Complete blood count

Hematology test

■ Hematology test (Complete blood count)

Blood cells are broadly divided into three categories: red blood cell series tests (hemoglobin
concentration, red blood cell count, hematocrit level, etc.), which are related to anemia; white
blood cell count, which is related to immunity, infection and inflammation; and platelet count,
which is related to bleeding and hemostasis.

■ Diseases detected by the test

In the red blood cell series tests, Hb (hemoglobin concentration) is the most important indicator.
A low Hb level is suspected of anemia, and a high Hb level is suspected of polycythemia.
A severely decreased or increased white blood cell count is suspected of so-called blood
cancer (hematopoietic tumor) such as leukemia. A severe decrease in platelet count is suspected
of idiopathic thrombocytopenic purpura or side effects of drugs, while a severe increase is suspected
of hematopoietic tumor.

Lipid profile

■Lipid profile

These tests measure total cholesterol level, LDL cholesterol level (bad cholesterol), HDL cholesterol level (good cholesterol), Triglycerides level (TG; triglycerides), etc.

■Diseases detected by tests

LDL cholesterol is a protein that transports serum cholesterol from the liver to tissues. When it becomes excessive, it accumulates in arterial walls and causes arteriosclerosis. On the other hand, HDL cholesterol is a protein that transports excessive cholesterol from tissues back to the liver. Since it works in an inhibitory manner against arteriosclerosis, a shortage of HDL cholesterol can cause arteriosclerosis. Neutral fat plays a role in supplying fatty acids as energy in the body. Excess of triglycerides accumulates in the liver and fat cells, causing fatty liver, subcutaneous fat increase, and arteriosclerosis.

Glucose metabolism

■Glucose metabolism

This is a test to check the ability of the body to process serum glucose. Insulin is required to bring glucose from the blood vessels to each organ cells. Diabetes is a disease in which the body lacks insulin or in which insulin does not function properly. In clinical, fasting plasma glucose, which is measured after being fast for at least 10 hours, and HbA1c, which is the average plasma glucose level over the past one month or two, are measured.

■Diseases detected by tests

If either of the two is high, the patient is “pre-diabetic” and requires additional tests and follow-up. If both are high, the diagnosis is “diabetes mellitus” and medication and exercise therapy are required. There are no symptoms in the early stages of the disease. But if diabetes progresses or is left untreated, it could cause microvascular lesions such as retinopathy, nephropathy, and neuropathy. These diseases can lead to blindness and the need for hemodialysis. In addition, there is a higher risk of life-threatening macrovascular lesions such as myocardial and cerebral infarction. Wounds also become more difficult to heal, and diabetic gangrene can occur.

Liver and biliary function

■ Liver and biliary function

The liver and biliary system function tests are used to evaluate hepatocellular damage (inflammation and necrosis), liver synthesis, detoxification and excretion.

■Diseases detected by tests

AST (GOT) and ALT (GPT), called transaminases, are enzymes that catalyze chemical reactions in the liver cells. When hepatocytes are damaged, they are released into the bloodstream, causing the values to rise. ALT often elevates in viral chronic hepatitis and obese fatty liver. In cirrhosis, acute hepatitis, and alcoholic hepatitis, AST often elevates. Gamma-GTP elevates in alcohol consumption and drug-induced disorders. Together with ALP and bilirubin, it is called a biliary enzyme. It is also elevated when the bile ducts are obstructed by gallstones, bile duct cancer, or pancreatic cancer. Total protein and albumin levels are related to nutritional status and immunity. Low albumin levels are suspected of poor nutritional status and inflammation, while abnormally high levels of total protein are suspected of blood cancer (hematopoietic tumor).

Pancreatic function

■Pancreatic function

The pancreas has an exocrine function to secrete digestive enzymes and an endocrine function to secrete hormones. Serum amylase level, which reflects the exocrine function, is mainly measured in physical examinations and health check-ups.

■Diseases detected by the test

If the amylase level is high, diseases such as pancreatitis and pancreatic cancer are suspected, but since it is also secreted by salivary glands, it may also be caused by salivary gland diseases. It needs to be confirmed by a detailed examination.

Kidney function

■Kidney function

The Creatinine level, eGFR – estimated glomerular filtration rate (calculated from the Creatinine level and Urea Nitrogen level) are measured. Creatinine is a waste product released to the bloodstream. Under normal circumstances, most of it is filtered out by the glomeruli of the kidneys and discharged in the urine. When kidney function declines, it is not discharged and accumulates in the blood.

■Diseases detected by tests

It is possible to diagnose chronic kidney disease at an early stage. It is estimated that 25.61 million people in Japan, or 13% of the adult population, have chronic kidney disease over the age of 20. Abnormalities in urine tests and eGFR are used to diagnose the disease, but many patients in the early stage of the disease have normal urine tests. Chronic kidney disease is a pre-dialysis condition, and early diagnosis can prevent the disease from progressing to dialysis.

Uric acid

■Uric acid

Uric acid is a metabolite that results from the breakdown of purine. Purine is found in a variety of foods, mainly beer and other alcoholic beverages and meat. Purine is also found in the nucleus of human cells.

■Diseases detected by tests

Hyperuricemia is a risk factor for gout and urinary tract stones. It has also been suggested to be related to hypertension and chronic kidney disease. If hyperuricemia is detected, lifestyle changes such as diet and exercise are necessary. If a gout attack is detected or the level is over 9.0 mg/dL, drug treatment is necessary. In the case of severe hypouricemia, there is a possibility of a genetic disorder.