Turning 40 is often when many people begin paying closer attention to their health.
Energy levels, exercise recovery time and metabolism may start to change, and many Malaysians undergo their first comprehensive health screening.
However, interpreting a multi-page laboratory report can be confusing.
The first thing to understand is that a laboratory “normal range” does not always mean optimal health.
These ranges are based on population averages and are designed mainly to detect disease.
Preventive health focuses on identifying risks early and understanding the overall pattern of results.
Heart disease risk
One of the most important sections is the lipid profile, which measures LDL (low density lipoprotein) cholesterol, HDL (high density lipoprotein) cholesterol and triglycerides.
LDL cholesterol plays a major role in the development of atherosclerosis and cardiovascular (heart) disease.
The ideal LDL level depends on an individual’s overall risk profile.
People with diabetes, kidney disease, a strong family history of early heart disease, or existing cardiovascular disease often require lower LDL levels.
HDL cholesterol is best considered a risk marker rather than a treatment target, while triglycerides should ideally remain below 1.7 mmol/L.
Raised triglycerides combined with low HDL cholesterol may indicate insulin resistance and increased metabolic risk.
Beyond standard cholesterol testing, additional markers can provide further insight.
Lipoprotein(a), or Lp(a), is an inherited cholesterol particle that independently increases the risk of heart attack, stroke and aortic valve disease.
Elevated Lp(a) is common, affecting approximately 20-30% of the population when defined as levels above 50mg/dL (about 125 nmol/L).
As Lp(a) is largely determined by genetics and remains stable throughout life, measuring it once in adulthood can help identify hidden cardiovascular risk.
Apolipoprotein B (ApoB) reflects the number of cholesterol particles that can contribute to plaque formation and may provide additional risk information, especially in individuals with diabetes, obesity, metabolic syndrome or elevated triglycerides.
Diagnosing diabetes
Another useful metabolic marker is HOMA-IR (Homeostatic Model Assessment of Insulin Resistance), which is calculated using fasting glucose and fasting insulin levels.
It may identify insulin resistance before blood sugar becomes abnormal, allowing earlier lifestyle intervention in selected individuals at higher metabolic risk.
HbA1c reflects average blood glucose over the previous two to three months, and is an important screening test for diabetes.
In Malaysia, diabetes affects almost one in five adults.
An HbA1c below 5.7% is considered normal, 5.7-6.4% suggests prediabetes, and 6.5% or above is consistent with diabetes when appropriately confirmed.
Identifying prediabetes provides an opportunity to reduce future risk through exercise, weight management and dietary changes.
Liver and blood
Your liver enzymes, particularly ALT (alanine transaminase) and AST (aspartate aminotransferase), provide clues about liver health.
Mild abnormalities may be associated with metabolic dysfunction-associated steatotic liver disease (MASLD), previously known as non-alcoholic fatty liver disease.
These results should be interpreted alongside body weight, waist circumference, alcohol intake, medications and other risk factors.
The Full Blood Count (FBC) evaluates red blood cells, white blood cells and platelets.
Low haemoglobin may indicate anaemia, while abnormal white cell or platelet counts may require further evaluation depending on any other signs or symptoms the person may have.
Optimising health
The most important lesson from health screening is that individual numbers rarely tell the whole story.
Doctors look for patterns – a combination of raised blood pressure, increased waist circumference, abnormal cholesterol and rising blood sugar may indicate metabolic syndrome and increased future cardiovascular risk.
Your annual health screening should not be viewed as a pass-or-fail test.
It is a roadmap that helps identify risks early and guides better decisions.
The goal is not simply to be within the laboratory reference range, but to optimise your health so that you can remain active and well for years to come.
Dr Kishen Sivakumar is a general practitioner (GP). For more information, email starhealth@thestar.com.my. The information provided is for educational and communication purposes only, and should not be considered as medical advice. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this article. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.
