Metabolic Health Check

HbA1c provides a long-term view of blood sugar control, unlike fasting glucose which reflects a single point in time. It is essential for diabetes diagnosis and management. Consult your healthcare provider.

A high ALT value can have different causes, from viral hepatitis (such as hepatitis B) to fatty liver. Doctors often look at AST and ALT together, and sometimes at gamma-GT, to get a broader view. A slightly raised value usually means something different from a strongly raised value. An abnormal value on its own does not confirm a diagnosis. Your GP can help you decide whether further steps are needed. If your ALT value is too high, this can have different causes and does not automatically mean something serious is going on. Your GP can help you decide whether further steps are needed.

Fasting insulin can detect insulin resistance years before diabetes develops. Early detection allows for lifestyle interventions that may prevent progression. Consult your healthcare provider for personalised advice.

A raised triglyceride level may contribute to atherosclerosis and is one part of metabolic syndrome. These fats are often elevated together with insulin resistance, so your GP looks at the wider picture rather than this single value. A raised level may increase the risk of heart and vascular disease, especially alongside an unfavourable total cholesterol. For that reason it is often interpreted together with your <a href="/en/biomarkers/total-cholesterol">total cholesterol</a>, your <a href="/en/biomarkers/hdl-cholesterol">HDL cholesterol</a>, and your <a href="/en/biomarkers/ldl-cholesterol">LDL cholesterol</a>. Together these values give a fuller view of your heart health. The type of fat matters too: saturated fat can affect your values unfavourably, while unsaturated fat from sources such as oily fish may be more favourable. Some medications, such as certain diuretics or beta blockers, can also play a role. Discuss with your GP what your values mean in your situation.

GGT can be a sensitive indicator for bile duct issues. A raised gamma-GT may point to bile duct obstruction, liver inflammation or long-term alcohol use, sometimes before other liver enzymes change. What a raised value means in your situation is something your GP can help assess. GGT is often viewed alongside other liver values, such as <a href="/en/biomarkers/alt">ALT</a>, <a href="/en/biomarkers/ast">AST</a>, <a href="/en/biomarkers/alp">alkaline phosphatase</a> and <a href="/en/biomarkers/bilirubin-total">bilirubin</a>. Together these values may help your healthcare provider identify the source of a liver or bile duct change.

Type 2 diabetes affects more than one million people in the Netherlands, and an estimated 1.1 million more have prediabetes without knowing it. Untreated, diabetes significantly increases the risk of cardiovascular disease, kidney damage, eye problems, and nerve damage. Prediabetes is a reversible stage. With lifestyle adjustments — weight loss, more exercise, less sugar and processed carbohydrates — more than half of people with prediabetes can prevent developing diabetes. This makes early detection through a fasting glucose test or HbA1c very valuable.

LDL cholesterol is the best-established modifiable risk factor for atherosclerotic cardiovascular disease. Every 1 mmol/L reduction in LDL reduces the risk of a cardiovascular event by approximately 20–25%. This effect is independent of how the reduction is achieved — through diet, exercise, or medication. In familial hypercholesterolaemia (FH) — a hereditary condition affecting approximately 1 in 250 people — LDL is elevated from a young age, significantly increasing the risk of early cardiovascular disease. Early detection and treatment are crucial.

Cardiovascular disease is the leading cause of death in the Netherlands. Elevated cholesterol — particularly LDL — is one of the best-established risk factors. The process of atherosclerosis progresses gradually over decades and causes no symptoms for a long time, until a heart attack or stroke occurs. The cholesterol level does not stand alone. Cardiovascular risk is determined by the interplay of cholesterol, blood pressure, age, smoking, diabetes, and family history. A cholesterol of 6.0 mmol/L in an otherwise healthy 30-year-old has a different meaning than the same value in a 60-year-old smoker with diabetes. Early detection and treatment of elevated cholesterol — through lifestyle and medication if needed — can significantly reduce the risk of cardiovascular disease.

HDL has an active protective function: it removes excess cholesterol from vessel walls and transports it to the liver. This process is called reverse cholesterol transport and counteracts atherosclerosis. Low HDL is an independent risk factor for cardiovascular disease, even when LDL is normal. Low HDL is often seen with metabolic risk factors: overweight, lack of exercise, smoking, insulin resistance, and type 2 diabetes. It is therefore a marker of overall metabolic health.