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.

ALT is one of the most commonly used markers to detect liver stress or damage early. The liver has a large regenerative capacity and often only produces symptoms when damage is already advanced. ALT can be elevated before you notice anything. Non-alcoholic fatty liver disease (NAFLD) is the most common cause of chronically mildly elevated ALT in Western countries. An estimated 25% of adults have some degree of fatty liver, often without knowing it. ALT monitoring can reveal this early, allowing lifestyle adjustments to prevent further damage. With alcohol use, the ALT/AST ratio provides additional information. An AST/ALT ratio above 2 is consistent with alcohol-related liver damage, while in fatty liver disease, ALT is typically higher than AST. Medications such as paracetamol (at high doses), statins, and certain antibiotics can also elevate ALT.

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.

Elevated triglycerides may contribute to atherosclerosis and are a component of metabolic syndrome. They are often elevated alongside insulin resistance. Consult your healthcare provider.

GGT is considered the most sensitive enzymatic indicator of bile duct problems. Elevated levels may suggest bile duct obstruction, liver inflammation, or chronic alcohol use, often before other liver enzymes become abnormal. Because GGT responds quickly to alcohol intake, it is frequently used to monitor alcohol-related liver damage. Tracking GGT over time can provide valuable insight into the effectiveness of lifestyle changes and treatment.

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.