Poor blood sugar regulation and unhealthy triglyceride and lipoprotein levels often present long before the diagnosis of type 2 Diabetes. SpectraCell's CardioMetabolic and Pre-Diabetes panels offer definitive diagnostic and clinically relevant evaluation to help define risk of atherosclerotic cardiovascular disease (ASCVD) and progression toward type 2 diabetes. These check points along with an overall pre-diabetes risk score, help patients understand that not just one factor, but rather a constellation of risk factors, contribute to the genesis and progression toward poor blood sugar control and/or ASCVD. Results of testing allow doctors to know when guidance, educational referral, or treatment is necessary. Key components of the CardioMetabolic Risk Panel are listed below.
The Pre-Diabetes Biomarkers identify metabolic abnormalities that may progress into diabetes. Pre-diabetes is a condition where the body cannot efficiently metabolize foods, especially carbohydrates, resulting in impaired glycemic (blood sugar) control which may progress to diabetes when not properly treated or addressed through lifestyle changes.
SpectraCell's Pre-Diabetes Risk Score is a way to estimate a patient's risk of developing diabetes and associated complications such as heart disease or stroke. The following tests have the largest impact on the pre-diabetes risk score: hemoglobin A1c, fasting blood sugar and metabolic syndrome traits. Other factors that significantly affect a pre-diabetic risk but that are not included in this report include weight, blood pressure (hypertension), smoking, inflammation and family history.
- Glucose - snapshot of blood sugar at time of blood draw
- Insulin - correlates to the efficiency with which a person can metabolize carbohydrates; high fasting levels indicate insulin resistance and possible pre-diabetes.
- Hemoglobin A1C - long term (2-3 months) marker of glycemic control; also considered a marker of accelerated aging
- C-peptide - a measure of endogenous insulin production; useful in distinguishing between ty pe 1 and type 2 diabetes
- Adiponectin - a hormone that ezymatically controls metabolism; high levels beneficial and indicate efficient cellular energy production
- Metabolic syndrome traits - A diagnosis of metabolic syndrome is confirmed if any three of the following six traits exist in a patient: (1) high triglycerides (2) high glucose (3) low HDL (4) high blood pressure (5) high waist circumference or (6) increased small dense LDL
Lipid profile indicates whether a person's cholesterol-carrying lipoproteins are predominantly healthy or atherogenic. The Lipoprotein Particle Profile is particularly useful in stratifying cardiometabolic risk in asymptomatic people. SpectraCell's report segments the Lipid Profile into a standard Lipid Panel & the gold standards Lipoprotein Particle Numbers.
The basic Lipid Panel is a very general marker for cardiometabolic risk. This standard lipid panel is helpful when viewed in the context of other biomarkers, particularly lipoprotein particle numbers. Lowering LDL-cholesterol is currently the primary target of treatment. However, elevated triglycerides and low HDL-cholesterol are highly associated with metabolic syndrome, which negatively impacts a pre-diabetic risk score.
- Standard lipid panel - Total cholesterol, HDL, LDL - Useful when viewed in conjunction with more clinically accurate lipoprotein particle testing
- Triglycerides - Elevated triglycerides promote the formation of atherogenic small, dense LDL (indicates abnormal lipoprotein metabolism) and cause endothelial dysfunction; a strong inverse correlation exists between triglycerides and heart protective HDL
Lipoprotein Particle Numbers
Measuring cholesterol alone is insufficient for accurately assessing cardiometabolic risk. SpectraCell's Lipoprotein Particle (LPPTM) is an advanced technology which accurately measures both the density and number of lipoprotein particles. This information reveals potential cardiovascular problems that are often missed when only using a standard lipid panel to assess risk.
- Lipoprotein Particle Profile - accurately measures the number ans size of all lipoprotein particles; helpful in determining the best treatment since the most effective treatment option varies depending on which lipoprotein is elevated
- VLDL, LDL and non-HDL Particles - accurate number of lipoprotein particles stratified by size and type
- Remnant Lipoprotein - highly atherogenic; causes platelet aggregation and impairs vascular relaxation
- Small Dense LDL - highly atherogenic; these are more dangerous because their small size allows them to more easily penetrate and damage the endothelial wall of blood vessels, thus contributing to atherosclerosis
- HDL2b - protective lipoproteins that indicate how well HDL is clearing excess cholesterol
Why is it important to know lipoprotein particle numbers?
Cardiovascular risk increases with a higher LDL particle count. With a higher non-HDL lipoprotein count the probability of particle penetration of the arterial wall rises regardless of the total amount of cholesterol contained in each particle. On average, the typical LDL particles contains 50 percent cholesterol.
More than 20 percent of the population has cholesterol-depleted LDL, a condition in which a patient's cholesterol may be "normal" but their lipoprotein particle number, and hence their actual risk, could be much higher than expected. This is especially common in persons whose triglycerides are high and HDL is low. In the population with a cholesterol-depleted LDL, there can be up to a 40 percent error in risk assessment