Analytes and Their Clinical Significance

This contains reference ranges as well as clinical significance of measured analytes regarding diagnosis/symptoms

Reference Range: Total Bilirubin

0.2-1mg/dL

Reference Range: BUN

6-20mg/dL

Reference Range: Calcium, total

8.6-10mg/dL

Reference Range: Chloride

98-107mEq/L

Reference Range: Creatinine, general

(Varies between men and women)

0.6-1.2mg/dL

Reference Range: Glucose, fasting

70-99mg/dL

Reference Range: Potassium

3.5-5.1 mEq/L

Reference Range: Sodium

136-145mEq/L

Reference Range: Total Protein

6.4-8.3g/dL

Reference Range: Uric Acid (Male)

3.5-7.2 mg/dL

Reference Range: Uric Acid (Female)

2.6-6 mg/dL

Analytes that increase in the A.M. (Diurinal Variation)

ACTH (Adrenocorticotropic Hormone)

Cortisol

Iron

Analytes that increase in the P.M. (Diurinal Variation)

Growth hormone

PTH (Parathyroid Hormone)

TSH (Thyroid Stimulating Hormone)

Analytes that vary DAY-TO-DAY

>20% for:

ALT (Alanine Aminotransferase)

Bilirubin (Bili)

Creatinine Kinase (CK)

Steroid Hormones

Triglycerides

Analytes INCREASED by recent food ingestion

Glucose

Insulin

Gastrin

Triglycerides 

Sodium

Uric Acid

Iron

Lactate Dehydrogenase (LD)

Calcium

Analytes DECREASED by recent food ingestion

Chloride

Phosphate

Potassium

Analytes that REQUIRE FASTING

Fasting glucose

Triglycerides

Lipid Panel

Analytes INCREASED by ALCOHOL consumption

Triglycerides

GGT (Gamma Glutamyl Transferase)

Analytes DECREASED by ALCOHOL consumption

Glucose

Analytes increased by POSTURE

Albumin

Cholesterol

Calcium (when standing)

Analytes increased by ACTIVITY in ambulatory patients

(meaning able to walk)

CK

Analytes increased by EXCERCISE

Potassium

Phosphate

Lactic acid

Creatinine/ Creatinine Kinase

Protein

AST (Aspartate aminotransferase)

LD

Analytes increased by STRESS

ACTH

Cortisol

Catecholamines

Using Isopropyl alcohol wipes to disinfect a venipuncture site can…

Compromise blood alcohol determination

Which analyte is increased when the site of capillary puncture is squeezed?

Potassium

Which analytes are increased when a fist is pumping during venipuncture?

Potassium

Lactic acid

Calcium

Phosphorus

Which analytes are decreased when a fist is pumping during venipuncture?

pH

Which analytes are increased when the tourniquet is on >1 min?

Potassium

Total protein

Lactic acid

Analytes increased by IV fluid contamination

Glucose

Potassium

Sodium

Chloride (depending on IV)

Possible dilution of other analytes

In the K₂EDTA tube, what happens when the incorrect anticoagulant or contamination from the incorrect order of draw occurs?

Increased: Potassium

Decreased: Calcium, Magnesium

In the Sodium heparin tube, what happens when the incorrect anticoagulant or contamination from the incorrect order of draw occurs?

Sodium increased if tube is not completely filled

In the Lithium heparin tube, what happens when the incorrect anticoagulant or contamination from the incorrect order of draw occurs?

Lithium increased

In the Gel tubes, what happens when the incorrect anticoagulant or contamination from the incorrect order of draw occurs?

Some gels may interfere with trace metals and certain drugs

Inadequate centrifugation leads to poor barrier formation in gel tubes, which can result in the increase of which analytes?

Potassium

LD

AST

Iron

Phosphorus

Recentrifugation of primary tubes can effect..

Hemolysis and increase potassium

What analytes are increased when there is a delay in separating serum/plasma? (unless gel tubes are used)

Ammonia

Lactic acid

Potassium 

Magnesium

LD

What analytes are decreased when there is a delay in separating serum/plasma? (unless gel tubes are used)

Glucose (Unless collected in fluoride tubes)

Analytes that are decreased when kept at room temp

Glucose (Unless collected in fluoride)

Analytes that are increased when kept at room temp

Lactic acid

Ammonia

Analytes that are decreased at 4C

LD

Analytes that are increased at 4C

ALP (Alkaline Phosphatase)

Which analytes are higher in plasma than serum?

Total Protein

LD

Calcium

Which analytes are higher in serum than plasma?

Potassium

Phosphate

Glucose

CK

Bicarbonate

ALP

Albumin

AST

Triglycerides

Which analytes are higher in plasma than whole blood?

Glucose

Which analytes are higher in capillary blood than venous blood?

Glucose (in postprandial specimen)

Potassium

Which analytes are higher in venous blood than capillary blood?

Calcium

Total protein

Which analytes are higher in red blood cells than plasma?

Potassium

Phosphate

Magnesium

Which analytes are higher in plasma than red blood cells?

Sodium 

Chloride