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THE COMPLETE CARDIO PROFILE includes the Oxidized LDL profiles.

Why Run the Complete Cardio Profile with Oxidized LDL?

Complete Cardio Profile with Oxidized LDL: Profile 6100

Cardiovascular disease (CVD) is the leading cause of death for both men and women, accounting for every 1 in 4 deaths. Certain health conditions, such as diabetes and overweight, and certain lifestyle choices, such as a poor diet, physical inactivity, smoking, and drinking too much alcohol, increase the risk.

The Complete Cardio Profile with Oxidized LDL offers doctors and patients a complete picture of a person’s CVD risk compared with a standard lipid profile. This Profile measures standard cardiovascular disease markers: total cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), very-low-density lipoprotein (VLDL), and triglycerides. In addition, the Complete Cardio Profile measures oxidized LDL, markers of inflammation, obesity, and metabolic syndrome.

Oxidized LDL

Oxidized LDL

Oxidized low-density lipoprotein (oxLDL) is LDL that has been damaged by unstable molecules known as free radicals. This type of LDL is more dangerous to the arteries than non-oxidized LDL and is more likely to lead to the formation of fatty deposits known as plaque. While LDL is often called, “the bad cholesterol,” oxLDL may be a more reliable indicator of plaque formation in arteries8. Levels of oxidized LDL may help predict who will develop metabolic syndrome, a group of risk factors that raises the risk for CVD. Information about oxLDL is presented as a ratio and as an individual marker. A high Ox LDL:HDL Ratio can help discriminate patients with coronary artery disease from healthy subjects.

OxLDL with Lipids is available as a stand-alone test.

Conditions associated with high levels of oxidized LDL include:

High Oxidized LDL: HDL Ratio• Atherosclerosis
• Coronary artery disease
• Obesity
• Type 2 diabetes
High Oxidized LDL 1• Atherosclerosis
• Acute myocardial infarction (AMI)
• Atherothrombosis
• Hypertension
• Obesity
• Type 2 diabetes
• Metabolic syndrome
• Multiple sclerosis (MS)
• Depression
• Polycystic ovary syndrome (PCOS)

Total Cholesterol

Total Cholesterol

Total cholesterol comprises high-density lipoprotein (HDL, or “good” cholesterol), LDL, and very-low-density lipoprotein (VLDL). Cholesterol is used as a screening test for heart disease.

Conditions associated with imbalanced total cholesterol levels include:

Low total cholesterol3,4• Cancer4,5
• Depression and anxiety4
• Preterm birth and low birth weight6
• Autism7
• Neurodevelopmental disorders7
High total cholesterol2• Atherosclerosis
• Coronary heart disease
• Stroke
• Peripheral vascular disease
• Type 2 diabetes
• High blood pressure

LDL


LDL

Low-density lipoprotein makes up 60-70% of total serum cholesterol. It is the degradation product of VLDL, whose primary role is to transport triglycerides in the blood. LDL has a longer half-life and is, therefore, the preferred measurement. While LDL is often called, “the bad cholesterol,” oxLDL may be a more reliable indicator of plaque formation in arteries8.

Conditions associated with imbalanced LDL levels include:

Low LDL9• Fatty liver disease
• Chronic liver disease
• Malnutrition
• Cancer5
• Parkinson’s disease5
High LDL• Familial hypercholesterolemia
• Insulin resistance
• Metabolic syndrome
• Subclinical hypothyroidism
• Bacterial and viral infections

HDL

HDL

High-density lipoprotein makes up about 20 to 30 percent of a person’s total cholesterol. It’s known as “good” cholesterol because it carries “bad” LDL cholesterol out of the bloodstream to the liver.

Conditions associated with imbalanced HDL levels include:

Low HDL10• Atherosclerosis
• Coronary heart disease
• Myocardial infarction
• Stroke
• Type 2 diabetes
• Obesity
High HDL• Chronic alcoholism
• Treatment with oral estrogen replacement therapy
• Treatment with niacin, statins, or fibrates

Triglycerides

Triglycerides

Triglycerides are a type of fat, or lipid, in the blood. Some triglycerides are made by the liver. Others come from eating. After a meal, any excess calories are converted into triglycerides and stored in fat cells. The fat cells release the triglycerides for energy when it’s needed. High triglycerides, in combination with low HDL or high LDL, can contribute to atherosclerotic disease.

Conditions associated with imbalanced triglyceride levels include:

Low Triglycerides11• Malnutrition
• Autoimmune disease
• Liver disease
High Triglycerides• Metabolic syndrome
• Type 2 diabetes
• Obesity
• Hypothyroidism
• Kidney disease
• Liver damage
• Pancreatitis

Cholesterol: HDL Ratio

Cholesterol

HDL Ratio:

Cholesterol: HDL ratio is a conventional lipoprotein ratio that is traditionally used to assess CVD. It has been used to detect ischemic heart disease risk. A lower ratio is ideal. For men, a ratio of 5 or less is recommended and for women, a ratio of 4.4 or less is ideal2.

Conditions that may be associated with elevated cholesterol: HDL levels include:12

• Coronary heart disease
• Myocardial infarction
• Angina pectoris
• Coronary insufficiency
• Coronary heart disease resulting in death

VLDL

VLDL

Very-low-density lipoprotein makes up 10-15% of total serum cholesterol and is the precursor of LDL, produced in the liver and the intestines.13 VLDL contains the highest quantity of triglycerides in its makeup, as opposed to other lipoproteins.

Conditions that may be associated with elevated VLDL14levels include:

• Cardiovascular disease
• Obesity
• Diabetes
• Hypertension
• Metabolic syndrome
• Insulin resistance

Hemoglobin A1c

Hemoglobin A1c (HbA1c)

Hemoglobin is an iron-containing protein in red blood cells that carries oxygen. Hemoglobin A1c, also known as HbA1c, is a type of hemoglobin that has become coated with glucose. High blood sugar levels result in more HbA1c.

This test indicates a person’s average level of blood glucose (blood sugar) over the previous 6 to 12 weeks. It’s used to confirm a suspicion of diabetes and to assess how well the disease is being managed.

Conditions associated with imbalanced HbA1c levels include:16

Low HbA1c• Iron-deficiency anemia
• Metabolic syndrome
• Chronic liver disease
• Inflammation
• Blood loss
• Hypertriglyceridemia
• Reactions to medications
High HbA1c• Type 2 diabetes
• Chronic kidney disease
• Heart disease
• Nerve damage
• Stroke
• Eye disease
• Alcoholism

Ferritin

Ferritin

Ferritin is a protein that binds to iron. The ferritin blood test indirectly measures the amount of iron in the blood. It’s used to evaluate the body’s iron stores. High ferritin levels can indicate an inflammatory condition.

Conditions associated with imbalanced ferritin levels include:17

Low Ferritin• Iron-deficiency anemia
• Excessive menstrual bleeding
• Intestinal malabsorption that may be brought about by celiac disease, Crohn’s disease, ulcerative colitis, or gluten intolerance
• Hypothyroidism
• Restless leg syndrome
High Ferritin• Atherosclerosis
• Myocardial infarction
• Liver disease
• Inflammation
• Alcoholism
• Rheumatoid arthritis
• Irritable bowel syndrome
• Bacterial infections
• Cancer
• Thyrotoxicosis

Fibrinogen

Fibrinogen

Fibrinogen, also known as factor 1, is a protein made in the liver that is necessary for blood clot formation. Inflammatory conditions can increase the level of fibrinogen. This test is sometimes used along with other CVD tests to help assess a person’s risk of heart disease.

Conditions associated with imbalanced fibrinogen levels include:

Low Fibrinogen19• Bleeding disorder
• Inherited or acquired coagulopathy
• Severe malnutrition
• Advanced liver disease
High Fibrinogen18• Atherosclerosis
• Stroke
• Acute or chronic inflammatory illnesses
• Acute infections
• Cancer

Erythrocyte Sed Rate

Erythrocyte Sed Rate

Erythrocyte sedimentation rate (ESR) is the rate at which red blood cells settle out of anticoagulated blood after the blood has been left standing. Inflammatory or necrotic processes in the body change plasma proteins, causing the erythrocytes to settle more quickly. The ESR provides a sensitive, non-specific indication of inflammation and tissue damage in the body. ESR is not diagnostic of any specific disease but can point to an ongoing disease process that should be further investigated.

Conditions associated with elevated ESR20 include:

• General inflammation
• Inflammatory disease
• Different types of arthritis, e.g. lupus, rheumatoid arthritis
• Cancer
• Stroke
• Chronic infection
• Anemia
• Thyroid disease
• Kidney disease
• Pregnancy

Adiponectin/Leptin

Adiponectin/Leptin

Adiponectin is a protein released by fat cells. It’s involved in breaking down fatty acids and in regulating blood sugar. Blood levels of adiponectin in people with diabetes who also have coronary artery disease (CAD) are lower than in those who don’t have CAD, suggesting that higher levels may help protect against CAD.21 As levels of adiponectin decrease, obesity tends to increase.22

Leptin is a hormone produced by fat cells that helps control appetite by signaling satiety (fullness). High levels correlate with increased body mass index (BMI) and increased body fat percentage.

The Adiponectin/Leptin Profile is also available as a stand-alone test. It measures both adiponectin and leptin and provides a ratio of the two.

Conditions associated with unfavorable adiponectin/leptin levels include:

• Overweight
• Type 2 diabetes
• Coronary artery disease
• Metabolic syndrome
• Atherosclerosis

Insulin

Insulin

Insulin is a hormone made by the pancreas that allows the body's cells to absorb glucose from the blood. It also reduces the amount of glucose the liver makes.

In insulin resistance, the body’s cells are insensitive to the messages from insulin. As a result, cells cannot absorb glucose properly and glucose builds up in the blood.23 The pancreas tries to compensate for this imbalance by producing more and more insulin. With enough insulin, blood glucose levels remain in range. However, the body eventually cannot produce enough insulin to override the difficulty of getting glucose into the cells. Prediabetes or type 2 diabetes develops when this break-down in cell communication progresses, leading to chronically elevated blood glucose and insulin levels.

Conditions associated with elevated insulin levels include:

• Metabolic syndrome
• Prediabetes
• Type 2 diabetes
• Obesity
• Hypertension (high blood pressure)
• Heart disease
• PCOS
• Hypothyroidism

References

References

  1. Holvoet P, De keyzer D, Jacobs DR. Oxidized LDL and the metabolic syndrome. Future Lipidol. 2008;3(6):637-649.
  2. The Family Health Guide. Making sense of cholesterol tests. The Harvard Medical School. 2005.
  3. Jacobs D, Blackburn H, Higgins M, et al. Report of the Conference on Low Blood Cholesterol: Mortality Associations. Circulation. 1992;86(3):1046-1060.
  4. Meilahn EN. Low Serum Cholesterol: Hazardous to Health? Circulation. 1995;92(9):2365-2366.
  5. Huang X, Chen H, Miller WC, et al. Lower low-density lipoprotein cholesterol levels are associated with Parkinson's disease. Mov Disord. 2007;22(3):377-81.
  6. Mortaz M, Fewtrell MS, Cole TJ, Lucas A. Birth weight, subsequent growth, and cholesterol metabolism in children 8-12 years old born preterm. Arch Dis Child. 2001;84(3):212-7.
  7. Tierney E, Bukelis I, Thompson RE, et al. Abnormalities of cholesterol metabolism in autism spectrum disorders. Am J Med Genet B Neuropsychiatr Genet. 2006;141B(6):666-8.
  8. Johnston N, Jernberg T, Lagerqvist B, Siegbahn A, Wallentin L. Improved identification of patients with coronary artery disease by the use of new lipid and lipoprotein biomarkers. Am J Cardiol. 2006;97(5):640-5.
  9. Porter R, Kaplan J, et al., eds. The Merck Manual Online. 19th ed. Whitehouse Station, NY: Merck Sharp & Dohme Corp.; 2013.
  10. Laurila PP, Surakka I, Sarin AP, et al. Genomic, transcriptomic, and lipidomic profiling highlights the role of inflammation in individuals with low high-density lipoprotein cholesterol. Arterioscler Thromb Vasc Biol. 2013;33(4):847-57.
  11. Iannello S, Cavaleri A, Milazzo P, Cantarella S, Belfiore F. Low fasting serum triglyceride level as a precocious marker of autoimmune disorders. MedGenMed. 2003;5(3):20.
  12. Nylander C, Toivonen H, Nasic S, Söderström U, Tindberg Y, Fernell E. Children and adolescents with type 1 diabetes and high HbA1c -- a neurodevelopmental perspective. Acta Paediatr. 2013;102(4):410-5.
  13. Kell DB, Pretorius E. Serum ferritin is an important inflammatory disease marker, as it is mainly a leakage product from damaged cells. Metallomics. 2014;6(4):748-73.
  14. Stec JJ, Silbershatz H, Tofler GH, et al. Association of fibrinogen with cardiovascular risk factors and cardiovascular disease in the Framingham Offspring Population. Circulation. 2000;102(14):1634-8.
  15. Kamath S, Lip GY. Fibrinogen: biochemistry, epidemiology and determinants. QJM. 2003;96(10):711-29.
  16. Kim K, Lee JH. Risk factors and biomarkers of ischemic stroke in cancer patients. J Stroke. 2014;16(2):91-6.
  17. Chandran M, Phillips, SA, Ciaraldi T, et al. Adiponectin: More than just another fat cell hormone? Diabetes Care. 2003;26(8):2442-2450.
  18. Shibata R, Ouchi N, Murohara T. Adiponectin and cardiovascular disease. Circ J. 2009;73(4):608-14.
  19. Balaz M, Vician M, Janakova Z, et al. Subcutaneous adipose tissue zinc-α2-glycoprotein is associated with adipose tissue and whole-body insulin sensitivity. Obesity (Silver Spring). 2014.