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By F.A.Davis

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The laboratory provides measurement of the waste products of degradation of proteins, such as ammonia and urea, and the waste product of the degradation of heme (bilirubin) to assess liver function. The clinical chemistry laboratory offers a plethora of tests that provide information about specific diseases of the liver. Measurement of the concentration of the enzyme alanine transaminase (ALT) provides information about hepatitis. Measurement of the enzyme alkaline phosphatase (ALP) provides information about biliary tract disorders.

Lipids are important insulators against heat loss and organ damage and allows for nerve conduction in the central nervous system. When conjugated with proteins, lipids compounds are called lipoproteins, the transport form of lipids in aqueous substances such as blood. Apolipoproteins are the protein moieties associated with plasma lipoproteins. Lipids are classified as simple lipids, esters of the fatty acids with various alcohols; conjugated lipids, esters of the fatty acids containing groups in addition to an alcohol and fatty acid; and derived lipids, substances derived from the above groups by hydrolysis.

A. Davis. Chapter 1 • OVERVIEW OF CLINICAL CHEMISTRY not be utilized for energy and abnormally high concentrations of lipids are degraded. Fatty acids are stored as triacylglycerols, as acyl residues attached to a glycerol molecule through three ester bonds. Sterols are alcohol derivatives of lipids. The primary sterol derivative, cholesterol, is used to produce bile acids, steroid hormones, and vitamins, such as vitamin D. Cholesterol also modulates cell membrane fluidity. Cholesterol is a ringed structure that can be produced endogenously in the liver or may enter the body through diet.

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