The norms of biochemical blood analysis, decoding,reasons for the increase and decrease in the table

Update: December 2018

Biochemical analysis of blood is one of the most popular
techniques for doctors and patients. If you learn to read correctly
This analysis can reveal even in the early stages such serious
pathologies like acute and chronic renal failure,
diabetes mellitus, viral hepatitis and malignant tumors and
completely stop their development.

How to prepare for blood sampling for biochemical

The nurse draws blood from the patient for a couple of minutes, this procedure is not
causes special discomfort. Biochemical examination
like any other, it requires preparation and compliance with a number of simple

  • blood must be donated strictly on an empty stomach;
  • dinner on the eve should not contain strong tea and coffee, and fat
    food and alcohol should not be consumed for 2-3 days;
  • 24 hours should refrain from any thermal procedures
    (bath, sauna) and heavy physical exertion;
  • tests are taken early in the morning, first of all, before medical
    procedures (droppers, injections, radiography);
  • when the patient came to the laboratory, before taking blood to him
    It is advisable to sit for 10-15 minutes, catch your breath and calm down;
  • to determine the exact blood sugar level of the patient in the morning
    before analysis it is not necessary to brush your teeth, drink tea or coffee; even
    your “morning starts with coffee,” you should refrain from it;
  • Also, before taking blood, it is not advisable to take hormonal
    drugs, antibiotics, diuretics and other drugs;
  • two weeks before the analysis should stop drinking
    drugs that reduce the concentration of lipids in the blood (see
    statins to lower cholesterol);
  • if necessary, re-examination of the analysis need to pass
    at the same time of day, in the same laboratory.

Table of biochemical analysis of blood with decoding

Indicator Norm
Total protein 63-87 g / l
Protein fractions:

  • albumins
  • глобулины (α1, α2, β, γ)
  • 35-45 g / l
  • 21.2-34.9 g / l
Urea 2,5-8,3 ммоль/л
  • women 44-97 micromolar per liter
  • men 62-124
Uric acid
  • For men – 0.12-0.43 mmol / l
  • For women – 0.24-0.54 mmol / l
Glucose 3.5-6.2 mmol per liter
Total cholesterol 3.3-5, 8 mmol / l
LDL less than 3 mmol per liter
  • women greater than or equal to 1.2 mmol per liter
  • men 1 mmol per liter
Triglycerides less than 1.7 mmol per liter
Total bilirubin 8.49-20.58 μmol / l
Direct bilirubin 2.2-5.1 μmol / l
Alanine aminotransferase (ALT) Up to 38 U / l
Aspartate Aminotransferase (AST) Up to 42 U / l
Alkaline phosphatase (ЩФ) Up to 260 U / l
Gamma-glutamyltransferase (GGT)
  • For men – up to 33.5 U / l
  • For women – up to 48.6 U / l
Creatine Kinase (КК) Up to 180 U / l
Α-amylase up to 110 E per liter
Sodium 130-155 mmol / l
Potassium 3.35-5.35 mmol / l

Total protein и его фракции

Protein plays a very important role in the body, it participates in
construction of new cells, the formation of humoral immunity and
переносе substances. Usually proteins consist of 20 essential
amino acids, although they may contain vitamins,
inorganic substances (metals), the remains of carbohydrates and lipids.

The liquid part of the blood contains about 165 different proteins, which
differ in structure and role in the body. All proteins are divided into
три категории или фракции: albumins, глобулины (α1,
α2, β, γ) и фибриноген. Since proteins are produced
mostly in the liver, their content reflects the synthetic
the function of this body.

The decrease in total protein is called hypoproteinemia (see common
белок в blood). This condition occurs when:

  • protein starvation (vegetarianism, protein-free diet);
  • increased urine excretion (kidney disease,
    pregnant women’s proteinuria);
  • blood loss (heavy menstruation, nosebleeds);
  • burns, especially blistering;
  • accumulation of plasma in the abdominal cavity (ascites), pleural
    cavity (exudative pleurisy), pericardium (exudative
  • malignant neoplasms (stomach cancer, urinary cancer
  • violation of the formation of protein (hepatitis, cirrhosis);
  • long-term treatment with glucocorticosteroids;
  • decrease in the absorption of substances (enteritis, colitis, celiac disease,

An increase in total protein is called hyperproteinemia, this
condition can be relative and absolute. Relative
an increase in proteins occurs when the loss of liquid plasma
(cholera, repeated vomiting). Absolute protein increase occurs
in inflammatory processes (due to globulins), myeloma
diseases. Physical labor and changing the position of the body changes
the concentration of this substance is 10%.

The main reasons for the change in the concentration of protein fractions

Фракции белка это: albumins, глобулины и фибриноген. Fibrinogen
not defined in biochemical analysis. This protein reflects
blood clotting process. It is defined in an analysis such as

Albumins Globulins


  • fluid loss in infectious diseases (dehydration)
  • burn disease

  • acute purulent inflammatory processes;
  • systemic connective tissue diseases (scleroderma,
    dermatomyositis, rheumatoid arthritis);
  • burns in the recovery phase;
  • nephrotic syndrome with glomerulonephritis.

Β- globulins:

  • hyperlipoproteinemia (atherosclerosis, diabetes mellitus);
  • nephrotic syndrome;
  • stomach and intestinal ulcers that bleed;
  • hypothyroidism.

Γ- глобулины:

  • viral and bacterial infections;
  • systemic connective tissue diseases (scleroderma,
    dermatomyositis, rheumatoid arthritis);
  • burns;
  • allergies;
  • worm infestation.

Level reduction

  • in newborns due to underdevelopment of liver cells;
  • during pregnancy;
  • pulmonary edema;
  • malignant neoplasms;
  • liver disease;
  • bleeding;
  • accumulation of plasma in the cavities of the body (anasarca)

Nitrogen metabolism

In the body, in addition to building cells, there is their constant
decay, accompanied by the accumulation of nitrogenous bases. These
toxic substances are formed in the liver and excreted by the kidneys.
Therefore, an increase in blood waste can speak as a decrease in work.
kidney and liver, and excessive protein breakdown. To the main
показателям азотистого обмена relate:

  • urea and creatinine
  • residual nitrogen, creatine, uric acid,
    ammonia, indican and others.

Why does the blood slag level change?

Reasons for raising Reasons for the decline


  • acute and chronic glomerulonephritis, pyelonephritis;
  • nephrosclerosis;
  • poisoning with salts of mercury, dichloroethane, ethylene glycol;
  • crash syndrome (long-term squeezing syndrome);
  • arterial hypertension;
  • polycystic kidney disease;
  • kidney tuberculosis;
  • acute and chronic renal failure
  • after administration of glucose;
  • increased urine output (polyuria);
  • after hemodialysis;
  • liver failure;
  • starvation;
  • metabolism reduction;
  • hypothyroidism


  • острая и chronic renal failure;
  • hyperthyroidism;
  • acromegaly;
  • декомпенсированный diabetes;
  • intestinal obstruction;
  • muscular dystrophy;
  • extensive burns

Uric acid

  • gout;
  • leukemia;
  • B-12 deficiency anemia;
  • Vacaise’s disease;
  • acute infections;
  • liver disease;
  • severe diabetes;
  • skin pathologies (dermatitis, pemphigus);
  • barbiturate poisoning with carbon monoxide

Glucose крови

Glucose – это основной показатель углеводного обмена. it
substance – the main energy product entering the cell,
it is from glucose and oxygen that the cell gets fuel for
further life activity.

Glucose поступает в кровь после приема пищи, затем поступает в
liver, where utilized in the form of glycogen. These процессы
controlled by pancreatic hormones – insulin and
глюкагоном (см. норма глюкозы в blood).

  • The lack of glucose in the blood is called hypoglycemia
  • Excess – hyperglycemia.

 What causes fluctuations in blood glucose concentration?

Hypoglycemia Hyperglycemia
  • длительное starvation;
  • violation of carbohydrate absorption (colitis, enteritis,
    dumping syndrome);
  • chronic liver disease;
  • hypothyroidism;
  • chronic adrenal insufficiency;
  • hypopituitarism;
  • overdose of insulin or oral hypoglycemic
    drugs (diabeton, glibenclamide, etc.);
  • meningitis (tuberculosis, purulent, cryptococcal);
  • encephalitisы, менингоencephalitisы;
  • insuloma;
  • sarcoidosis
  • Diabetes mellitus type 1 and 2
  • thyrotoxicosis;
  • pituitary tumors;
  • neoplasms of the adrenal cortex;
  • pheochromocytoma;
  • treatment with glucocorticoids;
  • epilepsy;
  • injuries and brain tumors;
  • carbon monoxide poisoning;
  • psycho-emotional arousal

Disruption of pigment metabolism

In the human body there are specific stained proteins.
These are usually peptides that have a metal in their composition.
(iron, copper). К ним relate: гемоглобин, церуллоплазмин,
myoglobin, cytochrome and others. The final decay product of such
proteins is bilirubin and its fractions. What happens to
bilirubin in the body?

When a red blood cell ends its existence in the spleen, its
gems splits. Biliverdin reductase forms bilirubin,
called indirect or free. itт вариант билирубина токсичен
for the whole body, and especially for the brain. But
due to the fact that it binds quickly to blood albumin,
the body is not poisoned. But with hepatitis, liver cirrhosis
high because it does not bind to glucuronic acid.

Further in the liver cells, indirect bilirubin binds to
glucuronic acid (turning into bound or direct,
non-toxic), its performance is high only for dyskinesias
желечевыводящих путей, при синдроме Жильбера (см. причины
высокого билирубина в blood). In analysis, direct bilirubin grows
in case of liver cell damage (for example, in hepatitis).

Further bilirubin enters the bile, which is from the liver
the ducts are transported to the gallbladder and then to the lumen
Duodenal ulcer. Urobilinogen is formed from bilirubin,
which is absorbed from the small intestine into the blood and, getting into the kidneys,
paints urine yellow. Remaining portion that reached thick
the intestines, under the action of the enzymes of bacteria becomes sterkobilin and
stains cal.

Why does jaundice occur?

There are three mechanisms:

  • increased decay hemoglobin and other pigment proteins
    (hemolytic anemia, snake bites, pathological hyperfunction
    spleen) – indirect bilirubin is formed in such huge
    quantities that the liver simply does not have time to process it and
  • liver diseases (hepatitis, cirrhosis, neoplasms) – pigment
    formed in normal volume, but the liver cells affected
    disease, can not perform their function;
  • violation of the outflow of bile (cholecystitis, cholelithiasis,
    acute cholangitis, pancreatic head tumors) – due to
    squeezing the biliary tract bile does not enter the intestines, and
    accumulates in the liver, causing the destruction of its cells and the entry
    bilirubin back to the blood.

All three states are very dangerous for human health, they
require immediate medical attention.

Indications for the study of bilirubin and its fractions:

  • hepatitis (viral, toxic);
  • liver tumors;
  • cirrhosis of the liver;
  • increased breakdown of red blood cells (hemolytic
  • the appearance of jaundice.

Lipid metabolism or cholesterol levels

Lipids play an important role in cell life. They
participate in the construction of the cell wall, the formation of bile,
many hormones (male and female sex hormones,
corticosteroids) and vitamin D. Fatty acids are the source
energy for organs and tissues.

All fats in the human body are divided into 3 categories:

  • triglycerides or neutral fats;
  • total cholesterol and its fractions;
  • phospholipids.

In the blood, lipids are in the form of the following compounds:

  • chylomicrons – contain mainly triglycerides;
  • high-density lipoproteins (HDL) – are composed of
    50% protein –30% phospholipids and 20% cholesterol;
  • low density lipoproteins (LDL) – contain 20% protein 20%
    phospholipids, 10% triglycerides and 50% cholesterol;
  • very low density lipoproteins (VLDL) – are formed when
    decay of LDL include a large amount of cholesterol.

The greatest clinical significance in the analysis has a common
cholesterol, LDL, HDL and triglycerides (see the norm of cholesterol in
blood). When collecting blood, remember that breaking the rules
preparing and eating fatty foods can lead to significant
errors in the analysis results.

What causes a violation of lipid metabolism and what it can
to lead?

Why cholesterol rises Why is declining

Total cholesterol

  • myxedema;
  • diabetes;
  • pregnancy;
  • familial combined hyperlipidemia;
  • cholelithiasis;
  • acute and chronic pancreatitis;
  • malignant tumors of the pancreas and prostate;
  • glomerulonephritis;
  • alcoholism;
  • hypertonic disease;
  • myocardial infarction;
  • coronary heart disease
  • злокачественные liver tumors;
  • cirrhosis of the liver;
  • rheumatoid arthritis;
  • hyperfunction of the thyroid and parathyroid glands;
  • starvation;
  • violation of the absorption of substances;
  • chronic obstructive pulmonary disease


  • viral hepatitis;
  • alcoholism;
  • алкогольный cirrhosis of the liver;
  • билиарный (желчный) cirrhosis of the liver;
  • cholelithiasis;
  • acute and chronic pancreatitis;
  • chronic renal failure;
  • hypertonic disease;
  • myocardial infarction;
  • coronary heart disease;
  • pregnancy;
  • cerebral thrombosis;
  • hypothyroidism;
  • diabetes;
  • gout;
  • Down syndrome;
  • acute intermittent porphyria
  • chronic obstructive pulmonary disease;
  • hyperfunction of the thyroid and parathyroid glands;
  • malnutrition;
  • malabsorption disorder

The degree of increase in cholesterol in the blood:

  • 5.2-6.5 mmol / l – mild increase in the substance, risk zone
  • 6.5-8.0 mmol / l – moderate increase, which is adjusted
  • over 8.0 mmol / l – high level of substance requiring
    drug intervention.

Depending on the change in lipid metabolism emit
5 clinical syndromes, the so-called dyslipoproteinemia
(1,2,3,4,5). These pathological conditions are precursors
severe diseases such as cerebral arteriosclerosis,
diabetes and others.

Blood enzymes

Enzymes are special proteins that speed up chemical reactions.
organism. The main blood enzymes include:
alanine aminotransferase (ALT), aspartate aminotransferase (AST),
alkaline phosphatase (alkaline phosphatase), gamma-glutamyltransferase (GGT),
creatine kinase (KK) and α-amylase.

All these substances are contained inside the cells of the liver, pancreas
glands, muscles, heart and other organs. Their content in the blood
very few, therefore, they measure enzymes in special international
units: U / l. Consider each enzyme separately.

Alanine aminotransferase and aspartate aminotransferase

These enzymes provide in chemical reactions the transfer of two
amino acids: aspartate and alanine. AST and ALT are contained in large
quantities in the tissues of the liver, heart muscle, skeletal
musculature Raising them in the blood indicates the destruction of these cells
organs, and the higher the level of enzymes, the more cells

The degree of increase of enzymes: What diseases increase AST and ALT?
  • easy – 1.5-5 times;
  • medium – 6-10 times;
  • high – 10 times and higher.
  • myocardial infarction (more AST);
  • acute viral hepatitis (more ALT);
  • toxic liver damage;
  • malignant tumors and metastases in the liver;
  • destruction of skeletal muscles (crash syndrome).

Alkaline phosphatase

This enzyme is responsible for the removal of phosphoric acid from
chemical compounds and transport of phosphorus inside the cell. Alkaline shield has
two forms: hepatic and bone. Reasons for increasing the enzyme:

  • osteogenic sarcoma;
  • bone metastasis;
  • myeloma;
  • lymphogranulomatosis;
  • hepatitis;
  • toxic and medicinal liver damage (aspirin,
    cytostatics, oral contraceptives, tetracycline);
  • fracture healing;
  • cytomegalovirus infection;
  • osteoporosis and osteomalacia (destruction of bones).


GGT is involved in the metabolism of fats, carrying cholesterol and triglycerides.
inside the cell. The greatest amount of enzyme found in the liver,
prostate, kidney, pancreas. His activity
in the blood increases with:

  • the above liver diseases;
  • alcohol intoxication;
  • diabetes;
  • infectious mononucleosis;
  • heart failure.

Creatine Kinase

QC is involved in the conversion of creatine and maintaining
energy metabolism in the cell. It has 3 subtypes:

  • MM (the enzyme is located in the muscle tissue)
  • CF (located in the heart muscle)
  • BB (in the brain).

The increase in the blood of this substance is usually caused by the destruction
cells of the above organs. What exactly disease
increase the level of QC?

Subtype MM Subtype MB BB subtype
  • prolonged crush syndrome;
  • myositis; – amyotrophic lateral sclerosis;
  • myasthenia gravis;
  • Guillain-Barre syndrome;
  • gangrene
  • острый myocardial infarction;
  • myocarditis;
  • hypothyroidism;
  • long-term treatment with prednisone
  • schizophrenia;
  • mini-depressive sclerosis;
  • encephalitis

Alpha amylase

A very important enzyme that breaks down complex carbohydrates into
more simple. It can be found in the pancreas and salivary.
glands. For the doctor plays an important role as an increase in the index, so
and its decline. Such fluctuations are observed when:

Alpha-amylase increase Reduced alpha-amylase
  • acute pancreatitis;
  • pancreas cancer;
  • viral hepatitis;
  • epidemic parotitis (in the people – mumps);
  • acute renal failure;
  • long-term use of alcohol, tetracycline,
  • thyrotoxicosis;
  • myocardial infarction;
  • complete necrosis of the pancreas;
  • pregnant women toxemia

Blood electrolytes

Potassium and sodium are the most important electrolytes in the blood.
It would seem that this is just trace elements, and the content in the body
their scanty. In fact, it is difficult to imagine at least one body
or a chemical process that would do without them.


Trace element plays a big role in enzyme processes and metabolism
substances. Its main function is to conduct electrical
impulses in the heart. Fluctuations in potassium levels are very bad
on myocardium.

The state when potassium is elevated is called hyperkalemia, and when
reduced – hypokalemia. What threatens to raise potassium?

  • violation of sensitivity;
  • arrhythmias (atrial fibrillation, intracardiac blockade);
  • pulse rate reduction;
  • drop in blood pressure;
  • stupefaction.

Such threatening conditions can occur with
trace element over 7.15 mmol / l.

Falling potassium levels below 3.05 mmol / l also poses a threat to
organism. To the main symptoms of element failure

  • nausea;
  • vomiting;
  • muscle weakness;
  • difficulty breathing;
  • involuntary discharge of urine and feces;
  • heart failure


Sodium не принимает непосредственного участия в обмене substances.
Its full full in extracellular fluid. Its main function
is the maintenance of osmotic pressure and pH. Sodium excretion
occurs with urine and is controlled by the hormone of the adrenal cortex –

A microelement elevation is called hypernatremia, and a decrease is

How does a violation of sodium metabolism?

Hyponatremia Hypernitraemia
  • apathy;
  • loss of appetite;
  • nausea;
  • vomiting;
  • headache;
  • drowsiness;
  • convulsions;
  • coma
  • thirst;
  • muscle tremors;
  • irritability;
  • muscle twitching;
  • convulsions;
  • coma

In conclusion, I would like to advise the readers of this article:
each laboratory, whether private or public, has its own
a set of reagents, their computing machines. Therefore, the norms
indicators can vary significantly. When the technician issues
you test results, make sure that on the form
written standards. This is the only way you can see if there is a change.
in your analyzes or not.

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