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Comprehensive Metabolic Panel Blood Test

Article
Health & Wellness
Laboratory Procedures
Contributed byKrish Tangella MD, MBAAug 07, 2019

What are the other Names for this Test? (Equivalent Terms)

  • Chem 12 Serum Blood Test
  • Comprehensive Blood Panel Test
  • SMA 20 Test

What is Comprehensive Metabolic Panel Blood Test? (Background Information)

  • Metabolism: Human body metabolism refers collectively to all processes occurring through a continuous set of chemical reactions having physiological implications; wherein the body digests food, transports nutrients to different parts, generates energy, responds to external environment, maintains body temperature, heals injuries, expels body wastes, etc.
  • Comprehensive Metabolic Panel (CMP) Blood Test: A group of several tests that measures various vital elements and compounds in blood serum. It is usually prescribed as part of a routine medical examination in preventative care, to indicate whether the body is healthy and that key metabolic activities are normal
  • A CMP Test provides information on blood glucose or sugar levels, electrolyte and body fluid levels, and is indicative of a proper functioning of the liver and kidneys. It gives a comprehensive picture of the body vitality and is an useful tool for early intervention screening and preemptive treatment

What are the Clinical Indications for performing the Comprehensive Metabolic Panel Blood Test?

A Comprehensive Metabolic Panel Blood Test may form part of a routine health check-up process (along with other tests). In some cases, this test is used to further probe:

  • Patients suffering from chronic ailments, like diabetes mellitus
  • To diagnose medical conditions, such as hypertension
  • For weight loss clinics to formulate dietary or nutrition plans, for those individuals seeking to reduce their weight
  • For hospitalized individuals, in order to monitor a variety of clinical conditions

How is the Specimen Collected for Comprehensive Metabolic Panel Blood Test?

Sample required: Blood

Process: Insertion of needle into a vein (arm), or using the finger stick (finger prick) method.

Preparation required: A minimum of 8 hours of complete fasting prior to the test.

What is the Significance of the Comprehensive Metabolic Panel Blood Test Result?

The Comprehensive Metabolic Panel Blood Test results may be a significant indicator to the physician on:

  • The functional status of  the kidneys and liver
  • Blood sugar, cholesterol, protein, and calcium levels
  • Body electrolyte levels, such as sodium, potassium, and chloride
  • Acid-base balance of the body - acid-base abnormalities in the body may be seen in metabolic acidosis, metabolic alkalosis, respiratory acidosis, and respiratory alkalosis

The normal ranges of the different parameters that constitute a Comprehensive Metabolic Panel Blood Test, and a general medical observation for each value, when the values fall out of the normal range, are provided (from Medline Plus, National Institute of Health). These numerical values are sometimes age- and gender-linked, influenced by other medical conditions, drugs, etc. and hence they may vary. Secondary tests may be required to confirm, both the results and interpretations.

Following are components of CMP with normal reference ranges:

  • Albumin: 3.9-5.0 g/dL

Low values imply kidney and liver related dysfunction, or protein absorption disorders

  • Alkaline phosphatase: 44-147 IU/L

Higher than average levels are related to a host of medical conditions seen in liver dysfunction, bone dysfunction (such as rickets), blood disorders, etc.

Low levels indicate protein deficiency and malnutrition

  • Alanine aminotransferase: 8-37 IU/L

High levels are linked to several liver dysfunctions

  • Aspartate aminotransferase: 10-34 IU/L

Higher values indicate renal failure, heart attacks, liver dysfunction, blood-related conditions, and the use of medications that affect the function of the liver and pancreas

  • Blood urea nitrogen: 7-20 mg/dL

Increased levels indicate heart, gastrointestinal, and kidney-related disorders, urinary tract obstruction, and the use of certain medications

Low levels indicate protein deficiency, malnutrition, and liver failure

  • Calcium: 8.5-10.9 mg/dl

Increased calcium or vitamin D intake may lead to higher than normal calcium levels. Such an increase in calcium level can also be seen in bacterial infections (like tuberculosis), thyroid-related conditions, Paget’s disease, sarcoidosis, etc.

Decreased levels indicate a decreased intake of magnesium, vitamin D, and/or it may be due to abnormal functioning of the kidneys, liver and gastrointestinal tract

  • Chloride: 96-106 mmol/l

Higher levels indicate body metabolism dysfunction, bromide poisoning, and the effect of certain medications

Low levels could mean metabolism concerns, or excessive loss of body fluids due to vomiting, sweating, dehydration, or other disorders

  • Carbon dioxide: 20-29 mmol/l

High values could imply breathing disorder, vomiting, Cushing syndrome, etc.

Low levels indicate medication poisoning, kidney disease, and diarrhea

  • Creatinine: 0.8-1.4 mg/dl (levels are closely linked to body mass and individual’s physical size)

High levels can be seen in kidney failure, muscular disorders, and occasionally pregnancy-related complications

Lower levels could indicate muscle conditions, such as muscular dystrophy

  • Glucose: ~100 mg/dl

High levels are symptomatic of diabetes, pancreatic disorders, etc.

Low levels are due to reduced food intake, high insulin intake, other endocrine gland related disorders

  • Potassium: 3.7-5.2 mEq/l

Higher values point to high potassium intake, possibility of recent blood transfusion, excessive breakdown of hemoglobin (hemolysis), kidney failure, metabolic disorders, etc.

Low levels are indicative of the presence of diuretics, deficient potassium in diet, renal conditions, etc.

  • Sodium: 136-144 mEq/l

High levels are due to high intake of salts, increased fluid loss, diabetes, Cushing syndrome, etc.

Low levels are suggestive of increased body water levels, due to certain medical conditions, effect of hormone vasopressin, or even due to loss of body water caused by vomiting, diarrhea, and dehydration

  • Total bilirubin: 0.2-1.9 mg/dL (in newborns, the bilirubin levels are closely monitored)

High bilirubin levels (termed as jaundice) are due to liver, gall bladder, bile duct medical conditions

  • Total protein: 6.0-8.3 g/dL

High levels are caused by multiple myeloma, chronic infections, etc.

Bleeding disorders, liver conditions, kidney disorders, and malnutrition, are some factors causing lower than normal levels of protein

The laboratory test results are NOT to be interpreted as results of a "stand-alone" test. The test results have to be interpreted after correlating with suitable clinical findings and additional supplemental tests/information. Your healthcare providers will explain the meaning of your tests results, based on the overall clinical scenario.

Additional and Relevant Useful Information:

Certain medications that you may be currently taking may influence the outcome of the test. Hence, it is important to inform your healthcare provider, the complete list of medications (including any herbal supplements) you are currently taking. This will help the healthcare provider interpret your test results more accurately and avoid unnecessary chances of a misdiagnosis.

Certain medications that you may be currently taking may influence the outcome of the test. Hence, it is important to inform your healthcare provider, the complete list of medications (including any herbal supplements) you are currently taking. This will help the healthcare provider interpret your test results more accurately and avoid unnecessary chances of a misdiagnosis.

The following DoveMed website links are some useful resources for additional information:

http://www.dovemed.com/common-procedures/procedures-laboratory/cholesterol-test/

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Krish Tangella MD, MBA

Pathology, Medical Editorial Board, DoveMed Team

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