How much do you know about the physical examination report?

This is the 4687th article of Da Yi Xiao Hu

When you get your physical examination report, do you feel anxious because you don’t understand the indicators? Now let’s follow the editor to unveil the mystery of physical examination indicators!

Body mass index

When Xiao Wang was measuring his height and weight, he saw the "BMI" value = 22.3 on the instrument. What does this number mean? He was confused. The doctor told him that BMI stands for body mass index, which is weight (kg) / height (m)², and the normal value is between 18.5 and 23.9.

For example, a young man with a height of 180cm and a weight of 70kg has a body mass index of 70 (kg)/1.8 (meters)²≈21.6, which is a standard body shape. If this value is between 23.9 and 27.9, it is overweight, and if it is ≥28, it is obese. On the contrary, if it is ≤18.5, it is thin. (See the figure below)

Studies have shown that the higher the body mass index, the greater the incidence of coronary heart disease and stroke.

Blood sugar index

Xiao Liu's appetite has increased recently. After drinking a lot of water, her urine output has increased and her weight has also decreased. She thought happily that she could eat and drink and lose weight! But when she got the medical examination report, she was dumbfounded. Her fasting blood sugar was 7.0mmol/L, and the doctor diagnosed her with diabetes.

Doctors say that drinking more, eating more, urinating more, and losing weight are commonly known as "three mores and one less", which are typical symptoms of diabetes (see the figure below). Remember: once the above symptoms appear, you must monitor your blood sugar.

Blood sugar is the content of glucose in the blood. Blood sugar tests are divided into fasting blood sugar and postprandial blood sugar. Physical examinations generally test fasting blood sugar. Fasting for 8 hours before testing is required to improve accuracy. The normal range of fasting blood sugar is 3.9 to 6.1 mmol/L.

So what are the diagnostic criteria for diabetes?

1. When the fasting blood sugar level is ≥7.0mmmol/L for 8 hours and "three mores and one less" occur at the same time, diabetes can be diagnosed.

2. When blood sugar level is ≥11.1mmol/L two hours after a meal, it can also be diagnosed as diabetes.

3. Glycated hemoglobin A1c (HbA1c) is an indicator to measure blood sugar control in the past 2 to 3 months. If this value is ≥6.5%, it can be used as a basis for diagnosing diabetes, and other tests should also be combined for diagnosis.

What are the complications of diabetes?

Complications of diabetes

It is divided into acute and chronic types.

Acute complications

Including ketoacidosis, hyperglycemic hyperosmolar state, and lactic acidosis.

Chronic complications

Including cardiovascular and cerebrovascular diseases, kidney disease, neuropathy, lower limb vascular disease, diabetic foot, retinopathy, etc.

Blood lipids (high/low density lipoprotein)

Xiao Zhang saw that his high-density lipoprotein index was high in his physical examination report. When he asked the doctor with concern, the doctor said that increased high-density lipoprotein plays an important role in preventing cardiovascular diseases. This explanation made Xiao Zhang confused.

Blood lipids are a general term for triglycerides, cholesterol, and lipids. Cholesterol cannot flow freely in the blood and needs to be transported by "vehicles" - high-density lipoprotein and low-density lipoprotein.

Memory Method

HDL, the higher the better

Low-density lipoprotein, the lower the better

As both are tools for transporting cholesterol, their effects on the body are very different due to their different transport directions.

High-density lipoprotein transports cholesterol from all parts of the body back to the liver, metabolizes it out of the body through bile, or reuses it. Therefore, it can lower the cholesterol level in the blood and protect the cardiovascular and cerebrovascular system.

Low-density lipoprotein is just the opposite. It transports cholesterol from the liver to various parts of the body. Once the content exceeds the standard, it can easily cause the formation of arteriosclerotic plaques, thereby causing cardiovascular and cerebrovascular diseases.

Helicobacter pylori

Xiao Chen's bad breath has been getting worse recently. He bought a bunch of products claiming to "freshen breath" online, but they didn't work. A friend who is a doctor reminded him to go to the hospital to check for "Helicobacter pylori". The test result was 15. The doctor said that he was infected with "Helicobacter pylori". If he didn't treat it, no matter how many "bad breath removal" products he took, it would only treat the symptoms and not the root cause.

Helicobacter pylori is a contagious bacterium that is associated with gastritis, gastric ulcers, and gastric cancer. It is mainly transmitted through fecal-oral transmission, so family members living together are more likely to be cross-infected.

The DOB value is less than 4, which is normal.

If you experience stomach bloating, stomach pain, acid reflux, belching, bad breath and hiccups, it is recommended to go to the hospital for testing for Helicobacter pylori. If the result is positive, not only should you actively follow the doctor's advice to take medication, but your family members who live with you should also be tested to rule out infection.

Liver function

Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) are mainly found in the liver. When the liver is damaged, these two enzymes will be released into the blood, and when the liver function is checked, these two transaminases will be elevated.

Elevated transaminases are common in acute and chronic hepatitis, alcohol or drug-induced liver cell damage.

Urinalysis

Urinalysis is an examination of excrement that reflects the body's metabolic status and is an important indicator for the diagnosis of many diseases. Abnormal urine routine is a sign of kidney or urinary tract disease (see the figure below). Urinalysis includes urine color, transparency, pH, red blood cells, white blood cells, epithelial cells, casts, protein, specific gravity and urine sugar.

Uric acid

Uric acid is the end product of purine metabolism. Long-term consumption of animal offal, seafood, or long-term smoking and drinking can cause abnormal purine metabolism and lead to elevated uric acid. High uric acid is the main cause of gout.

Bone density

It is an important indicator of bone strength. The higher the bone density, the more weight it can bear.

When bone density decreases and osteoporosis occurs, bones become weak and fragile.

Tumor markers

Tumor markers are synthesized and secreted by tumor cells during the growth of malignant tumors, or are abnormally produced due to the body's response to tumors.

The increase of tumor markers is affected by many factors such as lifestyle, inflammation, etc. Therefore, an increase does not necessarily mean cancer. The diagnosis of tumors also requires combined imaging, pathology and other examinations.

Cervical cancer screening

The main cause of cervical cancer is HPV virus, which is divided into low-risk HPV virus and high-risk HPV virus according to the risk of causing disease and cancer. However, it takes persistent infection with HPV virus to develop into cervical cancer.

Once HPV infection is discovered, especially HPV types 16 and 18, patients are advised to actively seek treatment to reverse the HPV to negative as much as possible so that it will not develop into cervical cancer.

Thyroid hormone

Thyroid hormones are secreted by the thyroid gland and are important hormones for maintaining basal metabolism and growth and development in the body. They mainly include T3, T4, FT3, FT4, and TSH.

When thyroid hormone production is insufficient, thyroid stimulating hormone (TSH) begins to increase.

When the thyroid gland overproduces hormone, TSH begins to decrease.

An excess of thyroid hormone is called hyperthyroidism, and a deficiency is called hypothyroidism. Both have an impact on the body.

Early prevention, early diagnosis, early treatment, maintain a healthy lifestyle and have a harmonious and happy life!

Note: Some pictures are from the Internet. If there is any infringement, please inform us and they will be deleted.

References

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[2] Wu Meiya, Analysis of the value of routine tests and biochemical tests in clinical diagnosis of diabetes[J]. Systems Medicine, 2023, 8(8): 77-80.

[3] Wang Dan, Yan Xiaoli, Zhang Yuan. Research progress on the effect of Helicobacter pylori infection on immunotherapy of gastric cancer[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2023, 28(2): 228-234.

[4] Zeng Yue, Wang Zhenhua, Chen Jun. Research progress on the correlation between high-density lipoprotein function and atherosclerotic cardiovascular disease [J]. Medical Theory and Practice, 2023, 36(2): 209-212.

[5] Yang Xiaoming, Zhang Lin, Zhao Jiayi, Huang Wenwei. Detection significance of liver function indicators and related biochemical indicators in patients with hepatitis cirrhosis [J]. Modern Medicine and Health Research, 2022, 6 (1): 109-111.

[6] Jiang Quan, Han Man, Tang Xiaopo, Luo Chenggui, Gong Xun. Guidelines for diagnosis and treatment of gout and hyperuricemia based on syndrome combination[J]. Journal of Traditional Chinese Medicine, 2021, 62(14): 1276-1288.

[7] Wu Zhenbin, Ye Dandan, Chen Xiling, Xu Zhiwei. Study on the correlation between bone mineral density and bone metabolism indexes and osteoporotic fractures[J]. Chinese Medical Guide, 2022, 20(6): 29-32.

[8] Zhang Bo, Liu Xin. Research progress on the relationship between multiple human papillomavirus infection and cervical precancerous lesions and cervical cancer [J]. Chinese Journal of Sexology, 2022, 32 (2): 83-87.

[9] Zhang Qianwei, Qi Yicheng, Tang Mingming, Suo Lixia. Research progress on iodine and thyroid diseases[J]. Medical Review, 2021, 27(7): 1373-1379.

Author: Shanghai Pudong New Area Zhoupu Hospital

Fan Yuting