Metabolic Syndrome and Glucose Control Including Insulin

Test Code

91398

CPT Codes
82947, 83525, 82465, 84478, 83718

Includes

Glucose
Insulin, Intact, LC/MS/MS
Cholesterol, Total
Triglycerides
HDL and Calculated Components

Preferred Specimen

3 mL serum collected in a Serum Separator Tube (SST®) and
0.4 mL serum collected in a red-top tube (no gel)

Patient Preparation
See individual assays
Triglyceride test only: Patient should fast 9-12 hours prior to collection.
As part of lipid panel testing: A fasting sample is not required.

Minimum Volume

1.5 mL serum collected in an SST® and 0.2 mL serum collected in a red-top tube (no gel)

Instructions

The assay manufacturer Beckman Coulter advises: "N-Acetyl Cysteine (NAC), when administered in therapeutic concentrations (for the treatment of acetaminophen overdose), has been...determined to interfere with assays for... Cholesterol, Uric Acid" where "NAC interference may lead to falsely low results." According to Beckman Coulter, the NAC interference should be insignificant by 12 hours after completion of the initial loading dose of an IV infusion treatment regimen consisting of an initial loading dose of 150 mg/kg administered over 1 hour, a second dose of 50 mg/kg administered over 4 hours and a third dose of 100 mg/kg administered over 16 hours.

Transport Container

Plastic screw-cap vial (x2)

Transport Temperature

Frozen

Specimen Stability

Serum Separator Tube (SST®)
Room temperature: 48 hours
Refrigerated: 7 days
Frozen: 15 days

Red-top tube (no gel)
Room temperature: 24 hours
Refrigerated: 24 hours
Frozen: 28 days

Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)

Gross hemolysis • Gross icteria • Moderate icteria • Anticoagulants

Methodology
Chromatography/Mass Spectrometry • Spectrophotometry (SP)

FDA Status
This test was developed and its analytical performance characteristics have been determined by Quest Diagnostics Nichols Institute. It has not been cleared or approved by the FDA. This assay has been validated pursuant to the CLIA regulations and is used for clinical purposes.

Setup Schedule

Set up: Mon, Wed, Fri nights; Report available: 3-6 days

Reference Range

See Laboratory Report

Clinical Significance

Identifying patients who have metabolic syndrome and who are thus at higher risk of diabetes, coronary heart disease or stroke. Identifying patients who are insulin resistant (fasting insulin at or above the 75th percentile) and who are thus at higher risk of diabetes, coronary heart disease, stroke, or liver disease. Monitoring of risk factors and insulin levels after life style change, medication use, or both.

Performing Laboratory

Quest Diagnostics Nichols Institute-San Juan Capistrano, CA

33608 Ortega Highway

San Juan Capistrano, CA 92675-2042

The CPT Codes provided in this document are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payor being billed. Any Profile/panel component may be ordered separately. Reflex tests are performed at an additional charge.