
What Do The Following Lab Test Reports Indicate?

1-I have a 21 anion gap? Usually mine is 10-13 so what is causing that? Concerns?
2-My glucose is 105, it was 99 last year. My LDL is good and my HDL went from 24-36 this year but my Tri went to 244. I havent done any exercise this year due to my PVC's worrying about a AFIB attack.
3-Bun Creatine is 27.7? This was above last time at 23 but both Bun and creatine alone are withing range?
4-My ALT is 43, a few years ago it was 90 then went to 36 last year? Any concerns
5-Last my PSA came back 1.18 and said it was high? I thought 3 and below is good.
Any suggestions on my labs? I see cardiologist in 2 weeks
thanks
I would explain as follows:
Detailed Answer:
Hello!
Welcome back on HCM!
Regarding your concern, Let me explain as follows:
1- An increased anion gap may be helpful at revealing certain pathological issues which may lead to pronounced difference between primary measured cations and anions (respectively sodium, potassium and chloride, bicarbonate).
So, certain issues like acidosis (diabetic ketoacidosis, lactic acidosis), renal failure, or certain drugs (like salicylates, alcohol, etc), etc. could be suspected facing such test result.
BUT, you should know that anion gap is a secondary helpful marker and could not be considered separated from the clinical symptomatology and other test results. In your case, as almost every other test is within normal ranges it is probable that anion gap be just erroneously concluded (by non properly integrating the correct time of blood sample drawing and processing, or not considering concomitant therapy, etc.)
For better concluding on such a parameter, I recommend to check a full arterial blood gas analysis, complete blood electrolytes levels.
2- You blood glucose level and lipid profile are actually around the upper limit of normal ranges.
In this regard, a glycosylated hemoglobin level(HbA1C) would be necessary to conclude for the body glucose metabolism.
Your cholesterol/HDL ratio is greater than 3.5 (in fact 5.6), posing you at great risk for developing atherosclerosis. Coming to this point, besides a strict dietary modulation, I would recommend starting a statin drug (atorvastatin, rosuvastatin, etc).
3- Your BUN/creatinine ratio doesn't appear problematic, as the separated components of this ration and what is most important your eGFR is quite normal.
4- Your ALT is around the upper limit of normal ranges. No concern for the moment. Just check it again after a couple of months.
5- Your PSA is quite normal for your age (0 - 2 ng/ml for 40 - 49 years).
So, nothing serious seems to be revealed by your actual lab tests.
I recommend to discuss with your doctor on the above recommended issues.
Hope to have been helpful to you!
Kind regards,
Dr. Iliri

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