Decreased serum calcium values are found in hypoparathyroidism, rickets, osteiomalacia and steatorrhea. A fall in serum calcium can occun in acute pancreatitis and in those forms of renal disease in which excessive proteinuria is observed. Increased serum calcium values are observed in hyperparathyroidism, hypervitamonosis D and multiple myeloma.
Uric acid is the end product of nucleoprotein metabolism. It is a low threshold excretory product. the serum uric acid level is ofter raised in gout. the determination has diagnostic value differentiating gout from non gout arthritis. uric acid levels are also increased in renal failure, uremia and leukemia.
NOTE :- Lipid profile range as per ncep – atp 111 are :
Serum cholestrol (Total) :
Desirable: < 200 mg/dl, Borderline: 200-239 mg/dl, Elevated : >250 mg/dl.
Serum high – density lipoprotein cholterol (HDL):
Desirable: > 60 mg/dl, Borderline: 40-60 mg/dl, Elevated : >70 mg/dl.
TOTAL cholestrol : HDL cholestrol:
Low risk : 3.3 - 4.4, Average risk : 4.4 – 7.1, Moderate risk : 7.1 – 11.0, High risk : >11.0
Serum low – density lipoprotein (LDL) cholesterol:
Desirable : < 100 mg/dl, Borderline: 100-159 mg/dl, Elevated : >160 mg/dl.
* It is ptreferable to measure lipid after 12 hrs fasting, as triglyceride levels rised and both HDL & LDL levels fall after fat containing meals.
* since serum lipid levels a vary widely from day to day( being largely dependaent on diet) , at least 2 - 3 measurments should be made days or weeks apart , before labelling a person as hyper lipidaemic/ normolipidaemic or before initiating therapy.
*Both LDL & HDL levels remains decreased for several weeks after acute inflammatory states, following myocardial infection, stress, trauma, surgery and recent illness.
* lipid profile values should always be corroborated in the light of clinical findings, dietary habits / axcess/ restrictions, effects of illness, exercise, inter & intra individual variations and drugs( Anabolic steroids, oral contraceptives) progestogens, antithypertensives, oestrogen, insulin & hydrochlorthiazide.
Methodology: Sedimentation
Factors increasing ESR -Old age -Pregnancy -Anemia -Elevated fibrinogen -Macrocytosis
Factors decreasing ESR -Microcytosis -Low fibrinogen -Polycythemia -Marked leukocytosis