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Pathology services sit at the heart of patient diagnosis and treatment. In fact, about 70% of decisions about patient care depend on tests carried out by scientists in pathology laboratories.

GSTS Pathology employs around 1000 people performing more than 14 million tests a year, and has one of the broadest portfolios of scientific diagnostic services as well as offering all routine pathology services.

We are supported by world-leading clinicians and scientists who will ensure we remain abreast of new developments in technology, and business management experts who will maintain and enhance our customer service.

We know that there is a person behind every test.

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Biochemical Sciences

Apolipoprotein A-1^

Biochemical Sciences, Cardiovascular Markers / g/L

Sample: Clotted (yellow SST tube) Serum 5 mL
TAT: 3 - 4 days
Reference Range:

Cardiovascular risk increases with ApoA1 <1.2 (men) or <1.3 g/L (women) Hypoalphalipoproteinaemia ApoA1 <0.9

Special Sample Instructions:

Seat the patient 5 minutes before sampling. Fasting sample preferred, but non-fasting acceptable. Patient should follow their normal diet for 3 weeks prior to sampling.

Apolipoprotein B-100^

Biochemical Sciences, Cardiovascular Markers / g/L

Sample: Clotted (yellow SST tube) Serum 5 mL
TAT: 3 - 4 days
Reference Range:

Cardiovascular risk increases with ApoB > 0.9 Dysbetalipoproteinaemia ApoB < 0.5

Special Sample Instructions:

Seat the patient 5 minutes before sampling. Fasting sample preferred, but non-fasting acceptable. Patient should follow their normal diet for 3 weeks prior to sampling.

Apo E genotyping

Biochemical Sciences, Cardiovascular Markers /

Sample: EDTA (purple top) Whole blood Non-fasting 5 mL
TAT: Batch dependant Average 2 - 3 months
Reference Range:

Common genotype ApoE3/ E3 CVD risk increases with allele dose of apoE4 Apo E2/E2 associated with remnant (IDL) hyperlipidaemia in the presence of other risk factors ApoE2/E4 and ApoE4/E4 associated with less severe remnant hyperlipidaemias

Special Sample Instructions:

The assay is specific for the 3 genotypes. Other rarer apoE mutations associated with hypertriglyceridaemia eg ApoELeiden are not detected.

C-Reactive Protein^ (high sensitivity assay)

Biochemical Sciences, Cardiovascular Markers / mg/L

Sample: Clotted (yellow SST tube) Serum or EDTA (purple top) 5 mL
TAT: 3 - 4 days
Reference Range:

<3

Special Sample Instructions:

Additional cardiovascular risk marker. To reduce variance needs to be measured twice about 1 month apart.

Familial Hypercholesterolaemia

Biochemical Sciences, Cardiovascular Markers /

Sample: EDTA (purple top) 3 x 4 mL blood
TAT: 3 - 6 months
Reference Range:

Results reported for point mutations, exon splicing disorders in the LDLreceptor, apoB exon 27 and PCSK-9 genes

Special Sample Instructions:

Initial screen of 57 mutations in 3 genes accounting for 50 - 70% of UK mutations performed by iPLEX technology by Genetics Laboratory (Belfast). Patient with evidence of xanthomata or high clinical suspicion of FH receive full sequencing and MPLA analysis if initial screen is negative. Please refer to lipid clinic for pre-screening and cascade testing. Contact Dr Anthony Wierzbicki (x81256) or Dr Martin Crook (x81263). Requires formal consent. Samples processed by Genetics.

Hepatic lipase

Biochemical Sciences, Cardiovascular Markers /

Sample: Lithium heparin (green top) 2 x 6 mL blood
TAT: 3 months
Reference Range:

Special Sample Instructions:

Indication: diagnosis of enzyme deficiency. This test is not suitable for subjects with heparin sensitivity, have a history of bleeding diathesis, proliferative retinopathy, CVA, have active rheumatic fever, a peptic ulcer or are taking aspirin. Sample must be received by laboratory within 30 minutes of collection or sent frozen on dry ice Fasted sample required Patient refrained from alcohol in the previous 24 hours and heavy exercise in the previous 48 hours. Please have all cli

Homocysteine+

Biochemical Sciences, Cardiovascular Markers / μmol/L

Sample: Lithium heparin (green top) Plasma 2 - 3 mL
TAT: 2 weeks
Reference Range:

CVD risk increases with HCY >12 Levels > 20 may justify MTFHR G677T genotyping

Special Sample Instructions:

Increased values can be seen during pregnancy, the follicular phase and post-menopause, with a high protein diet and some drugs. Renal function, folate and vitamin B12 status should be investigated on finding a high homocysteine. Sample must be received by laboratory within 30 minutes of collection. Fasting sample required for CVD risk assessment, values lowest in the morning.

Lipoprotein lipase

Biochemical Sciences, Cardiovascular Markers /

Sample: Lithium heparin (green top) 2 x 6 mL blood
TAT: 3 months
Reference Range:

Special Sample Instructions:

Indication: diagnosis of enzyme deficiency in type I and type V Fredrickson hyperlipidaemias. This test is not suitable for subjects with heparin sensitivity, have a history of bleeding diathesis, proliferative retinopathy, CVA, have active rheumatic fever, a peptic ulcer or are taking aspirin. Sample must be received by laboratory within 30 minutes of collection or sent frozen on dry ice Fasted sample required. Patient refrained from alcohol in the previous 24 hours and heavy exe

Lipoprotein(a) ^

Biochemical Sciences, Cardiovascular Markers / g/L

Sample: Clotted (yellow SST tube) or EDTA (purple top) Serum or plasma 5 mL
TAT: 3 - 4 days
Reference Range:

Cardiovascular risk increases with Lp(a) > 0.3

Special Sample Instructions:

Additional cardiovascular risk factor whose levels are mostly genetically determined. Indicated for risk assessment in patients with a strong family history of atherosclerosis. Levels are higher in West African and Afro-Caribbean populations. Interfere

Lipoprotein electrophoresis

Biochemical Sciences, Cardiovascular Markers /

Sample: EDTA (purple top) or Clotted (yellow SST tube) Serum or plasma 5 mL EDTA plasma is the specimen of choice
TAT: Batch dependant Average 2 - 3 months
Reference Range:

Please contact the laboratory to discuss

Special Sample Instructions:

Indications: Screening for X-linked ichthyosis; confirmation of abetalipoproteinaemia/ NARP syndromes Heparin therapy can lead to alterations in the migration of the lipoproteins, particularly beta-lipoproteins. Fasting sample recommended

Lipids ultracentrifugation (full fractionation; beta-quantification)

Biochemical Sciences, Cardiovascular Markers / mmol/L

Sample: EDTA (purple top) or Clotted (yellow SST tube) Serum or plasma 2 x 5 mL EDTA plasma is the specimen of choice
TAT: Batch dependant Average 2 - 3 months
Reference Range:

Low risk for cardiovascular disease if: Trigylceride < 1.7 Cholesterol < 4 VLDL-C < 0.3 LDL-C < 2 HDL-C (male) > 1.0 HDL-C (female) > 1.2

Special Sample Instructions:

Indications: diagnosis of lipid disorder especially those associated with hypertriglyceridaemia and classification by Fredrickson WHO criteria. Fasting (12 - 14 hr)

Lipids ultracentrifugation (LDL sub-fractionation)

Biochemical Sciences, Cardiovascular Markers /

Sample: EDTA (purple top) or Clotted (yellow SST tube) Serum or plasma 2 x 5 mL EDTA plasma is the specimen of choice
TAT: Batch dependant Average 2 - 3 months
Reference Range:

Please contact the laboratory to discuss

Special Sample Instructions:

Indications: diagnosis of rare lipid disorders (CETP deficiency, LCAT deficiency) Quantification and relative distribution of atherogenic LDL and HDL particles. Reported as cholesterol, triglyceride, apoA1 and apoB contents of fractions consistent with chylomicrons, VLDL, IDL, LDL subfractions 1 - 6 and HDL with interpretation of the profile. Fasting (12 - 14hr)

Aldosterone

Biochemical Sciences, Endocrine Blood tests /

Sample: EDTA Plasma - 5mL
TAT: 7-10 working days
Reference Range:

Aldosterone (pmol/L): Upright 100 - 800, Supine 100 - 450 Aldo/Renin ratio: <80: Conn’s unlikely. >/=200: Conn’s likely. 80-200: Conn’s not excluded.

Special Sample Instructions:

EDTA Plasma - Process blood samples at room temperature in a non-chilled centrifuge. Plasma should be separated from cells immediately after centrifugation, aliquoted into two 2mL pots (min 500µL in each), and frozen at –20ºC.

Alpha subunit

Biochemical Sciences, Endocrine Blood tests / IU/L

Sample: Clotted (yellow SST tube) Serum 5 mL
TAT: 2 weeks
Reference Range:

Male: 0.10 - 0.80 Female: Non menopausal 0.1 – 0.90 Menopausal 0.1 – 1.60

Special Sample Instructions:

Take sample to specimen reception immediately after collection. Separate and freeze sample straight away.

Anti-mullerian hormone (AMH)

Biochemical Sciences, Endocrine Blood tests / μg/L

Sample: Clotted (yellow SST tube) or EDTA (purple top) Serum or plasma 5 mL
TAT: 1 week
Reference Range:

At the 3rd day of a regular cycle the AMH concentration of normoovulating women varies from 2.2 - 6.8

Special Sample Instructions:

Do not use haemolysed samples. Take sample to CSR immediately after collection. Separate and freeze sample straight away

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