Are the patient's ALT, AST, bilirubin, serum creatinine, estimated glomerular filtration rate, non‑fasting hemoglobin A1c, lipid panel (total cholesterol, triglycerides, HDL cholesterol, LDL cholesterol, non‑HDL cholesterol), urine albumin‑to‑creatinine ratio, and cystatin C values within normal limits?

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Last updated: September 8, 2026 • View editorial policy

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Laboratory Values Assessment

Your laboratory values are largely normal, with one notable exception: your HDL cholesterol is low at 34 mg/dL, which increases cardiovascular risk and warrants intervention.

Detailed Analysis by System

Liver Function

Your liver enzymes are excellent:

  • ALT 9 U/L and AST 16 U/L are well within normal ranges (typically <40-50 U/L for adults) 1
  • Bilirubin levels (direct 0.12 mg/dL, total 0.4 mg/dL) are normal
  • These values indicate no evidence of hepatocellular injury or cholestasis

Kidney Function

Your renal parameters are normal:

  • Serum creatinine 0.83 mg/dL is within normal range 2
  • Cystatin C 0.9 mg/L is normal (typically <1.0 mg/L) 3, 4
  • eGFR 86 mL/min/1.73m² is above the threshold of concern (<60 mL/min/1.73m² flags as low per KDIGO guidelines) 2
  • Urine albumin <12.0 mg with creatinine 15.4 mg indicates no albuminuria (albumin-to-creatinine ratio would be <30 mg/g, which is normal) 2

The concordance between creatinine-based and cystatin C-based GFR estimates suggests accurate kidney function assessment without confounding from muscle mass or other non-GFR determinants 2.

Glucose Metabolism

  • HbA1c 5.4% (non-fasting) is normal and indicates no diabetes (diagnostic threshold ≥6.5%) 5

Lipid Panel - ACTION REQUIRED

Your lipid profile shows one significant abnormality:

  • Total cholesterol 129 mg/dL: Normal (desirable <200 mg/dL)
  • Triglycerides 70 mg/dL: Normal (desirable <150 mg/dL)
  • LDL cholesterol 84 mg/dL: Normal (optimal <100 mg/dL)
  • Non-HDL cholesterol 95 mg/dL: Normal (optimal <130 mg/dL)
  • HDL cholesterol 34 mg/dL: LOW (normal ≥40 mg/dL for men, ≥50 mg/dL for women) 5

Clinical Significance

Low HDL cholesterol is an independent cardiovascular risk factor even when other lipid parameters are normal. This pattern suggests:

  • Increased risk of atherosclerotic cardiovascular disease
  • Possible metabolic syndrome component (though your triglycerides and glucose are normal)
  • Need for lifestyle modification and possibly pharmacotherapy

Recommended Actions

For low HDL cholesterol:

  1. Lifestyle interventions (first-line):

    • Aerobic exercise (30-60 minutes most days)
    • Weight loss if overweight
    • Smoking cessation if applicable
    • Reduce refined carbohydrates
    • Moderate alcohol consumption may raise HDL (if no contraindications)

  2. Consider pharmacotherapy if lifestyle measures insufficient:

    • Statins (modest HDL increase, primarily lower LDL)
    • Fibrates (if triglycerides also elevated)
    • Niacin (though less commonly used now)

  3. Assess overall cardiovascular risk using a validated risk calculator to guide intensity of intervention

For monitoring:

  • Repeat lipid panel in 3-6 months after lifestyle intervention
  • Continue routine monitoring of kidney function given normal baseline
  • No specific intervention needed for other parameters

References

Related Questions

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