Read her lab report against the last one.

AKAnna Keller, 47 · Hypertension, prediabetes, LDL 162 mg/dl · 14 documents, read 16 September 2026

Answered on 16 September 2026

Fifteen values from 8 May, each against its reference range and against the report of November 2023. Seven are outside their range, and three of the seven have moved in the same direction twice. Lab 08.05.2026 Lab 02.11.2023

The three that carry a decision: LDL 162 mg/dl (145 in 2023), HbA1c 5.9 % (5.6 % in 2023, which crosses into prediabetes) and ALT 41 U/l with the steatosis on the May ultrasound. Vitamin D at 21 ng/ml is low and has never been treated. Eur Heart J Diabetes Care J Hepatol Ultrasound 12.05.2026

The FIB-4 from these values is 0.8, below the 1.3 threshold, so the liver needs no work-up now. That calculation is in the sheet with the four values it used. J Hepatol

Lab reviewBuilt from the chart, in the record

Laboratory, 8 May 2026

Fifteen values, seven outside their range
Each against its range and against the report of November 2023
The three that carry a decision, and the FIB-4 with the values it used

Every line carries the document it was read from

From the patient record3 of 14 documents

Laboratory report, 8 May 2026Laboratory
Laboratory report, 2 November 2023Laboratory
Abdominal ultrasound report, 12 May 2026Imaging

1.2019 ESC/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk.European Heart Journal. 2020;41:111-188. Mach F, Baigent C, Catapano AL, et al.Guideline
SummaryLDL cholesterol goals by risk category: below 116 mg/dl at low risk, below 100 mg/dl at moderate risk, below 70 mg/dl at high risk, below 55 mg/dl at very high risk. Statins first, ezetimibe second, PCSK9 inhibitors third. Statin interactions run mainly through CYP3A4 (atorvastatin, simvastatin) and OATP1B1; monitoring of ALT and CK is defined.
Source
Issuing body: ESC and European Atherosclerosis Society
Published: January 2020; focused update 2025
Grading system: ESC classes of recommendation I–III, levels of evidence A–C
Scope
Target population: Adults with dyslipidaemia or elevated cardiovascular risk
Scope: Targets, drugs, monitoring, special situations
2.2. Diagnosis and Classification of Diabetes: Standards of Care in Diabetes—2026.Diabetes Care. 2026;49(Suppl 1):S27-S49. American Diabetes Association Professional Practice Committee.Guideline
SummaryPrediabetes is defined by an HbA1c of 5.7 to 6.4 %, fasting glucose of 100 to 125 mg/dl or a 2-hour glucose of 140 to 199 mg/dl in an oral glucose tolerance test; diabetes from 6.5 % HbA1c, 126 mg/dl fasting or 200 mg/dl at 2 hours. People with prediabetes should be re-tested at least yearly and referred to structured lifestyle programmes.
Source
Issuing body: American Diabetes Association
Published: January 2026, updated annually
Grading system: ADA evidence grades A–E
Scope
Target population: Adults and children at risk of or with diabetes
Scope: Diagnostic criteria, screening intervals, classification
3.EASL-EASD-EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD).Journal of Hepatology. 2024;81:492-542. European Association for the Study of the Liver, European Association for the Study of Diabetes, European Association for the Study of Obesity.Guideline
SummarySteatotic liver disease with at least one cardiometabolic risk factor is MASLD. In primary care, patients with steatosis or metabolic risk should have non-invasive fibrosis assessment with FIB-4: below 1.3 rules out advanced fibrosis with repeat testing in one to three years; 1.3 or above calls for elastography or referral. Treatment is weight reduction, physical activity and control of the metabolic risk factors.
Source
Issuing body: EASL, EASD, EASO
Published: September 2024
Grading system: GRADE
Scope
Target population: Adults with steatotic liver disease and metabolic risk factors
Scope: Case finding, fibrosis assessment, management

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Anna Keller, 47Mosaic