Body Mass Index (BMI)

Measure of height & weight

Do you know that 24.4% of our adult population is overweight & 6% is obese? Obesity is associated with increased cardiac risks.

BMI = Weight (in kg) / [Height x Height] (in metres)

Optimum BMI – 18.5 to 22.9 Good
Low BMI – below 18.5 Risk of Osteoporosis & Nutritional Deficiency Disease
High BMI – 27.5 & above High risk of contracting Heart Disease & Diabetes

Blood Pressure Measurement (BP)

Closely associated with coronary artery disease, kidney disease & stroke.

Category Systolic BP (mmHg) Diastolic BP (mmHg) (Heart muscle relax)
Normal Below 130 Below 85
High Normal Between 130 to 139 Between 85 to 89
Hypertension (High Blood Pressure) 140 & Above 90 & Above

“Systolic” represents the peak pressure when the heart is maximally contracted, whilst “Diastolic” represents the lowest pressure when the heart is relaxed before the next contraction.

Waist & Hip Ratio

Measurements of waist and hip will be taken to assess one’s risk based on fat distribution. This test compares the deposition of fat in the abdominal region / hips & thighs.

Android (Apple shaped) Individuals who carry excess fat in their abdomen.
Gynoid (Pear shaped) Individuals who carry excess fat in their hips & thighs.

Research shows that Gynoid (Pear shaped) individuals with a high waist hip ratio are at a lower risk as compared to Android (Apple shaped) individuals.


Fasting Venous Blood Glucose (sugar)

Do you know that 9% of our adult population suffers from diabetes mellitus? Glucose is the main carbohydrate used by the body. The level of blood glucose is affected by your dietary intake and hormones such as insulin.

Below  6.0 mmol/L Blood glucose level is normal. No evidence of diabetes noted.
Between 6.1 to 6.9 mmol/L Blood glucose level may indicate presence of fasting hyperglycemia, impaired glucose tolerance or possible diabetes. Please consult your doctor for a repeat test or an oral glucose tolerance test as further evaluation.
7.0 mmol/L & Above Blood glucose level is high. Diabetes mellitus may be present, however a single measurement is not enough to make a diagnosis.
Diabetes symptom includes
– Lost of weight
– Excessive Thirst
– Increased frequency of urine
Please see your doctor for follow up. Meantime, maintain a healthy weight by reducing the intake of sweet & sugary foods. Have more complex carbohydrates such as polished, unpolished rice & whole meal bread. If you are a known diabetic, you should see your doctor for regular follow up on dietary and medical management.

HbA1C refers to glycosylated haemoglobin and is used in relation to diabetes.
Measuring HbA1c gives an indication of blood sugar level control in our body over a period of time (3-4 months).

*HbA1C only shown in report if glucose is above 7.0mmol/L

Fasting Blood Cholesterol
The full venous Fasting Lipid profile which includes the following:
– Total cholesterol
– HDL cholesterol (“Good” Cholesterol)
– LDL cholesterol (“Bad” Cholesterol)
– Total Cholesterol/HDL ratio
– Triglyceride

Total Cholesterol Mmol/L Mg/dL
Desirable Below 5.2 Below  200
Borderline High Between 5.2 to 6.1 Between 200 to 239
High 6.2 & Above 240 & Above

High level of HDL reduces arthrosclerosis and the risk of heart attack.

HDL Mmol/L Mg/dL
Low Below 1.0 Below 40
Desirable Between 1.0 to 1.5 Between 40 to 59
High 1.6 & above 60 & above

Elevated LDL is closely associated with increased risk of heart disease and stroke.

LDL Mmol/L Mg/dL
Optimal Below 2.6 Below 100
Desirable Between 2.6 to 3.3 Between 100 to 129
Borderline High Between 3.4 to 4.0 Between 130 to 129
High Between 4.1 to 4.8 Between 160 to 129
Very High 4.9 & above 190 & above
Total/ HDL Ratio Mmol/L
Normal Below 4.5
High 4.5 & above

Triglyceride is a form of fat often associated with elevated LDL and total cholesterol levels and uncontrolled diabetes. An elevation in triglyceride levels increases one’s risk of heart disease.

Triglycerides Mmol/L Mg/dL
Optimal Below 1.7 Below 150
Desirable Between 1.7 to 2.2 Between 150 to 199
Borderline High Between 2.3 to 4.4 Between 200 to 399
High 4.5 & above 400 & above

*Source: MOH Clinical Practice Guidelines on Lipids 2/2006

Full Blood Count consists of the following tests & screens for diseases such as anemia (low haemoglobin), clotting disorders, leukemia and infections.

– Haemoglobin
– 5 Part Differential Count
– Platelet Count
– Blood Film Comment

Kidney Function Test
– Sodium
– Potassium
– Chloride
– Urea
– Creatinine
– Bicarbonate

Our kidneys control the salt and water components & help to filter unwanted waste substance in our body.

Liver Function Test 

– Total Protein
– Albumin
– Globulin
– A/G Ratio
– Total Bilirubin
– Alkaline Phosphatase
– Gamma GT

This test detects inflammation and damage to the liver. (eg Hepatitis B, consumption of medication or alcohol for prolonged periods)
The Liver Function Test together with liver cancer marker test (AFP) is recommended for people with known Hepatitis B infection.

Bone & Joint Disease

– Calcium
– Phosphate
– Rheumatoid Factor

Calcium & Phosphate are important bone minerals. Increased levels may indicate bone disease while low levels may indicate Vitamin D deficiency or poor dietary calcium.

A person has an increased risk of developing osteoporosis with persistent low levels.

If you suffer from recurrent joint pains, you may wish to opt for the rheumatoid factor test associated with inflammatory joint disease

Gout Screen
– Uric Acid

Gout is a condition characterized by pain, swelling, redness & warmth of the affected joint.
High levels of uric acid may crystallize and deposit in tissues and joints resulting in gout.


Hepatitis A

Hepatitis A is an infectious disease which can cause acute liver swelling and yellowing of skin. It is transmitted by contaminated food or water as well as consumption of contaminated shellfish such as cockles, mussels and oysters.

The test determines whether you have immunity against the Hepatitis A virus and is recommended if you

– are a known Hepatitis B carrier
– are a frequent overseas traveller
– frequently consume shellfish.

Hepatitis A HAV IgG
Reactive You are immune. No vaccination against Hep A is required
Non Reactive Primary course of 2 vaccinations at 0 and 6-12 months is recommended.

6% of the local population have chronic Hepatitis B infection and are at risk of liver hardening & liver cancer.

Hepatitis B

The Hepatitis B screen comprises

a) Hepatitis B surface antigen (HbsAg)
b) Hepatitis B antibody (anti-HBsAb).

Reactive Non Reactive
Hepatitis B surface antigen (HbsAg) You have the Hepatitis B virus, please see your doctor for regular follow-up and screening You do not have the virus, please refer to Surface Antibody result for management
Hepatitis B antibody (anti-HBsAb) Results >10 — You are immune. No vaccination required Results <10 – Vaccination required. (for persons who have never developed immunity from primary Hepatitis vaccination)

Hepatitis C

Hepatitis C viral infection is the most common cause for non-A, non-B cases of viral hepatitis in the community, and there is no vaccine available at this time. It is a blood-borne virus, easily transmitted when intravenous drug users share needles, through body tattoos or piercing. Transmission through sexual intercourse and from mother to baby are relatively rare, as is transmission through blood transfusion as donated blood is screened for Hepatitis C.

Although mostly asymptomatic, individuals may experience weight loss, tiredness, nausea and vomiting, fever or abdominal pain and jaundice. Persons infected with Hepatitis C are at high risk of developing chronic Hepatitis C infection (about 75%), and although usually asymptomatic, it may progress to cirrhosis in 20-30% of patients, and liver cancer. Persons who have symptoms described above, or who fall within the high risk group should take this test.

Thyroid Disorder
– Free Thyroxine (Free T4)
– TSH (Thyroid Stimulating Hormone)

The thyroid gland controls our basal metabolic rate (rate at which body uses energy during rest to maintain vital functions such as breathing and keeping warm)

Thyroid hormones determine the body’s metabolism, an increased in levels may result in

– loss of weight
– increased appetite
– heat intolerance
– volatile temper

Low levels may cause the opposite to occur.

We recommend this test if you suffer from any of the above symptoms. TSH (Thyroid Stimulating Hormone) may be performed in cases where the FT4 is too low or too high.

Elevated TSH Hypothyroidism (Body lacks sufficient thyroid hormones)
Low TSH Hyperthyroidism (Body produces too much thyroid hormones)

Cancer Markers

Tumour Marker Colon & Lungs (Carcinoembryonic Antigen – CEA) You may wish to opt for this test if you have a family history of related cancer
CEA may be elevated in selected cases of cancers of the large intestine & lung
Smokers may also have mild elevations
Tumour Marker Liver
(Alpha fetoprotein – AFP)
Liver cancer marker test (AFP), together with Liver Function Test, is recommended for people with known Hepatitis B infection.
Tumour Marker Pancreas
(CA 19.9)
Serum CA19-9 levels are elevated in up to
a) 80% of patients with pancreatic cancer
b) 54-89% of patients with stomach cancer
c) 64% of patients with colorectal cancer
This test is also used to monitor patients who have recovered from pancreatic cancer.
Tumour Marker Nose
EBV is linked to the development of nasopharyngeal carcinoma (NPC)
You should consider taking this test if you
– have a family history of NPC
– are a smoker
– consume high quantities of salted vegetables, meat & fish high in nitrosamines
– suffer hearing loss, tinnitus or ear pain
– have loss of smell
– suffer from neck or throat lumps
– suffer from headaches
Tumour Marker Prostate
(PSA) – for males only
In Singapore, adenocarcinoma of the prostate is the 6th most common cancer among men.
Screening with PSA has the potential of early detection and treatment of organ-confined disease.
Tumour Marker Testicular
(Beta HCG) – for males only
Elevated Beta Human Chorionic Gonadotropin (HCG) levels may indicate testicular cancer in men.
Tumour Marker Ovarian
(CA125) – for females only
CA125 is a protein that may be elevated in cases of ovarian cancer.
You may consider this test if you
-have family history of ovarian cancer
– experience persistent abdominal pain related to menses
Tumour Marker Breast
(CA15.3) – for females only
The CA15.3 test is used to monitor metastatic breast cancer and early recurrence of breast cancer.

Helicobacter Pylori Antibody Test

Helicobacter Pylori is known to be a possible cause of gastric ulcers & cancer. This test is used to indicate the presence of a past or current infection.
Individuals with chronic gastric problems are recommended to take this test.

Cardiac Profile

– Wide Range C-Reactive Protein (wrCRP)
– Apolipoprotein A
– Apolipoprotein B

wrCRP Indicates inflammation of arteries
Elevated CRP levels tend to be associated with higher risk levels of cardiovascular diseases.
Apolipoprotein A Found in HDL (Good cholesterol)
Low levels of Apolipoprotein A are associated with increased risk of early cardiovascular disease.
Apolipoprotein B Found in LDL (Bad cholesterol)
High levels of Apolipoprotein B can lead to buildup of plaques in arteries, which can cause atherosclerosis.

Vitamin D

Vitamin D promotes the absorption and metabolism of calcium and phosphorus. Deficiency can lead to bone weakness in adults. 25-hydroxyvitamin D test is usually ordered to identify a possible deficiency in Vitamin D.

Syphilis Screen (VDRL)

– Syphilis Antibody
– RPR if Syphilis Antibody is positive
– TPHA if Syphilis Antibody is positive

This test screens for sexually transmitted infection (syphilis). If untreated, it can cause chronic condition such as
– Brain & spinal cord damage
– Blindness
– Insanity
– Miscarriage
– Birth defects in pregnant woman
– Occasionally fatal

A false positive result may occur due to other condition. To confirm the diagnosis, a secondary confirmatory test (TPHA) is required.


Urine FEME (Full and Microscopic Examination of Urine)
Urine sample is tested biochemically and examined under the microscope.
With the detection of protein, glucose, specific gravity, pH, ketones, red and white blood cells in the urine, this test may reveal underlying diabetes mellitus, urinary tract infection, kidney stones or kidney disease.

Urine Microalbumin/Creatinine Ratio (ACR)

This test allows us to identify persons with increased risk of developing kidney damage.

Urine Microalbumin: The small protein produced by liver and present in high concentrations in blood is called Microalbumin.
When kidneys function well, no protein is allowed to leak into the urine. However, these proteins are detected in urine for people with kidney damage.

Creatinine is a product of muscle breakdown and is excreted in the urine consistently.
You should the test if you suffer from
– High blood pressure
– Diabetes
– Hypertension
– Congenital kidney disease

Stool Occult Blood – Conventional

This test is one of the screening tools for colorectal cancer where blood is not visible to the naked eye and is recommended screening test for all above 50 years old. If present, it may indicate bleeding from the gut caused by piles, growths or infections.

Positive test result should be followed up with colonoscopy.

Lifetime probability of an individual developing colorectal cancer is approximately 5%.

Electrocardiography (Resting ECG)
Electrocardiography is a recording of the heart’s electrical activity over a short period of time by means of skin electrodes. Electrical impulses in the heart stimulate the heart muscles to contract and these electrical waves can be measured by selectively placing electrodes on different sides of the heart. Thus ECG measures the overall rhythm of the heart and is used to detect abnormal rhythms that may suggest weak or damaged conductive heart tissues. The ECG cannot reliably measure the heart’s pumping ability for which other tests may be employed.


Spirometry is the most common test of the respiratory system. It measures the lung function by the volume and flow of air that can be inhaled and exhaled.

Bone Mass Densitometry (BMD)
Bone Mass Densitometry is a test to measure the mineral density of a person’s bone. The measurements are generally useful to assess a person’s risk of developing osteoporosis.


Tonometry is the procedure used to determine the fluid pressure inside the eye. It is an important test used in the evaluation of patients at risk from glaucoma. Glaucoma is a group of eye diseases resulting in the damage to the optic nerve and vision loss.

Chest X-Ray
Chest X-Ray is typically performed as the first imaging test for symptoms of shortness of breath, persistent cough, chest pain, chest injury or fever. Chest x-rays are useful in picking up abnormal conditions involving the lungs, heart and great vessels. Pneumonia, heart failure, emphysema, lung cancer and other medical conditions can be diagnosed or suspected on a chest x-ray. Low doses of radiation are used to create an image of the chest. Thus, x-rays are to be generally avoided if you are or suspect that you are pregnant.

PAP Smear is a screening test for cervical cancer. Pap Smear checks for changes in the cells of the cervix which may develop into cancer at the later stage. All woman aged between 25 and 64 who have had sex before, are advised to have a Pap Smear done annually.

Breast Mammogram
Mammography is recommended annually for women over 40 years of age and once every 2 years for women over 50 years of age as a diagnostic screening tool to aid in the detection of breast cancer. Low doses of radiation are used to generate an image of the breast to look for characteristic masses or microcalcifications.

Abdomen / Pelvis Ultrasound
An ultrasound abdomen procedure uses sonography or high frequency sound waves to produce images of the internal organs of the abdomen including the liver, gallbladder, spleen, pancreas and kidneys. A pelvis ultrasound displays images of pelvic organs such as the uterus, ovaries and fallopian tubes. Both are useful in aiding investigations of abnormalities in the abdomen or pelvis evidenced by abdominal or pelvic pain.

Prostate Ultrasound

An ultrasound procedure that uses sonography or high frequency sound waves to produce images of organs in the pelvis; the most common indication is for the evaluation of the prostate gland in men with elevated prostate specific antigen (PSA), or with abnormal urinary symptoms. PSA is present in small quantities in the serum of men with healthy prostates but is often elevated in the presence of prostate cancer, infection or hypertrophy.

Treadmill Test
The treadmill test allows an objective assessment of cardiac fitness, and may detect abnormal heart rhythms and possible blockages in the heart arteries.