What is Obesity Profile? 

Obesity is a condition characterised by the accumulation of excessive fat in body. Obesity increases your risk of developing several other health problems. However, it can be reversed by maintaining a proper diet, regular physical exercise and engaging in long-term weight management instead of short-term diets (crash dieting) for weight loss.

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The various conditions associated with obesity are as follows:

An obesity panel is used to check if you are overweight or obese. It also helps look for underlying medical conditions that may be responsible for obesity. Depending on the results of this test, your healthcare provider will tell you if you need to lose weight. He/she will also tell you about the steps required to lose weight.

An obesity panel includes the following tests:

  • Blood sugar (fasting and postprandial (PP)): These tests check for the levels of blood sugar (glucose) in your blood. Glucose is the main source of energy in your body. It is formed with the breakdown of carbohydrates. Excess glucose is stored in liver in the form of glycogen. Insulin, a hormone produced by the pancreas (a gland in the abdomen) stimulates the liver to convert (and store) extra glucose to glycogen. Elevated levels of sugar in the blood are a sign of diabetes. Diabetes occurs when your body either does not produce insulin or insulin is produced, but it does not work properly. Fasting blood sugar is one of the tests to check the levels of sugar in your blood after fasting for 12 hours. The PP blood sugar is done after a meal. Usually, the blood sugar levels should go back to normal, two hours after a meal. Read more: Blood sugar test
  • Thyroid profile: A thyroid profile includes the following tests:
    • T3: T3 (triiodothyronine) is a hormone produced by the thyroid gland - a butterfly-shaped gland located in the neck. It is responsible for controlling growth, heart rate and body temperature and is present in both free (unattached) and bound (T3 attached to a protein) forms in blood. A T3 test checks the levels of both these forms of triiodothyronine in your blood.
    • T4: T4 is another hormone produced by the thyroid gland. Just like T3, T4 also plays a role in metabolism and growth and is present in the bound and free form in blood. A t4 test is a blood test to check the levels of T4 (thyroxine) - both bound and free T4 and total T4. Read more: Free T4 test
    • Thyroid-stimulating hormone (TSH): The pituitary gland in the brain produces TSH hormone. TSH regulates the thyroid hormone levels. If the thyroid hormone levels are low, the pituitary gland synthesises more TSH and vice versa. Abnormal levels of TSH indicate a problem with the thyroid. Read more: TSH test
  • Lipid profile: A lipid profile includes the following tests:
    • Total cholesterol: Cholesterol is a kind of fat that is needed for various functions in the body. The total cholesterol test checks the level of both high-density lipoprotein (HDL or good cholesterol) and low-density lipoprotein (LDL or bad cholesterol) cholesterol. 
    • Triglyceride: Triglycerides are a type of fat in blood. Your triglyceride levels are affected by the food you eat. If you eat a lot of food all the extra calories will be converted to triglycerides. High levels of triglycerides get deposited in body tissues and are associated with a higher risk of heart and blood vessel diseases.
    • HDL cholesterol-direct: HDL cholesterol is considered to be the good cholesterol as it moves the extra cholesterol out of arteries and reduces the risk of coronary heart disease
    • LDL cholesterol: LDL cholesterol is considered to be bad as it moves the cholesterol into arteries thus increasing the risk of coronary heart disease. 
    • VLDL (very low-density lipoproteins): VLDL cholesterol is a type of bad cholesterol as high levels of this cholesterol can clog arteries. VLDL levels are high in obese people and indicate a raised risk of cardiovascular diseases.
    • Cholesterol/HDL ratio: Cholesterol/HDL ratio is a calculated value obtained by comparing the total cholesterol value to the HDL value. It helps in assessing your risk of coronary heart disease and stroke.
    • LDL/HDL ratio: LDL/HDL ratio can help determine if you have an increased risk of cardiovascular problems. This ratio is similar to the cholesterol/HDL ratio as two-thirds of the total cholesterol is LDL and total cholesterol and LDL are very closely related.
  • Creatinine: Creatinine is the normal waste product that is produced when you use your muscles. If your kidneys are healthy, they eliminate most of the creatinine from your body. However, if you have a kidney problem, you may have high levels of creatinine in your blood. Thus, this test can help in estimating how well your kidneys are working. Read more: Creatinine test
  • Protein total: This test checks for the levels of two proteins, albumin and globulin, in your blood. Albumin helps in preventing fluid leakage from blood vessels, while globulin help in maintaining immunity.
  • Electrolytes (sodium, potassium and chloride): The test checks for the levels of sodium, potassium and chloride in your blood. Electrolytes are charged particles that help in regulating the acid-base balance in the body. Sodium helps in the normal functioning of nerves and muscles. Most of the potassium is present inside body cells, but a small amount circulates in blood. Potassium is necessary for proper heart functions, nerve conduction and muscle contraction. Chloride is responsible for transporting fluids in and out of blood cells.                  
  • Calcium: Calcium is present in both free and bound (to proteins like albumin) forms in body. A calcium test checks for both forms of calcium in your blood. Calcium is essential for heart function, muscle contraction, bones and teeth, blood clotting and nerve signalling.
  • Phosphorus: Phosphorus is a mineral that helps maintain the strength of your bones and teeth. Studies show that low phosphorus can increase your risk of weight gain and obesity. A phosphorus test measures the levels of the mineral phosphorus in your blood. Abnormal phosphorus levels are also a sign of health problems such as uncontrolled diabetes or improper kidney functioning.
  • Urine routine and microscopic (R/M): It is a complete urinalysis that checks the urine for: 
    • Visual appearance and odour. Any abnormality can indicate a disease condition.
    • Presence of blood, sugar and protein in urine using special strips of paper. This test can also provide information on how acidic the urine is.
    • Presence of blood cells, microorganisms and tumour cells as seen under a microscope.
  • Uric acid: Uric acid is a chemical formed from the breakdown of purines - which is a substance present in foods such as peas, mackerel, dried beans and beer. Most of the uric acid is eliminated in urine, but if it accumulates in blood, it can cause gout or kidney disease.

(Read More - Ayurvedic treatment for Obesity)

  1. Why is the Obesity Panel performed?
  2. How Do You Prepare for the Obesity Panel?
  3. How Is the Obesity Panel Performed?
  4. What Do the Obesity Panel Results Mean?

Your doctor may order this test to check if your weight is unhealthy and if you are already obese, this test would be done to check the cause behind the weight gain.

Along with being overweight, some additional symptoms may disrupt your life. You may be asked to get this test done if you show the following symptoms:

(Read More - Obesity Profile Test)

Fasting: For the lipid profile, you need to maintain a fasting condition for 12 hours before the test. Fasting for four hours is required before the uric acid test and for some time before the sodium test. You may be required to start fasting at midnight before the phosphorus test. 

For the fasting blood sugar test, you need to fast for 12 hours before the test. Do not take any hypoglycaemic drug such as insulin or oral medication before the test unless your doctor instructs otherwise. After the fasting test is done, you will be asked to have a meal with at least 75 g of carbohydrates. For the next two hours between the meal and the PP test, take rest and do not consume anything else. If you are pregnant, you may not need fasting.

Your doctor will tell you how to manage all these variable hours of fasting.

Some other factors that need to be kept in mind while going for an obesity profile test are:

  • Heart attack, infections, surgery, injury and pregnancy can affect the results of a lipid profile; therefore, for accurate results, it is advisable to wait for at least two months after these events to perform the test. Inform your doctor if you have had alcohol in the last two days or your diet has changed drastically in the last week. 
  • Some of the following conditions can affect the test results of the creatinine test:
    • Eating a lot of meat
    • Pregnancy
    • Consuming a large amount of vitamin C
    • Consuming medicines such as cimetidine, ranitidine, famotidine and trimethoprim
  • Dehydration will raise the level of proteins in the blood. Do not keep the tight band around your arm for too long when the blood is drawn as the albumin levels will be raised. 
  • If you have lost fluids due to diarrhoea or vomiting, your chloride levels may be low. Drinks which contain caffeine may lead to loss of water that may affect the test results.
  • Menstrual blood is considered to be a contaminant in the urine sample for the urine R/M. Certain substances such as food colour, beets and vitamin C supplements can affect the colour of urine.  
  • Consuming large amounts of milk, other dairy products and vitamin D supplements can also raise the levels of calcium in the body.
  • Some food items that can affect the results of the phosphorus test are chocolate, some types of beans, cheese, beer, cola and fish. Dialysis can also affect the results of phosphorus test. 

Make your doctor aware of all the drugs that you consume as they may affect the test results. Here is a list of some of the drugs that can affect the results of various tests in an obesity profile:

  • T3 and T4 tests: For the T3 test, drugs such as steroids, seizure medicines and birth control pills can influence the results. Similarly, for the T4 test, keep your doctor updated on drugs such as birth control pills, cardiac drugs, seizure drugs and aspirin can affect the results. 
  • Potassium test: Drugs such as epinephrine, heparin, histamine, isoniazid, mannitol, succinylcholine, aminocaproic acid, angiotensin receptor blockers, antineoplastic drugs, ACE inhibitors and potassium-sparing diuretics increase potassium. On the other hand, acetazolamide, aminosalicylic acid, amphotericin B, carbenicillin, cisplatin, gentamicin, insulin, laxatives, nafcillin, penicillin G, phenothiazines, salicylates and sodium polystyrene sulphonate decrease the levels of potassium. If you have a lot of liquorice, your potassium levels may be low. 
  • Calcium test: Your doctor may request you to stop taking certain medicines such as lithium, thyroxine, calcium salts that may be present in supplements and antacids, thiazide diuretics and vitamin D as they can affect the calcium test results.
  • Phosphorus test: Certain medicines such as L-dopa, anthraquinone laxatives, methocarbamol, nitrofurantoin, phenazopyridine, riboflavin, rifampicin and sulphasalazine can affect the results of the phosphorus test, and hence their consumption should be informed to the doctor.
  • Uric acid test: The drugs that can raise the uric acid levels are as follows: 
    • Aspirin
    • Ascorbic acid
    • Caffeine
    • Diazoxide
    • Cisplatin
    • Diuretics
    • Ethambutol
    • Epinephrine
    • Levodopa
    • Nicotinic acid
    • Methyldopa
    • Theophylline
    • Phenothiazines

Alcohol may also raise the levels of uric acid. 

  • Drugs that lower the uric acid levels are as follows: 
    • Allopurinol
    • Clofibrate
    • Azathioprine
    • Corticosteroids
    • Febuxostat
    • Oestrogen
    • Glucose
    • Probenecid
    • Guaifenesin
    • Mannitol
    • Warfarin

(Read More - Homeopathic treatment for Obesity)

All the tests in the obesity profile, other than urine R/M require a blood sample. The technician will draw the required amount of blood from a vein in your arm. 

For the urine R/M test, either be a random or a 24-hour urine sample will be taken. A random urine sample is collected through the following procedure: 

  • Rinse your hands with soap and water. 
  • Clean your genital area properly and urinate a little in the toilet first.
  • Place the container and collect the urine until the container is nearly half-filled. 
  • Finish urinating in the toilet bowl, close the cap and return the container to the laboratory for testing.

The 24-hour urine sample collection procedure is as follows:

  • You can start the urine collection anytime, but it is more common to start in the morning.
  • Do not save the first urine in the morning but note the time as that is the start time of the collection process.
  • Collect all the urine in the next 24 hours in a special container and keep it in a refrigerator. 
  • The next morning, collect the first urine of the day.
  • Once all the sample for 24 hours is collected, take it to the laboratory for testing.

(Read More - Diet chart for weight loss)

Normal results:

The normal results for the tests under the obesity panel are as follows:

  • Blood sugar (fasting): below 100 mg/dL
  • Blood sugar (PP):
    • For those with diabetes: below 180 mg/dL
    • For those who do not have diabetes: below 140 mg/dL
  • Thyroid profile: 
    • T3 for 1-5 years: 105-270 ng/dL
    • T3 for 6-10 years: 95-240 ng/dL
    • T3 for 11-15 years: 80-215 ng/dL
    • T3 for 16-20 years: 80-210 ng/dL
    • T3 for 20-50 years: 70-205 ng/dL
    • T3 for more than 50 years: 40-180 ng/dL
    • T4 for 1-5 years: 7-15 mcg/dL
    • T4 for 5-10 years: 6-13 mcg/dL
    • T4 for 10-15 years: 5-12 mcg/dL
    • T4 for adult male: 4-12 mcg/dL
    • T4 for adult female: 5-12 mcg/dL
    • T4 for above 60 years: 5-11 mcg/dL
    • T4 in pregnancy: 9-14 mcg/dL
    • TSH in adults: 2-10 mcU/mL
  • Lipid profile: 
    • Total cholesterol for aged 20 years or younger: 75-169 mg/dL
    • Total cholesterol for aged above 21 years: 100-199 mg/dL
    • HDL: above 40 mg/dL
    • LDL for those who have heart or blood vessel disease or are at very high risk of heart disease: below 70 mg/dL
    • LDL for high-risk patients: below 100 mg/dL
    • LDL for those at low risk of coronary artery disease: below 130 mg/dL
    • Triglycerides: below 150 mg/dL
    • VLDL: up to 30 mg/dL
    • Cholesterol/HDL: below 3.5:1
  • Creatinine: 
    • Men: 0.9-1.3 mg/dL
    • Women: 0.6-1.1 mg/dL
    • Children between 3 and 18 years: 0.5-1.0 mg/dL
    • Children below 3 years: 0.3-0.7 mg/dL
  • Total protein: 6-8.3 g/dL
  • Sodium: 136-145 mmol/L
  • Potassium:
    • Adults: 3.5-5.2 mEq/L 
    • Children (1-18 years): 3.4-4.7 mEq/L
  • Chloride: 
    • Adults: 98-106 mEq/L
    • Children: 90-110 mEq/L
    • Newborns: 96-106 mEq/L
    • Premature babies: 95-110 mEq/L
  • Calcium: 8.5-10.2 mg/dL
  • Phosphorus:
    • Adults: 2.8-4.5 mg/dL
    • Children: 4.0-7.0 mg/dL
  • Urine R/M test: The normal colour of the urine is almost colourless to dark yellow. However, eating some foods such as beets and blackberries may convert it to red colour. Generally, in normal conditions, the following are absent in the urine:
    • Glucose
    • Protein
    • Bilirubin
    • Ketones
    • Nitrites
    • Haemoglobin
    • White and red blood cells
  • Uric acid: 3.5-7.2 mg/dL

Abnormal results:

If the glucose test (fasting and PP) results are high, it indicates diabetes.

If the T3 results are above normal, it could indicate the following:

  • Hepatitis
  • Graves’ disease
  • Plummer’s disease (toxic multinodular goitre)
  • Factitious hyperthyroidism (abnormally high thyroid hormone levels usually due to over ingestion of thyroid medicines)
  • Acute thyroiditis
  • Toxic thyroid adenoma
  • Struma ovarii (a type of ovarian tumour)
  • Congenital hyperproteinaemia 

If the T3 results are below normal, it could indicate the following:

If your T4 results are higher than normal, it could be due to the following:

  • Hepatitis
  • Graves’ disease
  • Factitious hyperthyroidism
  • Toxic multinodular goitre
  • Congenital hyperproteinaemia
  • Acute thyroiditis
  • Toxic thyroid adenoma
  • Struma ovarii
  • Thyroid cancer

If your T4 levels are lower than normal, it could be due to the following:

  • Congenital hypothyroidism
  • Myxoedema
  • TSH receptor defects
  • Cushing’s syndrome
  • Hypothalamic failure
  • Pituitary insufficiency
  • Iodine insufficiency
  • Thyroid agenesis (birth defect in which one lobe of thyroid fails to grow)
  • Cirrhosis
  • Renal failure
  • Hashimoto’s thyroiditis

If the TSH levels are increased, it indicates the following:

  • Large doses of iodine
  • Thyroiditis
  • Primary hypothyroidism
  • Congenital hypothyroidism
  • Thyroid agenesis
  • Pituitary TSH-secreting tumour

If the TSH values are decreased, it can be due to the following:

If your lipid profile results are abnormal, it could indicate a risk of heart-related diseases.

If your creatinine levels are above normal, it is an indication of the following conditions:

  • Kidney disease
  • Muscle disease
  • Blockage in your urinary system
  • Diabetes
  • Overactive thyroid gland
  • Dehydration 
  • Congestive heart failure
  • Shock

If your creatinine levels are below normal, it could be due to the following conditions:

  • Muscle loss
  • Not enough protein in your diet
  • Severe liver disease

If your total protein levels are high, it indicates the following:

If your total protein levels are low, it could be a sign of the following: 

If your sodium levels are higher than normal, it could be due to the following:

  • A disorder of the kidney
  • Diarrhoea
  • A disorder of the adrenal glands
  • Diabetes insipidus

If your sodium levels are lower than normal, it could be due to the following:

Low levels of potassium could be due to the following: 

  • Diarrhoea, sweating or vomiting
  • Severe burn or draining wound
  • Nutritional deficiency as in the case of alcoholism
  • Cystic fibrosis
  • Primary aldosteronism
  • Alcoholism

If you have an excessive amount of potassium in your body, it could be due to the following:

  • Kidney disease or kidney failure
  • Uncontrolled diabetes
  • Systemic lupus erythematosus
  • Sickle cell disease
  • Addison’s disease
  • Trauma, such as burns, accidents or surgery

If the chloride levels are high, it could be due to the following:

  • Diarrhoea
  • Renal tubular acidosis
  • Addison’s disease
  • Metabolic acidosis
  • Respiratory alkalosis

If the chloride levels are low, it could be due to the following: 

  • Dehydration
  • Excessive sweating
  • Vomiting
  • Burns
  • Bartter syndrome
  • Syndrome of inappropriate diuretic hormone (SIADH) secretion
  • Hyperaldosteronism
  • Metabolic alkalosis
  • Respiratory acidosis 
  • Congestive heart failure

Some of the reasons that you may have high calcium levels are as follows:

  • Being on bed rest for a long time
  • Cancers such as multiple myeloma and T-cell lymphoma
  • Hyperparathyroidism
  • Sarcoidosis
  • Hyperthyroidism
  • Infections such as tuberculosis and certain mycobacterial infections and fungal infections
  • Metastatic bone tumour
  • Paget’s disease
  • Tumours producing a parathyroid hormone-like substance

If the calcium levels are low, it could be an indication of the following:

Some causes of high phosphorus levels are as follows:

  • Too much vitamin D
  • Too much phosphate in your diet
  • Hypoparathyroidism
  • Diabetic ketoacidosis
  • Kidney failure
  • Liver disease

If you have low phosphorus levels, it could be due to the following:

  • Poor nutrition
  • Hypercalcaemia
  • Alcoholism
  • Primary hyperparathyroidism 
  • Too little dietary intake of phosphate
  • Vitamin D deficiency, causing rickets or osteomalacia

If your urine R/M test shows abnormal results, it could be a sign of the following conditions:

The above-normal results for the uric acid test indicate the following:

If the levels of uric acid are below normal, it could be due to the following:

(Read More - Health risks of being overweight)

Disclaimer: All results must be clinically correlated with the patient’s complaints to make a complete and accurate diagnosis. The above information is provided from a purely educational point of view and is in no way a substitute for medical advice by a qualified doctor.

References

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