Cardio IQ Tests

Measuring Lipid Subclasses using Ion Mobility

The way most doctors test for heart disease is with a lipid panel. It helps detect what HDL (good) and LDL (bad) cholesterol are, so hopefully you can reduce your risk of a possible cardiac event such as a heart attack. Nearly half of all heart attack patients were found to have no prior risk which would indicate they were heading toward an attack.

Quest Diagnostics offers advanced cardiovascular tests that help provide a more accurate and individualized picture of risk. The tests look beyond just HDL and LDL cholesterol to identify undiagnosed (or additional) risk.

These advanced cardiovascular tests, along with your lipid panel, will provide more information that you and your doctor can use to understand your complete cardiovascular health.

Lipid Subclasses as measured by Ion Mobility Technology

Knowing what particles make up your LDL and HDL cholesterol may be important. Ion Mobility Technology provides subclass separation that will allow your healthcare provider to identify your cardiovascular risk over time. Following the change in your lipid profile as you respond to diet, exercise and possible medication to reduce your cardiovascular risk is important. Ion Mobility provides the opportunity to determine if treatment is working and if not, optimize the aggressiveness of therapy to hopefully make a difference that can be seen in the Ion Mobility measurement and graphical representation of your LDL and HDL particles. 

Cardio IQ™ Lipoprotein Fractionation, Ion Mobility 
Cardio IQ™ Lipid Panel
Cardio IQ™ Direct LDL 
Cardio IQ™ Apolipoprotein Evaluation 
Cardio IQ™ Lipoprotein (A)

Apo B

• Apo B is a direct measurement of the number of lipoprotein particles, including LDL (“bad cholesterol”), IDL, and VLDL
• A high Apo B number indicates increased risk for heart disease
• Certain medications, improved eating habits, increased physical activity, and loss of body fat are some ways to
  improve Apo B

Lipoprotein (A) - Lp(a)

• High levels of Lp(a) are associated with increased risk of cardiovascular disease and stroke
• Lp(a) levels may be influenced by genetics. Diet and exercise have limited to no effect on lowering Lp(a); however, certain
  medications can lower levels

Cardio IQ® Apolipoprotein Evaluation - (APOLIPOPROTEIN A1, APOLIPOPROTEIN B and APOLIPOPROTEIN B/A1 RATIO)

• Apolipoprotein A1 is the primary protein associated with HDL cholesterol. Like HDL cholesterol, increased concentrations are associated with reduced risk of cardiovascular disease. Apolipoprotein B-100 is the primary protein associated with LDL cholesterol and other lipid particles. Like LDL cholesterol, increased concentrations are associated with increased risk of cardiovascular disease. The ratio of these two apolipoproteins correlates with risk of cardiovascular disease.

• Apolipoprotein B, Cardio IQ™
• CARDIO IQ(R) LP PLA2 ACTIVITY
• hs-CRP, Cardio IQ™
• Lipid Panel, Cardio IQ™
• Lipoprotein (a), Cardio IQ™
• Lipoprotein Fractionation, Ion Mobility, Cardio IQ™

Cardio IQ® ASCVD Risk Panel with Score 

This panel provides the 10-year and lifetime risk of atherosclerotic cardiovascular disease (ASCVD) using lipid results with anthropomorphic data and family history. 
The ASCVD risk assessment is recommended in the 2013 ACC/AHA Guidelines on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults.

IMPORTANT: For risk calculations to be performed, the following patient-specific information must be provided and recorded at the time of specimen collection:

• Age: Years 
• Gender: M (for male) or F (for female) 
• Height Feet: Feet 
• Height Inches: Inches 
• Weight: lbs 
• Race-African American: Y (for yes) or N (for no) 
• Systolic Blood Pressure: mmHg
• Diastolic Blood Pressure: mmHg
• Treatment for High B.P.: Y (for yes) or N (for no) 
• Diabetes Status: Y (for yes) or N (for no)
• Parental History of Diab: Y (for yes) or N (for no) 
• Smoking Status: Y (for Yes) or N (for no)

 

 

• Apolipoprotein A-1, Cardio IQ™
• Cardio IQ(R) Homocysteine
• CARDIO IQ(R) LP PLA2 ACTIVITY
• hs-CRP, Cardio IQ™
• Lipid Panel, Cardio IQ™
• Lipoprotein (a), Cardio IQ™
• Lipoprotein Fractionation, Ion Mobility, Cardio IQ™
• Omega-3 and -6 Fatty Acids, Plasma

 

• Apolipoprotein A-1, Cardio IQ™
• Cardio IQ(R) Homocysteine
• CARDIO IQ(R) LP PLA2 ACTIVITY
• Fibrinogen Antigen, Nephelometry, Cardio IQ™
• hs-CRP, Cardio IQ™
• Lipid Panel, Cardio IQ™
• Lipoprotein (a), Cardio IQ™
• Lipoprotein Fractionation, Ion Mobility, Cardio IQ™
• Omega-3 and -6 Fatty Acids, Plasma

• Apolipoprotein A-1, Cardio IQ™
• Cardio IQ(R) Homocysteine
• CARDIO IQ(R) LP PLA2 ACTIVITY
• CARDIO IQ(R) MYELOPEROXIDASE (MPO)
• hs-CRP, Cardio IQ™
• Lipid Panel, Cardio IQ™
• Lipoprotein (a), Cardio IQ™
• Lipoprotein Fractionation, Ion Mobility, Cardio IQ™
• Omega-3 and -6 Fatty Acids, Plasma

• Apolipoprotein A-1, Cardio IQ™
• Cardio IQ(R) Homocysteine
• CARDIO IQ(R) LP PLA2 ACTIVITY
• CARDIO IQ(R) MYELOPEROXIDASE (MPO)
• Fibrinogen Antigen, Nephelometry, Cardio IQ™
• hs-CRP, Cardio IQ™
• Lipid Panel, Cardio IQ™
• Lipoprotein (a), Cardio IQ™
• Lipoprotein Fractionation, Ion Mobility, Cardio IQ™
• Omega-3 and -6 Fatty Acids, Plasma

Cardio IQ® Insulin Resistance Panel with Score

Includes

• Insulin, Intact, LC/MS/MS
• C-Peptide, LC/MS/MS
• Insulin Resistance Score

Patient Preparation

• Overnight fasting is required

Clinical Significance

The determination of insulin in serum is primarily used for the diagnosis of glycemic disorders in diabetic and pre-diabetic patients in the assessment of insulin resistant syndromes. Insulin is synthesized by the pancreatic beta cell as a precursor, proinsulin. Proinsulin is processed to insulin and C-peptide, a contiguous peptide between the insulin A and B chains, as it passes through the cell. The C-peptide in the proinsulin ensures correct folding and processing of proinsulin as it passes through the cell. Both insulin and C-peptide are released together from the beta cells in response to increased glucose levels. Because of differences in half-life and hepatic clearance, peripheral blood levels of C-peptide and insulin are no longer equimolar but remain highly correlated. A steady-state plasma glucose test in individuals undergoing an insulin suppression test to assess insulin resistance found that the combination of insulin and C-peptide was a better indicator of insulin resistance than either one individually.

 

 

Cardio IQ® Myeloperoxidase (MPO)

Clinical Significance

Myeloperoxidase testing may be used for individuals with multiple risk factors for cardiovascular disease, or those with established disease.

The test was developed and its performance characteristics determined by Cleveland HeartLab, Inc. 

Performing Laboratory 

Cleveland HeartLab, Inc 

6701 Carnegie Avenue, Suite 500

Cleveland, OH 44103-4623

 

This test will aid physicians in the assessment of risk of atrial fibrilation and cardioembolic stroke.

This test will aid in the assessment of risk associated with myocardial infarction (MI), especially before age 50 in males and age 60 in females.

Description: The ApoE Genotype test is used to identify which Apolipoprotein E Genotype a patient has to determine the patient’s cardiovascular risk and lipid metabolism.

Also Known As: ApoE Cardiac Risk Test, ApoE Cardiovascular Disease Test, Apolipoprotein E Test, Apo E Test, ApoE Protein Test

Collection Method: Blood Draw

Specimen Type: Whole Blood

Test Preparation: No preparation required

When is an ApoE Genotype test ordered?

APOE genotyping is requested as a test to assess cardiovascular risk or lipid metabolism in those who have:

• Levels of cholesterol and triglycerides that are significantly increased and do not go down as a result of dietary and lifestyle adjustments
• A physician who is interested in determining whether a person may be more at risk for developing early heart disease because family members have APOE e2/e2
• Xanthomas, which are yellowish skin lesions, are suspected to be type III hyperlipoproteinemia by the medical professional.

What does an ApoE Genotype test check for?

A protein called apolipoprotein E aids in the movement of lipids through the blood. It can transfer lipids to cells for utilization or storage as well as extra lipid to the liver for excretion because it is recognized by particular cell surface receptors.

There are three genetic variants of the apoE protein, each of which has a slightly different structure. ApoE2, ApoE3, and ApoE4 are their names. While ApoE3 and ApoE4 bind strongly to those receptors, cell surface receptors do not identify ApoE2 very well. Since poor binding of ApoE2 to receptors impairs transport from blood to cells, patients with ApoE2 typically have higher blood lipid levels.

e2, e3, and e4 are three distinct genes that, respectively, code for ApoE2, ApoE3, and ApoE4. Each parent contributes one allele to the individual. Homozygous individuals are those who inherit the same allele from both parents (e2/e2, e3/e3, or e4/e4). Heterozygous individuals are those who have multiple alleles, such as e2/e3, e2/e4, or e3/e4.

A person's DNA is examined as part of the APOE genotyping test to ascertain which APOE forms are present.

The most prevalent genotype of APOE, e3/e3, is regarded as "neutral." Disease risks are calculated in relation to the e3/e3 population.

A higher risk of atherosclerosis is linked to APOE e4, which is present in 25% of the population. When eating a diet high in saturated fat, individuals with certain genotypes may be prone to considerably higher levels of LDL-C and triglycerides.

Those who carry the APOE e2 allele typically have higher triglycerides but lower LDL-C values. Type III hyperlipoproteinemia/hyperlipidemia, a rare genetic condition that results in xanthomas, which are fatty yellow deposits on the skin, elevated triglyceride levels in the blood, and early-onset atherosclerosis, is also linked to APOE e2. With the e2/e2 genotype, type III hyperlipoproteinemia/hyperlipidemia only occurs in roughly 2% of individuals.

Lab tests often ordered with an ApoE Genotype test:

• Lipoprotein Fractionation Ion Mobility
• Lipid Panel
• Apolipoprotein A1
• Apolipoprotein B
• Lipoprotein (a)

Conditions where an ApoE Genotype test is recommended:

• Cardiovascular Disease
• Hyperlipoproteinemia

How does my health care provider use an ApoE Genotype test?

APOE genotyping is typically carried out in research settings, but it can also be applied in clinical settings to aid in the diagnosis and management of increased lipid levels.

When a person exhibits symptoms suggestive of type III hyperlipoproteinemia, APOE testing may be performed to confirm the diagnosis and assess the risk of the problem in other family members. This uncommon genetic condition results in xanthomas, which are fatty, yellowish skin deposits, elevated blood triglyceride levels, and early-onset atherosclerosis.

The APOE genotyping procedure has the potential to direct lipid therapy. Statins are typically regarded as the therapy of choice in situations of high cholesterol and triglyceride levels to lower the risk of developing cardiovascular disease. The APOE genotype, however, has some bearing on the broad variation in response to these lipid-lowering medications. The full clinical utility of this kind of information is still not fully recognized at this time.

What do my ApoE Genotype test results mean?

Genotype e3/e3 of APOE is the most prevalent. Since APOE e3 is linked to "normal" lipid metabolism, it is possible that it has no hereditary bearing on the likelihood of developing cardiovascular disease.

A higher risk of atherosclerosis is linked to APOE e4, which is present in 25% of the population. When eating a diet high in saturated fat, people with certain genotypes may be prone to considerably higher levels of LDL-C and triglycerides.

People who carry the APOE e2/e2 allele typically have higher triglycerides but lower LDL-C values. Type III hyperlipidemia and hyperlipoproteinemia are both linked to APOE e2. Although those who carry the APOE e2/e2 genotype are more likely to experience early vascular disease, they may never experience disease. If symptoms are present, e2/e2 can assist confirm type III hyperlipoproteinemia and APOE genotyping adds more information.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.

Description: Apo A1 is a blood test that measures that amount of Apolipoprotein A1 in the blood’s. This test is used to assess cardiovascular risk. Low levels of APO A1 are associated with Coronary Artery Disease (CAD) and are said to predict CAD better then triglycerides and HDL does.

Also Known As: Apo A1 Test, Apo A-1 Test, Apolipoprotein A-1 Test, A-1 Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: Fasting for at least 12 hours is required

When is an Apolipoprotein A1 test ordered?

Apolipoprotein A-I and B, as well as other lipid tests, may be ordered as part of a screening to identify a person's risk of cardiovascular disease.

Apo A-I is a protein that plays a key function in lipid metabolism and is the most abundant protein in HDL, or "good cholesterol." Excess cholesterol in cells is removed by HDL, which transports it to the liver for recycling or elimination. Apo A-I levels tend to rise and fall with HDL levels, and apo A-I deficits are linked to an increased risk of CVD.

What does an Apolipoprotein A1 test check for?

Lipids are transported throughout the bloodstream by apolipoproteins, which mix with them. Lipoproteins are held together by apolipoproteins, which protect the water-repellent (hydrophobic) lipids at their core.

Lipoproteins are cholesterol or triglyceride-rich proteins that transport lipids throughout the body for cell absorption. HDL, on the other hand, is like an empty cab. It travels to the tissues to collect excess cholesterol before returning it to the liver. Cholesterol is either recycled for future use or eliminated in bile in the liver. The only mechanism for cells to get rid of excess cholesterol is by HDL reverse transport. It protects the arteries and, if enough HDL is present, it can even reverse the formation of fatty plaques, which are deposits caused by atherosclerosis and can contribute to cardiovascular disease.

The taxi driver is Apolipoprotein A. It permits HDL to be detected and bound by receptors in the liver at the end of the transport by activating the enzymes that load cholesterol from the tissues into HDL. Apolipoprotein A is divided into two types: apo A-I and apo A-II. Apo A-I has a higher prevalence than apo A-II. Apo A-I concentrations can be evaluated directly, and they tend to rise and fall in tandem with HDL levels. Deficiencies in apo A-I are linked to an increased risk of cardiovascular disease.

Lab tests often ordered with an Apolipoprotein A1 test:

• Apolipoprotein B
• Cholesterol Total
• HDL Cholesterol
• LDL Cholesterol
• Triglycerides
• Lipid Panel
• Lipoprotein (a)
• Homocysteine
• hs-CRP
• Lipoprotein Fractionation, Ion Mobility

Conditions where an Apolipoprotein A1 test is recommended:

• Cardiovascular Disease
• Heart Attack
• Stroke
• Congestive Heart Failure
• Angina
• Coronary Heart Disease

How does my health care provider use an Apolipoprotein A1 test?

An apo B/apo A-I ratio can be determined by ordering both an apo A-I and an apo B test. To assess the risk of developing CVD, this ratio is sometimes used instead of the total cholesterol/HDL ratio.

An apo A-I test may be ordered in the following situations:

Assist in the diagnosis of apo A-I deficiency caused by genetic or acquired diseases.

Assist those with a personal or family history of heart disease, high cholesterol, or triglycerides in their blood.

Keep track of how well lifestyle changes and lipid therapies are working.

An apo A-I test can be ordered in conjunction with an apo B test to determine the apo B/apo A-I ratio. This ratio is occasionally used instead of the total cholesterol/HDL ratio (which is sometimes included in a lipid profile) to assess the risk of developing CVD.

What do my Apolipoprotein A1 test results mean?

Low apo A-I levels are linked to low HDL levels and slowed elimination of excess cholesterol from the body. Low levels of apo A-I, as well as high levels of apo B, are linked to a higher risk of cardiovascular disease.

Deficiencies in apo A-I are caused by a number of hereditary diseases. Abnormal lipid levels, notably excessive amounts of low-density lipoprotein, are common in people with certain illnesses. They frequently have a higher rate of atherosclerosis. Low apo A-I levels are caused by several genetic diseases.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.

Description: Apolipoprotein B is a blood test that measures that amount of Apolipoprotein B in the blood’s serum. This test is used to assess cardiovascular risk.

Also Known As: Apo B Test, Apolipoprotein B-100 Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is an Apolipoprotein B test ordered?

Apolipoprotein A-I and B, as well as other lipid tests, may be ordered as part of a screening to identify a person's risk of cardiovascular disease.

Apo B is a protein that plays a role in lipid metabolism and is the major protein component of lipoproteins including VLDL and LDL, popularly known as "bad cholesterol." Apo B concentrations are similar to LDL-C concentrations.

What does an Apolipoprotein B blood test check for?

Lipids are transported throughout the bloodstream by apolipoproteins, which mix with them. Lipoproteins are held together by apolipoproteins, which protect the water-repellent lipids at their core.

Lipoproteins are cholesterol or triglyceride-rich proteins that transport lipids throughout the body for cell absorption. HDL, on the other hand, is like an empty cab. It travels to the tissues to collect excess cholesterol before returning it to the liver. Cholesterol is either recycled for future use or eliminated in bile in the liver. The only mechanism for cells to get rid of excess cholesterol is by HDL reverse transport. It protects the arteries and, if enough HDL is present, it can even reverse the formation of fatty plaques, which are deposits caused by atherosclerosis and can contribute to cardiovascular disease.

Chylomicrons are lipoprotein particles that transport dietary fats from the digestive system to tissue, primarily the liver, via the bloodstream. These dietary lipids are repackaged in the liver and combined with apo B-100 to create triglyceride-rich VLDL. This combo is similar to a taxi with a full load of passengers and apo B-100 as the driver. The taxi moves from place to place in the bloodstream, releasing one passenger at a time.

Triglycerides are removed from VLDL by an enzyme called lipoprotein lipase, which produces intermediate density lipoproteins first, then LDL. VLDL contains one molecule of apo B-100, which is kept as VLDL loses triglycerides and shrinks to become the cholesterol-rich LDL. Apo B-100 is detected by receptors on the surface of many different types of cells in the body. The absorption of cholesterol into cells is aided by these receptors.

LDL and apo B-100 transport cholesterol that is essential for cell membrane integrity, sex hormone generation, and steroid production. Excess LDL, on the other hand, can cause fatty deposits in artery walls, as well as blood vessel hardening and scarring. Atherosclerosis is a condition in which fatty deposits restrict blood arteries. The risk of a heart attack increases as the atherosclerotic process progresses.

LDL-C levels, which are typically ordered as part of a lipid profile, tend to mimic Apo B-100 levels. Many experts believe that apo B levels will eventually show to be a more accurate predictor of CVD risk than LDL-C. Others disagree, believing that vitamin B is only a modestly superior choice and that it should not be used on a regular basis. The clinical utility of apo B, as well as other developing cardiac risk markers including apo A-I, Lp(a), and hs-CRP, is still unknown.

Lab tests often ordered with an Apolipoprotein B test:

• Apolipoprotein A1
• Cholesterol Total
• HDL Cholesterol
• LDL Cholesterol
• Triglycerides
• Lipid Panel
• Lipoprotein (a)
• Homocysteine
• hs-CRP
• Lipoprotein Fractionation, Ion Mobility

Conditions where an Apolipoprotein B test is recommended:

• Cardiovascular Disease
• Heart Attack
• Stroke
• Congestive Heart Failure
• Angina

How does my health care provider use an Apolipoprotein B test?

An apo B/apo A-I ratio can be determined by ordering both an apo A-I and an apo B test. To assess the risk of developing CVD, this ratio is sometimes used instead of the total cholesterol/HDL ratio.

As an alternative to non-HDL-C, Apo B levels may be ordered to assess the success of lipid treatment.

An apo B test may be conducted in rare circumstances to assist determine a genetic issue that causes apo B overproduction or underproduction.

What do my Apolipoprotein B test results mean?

Raised apo B levels are linked to elevated LDL-C and non-HDL-C levels, and are linked to an increased risk of cardiovascular disease. Elevations may be caused by a high-fat diet and/or a reduction in LDL clearance from the blood.

A direct cause of abnormal apo B levels is some hereditary diseases. Familial combined hyperlipidemia, for example, is an inherited condition that causes excessive cholesterol and triglyceride levels in the blood. Apolipoprotein B deficiency, also known as Bassen-Kornzweig syndrome, is a relatively rare hereditary disorder that results in unusually low amounts of apo B.

A variety of underlying diseases and other factors might result in abnormal apo B levels.

Is apoB a heart disease risk factor? 
The markers of particle number, apoB, or LDL particle number were better at predicting the risk of heart disease than LDL-C.

There are two major forms of Apolipoprotein B, B-100 and B-48. B-100, synthesized in the liver, is the major protein in VLDL, IDL, and LDL cholesterol. B-48, synthesized in the intestines, is essential for the assembly and secretion of chylomicrons. Patients with increased concentrations of Apolipoprotein B are at increased risk of atherosclerosis.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.

Description: Apo A1 and B is a blood test that measures that amount of Apolipoprotein A1 and Apolipoprotein B in the blood’s serum along with the ratio between B/A1. This test is used to assess cardiovascular risk. Low levels of APO A1 are associated with Coronary Artery Disease (CAD) and are said to predict CAD better then triglycerides and HDL does.

Also Known As: Apo A1 and B Test, Apo A1 Test, Apo B Test, APOAB Test, Apolipoprotein B-100 Test, Apolipoprotein Evaluation Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: Fasting for 12 hours is required.

When are Apolipoprotein A1 and B tests ordered?

Apolipoprotein A-I and B, as well as other lipid tests, may be ordered as part of a screening to identify a person's risk of cardiovascular disease.

Apo A-I is a protein that plays a key function in lipid metabolism and is the most abundant protein in HDL, or "good cholesterol." Excess cholesterol in cells is removed by HDL, which transports it to the liver for recycling or elimination. Apo A-I levels tend to rise and fall with HDL levels, and apo A-I deficits are linked to an increased risk of CVD.

Apo B is a protein that plays a role in lipid metabolism and is the major protein component of lipoproteins including VLDL and LDL, popularly known as "bad cholesterol." Apo B concentrations are similar to LDL-C concentrations.

What does Apolipoprotein A1 and B blood tests check for?

Lipids are transported throughout the bloodstream by apolipoproteins, which mix with them. Lipoproteins are held together by apolipoproteins, which protect the water-repellent lipids at their core.

Lipoproteins are cholesterol or triglyceride-rich proteins that transport lipids throughout the body for cell absorption. HDL, on the other hand, is like an empty cab or taxi. It travels to the tissues to collect excess cholesterol before returning it to the liver. Cholesterol is either recycled for future use or eliminated in bile in the liver. The only mechanism for cells to get rid of excess cholesterol is by HDL reverse transport. It protects the arteries and, if enough HDL is present, it can even reverse the formation of fatty plaques, which are deposits caused by atherosclerosis and can contribute to cardiovascular disease.

Sticking with the taxi analogy, the driver is Apolipoprotein A. It permits HDL to be detected and bound by receptors in the liver at the end of the transport by activating the enzymes that load cholesterol from the tissues into HDL. Apolipoprotein A is divided into two types: apo A-I and apo A-II. Apo A-I has a higher prevalence than apo A-II. Apo A-I concentrations can be evaluated directly, and they tend to rise and fall in tandem with HDL levels. Deficiencies in apo A-I are linked to an increased risk of cardiovascular disease.

Chylomicrons are lipoprotein particles that transport dietary fats from the digestive system to tissue, primarily the liver, via the bloodstream. These dietary lipids are repackaged in the liver and combined with apo B-100 to create triglyceride-rich VLDL. This combo is similar to a taxi with a full load of passengers and apo B-100 as the driver. The taxi moves from place to place in the bloodstream, releasing one passenger at a time.

Triglycerides are removed from VLDL by an enzyme called lipoprotein lipase, which produces intermediate density lipoproteins first, then LDL. VLDL contains one molecule of apo B-100, which is kept as VLDL loses triglycerides and shrinks to become the cholesterol-rich LDL. Apo B-100 is detected by receptors on the surface of many different types of cells in the body. The absorption of cholesterol into cells is aided by these receptors.

LDL and apo B-100 transport cholesterol that is essential for cell membrane integrity, sex hormone generation, and steroid production. Excess LDL, on the other hand, can cause fatty deposits in artery walls, as well as blood vessel hardening and scarring. Atherosclerosis is a condition in which fatty deposits restrict blood arteries. The risk of a heart attack increases as the atherosclerotic process progresses.

LDL-C levels, which are typically ordered as part of a lipid profile, tend to mimic Apo B-100 levels. Many experts believe that apo B levels will eventually show to be a more accurate predictor of CVD risk than LDL-C. Others disagree, believing that vitamin B is only a modestly superior choice and that it should not be used on a regular basis. The clinical utility of apo B, as well as other developing cardiac risk markers including apo A-I, Lp(a), and hs-CRP, is still unknown.

Lab tests often ordered with Apolipoprotein A1 and B tests:

• Cholesterol Total
• HDL Cholesterol
• LDL Cholesterol
• Triglycerides
• Lipid Panel
• Lipoprotein (a)
• Homocysteine
• hs-CRP
• Lipoprotein Fractionation, Ion Mobility

Conditions where Apolipoprotein A1 and B tests are recommended:

• Cardiovascular Disease
• Heart Attack
• Stroke
• Congestive Heart Failure
• Angina

How does my health care provider use Apolipoprotein A1 and B tests?

An apo B/apo A-I ratio can be determined by ordering both an apo A-I and an apo B test. To assess the risk of developing CVD, this ratio is sometimes used instead of the total cholesterol/HDL ratio.

An apo A-I test may be ordered in the following situations:

Assist in the diagnosis of apo A-I deficiency caused by genetic or acquired diseases.

Assist those with a personal or family history of heart disease, high cholesterol, or triglycerides in their blood.

Keep track of how well lifestyle changes and lipid therapies are working.

An apo A-I test can be ordered in conjunction with an apo B test to determine the apo B/apo A-I ratio. This ratio is occasionally used instead of the total cholesterol/HDL ratio to assess the risk of developing CVD.

As an alternative to non-HDL-C, Apo B levels may be ordered to assess the success of lipid treatment.

An apo B test may be conducted in rare circumstances to assist determine a genetic issue that causes apo B overproduction or underproduction.

What do my Apolipoprotein A1 and B test results mean?

Low apo A-I levels are linked to low HDL levels and slowed elimination of excess cholesterol from the body. Low levels of apo A-I, as well as high levels of apo B, are linked to a higher risk of cardiovascular disease.

Deficiencies in apo A-I are caused by a number of hereditary diseases. Abnormal lipid levels, notably excessive amounts of low-density lipoprotein, are common in people with certain illnesses. They frequently have a higher rate of atherosclerosis. Low apo A-I levels are caused by several genetic diseases.

Raised apo B levels are linked to elevated LDL-C and non-HDL-C levels, and are linked to an increased risk of cardiovascular disease. Elevations may be caused by a high-fat diet and/or a reduction in LDL clearance from the blood.

A direct cause of abnormal apo B levels is some hereditary diseases. Familial combined hyperlipidemia, for example, is an inherited condition that causes excessive cholesterol and triglyceride levels in the blood. Apolipoprotein B deficiency, also known as Bassen-Kornzweig syndrome, is a relatively rare hereditary disorder that results in unusually low amounts of apo B.

A variety of underlying diseases and other factors might result in abnormal apo B levels.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.

Description: The Cholesterol Total test is a blood test used to check levels of cholesterol in your blood’s serum to determine risk of heart disease.

Also Known As: Blood Cholesterol Test, Total Cholesterol Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: If a cholesterol measurement is to be performed along with triglycerides, the patient should be fasting for at least 9 hours.

When is a Cholesterol Total test ordered?

Cholesterol testing is advised as a screening test for all persons without heart disease risk factors at least once every four to six years. It is frequently combined with a standard physical examination.

When a person has one or more risk factors for heart disease, their cholesterol is tested more frequently.

Children and young people should have their lipid profiles checked for elevated cholesterol. Between the ages of 9 and 11, and again between the ages of 17 and 21, they should be tested. Children and teenagers who are at a higher risk of developing heart disease as adults should be screened with a lipid profile earlier and more frequently. A family history of heart disease or health problems such as diabetes, high blood pressure, or being overweight are some of the risk factors, which are comparable to those in adults. Cholesterol testing is indicated when a child's BMI is at or above the 85th percentile. Laboratory testing to evaluate cholesterol levels may be recommended every two years for an obese adolescent.

According to the American Academy of Pediatrics, high-risk children should receive their first cholesterol test between the ages of 2 and 8. Children under the age of two are not eligible for testing. The fasting test should be repeated in three to five years if the initial results are not alarming.

Total cholesterol tests may be conducted at regular intervals as part of a lipid profile to assess the success of lipid-lowering lifestyle changes like diet and exercise, or to determine the efficacy of medication therapy like statins. Adults on statins should have a fasting lipid profile done 4 to 12 weeks after commencing therapy and then every 3 to 12 months after that to ensure that the drug is effective, according to the American College of Cardiology and the American Heart Association.

What does a Cholesterol Total blood test check for?

Cholesterol is a vital component of life. It creates cell membranes in all of the body's organs and tissues. Hormones required for development, growth, and reproduction are produced using it. It produces bile acids, which are necessary for food absorption. The total cholesterol transported in the blood by lipoproteins is measured by the cholesterol test.

Lipoproteins are complex particles that carry a small quantity of cholesterol in the blood. Each particle comprises a mixture of protein, cholesterol, triglyceride, and phospholipid molecules, and they are classed as high-density lipoproteins, low-density lipoproteins, or very low-density lipoproteins based on their density. LDL-C particles, also known as "bad" cholesterol, deposit cholesterol in tissues and organs whereas HDL-C particles take excess cholesterol away for disposal.

It is critical to monitor and maintain good cholesterol levels in order to stay healthy. The body manufactures the cholesterol it needs to function correctly, although some cholesterol comes from food. If a person has a hereditary propensity to high cholesterol levels or consumes too many foods high in saturated and trans unsaturated fats, the amount of cholesterol in their blood may rise, posing a health risk. Plaques on the walls of blood arteries may form as a result of excess cholesterol in the circulation. Plaques can constrict or block blood channel openings, resulting in artery hardening (atherosclerosis) and an increased risk of a variety of health problems, including heart disease and stroke.

Lab tests often ordered with a Cholesterol Total test:

• Lipid Panel
• HDL Cholesterol
• LDL Cholesterol
• Triglycerides
• Lipoprotein Fractionation Ion Mobility

Conditions where a Cholesterol Total test is recommended:

• Heart Disease
• Cardiovascular Disease
• Heart Attack
• Stroke

How does my health care provider use a Cholesterol Total test?

The total cholesterol test is used alone or in conjunction with a lipid profile to assist forecast an individual's risk of developing heart disease and to help determine what treatment may be required if the risk is borderline or high. It can also be used to evaluate the effectiveness of treatment once it is started as part of a lipid profile

Cholesterol testing is considered a normal aspect of preventative healthcare because high blood cholesterol has been linked to artery hardening, heart disease, and an increased risk of mortality from heart attacks.

The results of the cholesterol test and other components of the lipid profile, as well as other recognized heart disease risk factors, are utilized to build a treatment and follow-up strategy. Treatment options may include lipid-lowering medicines such as statins or lifestyle changes such as diet and exercise regimens.

What do my Cholesterol test results mean?

Healthy lipid levels, in general, aid in the maintenance of a healthy heart and reduce the risk of heart attack or stroke. To evaluate a person's overall risk of heart disease, if therapy is necessary, and, if so, which treatment will best serve to minimize the person's risk, a healthcare practitioner will consider total cholesterol results and the other components of a lipid profile, as well as other risk factors.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.

This test detects variants in the CYP2C19 gene leading to altered enzyme activity and may require alternative treatments or altered drug dosage of a drug metabolized by CYP2C19 for optimal therapeutic response.

Description: Direct LDL is a blood test that measures LDL cholesterol in your blood’s serum to determine risk of heart  disease.

Also Known As: Direct LDL-C Test, Direct LDL Cholesterol Test, DLDL Test, LDL D Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: If an LDL-cholesterol measurement is to be performed along with triglycerides, the patient should be fasting 9-12 hours prior to collection

When is a Direct LDL test ordered?

When calculating LDL cholesterol is impossible due to a considerable increase in triglycerides, a direct LDL-C test is ordered. A doctor may order it if previous tests have revealed elevated triglyceride levels. When triglyceride levels are too high to calculate LDL-C, certain laboratories will automatically do this direct LDL test. This saves the doctor time by avoiding the need to order another test, the patient time by avoiding the need for a second blood sample, and the time it takes to get the test results.

What does a Direct LDL blood test check for?

The direct low-density lipoprotein cholesterol test determines the amount of LDL cholesterol in the blood, also known as "bad" cholesterol. LDL-C levels beyond a certain threshold are linked to an increased risk of artery hardening and heart disease. The amount of LDL-C is usually determined using readings from a typical lipid profile. This is a good estimate of LDL-C in most circumstances, although it becomes less accurate as triglyceride levels rise. When triglycerides are high, direct measurement of LDL-C is less impacted by them and can be employed.

Lab tests often ordered with a Direct LDL test:

• LDL Cholesterol
• Lipid Panel
• Total Cholesterol
• Triglycerides
• HDL Cholesterol
• Apolipoprotein B
• Apolipoprotein A1
• Lipoprotein Fractionation Ion Mobility

Conditions where a Direct LDL test is recommended:

• Heart Disease
• Coronary Artery Diseases

How does my health care provider use a Direct LDL test?

Low density lipoprotein cholesterol levels are commonly used to determine a person's risk of heart disease or to monitor their response to cholesterol-lowering medication. Total cholesterol, high-density lipoprotein cholesterol, and triglycerides are all assessed in a conventional lipid profile. The amount of cholesterol present in low-density lipoprotein can be calculated using a mathematical calculation based on the three observed values. The calculated LDL-C value is often included in the lipid profile. The calculation is no longer applicable when triglycerides are high. The only way to precisely determine LDL-C in this case is to measure it directly.

A metabolic disease affecting lipids could cause high triglycerides. After eating, though, anyone can have high triglycerides. The direct LDL-C test can identify the amount of LDL in a person's blood in either condition.

What do my Direct LDL test results mean?

Increased LDL levels, as determined by the direct LDL-C test, suggest a higher risk of heart disease. Reduced levels imply a reduction in the risk of heart disease as a result of lipid-lowering lifestyle adjustments and/or pharmacological therapy.

Low LDL levels are usually not a cause for worry and are not monitored. They can appear in persons who have a hereditary lipoprotein insufficiency, as well as in people who have hyperthyroidism, infection, or inflammation.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.

Low levels of fibrinogen are associated with bleeding most commonly secondary to liver disease or disseminated intravascular coagulation (DIC). Fibrinogen is an acute phase reactant and thus elevated levels may be associated with inflammation. Increased concentrations are also associated with increased risk of atherosclerosis.

HDL Cholesterol is inversely related to the risk for cardiovascular disease. It increases following regular exercise, moderate alcohol consumption and with oral estrogen therapy. Decreased levels are associated with obesity, stress, cigarette smoking and diabetes mellitus.

Description: Hemoglobin A1c is the protein Hemoglobin found in red blood cells, but with glucose attached to it. Hemoglobin A1c is used to check for and monitor diabetes as it shows average blood glucose levels over the past 2 to 3 months.

Also Known As: A1c Test, HbA1c Test, Glycohemoglobin Test, Glycated Hemoglobin Test, Glycosylated Hemoglobin Test, HbA1c Test

Collection Method: Blood Draw

Specimen Type: Whole Blood

Test Preparation: No preparation required

When is a Hemoglobin A1c test ordered?

A1c may be requested as part of a routine physical examination or when a practitioner suspects a patient of having diabetes due to characteristic signs or symptoms of high blood sugar, such as:

• Increased thirst and fluid intake
• Increased urination
• Increase in hunger
• Fatigue
• Vision is hazy
• Infections that take a long time to heal

Adults who are overweight and have the following additional risk factors may consider doing the A1c test:

• Physically inactive
• Diabetes in a first-degree relative
• Race/ethnicity that is at high risk such as African Americans, Latinos, Native Americans, Asian Americans, and Pacific Islanders
• Blood pressure that is high
• A lipid profile that is abnormal.
• Polycystic ovarian syndrome 
• Cardiovascular disease 
• Insulin resistance and other conditions links to insulin resistance

People who have not been diagnosed with diabetes but have been assessed to be at an increased risk of developing diabetes should have their A1c levels tested at least once a year.

Monitoring

The A1c test may be performed 2 to 4 times a year, depending on the type of diabetes a person has, how well their diabetes is controlled, and the healthcare provider's recommendations. If diabetics are fulfilling treatment goals and have stable glycemic control, the American Diabetes Association advises A1c testing at least twice a year. A1c may be ordered quarterly when someone is first diagnosed with diabetes or if control isn't good.

What does a Hemoglobin A1c blood test check for?

Hemoglobin A1c, often known as A1c or glycated hemoglobin, is hemoglobin that has been attached to glucose. By assessing the proportion of glycated hemoglobin, the A1c test determines the average quantity of glucose in the blood during the previous 2 to 3 months.

Hemoglobin is a protein present inside red blood cells that transports oxygen.

Glycated hemoglobin is generated in proportion to the amount of glucose in the blood. Once glucose attaches to hemoglobin, it stays there for the duration of the red blood cell's life, which is usually about 120 days. The most common kind of glycated hemoglobin is known as A1c. A1c is created on a daily basis and is gradually removed from the bloodstream as older RBCs die and younger RBCs replace them.

This test can be used to detect and diagnose diabetes, as well as the risk of developing it. According to the American Diabetes Association's standards of medical care in diabetes, diabetes can be diagnosed using either A1c or glucose.

This test can also be used to track the progress of a diabetic patient's treatment. It aids in determining how well a person's glucose levels have been controlled over time by medication. An A1c of less than 7% suggests good glucose control and a lower risk of diabetic complications for the majority of diabetics for monitoring reasons.

Lab tests often ordered with a Hemoglobin A1c test:

• Complete Blood Count
• Glucose
• Frucstosamine
• Albumin
• Comprehensive Metabolic Panel
• Microalbumin w/creatinine
• Lipid panel

Conditions where a Hemoglobin A1c test is recommended:

• Type 1 Diabetes
• Type 2 Diabetes

How does my health care provider use a Hemoglobin A1c test?

Adults can use the hemoglobin A1c test to screen for and diagnose diabetes and prediabetes.

A fasting glucose or oral glucose tolerance test should be done to screen or diagnose diabetes in these instances.

The A1c test is also used to track diabetics' glucose control over time. Diabetics strive to maintain blood glucose levels that are as close to normal as feasible. This helps to reduce the risks of consequences associated with chronically high blood sugar levels, such as progressive damage to body organs such as the kidneys, eyes, cardiovascular system, and nerves. The result of the A1c test depicts the average quantity of glucose in the blood over the previous 2-3 months. This can help diabetics and their healthcare professionals determine whether the steps they're taking to control their diabetes are working or if they need to be tweaked.

A1c is a blood test that is usually used to help newly diagnosed diabetics identify how high their uncontrolled blood glucose levels have been in the previous 2-3 months. The test may be ordered multiple times throughout the control period, and then at least twice a year after that to ensure that good control is maintained.

What does my Hemoglobin A1c test result mean?

HbA1c levels is currently reported as a percentage for monitoring glucose control, and it is suggested that most diabetics try to keep their hemoglobin A1c below 7%. The closer diabetics can keep their A1c to the therapeutic objective of less than 7% without experiencing abnormally low blood glucose, the better their diabetes is controlled. The risk of problems rises as the A1c rises.

However, a person with type 2 diabetes may have an A1c goal set by their healthcare professional. The length of time since diagnosis, the presence of other diseases as well as diabetes complications, the risk of hypoglycemia complications, life expectancy, and whether or not the person has a support system and healthcare resources readily available are all factors that may influence the goal.

For example, a person with heart disease who has had type 2 diabetes for many years without diabetic complications may have a higher A1c target set by their healthcare provider, whereas someone who is otherwise healthy and newly diagnosed may have a lower target set by their healthcare provider as long as low blood sugar is not a significant risk.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.

Description: Homocysteine is an amino acid that is present in every cell. There is a small amount present as it is an amino acid that changes quickly into other needed products in the body.

Also Known As: Homocysteine Cardiac Risk Test, Homocysteine Blood Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: Fasting for at least 8 hours is preferred

When is a Homocysteine test ordered?

When a doctor feels a person may be deficient in vitamin B12 or folate, he or she may request this test. At first, the signs and symptoms are vague and ambiguous. People who have an early deficit may be diagnosed before they show any visible symptoms. Other persons who are impacted may experience a range of moderate to severe symptoms, including:

• Diarrhea
• Dizziness
• Weakness and exhaustion
• Appetite loss
• Paleness
• Heart rate that is quite fast
• Breathing problems
• Tongue and mouth ache
• In the feet, hands, arms, and legs, there is tingling, numbness, and/or burning

Depending on an individual's age and other risk factors, homocysteine may be requested as part of determining a person's risk of developing cardiovascular disease. It may also be ordered after a heart attack or stroke to aid in treatment planning.

When newborn screening identifies an increased level of methionine or if an infant or kid shows signs and symptoms of homocystinuria, this test may be ordered. Babies with this illness will appear normal at birth, but if left untreated, they will develop symptoms such as a displaced lens in the eye, a long slender build, long thin fingers, and skeletal abnormalities within a few years.

What does a Homocysteine blood test check for?

Homocysteine is an amino acid that is found in trace amounts in all of the body's cells. The body generally converts homocysteine to other compounds fast. Because vitamins B6, B12, and folate are required for homocysteine metabolism, elevated levels of the amino acid could indicate a vitamin deficit. The level of homocysteine in the blood is determined by this test.

Increased homocysteine levels have also been linked to an increased risk of coronary heart disease, stroke, peripheral vascular disease, and artery hardening. Homocysteine has been linked to cardiovascular disease risk through a variety of processes, including damage to blood vessel walls and support for the production of abnormal blood clots, but no direct linkages have been established. Several studies have also found no benefit or reduction in CVD risk with folic acid and B vitamin supplementation. The American Heart Association does not believe it to be a significant risk factor for heart disease at this time.

Homocysteine levels in the blood can also be dramatically increased by a rare genetic disorder known as homocystinuria. In homocystinuria, one of multiple genes is mutated, resulting in a defective enzyme that prevents the normal breakdown of methionine, the precursor of homocysteine. Methionine is one of the eleven necessary amino acids that the body cannot make and must therefore be obtained from food.

Homocysteine and methionine build up in the body without the necessary enzyme to break them down. Babies born with this condition appear normal at birth, but develop symptoms such as a long slender build, a dislocated lens in the eye, long thin fingers, osteoporosis, skeletal abnormalities, and a significantly increased risk of thromboembolism and atherosclerosis, which can lead to premature CVD within a few years.

In addition to intellectual disability, mental illness, a little low IQ, behavioral issues, and seizures, artery blockages can induce intellectual disability, mental illness, and seizures. Some of them can be avoided if homocystinuria is diagnosed early, which is why all states screen neonates for the disease.

Lab tests often ordered with a Homocysteine test:

• Vitamin B12
• Folate
• MTHFR Mutation
• Intrinsic Factor Antibody

Conditions where a Homocysteine test is recommended:

• Vitamin B12 and Folate Deficiency
• Heart Attack
• Heart Disease
• Stroke

How does my health care provider use a Homocysteine test?

The homocysteine test can be used in a variety of ways, including:

A homocysteine test may be ordered by a doctor to see if a person is deficient in vitamin B12 or folate. Before B12 and folate tests are abnormal, the homocysteine level may be raised. Homocysteine testing may be recommended by some health professionals in malnourished people, the elderly, who absorb less vitamin B12 from their diet, and people who have poor nutrition, such as drug or alcohol addicts.

For those at high risk of a stroke or heart attack, homocysteine testing may be requested as part of a health screening. It could be beneficial for someone who has a family history of coronary artery disease but no other recognized risk factors like smoking, high blood pressure, or obesity. However, because the specific role of homocysteine in the course of cardiovascular disease is unknown, the screening test's efficacy continues to be questioned.

If a health professional believes that an infant or kid has homocystinuria, tests for both urine and blood homocysteine can be utilized to assist diagnose the genetic condition. As part of their newborn screening in the United States, all babies are regularly tested for excess methionine, a symptom of homocystinuria. If a baby's test results are positive, urine and blood homocysteine tests are frequently used to confirm the results.

What do my homocysteine test results mean?

Homocysteine levels may be high in cases of suspected malnutrition, vitamin B12, or folate insufficiency. If a person does not consume enough B vitamins and/or folate through diet or supplements, the body may be unable to convert homocysteine into forms that the body can use. The level of homocysteine in the blood may rise in this scenario.

According to studies conducted in the mid- to late-1990s, those with high homocysteine levels have a substantially higher risk of heart attack or stroke than those with normal levels. The study of the relationship between excessive homocysteine levels and heart disease is still ongoing. However, considering that multiple trials studying folic acid and B vitamin supplementation have found no benefit or reduction in CVD risk, the use of homocysteine levels for risk assessment of cardiovascular disease, peripheral vascular disease, and stroke is now questionable.

A 2012 research study using various datasets, including 50,000 persons with coronary heart disease, called into question the possibility of a cause-and-effect relationship between homocysteine levels and heart disease. Although the American Heart Association recognizes a link between homocysteine levels and heart attack/stroke survival rates, it does not consider high homocysteine to be a major CVD risk factor.

While the AHA does not advocate for widespread use of folic acid and B vitamins to reduce the risk of heart attack and stroke, it does advocate for a balanced, nutritious diet and advises doctors to consider total risk factors as well as nutrition when treating cardiovascular disease.

Significantly elevated homocysteine concentrations in the urine and blood indicate that an infant is likely to have homocystinuria and need additional testing to confirm the reason of the increase.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.

Description: A hs-CRP or High Sensitivity C-Reactive Protein test is a blood test used to accurately detect lower concentrations of the protein C-Reactive Protein. This test is used to evaluate your risk of cardiovascular and heart disease and to check for inflammation and many other issues.

Also Known As: hsCRP Test, Cardiac CRP Test, high sensitivity C-reactive protein Test, CRP Test for heart disease.

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is a hs-CRP test ordered?

There is currently no consensus on when to get an hs-CRP test. It may be beneficial for treatment purposes to order hs-CRP for those that have kidney disease, diabetes or inflammatory disorders.

It's possible that hs-CRP will be tested again to confirm that a person has persistently low levels of inflammation.

What does a hs-CRP blood test check for?

C-reactive protein is a protein found in the blood that rises in response to infection and inflammation, as well as after trauma, surgery, or a heart attack. As a result, it's one of numerous proteins referred to as acute phase reactants. The high-sensitivity CRP test detects low levels of inflammation in the blood, which are linked to an increased risk of developing cardiovascular disease.

According to the American Heart Association, CVD kills more people in the United States each year than any other cause. A number of risk factors have been related to the development of CVD, including family history, high cholesterol, high blood pressure, being overweight or diabetic, however a considerable number of people with few or no recognized risk factors will also acquire CVD. This has prompted researchers to investigate for new risk variables that could be causing CVD or could be used to identify lifestyle modifications and/or treatments that could lower a person's risk.

High-sensitivity CRP is one of an increasing number of cardiac risk markers that may be used to assess an individual's risk. According to certain research, monitoring CRP with a highly sensitive assay can assist identify the risk level for CVD in persons who appear to be healthy. CRP levels at the higher end of the reference range can be measured with this more sensitive test. Even when cholesterol levels are within an acceptable range, these normal but slightly elevated levels of CRP in otherwise healthy persons might indicate the future risk of a heart attack, sudden cardiac death, stroke, and peripheral artery disease.

Lab tests often ordered with a hs-CRP test:

• Complete Blood Count
• Lipid Panel
• Comprehensive Metabolic Panel
• Lp-Pla2
• Glucose

Conditions where a hs-CRP test is recommended:

• Heart Attack
• Heart Disease
• Cardiovascular Disease
• Stroke

How does my health care provider use a hs-CRP test?

A test for high-sensitivity C-reactive protein can be used to assess a person's risk of cardiovascular disease. It can be used in conjunction with a lipid profile or other cardiac risk markers, such as the lipoprotein-associated phospholipase A2 test, to provide further information regarding the risk of heart disease.

CRP is a protein that rises in the bloodstream as a result of inflammation. A continuous low level of inflammation, according to studies, plays a crucial role in atherosclerosis, the narrowing of blood vessels caused by the build-up of cholesterol and other lipids, which is typically linked to CVD. The hs-CRP test successfully detects low levels of C-reactive protein, indicating low but chronic inflammation, and so aids in predicting a person's risk of developing CVD.

Some specialists believe that high-sensitivity CRP is a good test for assessing CVD, heart attacks, and stroke risk, and that it can help in the evaluation process before a person gets one of these health problems. Some experts believe that combining a good marker for inflammation, such as hs-CRP, with a lipid profile is the best way to predict risk. This test has been recommended by several organizations for persons who are at a moderate risk of having a heart attack in the following ten years.

What does my hs-CRP test result mean?

Even when cholesterol levels are within an acceptable range, high levels of hs-CRP in otherwise healthy people have been found to predict an elevated risk of future heart attacks, strokes, sudden cardiac death, and/or peripheral arterial disease.

Higher hs-CRP concentrations indicate a higher risk of cardiovascular disease, while lower values indicate a lower risk. Individuals with hs-CRP values at the high end of the normal range are 1.5 to 4 times more likely than those with low levels of hs-CRP to have a heart attack.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.

Brief Description: An Insulin test is a blood test that measures the insulin levels in the blood's serum. It is a measurement that is heavily used in patients with diabetes.

Also Known As: Fasting Insulin Test, Insulin Assay Test, Insulin Serum Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: 9 Hours Fasting Required

When is an Insulin test ordered?

Insulin levels are most commonly ordered after a low glucose result or when someone has acute or chronic symptoms of hypoglycemia.  Hypoglycemia can cause the following symptoms:

• Sweating
• Palpitations
• Hunger
• Brain fox
• Hazy vision
• Dizziness
• Fainting

Seizures and loss of consciousness are common in severe instances.

While low blood glucose can cause these symptoms, they can also be caused by other illnesses.

When a person has or is suspected of having insulin resistance, an insulin test may be performed. People with type 2 diabetes, polycystic ovary syndrome, prediabetes or cardiac disease, or metabolic syndrome may fall into this category.

After an insulinoma has been effectively removed, a health practitioner may arrange insulin and C-peptide testing to verify the effectiveness of treatment and subsequently order the tests on a regular basis to monitor for recurrence.

Periodic testing can also be performed to track the success of an islet cell transplant by determining the graft's insulin-producing capacity.

What does an Insulin blood test check for?

Insulin is a hormone produced in the pancreas' beta cells and stored there. It is necessary for the transfer and storage of glucose, the body's primary energy source. Insulin aids in the delivery of glucose from the bloodstream to cells, as well as the regulation of blood glucose levels and lipid metabolism. This test determines how much insulin is present in the blood.

The levels of insulin and glucose in the blood must be balanced. Carbohydrates are frequently broken down into glucose and other simple sugars after a meal. The blood glucose level rises, prompting the pancreas to produce insulin into the bloodstream. The amount of glucose in the blood reduces as it enters cells, and the amount of insulin released by the pancreas decreases.

If an individual is unable to produce enough insulin, or if the body's cells become resistant to its effects, glucose is unable to reach the majority of the body's cells, causing the cells to starve as blood glucose climbs to harmful levels. This can disrupt normal metabolic processes, leading to a variety of illnesses and difficulties, such as kidney disease, cardiovascular disease, and eyesight and neurological issues.

Diabetes is a life-threatening illness characterized by excessive glucose levels and diminished insulin action. People with type 1 diabetes produce relatively little insulin, necessitating the use of insulin supplements. Insulin resistance is a common cause of type 2 diabetes, which worsens over time.

Insulin resistance occurs when the body is unable to respond to insulin's effects. The body makes up for this by manufacturing more of the hormone. Hyperinsulinemia and overstimulation of some insulin-sensitive tissues happen as a result of this. This process generates an imbalance in the connection between glucose and insulin over time, which, if left untreated, can lead to health problems affecting numerous regions of the body.

Insulin resistance can be present in people with polycystic ovary syndrome, prediabetes or cardiac disease, metabolic syndrome, and diseases of the pituitary or adrenal glands, in addition to type 2 diabetes.

Hyperinsulinemia is most commonly seen in persons with tumors of the pancreatic islet cells or an excess of injected insulin, aside from insulin resistance. Low blood sugar is caused by hyperinsulinemia, which can cause sweating, hunger, palpitations, confusion, dizziness, blurred vision, seizures, and fainting. Because the brain relies on blood glucose for energy, severe glucose deprivation caused by hyperinsulinemia can swiftly result in insulin shock and death.

Lab tests often ordered with an Insulin test:

• Glucose
• Hemoglobin A1c
• C-Peptide
• Comprehensive Metabolic Panel

Conditions where an Insulin test is recommended:

• Diabetes
• Insulin Resistance
• PCOS
• Metabolic Syndrome

Commonly Asked Questions:

How does my health care provider use an insulin test?

Insulin testing can be used for a variety of purposes. Insulin is a hormone produced in the pancreas' beta cells and stored there. Insulin is a hormone that aids in the movement of glucose, the body's primary source of energy, from the bloodstream to the cells. Cells starve if a person produces too little insulin or is resistant to its effects. When someone produces too much insulin, such as when they have an insulin-producing tumor, symptoms of low blood glucose appear.

Insulin testing may be used to assist with the following:

• Diagnose an insulinoma, confirm that the tumor was successfully removed, and/or keep an eye out for recurrence.
• Determine the source of hypoglycemia in a person who has signs and symptoms.
• Recognize insulin resistance.
• In this instance, a C-peptide test may be used to monitor the quantity of insulin produced by the beta cells in the pancreas. As part of the conversion of proinsulin to insulin in the pancreas, the body produces both insulin and C-peptide at the same time. When a doctor wishes to know how much insulin is created by the body and how much comes from outside sources like insulin injections, both tests may be ordered. The C-peptide test indicates insulin produced by the pancreas, but the insulin test analyzes insulin from both sources.
• Determine when a type 2 diabetic may need to supplement oral medications with insulin.

Insulin tests can be ordered in conjunction with glucose and C-peptide tests. In addition to the glucose tolerance test, insulin levels are sometimes employed. To assess insulin resistance, blood glucose and insulin levels are tested at pre-determined time intervals in this circumstance.

What do my Insulin test result mean?

Insulin levels must be reviewed in the context of other diagnostic tests and symptoms.

Insulin levels can be elevated with:

• Acromegaly
• Cushing's syndrome
• Use of medications such as corticosteroids, levodopa, and oral contraceptives
• Intolerance to fructose or galactose
• Insulinomas
• Obesity
• Insulin resistance, as seen in type 2 diabetes and metabolic syndrome

Insulin levels can be low with:

• Diabetes 
• Hypopituitarism
• Chronic pancreatitis 
• Pancreatic cancer

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.

This test detects a gene variant associated with increased coronary heart disease (CHD) risk and such CHD event can be reduced from atorvastatin and pravastatin therapy.