💠SERUM CHOLESTEROL:
1- Fasting is not needed unless the cholesterol is part of a lipid profle.
2- Because cholesterol can fluctuate considerably from day to day, at least two samples should be drawn if the frst level is 200 mg/dL or greater.
💢If the second level is within 30 mg/dL of the frst level, the average of the two can be used.
💢 If the frst two samples vary by more than 30 mg/dL, a third sample is needed, and the average of the three isused to guide the treatment plan.
The two or three samples should be drawn within a period of 1–8 weeks.
3- Some drugs, such as vitamin E, phenytoin, and steroids, may cause false elevations, whereas other drugs, such as some antibiotics, may cause falsely low readings.

✳Methods:
1- Spectrophotometry SEE PICTURE
2- Home Testing: Finger sticks can be used for initial screening when an automated analyzer is used.
3- Skin Test: The test can be done in a clinic or an offce.
● An adhesive foam pad is placed on the palm of the hand, and drops of an indicator solution are added to a test well in the pad.
● A handheld spectrophotometer reads the amount of blue color and displays the results on a computer screen.

💠Triglycerides
Triglycerides are composed of three fatty acids and a glycerol moiety.
✳Analyzing :-
a serum or plasma sample for triglycerides typically involves four reactions.

☞The Reaction: -
1⃣Lipase:TGA→3 fatty acids+glycerol

2⃣Glycerol Kinase:Glycerol+ATP→glycerol-3-phosphate+ADP

3⃣Pyruvate Kinase:ADP+phosphoenol pyruvate → ATP+pyruvate

4⃣Lactate Dehydrogenase:NADH+H+pyruvate → NAD+lactate

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Medical Biochemistry 4th ⤵️

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D I A B E T E S S C R E E N I N G
T E S T S

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🔴Diabetes Screening Tests ,

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( hemoglobin A1c, HbA1c, A1C, or Hb1c; sometimes also HbA1c):
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♦️It is a form of hemoglobin which is measured primarily to identify the average plasma glucose concentration over prolonged periods of time. It is formed in a non-enzymatic glycation pathway by hemoglobin's exposure to plasma glucose.

♦️Normal levels of glucose produce a normal amount of glycated hemoglobin. As the average amount of plasma glucose increases, the fraction of glycated hemoglobin increases in a predictable way. This serves as a marker for average blood glucose levels over the previous months prior to the measurement.

♦️The 2010 American Diabetes Association Standards of Medical Care in Diabetes added the A1c ≥ 48 mmol/mol (≥6.5%) as another criterion for the diagnosis of diabetes.
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♦️Laboratory results may differ depending on:
🔸The analytical technique,
🔸The age of the subject,
🔸And biological variation among individuals.

♦️Two individuals with the same average blood sugar can have A1C values that differ by as much as 3 percentage points.

♦️Results can be unreliable in many circumstances, such as :
1⃣After blood loss, for example, after surgery, blood transfusions, anemia, or high erythrocyte turnover;
2⃣In the presence of chronic renal or liver disease;
3⃣After administration of high-dose vitamin C; or erythropoetin treatment.
In general, the reference range (that found in healthy persons), is about 20-40 mmol/mol (4%-5.9%).

♦️The approximate mapping between HbA1c values given in DCCT percentage (%) and eAG (estimated average glucose) measurements is given by the following equation:

eAG(mg/dl) = 28.7 x A1C - 46.7
eAG(mmol/l) = 1.59 x A1C - 2.59

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HgB A₁c Diabetes Control Chart

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Fasting Blood Glucose

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Oral Glucose Tolerance Test ((OGTT))

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Gestational Diabetes: Glucose Challenge Test .

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Gestational Diabetes Diagnostics (OGTT)

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🌺 Standard or standard materials :
Standard: is a substance of known purity which is used as the basis for a comparison of measurements in the determination of this substance in a specimen.

🔴من إحدى المتطلبات الاساسية، لإعطاء نتائج صحيحة ومضبوطة في المختبرات العلمية بشكل عام والطبية السريرية بشكل خاص، هي استخدام محاليل عيارية معلومة التراكيز، ذات خصائص مناسبة من حيث النقاوة والاستقرارية، وغيرها من الخصائص التي تشترطها جهات متخصصة، لقبوله كمحلول عياري او ما نعرفه بالـ: استاندارد.
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🔴يعرف الاستاندارد بانه مادة نقية جدا، لا تحتوي على أي مواد اخرى مهما كانت تراكيزها ضئيلة.. لا مواد حافظة.. ولا ماء.. ولا اي مواد اخرى، وان لزم الامر للاضافة، كما في بعض انواع الاستندرات(سنذكرها هنا لاحقا)؛ فلابد ان تكون بالكميات القليلة الضرورية فقط التي لا تغيّر من خصائص هذه المادة بعد الاضافة ، وإلا فلا يعتبر مادة عيارية او قياسية.
ويحتوي الاستاندارد على مادة بعينها تكون معلومة التركيز تُستخدم لايجاد تركيز مادة اخرى مجهولة التركيز بالمقارنة وبإستخدام قوانين معروفة، كقانون بير لامبرت او غيره من القوانين ذات الصلة.

🔴Types Of Standards :
IUPAC classification for high-purity standard materials :
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🔻Grade A: Atomic-weight standard.

🔻Grade B: Ultimate standard:
a substance which can be purified to virtually atomic-weight standard.

🔻Grade C: Primary standard:
a commercially available substance of purity 100 ± 0.02%.

🔻Grade D: Working standard:
a commercially available substance of purity 100 ± 0.05%

🔻Grade E: Secondary standard:
a substance of lower purity, which can be standardized against primary (Grade C) material.

IUPAC International Union of Purity and Applied Chemistry.

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