Bone & Joints
Bone is the rigid, hard connective tissue that comprises the majority of the skeleton in humans. It is a living, growing tissue that turns over at a rate of about 10% a year. Bone markers are blood and urine tests that detect products of bone remodelling to help determine if the rate of bone resorption and/or formation is abnormally increased, suggesting a potential bone disorder. The markers can be used to help determine a person's risk of bone fracture and to monitor drug therapy for people receiving. Several diseases and conditions can cause an imbalance between bone resorption and formation, and bone markers can be useful in detecting the imbalance and bone loss. Most often, the markers have been studied in the evaluation and monitoring of osteoporosis, including age-related osteoporosis or secondary osteoporosis, which is bone loss due to an underlying condition. Bone loss may result from conditions such as rheumatoid arthritis, hyperparathyroidism, Cushing disease, chronic kidney disease, multiple myeloma, or from prolonged use of drugs such as anti-epileptics, glucocorticoids, or lithium.
Calcium
Calcium is the most abundant and one of the most important minerals in the body. It is essential for cell signaling and the proper functioning of muscles, nerves, and the heart. Calcium is needed for blood clotting and is crucial for the formation, density, and maintenance of bones and teeth. This test measures the amount of calcium in the blood or urine, which reflects the amount of total and ionized calcium in the body.
About 99% of calcium is found complexed in the bones, while the remaining 1% circulates in the blood. Calcium levels are tightly controlled; if there is too little absorbed or ingested, or if there is excess loss through the kidney or gut, calcium is taken from bone to maintain blood concentrations. Some calcium is lost from the body every day, filtered from the blood by the kidneys and excreted into the urine and sweat. Measurement of the amount of calcium in the urine is used to determine how much calcium the kidneys are eliminating.
Phosphate
Phosphorus/Phosphate is a mineral that combines with other substances to form organic and inorganic phosphate compounds. Phosphates are vital for energy production, muscle and nerve function, and bone growth. They also play an important role as a buffer, helping to maintain the body's acid-base balance.
We get the phosphorus we need through the foods we eat. It is found in many foods and is readily absorbed by the digestive tract. Most of the body's phosphates combine with calcium to help form bones and teeth. Smaller amounts are found in muscle and nerve tissue. The rest is found within cells throughout the body, where they are mainly used to store energy.
Phosphorus deficiencies (hypophosphatemia) may be seen with malnutrition, mal-absorption, acid-base imbalances, increased blood calcium, and with disorders that affect kidney function. Phosphorus excesses (hyperphosphatemia) may be seen with increased intake of the mineral, low blood calcium, and with kidney dysfunction.
Someone with a mild to moderate phosphorus deficiency often does not have any symptoms. With a severe phosphorus deficiency, symptoms may include muscle weakness and confusion. An extreme excess of phosphorus may cause symptoms that are similar to those seen with low calcium, including muscle cramps, confusion, and even seizures.
Uric Acid
Uric acid is produced by the breakdown of purines. Purines are nitrogen-containing compounds found in the cells of the body, including our DNA. As cells get old and die, they break down, releasing purines into the blood. To a lesser extent, purines may come from the digestion of certain foods, such as liver, anchovies, mackerel, dried beans and peas and certain alcoholic drinks, primarily beer. Most uric acid is removed from the body by the kidneys and is eliminated from the body in the urine, with the remainder eliminated in the stool.
If too much uric acid is produced or not enough is removed, it can accumulate in the body, causing increased levels in the blood (hyperuricemia). The presence of excess uric acid can cause gout, a condition characterised by inflammation of the joints due to the formation of uric acid crystals in the joint (synovial) fluid. Excess uric acid can also be deposited in tissues such as the kidney, leading to kidney stones or kidney failure.
The build-up of too much uric acid in the body can be due to producing too much, not eliminating enough, or a combination of both. Elevated levels of uric acid can occur when there is an increase in cell death, as seen with some cancer therapies or, rarely, as an inherited tendency to produce too much uric acid. Decreased elimination of uric acid is often a result of impaired kidney function due to kidney disease.
Rheumatoid Factor (RA Factor)
Rheumatoid factor (RF) is an auto-antibody, an immunoglobulin M (IgM) protein that is produced by the body's immune system. Auto-antibodies attack a person's own tissues, mistakenly identifying the tissue as "foreign." While the biologic role of RF is not well understood, its presence is useful as an indicator of inflammatory and auto-immune activity.
Rheumatoid Arthritis (RA) is a chronic, systemic auto-immune disease that causes inflammation, pain, stiffness, and destructive changes in the hands, feet, and other joints throughout the body. Some patients may show signs of fatigue, low-grade fevers, and weight loss.
It can affect anyone at any age but usually develops in the late child-bearing years in women and between the ages of 60 to 80 in men. Over 70% of those affected with RA are women. The course of RA and its prognosis are variable. It may develop and progress slowly or rapidly. It may go into remission in some people and, in a few, it may go away. Left untreated, RA can shorten a person's lifespan and can, within a few years, leave many of those affected too disabled to work.
There are a variety of treatments available to minimise the complications of RA, but they depend on making an accurate diagnosis and on beginning treatment before the development of significant joint damage.
Rheumatoid factor has been used to detect RA. Because the sensitivity and specificity of RF are not ideal, other laboratory tests are often performed in conjunction with RF testing. About 80% of those with RA will have a positive RF test, but it can be negative in people who have clinical signs of RA.
Total Vitamin D
Vitamin D is a family of compounds that is essential for the proper growth and formation of teeth and bones. Two forms of vitamin D can be measured in the blood, 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D. The 25-hydroxyvitamin D is the major form found in the blood and is the relatively inactive precursor to the active hormone, 1,25-dihydroxy vitamin D. Because of its long half-life and higher concentration, 25-hydroxyvitamin D is commonly measured to assess and monitor vitamin D status in individuals.
Vitamin D comes from two sources: endogenous, which is produced in the skin on exposure to sunlight, and exogenous, which is ingested in foods and supplements. The chemical structures of the types of vitamin D are slightly different, and they are named vitamin D2 (ergocalciferol, which comes from plants) and vitamin D3 (cholecalciferol, which comes from animals). The D2 form is found in fortified foods and in most vitamin preparations and supplements. Vitamin D3 is the form produced in the body and is also used in some supplements. Vitamin D2 and D3 are equally effective when they are converted by the liver and the kidney into the active form, 1,25-dihydroxy vitamin D.
Source: Testing.com - https://www.testing.com/
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