Heart Attack Risk

CVD - 1. Low Heart Health Risk

CVD - 2. Moderate Heart Health Risk

CVD - 3. High Heart Health Risk

CVD - 4. High Heart Health Risk Plus

Reference Range(s)

• ADMA (Asymmetric dimethylarginine)<100 ng/mL 
• SDMA (Symmetric dimethylarginine)73-135 ng/mL

Clinical Significance

ADMA and SDMA may be measured in individuals with multiple risk factors for the development of cardiovascular disease

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: 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: 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: 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.

Cardio IQ® Lipoprotein Subfractionation, Ion Mobility

Clinical Significance

There is a correlation between increased risk of premature heart disease with decreasing size of LDL particles. Ion mobility offers the only direct measurement of lipoprotein particle size and concentration for each lipoprotein from HDL3 to large VLDL.

Includes

HDL Particle Number; LDL Particle Number; Non-HDL Particle Number; HDL, Small; HDL Large; LDL, Very Small-d; LDL, Very Small-c; LDL, Very Small-b; LDL, Very Small-a; LDL Small; LDL Medium; LDL, Large-b; LDL, Large-a; IDL, Small; IDL, Large; VLDL, Small; VLDL, Medium; VLDL, Large; LDL Pattern; LDL Peak Size

Patient Preparation

Fasting preferred

Methodology

Ion Mobility

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: Ion Mobility Lipoprotein Fractionation is a test that uses a gas-phase technology to separate the lipid particles by size. As each particle is separated, they are counted.

Also Known As: LDL Particle Testing, LDL-P Test, LDL Subclass Test, sdLDL Test, LDL Fractionations Test, LDL Particle Size Test, LDL Particle Number Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: Fasting preferred, but not required

When is a Lipoprotein Fractionation test ordered?

When someone has a personal or family history of early cardiovascular disease, this testing may be ordered as part of an overall evaluation of cardiac risk, especially if the person does not have typical cardiac risk factors like high cholesterol, high LDL cholesterol, high triglyceride, low HDL cholesterol, smoking, obesity, inactivity, diabetes, and/or hypertension.

When a person with elevated LDL-P and/or a high proportion of tiny, dense LDL particles has undertaken cholesterol-lowering treatment or lifestyle adjustments, the healthcare practitioner may conduct LDL lipoprotein subfraction testing, as well as other lipid tests, to assess treatment success.

Although LDL-P is not typically suggested as a screening test, some healthcare practitioners are using it in conjunction with a battery of other cardiac risk tests to evaluate a person's overall risk of getting CVD.

What does a Lipoprotein Fractionation blood test check for?

Low-density lipoproteins are lipid-transporting particles that travel throughout the body. Protein, cholesterol, triglyceride, and phospholipid molecules are all present in each particle. As they move through the bloodstream, their makeup changes. Lipoprotein particles range in size from large and fluffy to small and dense, depending on which molecules are eliminated and which are added. The relative amounts of particles with different characteristics in the blood are determined by LDL particle testing. Subfractionation testing is a term used to describe this process.

Traditional lipid testing determines the amount of LDL cholesterol in the blood but does not assess the number of LDL particles. Increased numbers of small, dense LDL particles have been linked to inflammation and are more likely to produce atherosclerosis than fewer light, fluffy LDL particles, according to some research. Researchers believe that the existence of an elevated quantity of sdLDL could be one of the reasons why some people have heart attacks while having relatively low total and LDL cholesterol levels.

The number of sdLDL particles in a person's blood is determined in part by genetics, in part by sex, and in part by lifestyle and overall health. Increased levels of sdLDL are linked to certain diseases and disorders, like as diabetes and hypertension.

By examining a person's triglyceride and high-density lipoprotein cholesterol levels, it is usually able to estimate whether they have a high amount of sdLDL particles. Typically, these tests are done as part of a lipid profile. People with high triglycerides and low HDL-C have higher levels of sdLDL. More sdLDL is connected with a triglyceride level greater than 120 mg/dL and an HDL-C level less than 40 mg/dL in men and less than 50 mg/dL in women.

Other lipoprotein particles, such as HDL and VLDL, can also be subfractionated, however these tests are generally utilized in research settings and are not discussed on this page.

Lab tests often ordered with a Lipoprotein Fractionation test:

• Lipid Panel
• HDL Cholesterol
• LDL Cholesterol
• Direct LDL
• Apolipoprotein A-1
• Apolipoprotein B
• Lipoprotein (a)
• Triglycerides
• Homocysteine
• Hs-CRP
• VAP

Conditions where a Lipoprotein Fractionation test is recommended:

• Cardiovascular Disease
• Heart Disease

How does my health care provider use a Lipoprotein Fractionation test?

Low-density lipoprotein particle testing determines the number, size, density, and/or electrical charge of LDL particles. It may be useful in determining cardiac risk in patients with a personal or family history of heart disease at a young age, particularly if their total cholesterol and LDL cholesterol levels are not markedly increased. LDL subfraction testing is usually done in conjunction with or after a lipid profile.

While the LDL-C test is a good predictor of cardiovascular disease risk for many people, research has indicated that certain persons with healthy LDL-C levels nonetheless have an increased risk of CVD. Similarly, even if their LDL-C is at a safe level, people with chronic diseases like diabetes may be at higher risk. The quantity of LDL particles and/or their size has been recommended as an additional factor to consider when assessing CVD risk in these populations. Lipoprotein subfraction testing may be done in these situations to further assess a person's CVD risk.

LDL-P is sometimes requested to see how well a treatment is working at reducing the quantity of tiny, dense LDL particles.

LDL subfraction testing has been employed in clinical settings, although VLDL or HDL subfraction testing is primarily used in research. This is because LDL cholesterol has been established as the key risk factor for heart disease, and LDL assessment has received increased attention in research and development.

What do my Lipoprotein Fractionation test results mean?

The method and reporting format utilized in an LDL-P test, as well as the person's total cholesterol, LDL-C, VLDL, and/or HDL cholesterol, are all reflected in the results. Because different methods divide subclasses based on different physical qualities, results may not be immediately comparable from one method to the next or from one laboratory to the next.

Usually, the result is evaluated in context of a lipid profile and the risk it implies:

• If a person has a high number of mostly tiny, dense LDL and an elevated LDL-P, this result will enhance the person's risk of cardiovascular disease beyond the risk associated with total LDL.
• If a person only has large, fluffy LDL and a low LDL-P, this discovery will not put them at any greater risk.

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

Clinical Significance
Lipoprotein Fractionation, NMR - The Lipoprotein Fractionation, NMR test is used to help assess the risk for cardiovascular disease (CVD) in patients with intermediate or high risk based on traditional or emerging risk factors, and to assess therapeutic response in patients undergoing lipid-lowering therapy.

Includes
LDL P, Small LDL P, LDL Size
HDL P, Large HDL P, HDL Size
Large VLDL P, VLDL Size

Patient Preparation
Patient should be fasting 12 hours

Description: The Lp-PLA2 test is a blood test that measures the levels and activity of Lp-PLA2, an enzyme that plays a role in inflammation, in your blood’s serum.

Also Known As: LpPLA2 Test, Ps-PLA2 Activity Test, Platelet-activating Factor Acetylhydrolase Test, PAF-AH Test, PLAC Test, Lipoprotein-associated phospholipase A2 Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is a Lp-PLA2 Activity test ordered?

Lp-PLA2 is a newer test. When someone has a family history of CHD, metabolic syndrome, and/or is deemed to be at a moderate to elevated risk for CHD or ischemic stroke, certain health practitioners may request it along with other cardiac risk markers.

What does a Lp-PLA2 Activity blood test check for?

Lp-PLA2 is an enzyme that appears to play a role in blood vessel inflammation and is thought to contribute to atherosclerosis. This test determines the amount of Lp-PLA2 in the blood as well as its activity.

Lp-PLA2 has been demonstrated in recent research to be an independent risk factor for cardiovascular disease, such as coronary heart disease and ischemic stroke. Increased levels of Lp-PLA2 were seen in many persons diagnosed with CHD and ischemic stroke in these investigations, regardless of other risk factors. These findings suggest that this relatively new test could be beneficial as one of an increasing number of cardiac risk markers for determining a person's CVD risk.

According to the Centers for Disease Control and Prevention, cardiovascular disease causes more deaths in the United States each year than any other cause. Both coronary heart disease and ischemic stroke are caused by the formation of unstable fatty plaque deposits in the arteries, which can cause blood vessel blockages and heart attacks or brain damage. High blood pressure, diabetes, metabolic syndrome, smoking, obesity, high cholesterol levels, elevated LDL, and decreased HDL are all risk factors linked to both illnesses.

CVD affects many people who have one or more of the generally recognized risk factors, but it also affects a large number of persons who have few or none of these risk factors. This has prompted researchers to hunt for new markers that could help them identify those who are at a higher risk of cardiovascular disease.

A low level of chronic, systemic inflammation and blood vessel inflammation, in addition to the usual risk factors listed above, is thought to contribute to overall risk of developing CVD. The hs-CRP test is linked to systemic inflammation, and high levels are linked to an increased risk of cardiovascular disease. The Lp-PLA2 test is linked to vascular inflammation, and high levels have been linked to an increased risk of cardiovascular events such as heart attack or stroke.

Lab tests often ordered with a Lp-PLA2 Activity test:

• Lipid Panel
• Lipoprotein Fractionation, Ion Mobility
• Lipoprotein Subfractionation
• Hs-CRP
• Cholesterol Total
• LDL Cholesterol
• HDL Cholesterol

RelateConditions where a Lp-PLA2 Activity test is recommended:

• Heart Disease
• Cardiovascular Disease
• Stroke
• Metabolic Syndrome
• Hypertension

How does my health care provider use a Lp-PLA2 Activity test?

The Lp-PLA2 test is sometimes used to determine a person's risk of coronary heart disease or suffering an ischemic stroke.

Lp-PLA2 is an enzyme that appears to play a role in blood vessel inflammation and is thought to contribute to atherosclerosis. Lp-PLA2 has been demonstrated in recent research to be an independent risk factor for cardiovascular disease, such as coronary heart disease and ischemic stroke.

The test is often used to assess someone who is at a moderate to high risk of CHD or stroke, as well as someone who has one or more other risk factors. When someone has normal or minimally raised lipid levels, borderline high blood pressure, or metabolic syndrome, it may be ordered.

To assess a person's level of underlying inflammation linked to CVD risk, a Lp-PLA2 test may be utilized in conjunction with a hs-CRP test. Unlike the hs-CRP test, the Lp-PLA2 test is unaffected by disorders other than CVD that can produce general inflammation, hence it can be used to diagnose inflammatory conditions like arthritis.

Lp-PLA2 is a relatively new test that is rarely requested, and its clinical utility has yet to be determined. Its purpose is to provide extra information rather than to replace cholesterol and other lipid monitoring.

Some academics are looking at whether lowering Lp-PLA2 levels can reduce the risk of CHD and ischemic stroke. If lowering Lp-PLA2 lowers the risk of CVD and stroke, the Lp-PLA2 test may be requested more regularly and used to track a person's response to treatment.

What do my Lp-PLA2 test results mean?

A highly elevated Lp-PLA2 level implies an increased chance of developing CHD or having an ischemic stroke, as well as providing extra information to a health practitioner about the examined person's overall risk.

A low or normal Lp-PLA2 level indicates that this factor does not add to the risk of CVD in the person being examined.

The test is a risk indicator, not a diagnosis of CHD or ischemic stroke. Many persons with high quantities will not get these symptoms, whereas others with normal concentrations may.

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

Description: A CBC or Complete Blood Count with Differential and Platelets test is a blood test that measures many important features of your blood’s red and white blood cells and platelets. A Complete Blood Count can be used to evaluate your overall health and detect a wide variety of conditions such as infection, anemia, and leukemia. It also looks at other important aspects of your blood health such as hemoglobin, which carries oxygen. 

Also Known As: CBC test, Complete Blood Count Test, Total Blood Count Test, CBC with Differential and Platelets test, Hemogram test  

Collection Method: Blood Draw 

Specimen Type: Whole Blood 

Test Preparation: No preparation required 

When is a Complete Blood Count test ordered?  

The complete blood count (CBC) is an extremely common test. When people go to the doctor for a standard checkup or blood work, they often get a CBC. Suppose a person is healthy and their results are within normal ranges. In that case, they may not need another CBC unless their health condition changes, or their healthcare professional believes it is necessary. 

When a person exhibits a variety of signs and symptoms that could be connected to blood cell abnormalities, a CBC may be done. A health practitioner may request a CBC to help diagnose and determine the severity of lethargy or weakness, as well as infection, inflammation, bruises, or bleeding. 

When a person is diagnosed with a disease that affects blood cells, a CBC is frequently done regularly to keep track of their progress. Similarly, if someone is being treated for a blood condition, a CBC may be performed on a regular basis to see if the treatment is working. 

Chemotherapy, for example, can influence the generation of cells in the bone marrow. Some drugs can lower WBC counts in the long run. To monitor various medication regimens, a CBC may be required on a regular basis. 

What does a Complete Blood Count test check for? 

The complete blood count (CBC) is a blood test that determines the number of cells in circulation. White blood cells (WBCs), red blood cells (RBCs), and platelets (PLTs) are three types of cells suspended in a fluid called plasma. They are largely created and matured in the bone marrow and are released into the bloodstream when needed under normal circumstances. 

A CBC is mainly performed with an automated machine that measures a variety of factors, including the number of cells present in a person's blood sample. The findings of a CBC can reveal not only the quantity of different cell types but also the physical properties of some of the cells. 

Significant differences in one or more blood cell populations may suggest the presence of one or more diseases. Other tests are frequently performed to assist in determining the reason for aberrant results. This frequently necessitates visual confirmation via a microscope examination of a blood smear. A skilled laboratory technician can assess the appearance and physical features of blood cells, such as size, shape, and color, and note any anomalies. Any extra information is taken note of and communicated to the healthcare provider. This information provides the health care provider with further information about the cause of abnormal CBC results. 

The CBC focuses on three different types of cells: 

WBCs (White Blood Cells) 

The body uses five different types of WBCs, also known as leukocytes, to keep itself healthy and battle infections and other types of harm. The five different leukocytes are eosinophiles, lymphocytes, neutrophiles, basophils, and monocytes. They are found in relatively steady numbers in the blood. Depending on what is going on in the body, these values may momentarily rise or fall. An infection, for example, can cause the body to manufacture more neutrophils in order to combat bacterial infection. The amount of eosinophils in the body may increase as a result of allergies. A viral infection may cause an increase in lymphocyte production. Abnormal (immature or mature) white cells multiply fast in certain illness situations, such as leukemia, raising the WBC count. 

RBCs (Red Blood Cells) 

The bone marrow produces red blood cells, also known as erythrocytes, which are transferred into the bloodstream after maturing. Hemoglobin, a protein that distributes oxygen throughout the body, is found in these cells. Because RBCs have a 120-day lifespan, the bone marrow must constantly manufacture new RBCs to replace those that have aged and disintegrated or have been lost due to hemorrhage. A variety of diseases, including those that cause severe bleeding, can alter the creation of new RBCs and their longevity. 

The CBC measures the number of RBCs and hemoglobin in the blood, as well as the proportion of RBCs in the blood (hematocrit), and if the RBC population appears to be normal. RBCs are generally homogeneous in size and shape, with only minor differences; however, considerable variances can arise in illnesses including vitamin B12 and folate inadequacy, iron deficiency, and a range of other ailments. Anemia occurs when the concentration of red blood cells and/or the amount of hemoglobin in the blood falls below normal, resulting in symptoms such as weariness and weakness. In a far smaller percentage of cases, there may be an excess of RBCs in the blood (erythrocytosis or polycythemia). This might obstruct the flow of blood through the tiny veins and arteries in extreme circumstances. 

Platelets 

Platelets, also known as thrombocytes, are small cell fragments that aid in the regular clotting of blood. A person with insufficient platelets is more likely to experience excessive bleeding and bruises. Excess platelets can induce excessive clotting or excessive bleeding if the platelets are not operating properly. The platelet count and size are determined by the CBC. 

Lab tests often ordered with a Complete Blood Count test: 

• Reticulocytes
• Iron and Total Iron Binding Capacity
• Basic Metabolic Panel
• Comprehensive Metabolic Panel
• Lipid Panel
• Vitamin B12 and Folate
• Prothrombin with INR and Partial Thromboplastin Times
• Sed Rate (ESR)
• C-Reactive Protein
• Epstein-Barr Virus
• Von Willebrand Factor Antigen

Conditions where a Complete Blood Count test is recommended: 

• Anemia
• Aplastic Anemia
• Iron Deficiency Anemia
• Vitamin B12 and Folate Deficiency
• Sickle Cell Anemia
• Heart Disease
• Thalassemia
• Leukemia
• Autoimmune Disorders
• Cancer
• Bleeding Disorders
• Inflammation
• Epstein-Barr Virus
• Mononucleosis

Commonly Asked Questions: 

How does my health care provider use a Complete Blood Count test? 

The complete blood count (CBC) is a common, comprehensive screening test used to measure a person's overall health status.  

What do my Complete Blood Count results mean? 

A low Red Blood Cell Count, also known as anemia, could be due many different causes such as chronic bleeding, a bone marrow disorder, and nutritional deficiency just to name a few. A high Red Blood Cell Count, also known as polycythemia, could be due to several conditions including lung disease, dehydration, and smoking. Both Hemoglobin and Hematocrit tend to reflect Red Blood Cell Count results, so if your Red Blood Cell Count is low, your Hematocrit and Hemoglobin will likely also be low. Results should be discussed with your health care provider who can provide interpretation of your results and determine the appropriate next steps or lab tests to further investigate your health. 

What do my Differential results mean? 

A low White Blood Cell count or low WBC count, also known as leukopenia, could be due to a number of different disorders including autoimmune issues, severe infection, and lymphoma. A high White Blood Cell count, or high WBC count, also known as leukocytosis, can also be due to many different disorders including infection, leukemia, and inflammation. Abnormal levels in your White Blood Cell Count will be reflected in one or more of your different white blood cells. Knowing which white blood cell types are affected will help your healthcare provider narrow down the issue. Results should be discussed with your health care provider who can provide interpretation of your results and determine the appropriate next steps or lab tests to further investigate your health. 

What do my Platelet results mean? 

A low Platelet Count, also known as thrombocytopenia, could be due to a number of different disorders including autoimmune issues, viral infection, and leukemia. A high Platelet Count, also known as Thrombocytosis, can also be due to many different disorders including cancer, iron deficiency, and rheumatoid arthritis. Results should be discussed with your health care provider who can provide interpretation of your results and determine the appropriate next steps or lab tests to further investigate your health. 

NOTE: Only measurable biomarkers will be reported. Certain biomarkers do not appear in healthy individuals. 

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

Reflex Parameters for Manual Slide Review

CBC Reflex Pathway

Step 1 - The slide review is performed by qualified Laboratory staff and includes:

• Confirmation of differential percentages
• WBC and platelet estimates, when needed
• Full review of RBC morphology
• Comments for toxic changes, RBC inclusions, abnormal lymphs, and other
• significant findings
• If the differential percentages agree with the automated counts and no abnormal cells are seen, the automated differential is reported with appropriate comments

Step 2 - The slide review is performed by qualified Laboratory staff and includes: If any of the following are seen on the slide review, Laboratory staff will perform a manual differential:

• Immature, abnormal, or toxic cells
• nRBC’s
• Disagreement with automated differential
• Atypical/abnormal RBC morphology
• Any RBC inclusions

Step 3 - If any of the following are seen on the manual differential, a Pathologist will review the slide:

• WBC<1,500 with abnormal cells noted
• Blasts/immature cells, hairy cell lymphs, or megakaryocytes
• New abnormal lymphocytes or monocytes
• Variant or atypical lymphs >15%
• Blood parasites
• RBC morphology with 3+ spherocytes, RBC inclusions, suspect Hgb-C,
• crystals, Pappenheimer bodies or bizarre morphology
• nRBC’s

Description: A Comprehensive Metabolic Panel or CMP is a blood test that is a combination of a Basic Metabolic Panel, a Liver Panel, and electrolyte panel, and is used to screen for, diagnose, and monitor a variety of conditions and diseases such as liver disease, diabetes, and kidney disease. 

Also Known As: CMP, Chem, Chem-14, Chem-12, Chem-21, Chemistry Panel, Chem Panel, Chem Screen, Chemistry Screen, SMA 12, SMA 20, SMA 21, SMAC, Chem test

Collection Method: 

Blood Draw 

Specimen Type: 

Serum 

Test Preparation: 

9-12 hours fasting is preferred. 

When is a Comprehensive Metabolic Panel test ordered:  

A CMP is frequently requested as part of a lab test for a medical evaluation or yearly physical. A CMP test consists of many different tests that give healthcare providers a range of information about your health, including liver and kidney function, electrolyte balance, and blood sugar levels. To confirm or rule out a suspected diagnosis, abnormal test results are frequently followed up with other tests that provide a more in depth or targeted analysis of key areas that need investigating. 

What does a Comprehensive Metabolic Panel blood test check for? 

The complete metabolic panel (CMP) is a set of 20 tests that provides critical information to a healthcare professional about a person's current metabolic status, check for liver or kidney disease, electrolyte and acid/base balance, and blood glucose and blood protein levels. Abnormal results, particularly when they are combined, can suggest a problem that needs to be addressed. 

The following tests are included in the CMP: 

• Albumin: this is a measure of Albumin levels in your blood. Albumin is a protein made by the liver that is responsible for many vital roles including transporting nutrients throughout the body and preventing fluid from leaking out of blood vessels. 

• Albumin/Globulin Ratio: this is a ratio between your total Albumin and Globulin  

• Alkaline Phosphatase: this is a measure of Alkaline phosphatase or ALP in your blood. Alkaline phosphatase is a protein found in all body tissues, however the ALP found in blood comes from the liver and bones. Elevated levels are often associated with liver damage, gallbladder disease, or bone disorder. 

• Alt: this is a measure of Alanine transaminase or ALT in your blood. Alanine Aminotransferase is an enzyme found in the highest amounts in the liver with small amounts in the heart and muscles. Elevated levels are often associated with liver damage. 

• AST: this is a measure of Aspartate Aminotransferase or AST. Aspartate Aminotransferase is an enzyme found mostly in the heart and liver, with smaller amounts in the kidney and muscles. Elevated levels are often associated with liver damage. 

• Bilirubin, Total: this is a measure of bilirubin in your blood. Bilirubin is an orange-yellowish waste product produced from the breakdown of heme which is a component of hemoglobin found in red blood cells. The liver is responsible for removal of bilirubin from the body. 

• Bun/Creatinine Ratio: this is a ratio between your Urea Nitrogen (BUN) result and Creatinine result.  

• Calcium: this is a measurement of calcium in your blood. Calcium is the most abundant and one of the most important minerals in the body as it essential for proper nerve, muscle, and heart function. 

• Calcium: is used for blood clot formation and the formation and maintenance of bones and teeth. 

• Carbon Dioxide: this is a measure of carbon dioxide in your blood. Carbon dioxide is a negatively charged electrolyte that works with other electrolytes such as chloride, potassium, and sodium to regulate the body’s acid-base balance and fluid levels.  

• Chloride: this is a measure of Chloride in your blood. Chloride is a negatively charged electrolyte that works with other electrolytes such as potassium and sodium to regulate the body’s acid-base balance and fluid levels. 

• Creatinine: this is a measure of Creatinine levels in your blood. Creatinine is created from the breakdown of creatine in your muscles and is removed from your body by the kidneys. Elevated creatinine levels are often associated with kidney damage. 

• Egfr African American: this is a measure of how well your kidneys are functioning. Glomeruli are tiny filters in your kidneys that filter out waste products from your blood for removal while retaining important substances such as nutrients and blood cells. 

• Egfr Non-Afr. American: this is a measure of how well your kidneys are functioning. Glomeruli are tiny filters in your kidneys that filter out waste products from your blood for removal while retaining important substances such as nutrients and blood cells. 

• Globulin: this is a measure of all blood proteins in your blood that are not albumin. 

• Glucose: this is a measure of glucose in your blood. Glucose is created from the breakdown of carbohydrates during digestion and is the body’s primary source of energy. 

• Potassium: this is a measure of Potassium in your blood. Potassium is an electrolyte that plays a vital role in cell metabolism, nerve and muscle function, and transport of nutrients into cells and removal of wastes products out of cells. 

• Protein, Total: this is a measure of total protein levels in your blood. 
  Sodium: this is a measure of Sodium in your blood. Sodium is an electrolyte that plays a vital role in nerve and muscle function. 

• Sodium: this is a measure of sodium in your blood's serum. Sodium is a vital mineral for nerve and muscle cell function.

• Urea Nitrogen (Bun): this is a measure of Urea Nitrogen in your blood, also known as Blood UreaNitrogen (BUN). Urea is a waste product created in the liver when proteins are broken down into amino acids. Elevated levels are often associated with kidney damage. 

Lab tests often ordered with a Comprehensive Metabolic Panel test: 

• Complete Blood Count with Differential and Platelets
• Iron and Total Iron Binding Capacity
• Lipid Panel
• Vitamin B12 and Folate
• Prothrombin with INR and Partial Thromboplastin Times
• Sed Rate (ESR)
• C-Reactive Protein

Conditions where a Comprehensive Metabolic Panel test is recommended: 

• Diabetes
• Kidney Disease
• Liver Disease
• Hypertension

Commonly Asked Questions: 

How does my health care provider use a Comprehensive Metabolic Panel test? 

The comprehensive metabolic panel (CMP) is a broad screening tool for assessing organ function and detecting diseases like diabetes, liver disease, and kidney disease. The CMP test may also be requested to monitor known disorders such as hypertension and to check for any renal or liver-related side effects in persons taking specific drugs. If a health practitioner wants to follow two or more separate CMP components, the full CMP might be ordered because it contains more information. 

What do my Comprehensive Metabolic Panel test results mean? 

The results of the tests included in the CMP are usually analyzed together to look for patterns. A single abnormal test result may indicate something different than a series of abnormal test findings. A high result on one of the liver enzyme tests, for example, is not the same as a high result on several liver enzyme tests. 

Several sets of CMPs, frequently performed on various days, may be examined to gain insights into the underlying disease and response to treatment, especially in hospitalized patients. 

Out-of-range findings for any of the CMP tests can be caused by a variety of illnesses, including kidney failure, breathing issues, and diabetes-related complications, to name a few. If any of the results are abnormal, one or more follow-up tests are usually ordered to help determine the reason and/or establish a diagnosis. 

Is there anything else I should know? 

A wide range of prescription and over-the-counter medications can have an impact on the results of the CMP's components. Any medications you're taking should be disclosed to your healthcare professional. Similarly, it is critical to provide a thorough history because many other circumstances can influence how your results are interpreted. 

What's the difference between the CMP and the BMP tests, and why would my doctor choose one over the other? 

The CMP consists of 14 tests, while the basic metabolic panel (BMP) is a subset of those with eight tests. The liver (ALP, ALT, AST, and bilirubin) and protein (albumin and total protein) tests are not included. If a healthcare provider wants a more thorough picture of a person's organ function or to check for specific illnesses like diabetes or liver or kidney disease, he or she may prescribe a CMP rather than a BMP. 

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

Please note the following regarding BUN/Creatinine ratio: 

The lab does not report the calculation for the BUN/Creatinine Ratio unless one or both biomarkers’ results fall out of the published range. 

If you still wish to see the value, it's easy to calculate. Simply take your Urea Nitrogen (BUN) result and divide it by your Creatinine result.  

As an example, if your Urea Nitrogen result is 11 and your Creatinine result is 0.86, then you would divide 11 by 0.86 and get a BUN/Creatinine Ratio result of 12.79. 

Description: Creatine Kinase is a test that is measuring for the level of CK in the blood’s serum. CK is found in the heart tissue and the skeletal muscle. This test can be used to determine if there has been damage done to the muscles.

Also Known As: CK Test, Total Ck Test, Creatine Phosphokinase, CPK Test, CPK Level

Collection Method: Blood draw

Specimen Type: Serum

Test Preparation: No preparation required

When is a Creatine Kinase Total test ordered?

When muscle injury is suspected, a CK test may be requested, as well as at regular intervals to monitor for continuing damage. When a muscle illness, such as muscular dystrophy, is suspected, or when someone has suffered physical trauma, such as crushing injuries or major burns, it may be ordered. The test may be ordered if a person is experiencing symptoms of muscular damage, such as:

• Muscle aches and pains
• Muscle deterioration
• Urine that is dark in color

When a person has nonspecific symptoms, testing may be recommended, especially if they are using a drug or have been exposed to a substance that has been associated to potential muscle damage.

What does a Creatine Kinase Total blood test check for?

The enzyme creatine kinase is found in the brain, heart, skeletal muscle, and other organs. When there is muscle injury, more CK is released into the bloodstream. The quantity of creatine kinase in the blood is measured in this test.

Skeletal muscles produce the little quantity of CK that is routinely found in the blood. An increase in CK can be caused by any disorder that causes muscular injury and/or interferes with muscle energy generation or usage. Strenuous activity and muscle inflammation, known as myositis, as well as muscle illnesses such muscular dystrophy, can raise CK levels. Rhabdomyolysis, or the severe breakdown of skeletal muscle tissue, is linked to a large increase in CK levels.

Lab tests often ordered with a Creatine Kinase Total test:

• CK-MB
• Myoglobin
• Troponin
• Lipid Panel
• Hs-CRP
• Homocysteine
• Lipoprotein Fractionation, Ion Mobility

Conditions where a Creatine Kinase Total test is recommended:

• Endocrine System and Syndromes
• Lupus
• Rheumatoid Arthritis
• Heart Attack

How does my health care provider use a Creatine Kinase Total test?

A creatine kinase test can be used to detect muscle inflammation or damage caused by muscle illnesses such muscular dystrophy, or to help diagnose rhabdomyolysis if signs and symptoms are present. Other blood chemistry tests, such as electrolytes, BUN, or creatinine, may be conducted in addition to CK. A urine myoglobin test may be requested as well.

Muscle injury can present with few or vague symptoms such as weakness, fever, and nausea, which can also be associated with a range of other illnesses. In these circumstances, a healthcare practitioner may utilize a CK test to detect muscle injury, particularly if the person is taking a statin, using ethanol or cocaine, or has been exposed to a known toxin linked to probable muscle damage. A CK test may be used to assess and monitor muscle damage in those who have been physically injured.

Muscle injury can be tracked using a series of CK tests to evaluate if it improves or worsens. If a CK is increased and the site of muscle damage is unknown, a healthcare provider may order CK isoenzymes or a CK-MB as follow-up tests to differentiate between the three forms of CK: CK-MB, CK-MM, and CK-BB.

The CK test was originally one of the most common tests used to diagnose a heart attack, but the troponin test has mostly superseded it in the United States. The CK test, on the other hand, may be used to detect a second heart attack that occurs soon after the first.

What do my Creatine Kinase test results mean?

A high CK level, or a spike in levels in subsequent samples, often suggests that muscle injury has occurred recently, although it does not identify the location or origin of the damage. Serial test findings that peak and then begin to decline indicate that new muscle damage has subsided, whereas increasing and persistent elevations indicate that new muscle damage has persisted.

Increased CK levels can be detected in a range of muscular disorders caused by a variety of factors. Depending on the severity of muscle damage, people's CK levels may be significantly to severely elevated. Rhabdomyolysis patients may have CK levels that are 100 times higher than usual, and in some cases even higher.

Normal CK levels could mean there hasn't been any muscle injury or that it happened a few days before the test.

Following severe exercise, such as weight lifting, contact sports, or long exercise sessions, moderately elevated CK levels may be observed.

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

Description: The Cystatin C blood test is used to determine kidney health by measuring levels of the protein Cystatin C.

Also Known As: CysX Test, CysC Test, Cystatin C Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is a Cystatin C test ordered?

Studies are confirming and defining the utility of cystatin C, particularly as an early, sensitive diagnostic for chronic kidney disease. It may be requested if a person has a known or suspected condition that affects or may influence kidney function and reduces the glomerular filtration rate, which is the rate at which the kidneys filter pollutants from the blood.

It may be ordered if a healthcare provider is dissatisfied with the results of previous tests, such as a creatinine or creatinine clearance, or wants to check for early renal dysfunction, especially in the elderly or unwell babies, and/or wants to track known impairment over time.

The study of cystatin C as a predictor of end-stage renal disease, heart failure, and death is still underway. Cystatin C, when paired with blood creatinine in an equation, has been found to increase the estimation of GFR in a variety of populations.

What does a Cystatin C blood test check for?

Cystatin C is a tiny protein generated by all cells with a nucleus and found in a number of body fluids, including the blood. It is constantly created, filtered from the blood by the kidneys, and broken down. This test evaluates kidney function by measuring the level of cystatin C in the blood.

The glomeruli, clusters of microscopic blood capillaries in the kidneys that allow water, dissolved substances, and wastes to flow past their walls while holding blood cells and bigger proteins, filter cystatin C out of the blood. Filtrate fluid is made up of what goes through the glomeruli's walls. The kidneys reabsorb cystatin C, glucose, and other chemicals from this fluid. The remainder of the fluid and wastes are transported to the bladder and expelled as urine. The cystatin C that has been reabsorbed is then broken down and not reintroduced to the bloodstream.

The glomerular filtration rate is the rate at which the fluid is filtered. The GFR falls as kidney function declines, whereas cystatin C and other renal function indicators such as creatinine and urea in the blood rise. These levels rise because the kidneys are unable to filter the blood correctly at a regular rate, resulting in their buildup in the blood. Improvements in kidney function, on the other hand, are predicted to lead to increases in GFR, which will result in lower levels of cystatin C, creatinine, and urea as the kidneys are better able to remove them from the blood.

Cystatin C concentrations in the blood are stable while the kidneys are working properly. The concentrations begin to grow as renal function deteriorates. This rise in cystatin C occurs when GFR declines and is generally apparent before kidney function declines significantly.

The cystatin C test has gained popularity as a technique of measuring kidney function since cystatin C levels fluctuate with changes in GFR. Creatinine, a result of muscle metabolism that is detected in the blood and urine, blood urea nitrogen, and eGFR are currently employed tests. Cystatin C, unlike creatinine, is unaffected by muscle mass, race, or diet, leading to the hypothesis that it could be a more trustworthy measure of renal function and so used to provide a more precise estimate of GFR.

While there is increasing evidence and literature to support the use of cystatin C, there is still some debate over when and how it should be administered. However, testing is becoming more widely available, and measures are being conducted to standardize cystatin C results calibration.

Lab tests often ordered with a Cystatin C test:

• Creatinine
• Creatinine Clearance
• Urine Albumin
• Lipid Panel
• Lipoprotein Fractionation Ion Mobility
• Blood Urea Nitrogen
• Comprehensive Metabolic Panel (CMP)

Conditions where a Cystatin C test is recommended:

• Kidney Disease
• Diabetes

How does my health care provider use a Cystatin C test?

In those who have known or suspected renal disease, a cystatin C test can be used instead of creatinine and creatinine clearance to screen for and monitor kidney dysfunction. It's especially beneficial in circumstances where creatinine measurements aren't accurate.

Creatinine measurements may not be trustworthy in people who have liver cirrhosis, are very fat, are malnourished, follow a vegetarian diet, have amputated limbs, or have reduced muscle mass. Because creatinine is dependent on muscle mass, assessing kidney function in people with abnormally high or low body mass may be inaccurate. Cystatin C is a more reliable indicator of renal function than creatinine since it is unaffected by body mass or diet.

When other test findings are normal or borderline, and an affected person has few, if any, symptoms, measuring cystatin C may be helpful in early diagnosis of kidney disease. In this scenario, the healthcare provider may wish to measure cystatin c to see if chronic renal disease is present.

Other applications of cystatin C are being investigated, such as measuring glomerular filtration rate using it alone or in combination with blood creatinine. An equation for eGFR that incorporates both creatinine and cystatin C was found to be more accurate than one that utilizes either of these alone in a recent study, and could be used to diagnose chronic kidney disease in persons with an eGFR near 60, the CKD threshold. It has been linked to a higher risk of mortality, cardiovascular disease, and heart failure in older persons, in addition to kidney impairment. Before being completely integrated into clinical practice, these equations are now being validated in various patient populations.

Finally, some study suggests that cystatin C returns to normal faster than creatinine, and that it could be used to assess renal function and severity of sickness in critically ill hospitalized patients when GFR is rapidly changing.

What do my Cystatin C test results mean?

A high amount of cystatin C in the blood indicates a lower glomerular filtration rate and, as a result, kidney failure.

Because cystatin C is made at a constant rate throughout the body and eliminated and broken down by the kidneys, it should stay at a constant level in the blood if the kidneys are healthy and the GFR is normal.

Increased levels of cystatin C have been linked to an increased risk of heart disease, heart failure, and mortality in recent investigations.

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

Description: A Fibrinogen Activity Clauss test is a blood test that measures the amount of active Fibrinogen in your blood to evaluate your blood’s ability to form clots.

Also Known As: Fibrinogen Activity Test, Factor 1 Assay Test, Cardiac Fibrinogen Test, Fibrinogen Test, Clotting factors Test

Collection Method: Blood Draw

Specimen Type: Whole Blood

Test Preparation: No preparation required

When is a Fibrinogen test ordered?

A fibrinogen activity test may be ordered by a doctor if someone:

• Has any unexplained or prolonged bleeding
• Has thrombosis
• Has a PT and PTT test result that is abnormal
• Has DIC or abnormal fibrinolysis symptoms or is being treated for it.
• Has or may have inherited coagulation factor deficiency or dysfunction
• Has a bleeding issue, and their health care provider wishes to assess and monitor their clotting capacity

When someone obtains a low result on a fibrinogen activity test, a fibrinogen antigen test may be used to establish whether the low result is due to insufficient or malfunctioning fibrinogen.

Coronary heart disease, myocardial infarction, and peripheral artery disease have all been linked to high fibrinogen levels. When a health practitioner wants to assess an individual's risk of developing cardiovascular disease, fibrinogen activity testing may be used in conjunction with other tests.

What does a Fibrinogen blood test measure?

Fibrinogen is a protein that is a coagulation factor in the production of blood clots. A fibrinogen activity test determines how well fibrinogen aids in the formation of a blood clot, whereas a fibrinogen antigen test determines the amount of fibrinogen in the blood.

Fibrinogen is produced in the liver, and is then delivered into the bloodstream along with many other coagulation factor proteins. Hemostasis stops bleeding at the site of injury when a blood vessel or body tissue is damaged. Platelets, small cell fragments, stick to and cluster at the site, triggering a coagulation cascade in which clotting components are activated one by one.

As the cascade develops, soluble fibrinogen turns into insoluble fibrin strands. At the wound site, a fibrin net is created by the crosslinking of these threads and stabilizes it. Together with the platelets, the fibrin net adheres to the area of injury and creates a solid blood clot. This barrier prevents more blood loss and is present while the injured area recovers.

There must be enough typically functioning platelets and coagulation factors for a stable clot to form. It can cause bleeding episodes and/or the creation of an inappropriate blood clot if there are defective factors or platelets, or if there are too few or too many of them. Hemostasis can be assessed using a variety of laboratory techniques, including fibrinogen assays.

Coagulation tests are now known to be based on what happens artificially in the test setting and so do not always reflect what happens in the body. The tests can, however, be used to assess individual components of the hemostasis system. The fibrinogen activity test measures the amount of soluble fibrinogen that is transformed into fibrin threads during the hemostatic process. The fibrinogen test bypasses the rest of the coagulation factors and concentrates on the function of fibrinogen after adding thrombin to the test sample.

A fibrinogen activity test determines how long it takes for a fibrin clot to form after a standard dose of thrombin is added to plasma. This test assesses the function of fibrinogen, specifically its capacity to convert into fibrin. The amount of active fibrinogen present directly correlates with the time it takes for a clot to develop. Prolonged clot formation periods can be caused by low levels of normal fibrinogen or by fibrinogen that is dysfunctional.

Acute phase reactants are a group of blood components that include fibrinogen. When conditions cause acute tissue inflammation or injury, blood levels of fibrinogen and other acute phase reactants rise dramatically. These acute phase reactants, including fibrinogen, can be tested to see how much inflammation is present in the body.

Lab tests often ordered with a Fibrinogen test:

• PT and INR
• PTT
• D-Dimer
• Coagulation Factors
• Thrombin Time
• Hs-CRP
• Complete Blood Count CBC

Conditions where a Fibrinogen test is recommended:

• Excessive Clotting Disorders
• Bleeding Disorders
• Liver Disease
• Cardiovascular Disease
• DIC

Commonly Asked Questions:

How does my health care provider use a Fibrinogen test?

This test is designed to assess fibrinogen, a protein that is required for the production of blood clots. When an injury happens and bleeding occurs, the body goes through a sequence of actions to build a blood clot. One of the final phases is converting soluble fibrinogen into insoluble fibrin threads that crosslink to form a net that stabilizes and binds to the injured site until it heals.

A fibrinogen activity test assesses fibrinogen's function and capacity to convert to fibrin. It's utilized to:

• It's utilized to:
• As follow-up testing to an abnormal bleeding disorder test result and/or an episode of prolonged or inexplicable bleeding
• To help detect disseminated intravascular coagulation or aberrant fibrinolysis, testing such as Prothrombin, Partial Thromboplastin Times, Platelet Count, and D-dimer are often ordered.
• Occasionally, to aid in the monitoring of the progress of a progressive disease over time, or, in rare cases, to aid in the monitoring of the treatment of an acquired ailment.

Other cardiac risk markers, such as C-reactive protein, are sometimes used to assist in evaluating a person's overall risk of developing cardiovascular disease. However, because there are no direct treatments for increased levels, this application of the test has not achieved general adoption. Many health professionals, on the other hand, believe that measuring fibrinogen activity provides them with extra information that may drive them to be more aggressive in addressing those risk factors that they can control.

What do my fibrinogen activity test results mean?

The concentration of protein in the blood is reported as the result of a fibrinogen test. 

The presence of normal fibrinogen activity usually indicates that the blood clotting ability is normal.

Reduced or malfunctioning fibrinogen may be the cause of significantly reduced fibrinogen activity. Reduced fibrinogen activity and antigen levels can make it more difficult for the body to produce a stable blood clot.

Reduced production owing to a hereditary illness such as afibrinogenemia or hypofibrinogenemia, or a condition such as malnutrition or liver disease, can cause chronically low levels.

Acutely low levels are frequently associated with fibrinogen consumption, such as in disseminated intravascular coagulation and irregular fibrinolysis, which happens when the body is overly active in removing blood clots. Reduced fibrinogen levels can also occur as a result of quick, large-volume blood transfusions or in malnourished patients.

A ratio of the antigen test and the activity test is sometimes used by a doctor. This is to differentiate dysfibrinogenemia from hypofibrinogenemia.

Fibrinogen is an acute phase reactant, which means that it can rapidly rise in amounts in any situation that causes inflammation or tissue injury. Elevated fibrinogen concentrations aren't specific, which means they don't inform the doctor what's causing the problem or where it's happening. These increases in fibrinogen are usually just transitory, returning to normal after the underlying problem is treated. Elevated levels can be seen in the following ways:

• Infections that are severe
• Cancer
• Myocardial infarction, coronary artery disease
• Stroke
• Inflammatory conditions
• Trauma
• Smoking a cigarette
• Pregnancy
• Peripheral artery disease, a condition that affects the arteries
• When fibrinogen levels are high, a person's risk of cardiovascular disease and producing a blood clot is raised

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

Galectin-3

Clinical Significance

A galectin-3 test may be ordered for the identification of individuals with chronic heart failure at elevated risk of disease progression.

Performing Laboratory 

Cleveland HeartLab, Inc 
6701 Carnegie Avenue, Suite 500
Cleveland, OH 44103-4623

Description: A Gamma Glutamyl Transferase or GGT test is a test that measures that level of GGT in your blood’s serum to check for a variety of conditions related to liver health such as hepatitis or cirrhosis along with diabetes and heart health.

Also Known As: Gamma Glutamyltransferase GGT test, Gamma-Glutamyl Transferase Test, Gamma-Glutamyl Transpeptidase Test, Gamma-GT Test, GGTP Test, GTP Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is a GGT test ordered?

When someone has an increased ALP level, a GGT test may be ordered. Even if no symptoms are present, an ALP test may be conducted alone or as part of a standard liver panel to screen for liver disease. When the ALP test results are high but the other tests in the liver panel are not, a GGT test may be ordered.

When a person has indications or symptoms that imply liver disease, GGT may be administered in conjunction with or as a follow-up to other liver function tests. The following are some of the signs and symptoms of liver damage:

• Weakness and exhaustion
• Appetite loss.
• Vomiting and nausea
• Swelling and/or pain in the abdomen
• Jaundice
• Urine that is dark in color and feces that is light in color
• Pruritus

GGT may also be done after someone with a history of alcohol abuse has finished alcohol treatment to ensure that the treatment program is being followed.

What does a GGT blood test check for?

Glutamyl transferase is an enzyme found throughout the body, with the liver having the highest amount of it. GGT levels in the blood are raised in most disorders that affect the liver or bile ducts. This test determines the amount of GGT present in a blood sample.

GGT is normally present in tiny amounts, however when the liver is harmed, the level of GGT might grow. When any of the bile ducts that convey bile from the liver to the intestines become clogged, GGT levels are usually the first liver enzyme to become elevated in the blood. It's the most sensitive liver enzyme test for diagnosing bile duct issues because of this.

However, because it can be raised with many types of liver disorders, the GGT test is not highly specific and is not effective in differentiating between various causes of liver damage. As a result, the GGT test is not suggested for usage on a regular basis. It can, however, be used in conjunction with other tests to determine the source of a high alkaline phosphatase level, which is another liver enzyme.

In liver disorders, both GGT and ALP are elevated, whereas only ALP is elevated in diseases that impact bone tissue. As a result, GGT can be used as a follow-up test to establish whether an elevated ALP result is related to liver or bone illness.

When even small amounts of alcohol are consumed, GGT levels can sometimes rise. Chronic heavy drinkers have higher levels than persons who drink less than 2 to 3 drinks per day or who only drink heavily on rare occasions. The GGT test can be used to determine whether someone is suffering from acute or chronic alcoholism.

Lab tests often ordered with a GGT test:

• AST
• ALT
• ALP
• Bilirubin
• Hepatic Function Panel
• Ethanol
• Comprehensive Metabolic Panel

Conditions where a GGT test is recommended:

• Liver Disease
• Alcoholism
• Hepatitis
• Cirrhosis

Commonly Asked Questions:

How does my health care provider us a GGT test?

The gamma-glutamyl transferase test can be used to figure out why your alkaline phosphatase is high. In bile duct illness and several liver diseases, both ALP and GGT are increased, while only ALP is elevated in bone disease. As a result, if a person's GGT level is normal but their ALP is high, the culprit is most likely bone disease.

The GGT test can be used to diagnose liver disease and bile duct blockages. Other liver tests such as ALT, AST, ALP, and bilirubin are frequently ordered in conjunction with or as a follow-up to this test. An elevated GGT level shows that a person's liver is being damaged in general, but it does not particularly point to a condition that could be causing the damage.

GGT can be used to test for chronic alcohol abuse and to monitor for alcohol use in patients undergoing alcoholism or alcoholic hepatitis therapy.

What do my GGT test results mean?

An high GGT level indicates that the liver is being harmed by a condition or disease, but it does not specify what that ailment or disease is. In general, the higher the level, the worse the liver damage. Elevated levels can be caused by liver illnesses like cirrhosis or hepatitis, but they can also be caused by other conditions like congestive heart failure, diabetes, or pancreatitis. They can also be caused by alcohol misuse or the use of liver-toxic medications.

A GGT test result that is low or normal suggests that a person does not have liver disease or has not recently consumed alcohol.

A high GGT level can help rule out bone disease as the source of an elevated ALP level, but if GGT is low or normal, bone disease is the most likely explanation.

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.