Lab review · Markus Vogel, 44
Lab review

Prevention panel, 15 September 2026

Markus Vogel, 44 · 15 September 2026 · Shared with the patient, 16 September 2026, opened

Five decisions

  • 158LDL mg/dlLipids above the moderate-risk goalThree months of lifestyle, then decide on a statin in December. Goal LDL below 100, ApoB below 100.
  • 92Lp(a) nmol/lLipoprotein(a) in the grey zoneMeasured once. A modifier that argues for taking the December decision seriously.
  • 5.8HbA1c %Prediabetes, first timeThe finding with the most to gain: weight and activity cut progression by 58 % in the Diabetes Prevention Program.
  • 52ALT U/lLiver values fit steatosisFIB-4 0.9 rules out advanced fibrosis. Ultrasound, alcohol below 100 g a week, weight.
  • 17Vitamin D ng/mlVitamin D deficiency2,000 IU daily, re-test in December.

Heart and lipids

7 values · 6 to look at
LDL cholesterol158mg/dl
Above rangeaim below 100

Moderate SCORE2 risk sets the goal at 100 mg/dl; lifestyle for three months, then decide.

Apolipoprotein B118mg/dl
Above rangeaim below 100

Counts the particles rather than the cholesterol in them; the same goal category as LDL.

Non-HDL cholesterol190mg/dl
Above rangeaim below 130

The input to SCORE2. With LDL and ApoB it carries the December decision.

Triglycerides212mg/dl
Above rangebelow 150

Fits the waist, the alcohol and the liver values; responds fastest to the three measures.

HDL cholesterol41mg/dl
In rangeabove 40
Total cholesterol231mg/dl
Above rangebelow 200

Up from 214 in 2019.

Lipoprotein(a)92nmol/l
Borderlinebelow 75

Grey zone 75 to 125 nmol/l (EAS 2022). A modifier on top of moderate risk; measured once, not again.

Sugar and metabolism

5 values · 4 to look at
HbA1c5.8%
Above rangebelow 5.7

Prediabetes range 5.7 to 6.4 % (ADA 2026). First measurement; yearly from now on.

Fasting glucose104mg/dl
Above range70 to 99

Impaired fasting glucose, 100 to 125 mg/dl. Confirms the HbA1c.

HOMA-IR3.6
Borderlinebelow 2.5

From insulin 14 µU/ml and glucose 104 mg/dl. Insulin resistance, consistent with the waist and the liver.

Fasting insulin14µU/ml
In range2.6 to 24.9
Uric acid7.4mg/dl
Above range3.5 to 7.0

Above the reference. Without gout no drug (EULAR 2016); falls with weight and alcohol.

Liver

7 values · 2 to look at
ALT52U/l
Above rangebelow 33

Above the healthy upper limit for men (ACG 2017); 39 in 2019. With GGT and triglycerides: steatosis until the ultrasound says otherwise.

GGT78U/l
Above rangebelow 60

Alcohol-sensitive. Expected to fall within weeks of halving the wine.

AST34U/l
In rangebelow 35
FIB-40.9
In rangebelow 1.3
Alkaline phosphatase71U/l
In range40 to 130
Bilirubin0.8mg/dl
In rangebelow 1.2
Albumin4.4g/dl
In range3.5 to 5.2

Kidney

3 values
eGFR94ml/min/1.73 m²
In range90 or above
Creatinine0.98mg/dl
In range0.7 to 1.2
Urine albumin/creatinine8mg/g
In rangebelow 30

Thyroid

2 values
TSH2.1mIU/l
In range0.4 to 4.1
Free T41.2ng/dl
In range0.8 to 1.8

Iron and vitamins

5 values · 1 to look at
25-hydroxyvitamin D17ng/ml
Below range30 or above

Deficient, below 20 ng/ml (Endocrine Society). Supplement, re-test in December.

Ferritin186µg/l
In range30 to 200
Transferrin saturation31%
In range20 to 45
Vitamin B12410pg/ml
In range200 to 900
Folate9ng/ml
In rangeabove 4

Inflammation

1 value · 1 to look at
hs-CRP2.6mg/l
Borderlinebelow 1

Average-risk band, 1 to 3 mg/l (AHA/CDC 2003). Falls with weight loss; no action on its own.

Blood count

4 values
Haemoglobin15.2g/dl
In range13.5 to 17.5
Leukocytes6.8/nl
In range4 to 10
Platelets228/nl
In range150 to 400
MCV91fl
In range80 to 98

What follows from this

  • Prevention programme, twelve monthsDrafted from these results: three measures, one supplement, blood tests in December and September
  • Ultrasound of the liverTo confirm the steatosis the values suggest
  • Seven days of home blood pressureOffice 138/88 is “elevated”; the ESC wants home readings before it is called anything

Sources

Lab report 15.09.2026ESC 2021ESC/EAS 2019EAS 2022 Lp(a)ADA 2026EASL 2024Endocrine Society 2011

Read from the laboratory report of 15 September 2026 and compared with the occupational check of March 2019. Reference ranges from the laboratory; targets from the ESC/EAS, ADA, EASL and Endocrine Society guidelines named at each value. FIB-4 and HOMA-IR computed from the report.