The Root Cause Medicine Podcast
New Course: Advanced Blood Labs 201
November 6, 2025
In this episode of The Root Cause Medicine Podcast, Dr. Kate Kresge interviews Dr. Chris Magryta and Dr. Erik Lundquist about Advanced Blood Labs 201—a course designed to help clinicians interpret metabolic and immune biomarkers across pediatric and adult populations. They explain how to use tests like C-peptide, adiponectin, leptin, and glutathione to identify early metabolic stress, and explore immune indices such as SII (Systemic Immune Inflammation Index) and SIRI (Systemic Inflammation Response Index) to uncover inflammation trends in both children and adults.
In this episode, Dr. Chris Magryta and Dr. Erik Lundquist to discuss their new course, Advanced Blood Labs 201—a masterclass in interpreting metabolic and immune biomarkers for proactive, data-informed clinical care. They explore how early identification of metabolic dysfunction and immune dysregulation can improve long-term health outcomes through advanced yet accessible diagnostics. The discussion covers biomarkers such as C-peptide, adiponectin, leptin, fructosamine, LDH, GGT, and glutathione, along with emerging immune markers like SII and SIRI. Listeners will learn how to integrate these insights into practice for earlier, more precise intervention in both children and adults.


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Frequently Asked Questions About Pediatric and Adult Biomarkers


What is C-peptide and why might it be important to measure in both children and adults?

C-peptide is released with insulin from pancreatic β-cells and reflects endogenous insulin production and β-cell function. Elevated C-peptide may indicate insulin resistance, while low levels can signify β-cell exhaustion. It can be a key tool for identifying early metabolic dysfunction in both pediatric and adult patients early in disease progression (American Diabetes Association, Diabetes Care, 2025).


How does adiponectin relate to inflammation and metabolism across ages?

Adiponectin regulates glucose and lipid metabolism and has anti-inflammatory properties. Low adiponectin levels are linked to insulin resistance and chronic inflammation in children and adults (Nature Reviews Immunology, 2024) and respond positively to healthy lifestyle interventions (The Journal of Clinical Endocrinology & Metabolism, 2008).


What does leptin resistance imply in pediatric and adult patients?

Leptin helps to regulate appetite and energy balance. When cells become resistant to leptin, metabolism and inflammatory control are impaired. Elevated leptin with low adiponectin can correlate with metabolic syndrome and obesity risk across age groups (Nature Reviews Immunology, 2024).


How do SII and SIRI biomarkers relate to immune dysregulation?

The Systemic Immune-Inflammation Index (SII) and Systemic Inflammation Response Index (SIRI) use platelet, neutrophil, lymphocyte, and monocyte counts from a CBC to reflect immune activation and inflammation balance. Elevated SII or SIRI can indicate systemic inflammation or immune imbalance. Recent pediatric studies found these indices correlate with insulin resistance and metabolic status in adolescents (Frontiers in Endocrinology, 2024).


Can oxidative stress markers like LDH and GGT help to assess long-term health?

These markers can reflect the body’s oxidative stress burden and antioxidant capacity. Elevated LDH or GGT may suggest increased oxidative load and reduced resilience, potentially influencing mitochondrial and metabolic health (Artery Research, 2024).


What is the role of fructosamine in blood sugar evaluation for children and adults?

Fructosamine can provide a two- to three-week snapshot of blood glucose control, offering faster feedback than HbA1c. It’s useful in both adults and children for monitoring short-term glycemic changes (BMJ Open, 2015) and for pediatric patients with variable glucose control (Diabetes Care, 1991).


Are these biomarkers clinically useful in pediatrics, or only in adults?

The guests describe that these biomarkers can be relevant across ages. Early metabolic and immune imbalances often begin in childhood, and monitoring markers like C-peptide, adiponectin, leptin, and SII/SIRI can help identify at-risk children (Frontiers in Endocrinology, 2024).

References
  1. Connecting the Spots: Serial Home C-Peptide Measurements for Assessing β-Cell Function. Diabetes Care, American Diabetes Association, 2025. https://diabetesjournals.org/care/article/48/9/1472/163233/Connecting-the-Spots-Serial-Home-C-peptide
  2. Adiponectin as a Key Regulator of Inflammation and Metabolism. Nature Reviews Immunology, 2024.  https://www.nature.com/articles/s41577-024-01103-8
  3. Changes in Adiponectin and the Leptin/Adiponectin Ratio During Lifestyle Intervention and Association With Metabolic Improvement in Obese Children. The Journal of Clinical Endocrinology & Metabolism, Vol. 93, Issue 8, 2008. https://pubmed.ncbi.nlm.nih.gov/18492759/
  4. Systemic Immune-Inflammation Index (SII) and Systemic Inflammation Response Index (SIRI) as Markers of Metabolic Risk in Adolescents. Frontiers in Endocrinology, 2024. https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2024.1426404/full
  5. Oxidative Stress Biomarkers and Mitochondrial Dysfunction in Cardiometabolic Health. Artery Research, 2024. https://arteryresearch.biomedcentral.com/articles/10.1007/s44200-024-00062-8
  6. Evaluation of Fructosamine as a Short-Term Glycemic Marker in Diabetes. BMJ Open, 2015. https://bmjopen.bmj.com/content/5/5/e007689
  7. Use of Fructosamine Test in Diabetic Children. Diabetes Care, Vol. 14, Issue 7, 1991. https://diabetesjournals.org/care/article/14/7/578/17573/Use-of-Fructosamine-Test-in-Diabetic-Children

Disclaimer: The information discussed in this episode is for educational purposes only and is not intended to diagnose, treat, cure, or prevent any disease. The views expressed are those of the speakers and do not necessarily reflect those of Fullscript, Rupa Health, or affiliated organizations. Always consult your licensed healthcare provider before making changes to your health regimen.