CMP is Complete Metabolic Profile – Part 4

August 4, 2013 Leave your thoughts

Fracture Risk is much more than Bone Mineral Density (BMD) or t-score.  Many medical conditions cause osteoporosis and fractures.  Blood tests can detect those medical problems.  This is the post on CMP.

Albumin is the major protein in the blood.  A large portion of the calcium in the blood is bound to albumin.  What is important is “free calcium”, so a mildly low calcium combined with a low albumin is less of a problem for heart and nerves. However, a low albumin generally means poor nutrition, especially too little protein intake, and protein is the major component of bone, so too little protein is a problem.

Globulins are antibodies, a key part of the immune system.  We calculate the globulin level by subtracting albumin from “total protein” when it is not reported separately.  Low globulins could indicate immune system issues.  High globulins can indicate infection, allergies, or myeloma.  Myeloma is a tumor of bone marrow cells which can cause vertebral fractures.

Serum Protein Electrophoresis (SPEP) is a test which separates out the various globulins.  A monoclonal (just one specific globulin protein) spike on SPEP can indicate Myeloma.  More commonly MGUS (monoclonal gammopathy of undetermined significance) which is usually benign for years or decades.  Any abnormalities on SPEP, I refer to Hematology for observation or treatment.

Testing detects medical conditions that affect bone health.  If we find them, we can fix them.  Next time PTH.

Jay Ginther, MD

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