BUN)

6. Calcium

• Normal range: 9.2–11.0 mg/dL (4.6–5.5 meq/L)
• Function:
• Strengthening bones and teeth 
• Regulating muscle functioning, such as contraction and relaxation
• Regulating heart functioning
• Blood clotting
• Transmission of nervous system messages
• Enzyme function
• Low: 
• Low blood protein levels, especially a low level of albumin, which can result from liver disease or malnutrition, both of which may result from alcoholism or other illnesses. 
• People who are acutely ill. With low albumin, only the bound calcium is low. Ionized calcium remains normal, and calcium metabolism is being regulated appropriately.
• High:
• Hyperparathyroidism, an increase in parathyroid gland function
• Cancer: 
• cancer spreads to the bones
• cancer produces a hormone similar to PTH
• Disease: Hypocalcemia, Hypercalcemia

7. Chloride

• Normal range: 95–103 meq/L
• Function:
• Electrolytes in the blood
• Maintain proper blood volume, blood pressure, and pH of body fluids
• Low: May have Dehydration, Kidney disease, Acidosis, Alkalosis
• High: May have Heart failure, Lung diseases, Addison's disease
• Disease: Hypochloremia, Hyperchloremia

8. Cholesterol

• Normal range: 
• 
  
  
  
  
• Function:
• Production of sex hormones
• Bile production in the liver
• Production of Vitamin D
• Maintain the integrity and fluidity of cell membranes
• Low: 
• May having statins, hyperthyroidism, adrenal insufficiency, liver disease, malabsorption (inadequate absorption of nutrients from the intestines), malnutrition and so on.
• High: 
• Increase your risk of heart disease, or having diabetes, Chronic kidney disease, HIV/AIDS, Hypothyroidism, and so on.
• Disease: Hypocholesterolemia, Hypercholesterolemia

9. Creatinine 肌酐

• Normal range: 0.6–1.2 mg/dL
• Function: Determine kidney function
• Creatinine is a waste product that comes from the normal wear and tear on muscles of the body
• Low: May have Muscle disease (eg. muscular dystrophy), liver disease or Excess water loss. 
• High: May have 
  • Kidney damage or kidney failure
  • Kidney infection
  • Reduced blood flow to the kidneys
  • Dehydration

10. GGT (γ-glutamyltransferase)

• Normal range: 5–40 IU/L
• Function:
• A transport molecule, helping the liver metabolize drugs and other toxins
• Catalyzes the transfer of the gamma-glutamyl group of glutathione to peptides, amino acids, or water to form glutamate.
• Low: unlikely have liver disease or have consumed any alcohol. 
• (If elevated ALP with a low or normal GGT means is more likely due to bone disease)
• High: Liver or bile duct damage, Chronic alcohol abuse
• Disease: Low Gamma-GT Intrahepatic Cholestasis, 

11. Glucose (fasting)

• Normal range: < 99 mg/dL
• 100 to 125 mg/dL = have prediabetes, 
• 126 mg/dL or higher = have diabetes.
• Function:
• A test to determine how much glucose (sugar) is in a blood sample after an overnight fast. 
• commonly used to detect diabetes mellitus.
• A primary role for the glucose molecule is to act as a source of energy
• Low: May have hypoglycemia
• High: 
  • Body has been unable to lower the levels of sugar in the blood 
• Point to insulin resistance or inadequate insulin production, or both
• Disease: Hypoglycemia, Diabetes mellitus

12. Insulin

• Normal range: 4–24 μIU/mL
• Function: Regulate blood sugar levels
• Low: Too much insulin or other diabetes
• High: Caused by long-term stress, infections, long-term sleep deprivation, obesity and pregnancy
• Disease: Hypoglycemia, Hyperinsulinemia

13. Iron

• Normal range:
• Male: 65 to 176 µg/dL 
• Female: 50 to 170 µg/dL
• Iron saturation: 25% to 35%
• Function:
• Blood production
• Oxygenate the blood
• Convert blood sugar to energy
• Boosts the immune system
• Supports healthy skin, hair and nails
• Low: May caused by blood loss, poor diet, or an inability to absorb enough iron from foods.
• High: May have iron poisoning
• Disease: Iron deficiency anemia, Hemochromatosis

14. Osmolality

• Normal range: 275 to 295 mOsm/kg
• Function: Determine whether a person has ingested a toxin such as methanol or ethylene glycol (antifreeze)
• Low: Particles are more diluted (excess fluid intake or over hydration)
• High: More particles in your serum (dehydration, diabetes insipidus, head trauma)
• Disease: Hyponatremia, Diabetes insipidus

15. Phosphorus

• Normal range: 3.4 to 4.5 mg/dl (1.12 to 1.45 mmol/L)
• Function:
• keep bones strong and healthy
• help make energy
• move muscles
• Low: Caused by poor diets or eating disorders
• High: May have kidney disease
• Disease: Hypophosphatemia, Hypoparathyroidism

16. Potassium

• Normal range: 3.5 to 5.0 mmol/L
• Function: An essential mineral and electrolyte involved in heart function, muscle contraction, and water balance
• Low: Muscles feel weak, cramp, twitch, or even become paralyzed, and abnormal heart rhythms may develop
• High: Heart may beat irregularly, which in the worst cases, can cause heart attack
• Disease: Hypokalemia, Hyperkalemia

17. Protein

• Normal range: 6.0 to 8.3 g/dL
• Function:
• Growth and maintenance of tissues
• Causes Biochemical Reactions
• Acts as a Messenger
• Provide cells and tissues with stiffness and rigidity
• Maintains Proper pH
• Regulate body processes to maintain fluid balance
• Form immunoglobulins, or antibodies, to fight infection
• Transports and Stores Nutrients
• Provides Energy
• Low: May cause muscle wasting and increase the risk of bone fractures
• High: May indicate dehydration or a certain type of cancer, such as multiple myeloma
• Disease: Hypoproteinemia, Amyloidosis

18. Sodium

• Normal range: 135 to 145 mEq/L
• Function:
• Regulate osmotic pressure and fluid balance
• Regulate acid-base balance in association with chloride and bicarbonate
• Absorption of glucose, galactose, aminoacids
• Cell permeability
• Low: May caused by consumption of too many fluids, kidney failure, heart failure, cirrhosis, and use of diuretics
• High: May caused by Excess thirst, Infrequent urination, Vomiting, Diarrhea
• Disease: Hyponatremia, Hypernatremia

19. Thyroid hormones

• Normal range: 
• T3 resin uptake: 24% to 37%
• Thyrotropin (TSH): 0.5 to 5.0 mIU/L
• Thyroxine, free (FT4): 0.8 to 1.8 ng/dL
• Thyroxine, total (T4): 5.0 to 12.0 μg/dL
• Triiodothyronine (T3): 100 to 200 ng/dL
• Function: blood test performed as part of an evaluation of thyroid function
• Thyroid hormones: regulate many body processes, including growth, energy balance, body temperature, and heart rate.
• triiodothyronine (T3) and thyroxine (T4).
• Low: May have hypothyroidism
• High: May have hyperthyroidism
• Disease: Hypothyroidism, Hyperthyroidism

20. Platelet count

• Normal range: 150,000 to 450,000/μl
• Function: Blood clotting
• Low: May have dangerous internal bleeding
• High: bone marrow to make too many platelets
• Disease: Thrombocytopenia, Thrombocytosis

21. White cell count

• Normal range: 4500–11000/μL
• Function: Create antibodies to fight against bacteria, viruses, and other potentially harmful invaders
• Low: Indicator of lupus, rheumatoid arthritis, vitamin deficiencies, or a side effect of cancer treatment or increases risk of developing a potentially life-threatening infection
• High: Indicate that the immune system is working to destroy an infection
• Disease: Leukocytosis (High)

22. Lymphocyte count

• Normal range: 1,000–4,800/μL (about 34%)
• Function: antibody production, direct cell-mediated killing of virus-infected and tumor cells, and regulation of the immune response
• Low: Hard to fight infection
• High: Indicate body is dealing with an infection or other inflammatory condition
• Disease: Lymphocytopenia, Leukemia
  

23. Mean corpuscular volume (MCV)

• Normal range: 80–96 μm3
• Function: Measures the average size of your red blood cells, also known as erythrocytes
• Red blood cells move oxygen from lungs to every cell in your body. Cells need oxygen to grow, reproduce, and stay healthy.
• Low: Red blood cells are smaller than average
• High: Red blood cells are larger than average
• Disease: Microcytic anemia, Macrocytic anemia

24. Mean corpuscular hemoglobin (MCH)

• Normal range: 27.5–33.2 pg
• Function: The average amount in each of your red blood cells of a protein called hemoglobin, which carries oxygen around your body
• Low: Insufficient hemoglobin
• High: Excessive hemoglobin
• Disease: Microcytic anemia, Macrocytic anemia

25. Mean corpuscular hemoglobin concentration (MCHC)

• Normal range: 33.4–35.5%
• Function: The average concentration of hemoglobin in your red blood cells. Hemoglobin is the protein molecule that allows red blood cells to carry oxygen to tissues within your body.
• Low: Low concentration of hemoglobin
• High: High concentration of hemoglobin
• Disease: Microcytic anemia, Macrocytic anemia

26. Hemoglobin

• Normal range: 
• Female 12–16 g/dL
• Male 13.5–18 g/dL
• Function: Transferring oxygen in your blood from the lungs to the tissues
• Low: May causes symptoms like fatigue and trouble breathing
• High: Body requires an increased oxygen-carrying capacity, usually because smoke

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