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Physicians Cardiometabolic Assessment

Cardiovascular disease (CVD) is still the leading cause of death globally, accounting for 1 in 3 deaths in the US.1,2 While 50% of adult Americans have at least one of the commonly known risk factors—high blood pressure, high low-density lipoprotein (LDL) cholesterol, and smoking—many more are equally at risk from diabetes, obesity, sedentary lifestyle, poor diet, and/or excess alcohol intake.3

It’s not just about cholesterol!

Standard of care for reducing risk of cardiometabolic disease focuses on fasting blood lipids (cholesterol, triglycerides) and glucose. However, half of all patients hospitalized with coronary artery disease have acceptable levels of LDL cholesterol, and by the time blood glucose reaches levels diagnostic of prediabetes, up to 80% of pancreatic β-cell function has been lost.4,5 The residual or ‘‘hidden’’ risk unidentified by just measuring lipids and glucose is a major contributor to CVD-related morbidity and mortality.6

Scientific research is proving that INFLAMMATION and INSULIN RESISTANCE are intimate precursors to cardiometabolic diseases and huge risk factors for ischemic heart disease.7-9

  • Inflammation can be triggered by gut problems (e.g., intestinal dysbiosis, infections, food sensitivities, Western diet), stress, excess weight, sleep deficits, hormonal imbalances, and other factors that induce production of pro-inflammatory cytokines.10 If detected early using simple blood tests, and addressed with diet/lifestyle changes and other appropriate interventions, such high-risk prodromic states can be reversed and many chronic diseases prevented or erased.11-15

With the comprehensive biomarker tests offered by Salveo Diagnostics, the modern practitioner now has effective tools to help uncover and treat the root causes of cardiometabolic disease.

  • Our cardiovascular risk assessment uses validated serum biomarkers of dyslipoproteinemia, insulin resistance, inflammation, oxidative stress, cardiac stress, and hemostasis/thrombosis, to catch warning signs early. The Salveo Diagnostics systems biology approach can help practitioners identify and address the expanded set of risk factors that influence cardiometabolic health on a patient-by-patient basis.

Lipids

Total Cholesterol

LDL-C

HDL-C

Non-HDL-C

Triglycerides

Triglycerides, Blanked

Triglycerides/HDL-C Ratio

Lipoprotein Particles

LDL-P

Lp(a)-P

VLDL-P

IDL-P

Apolipoprotein B

Apolipoprotein A-I

ApoB/ApoA-I Ratio

sdLDL-C

Apolipoprotein E Genotype

CVD Metabolism/Inflammation/Oxidative Stress

Myeloperoxidase

High Sensitivity C-Reactive Protein

Fibrinogen

Vitamin D

Homocysteine

Vitamin B12

RBC Folate

MTHFR C677T & A1298C Genotypes

Uric Acid

Creatine Kinase 

Diabetes/Insulin Resistance

Glucose

HbA1c

Insulin

Fructosamine

HOMA-IR

C-Peptide

Adiponectin

Leptin

IGF-1

Free Fatty Acids

Proinsulin

Proinsulin/C-Peptide Ratio

Anti-GAD Antibody

Cardiac Stress

NT-proBNP

Omega-3 Fatty Acids

RBC Omega-3 Index

Hemostasis/Thrombosis

Factor V Leiden Genotype

Prothrombin G20210A Genotype

Antiphospholipid Antibodies

Cholesterol Absorption/Synthesis

Noncholesterol Sterols/Stanol (Sitosterol, Campesterol, Cholestanol, Desmosterol)

References

  1. Mozzafarian S, et al. Heart disease and stroke statistics—2015 update. Circulation 2016;133:e38–e360.
  2. Alwan A, et al. Monitoring and surveillance of chronic noncommunicable disease. Lancet 2010;376:1861–1868.
  3. Centers for Disease Control and Prevention. Chronic Disease Overview. Feb 23, 2016. Available at http://www.cdc.gov/chronicdisease/overview. Accessed Nov 15, 2016.
  4. Sachdeva A, et al. Lipid levels in patients hospitalized with coronary artery disease: An analysis of 136,905 hospitalizations in Get With The Guidelines. Am Heart J 2009;157:111–7e2.
  5. DeFronzo RA. From the triumvirate to the ominous octet: A new paradigm for the treatment for type 2 diabetes mellitus. Diabetes 2009;58:773–795.
  6. Kones R. Molecular sources of residual cardiovascular risk. Vasc Health Risk Management 2013;9:617–670.
  7. Libby P. Inflammation in atherosclerosis. Cardiovasc Res 2015;107:307–309.
  8. Salazar MR, et al. Insulin resistance: The linchpin between prediabetes and cardiovascular disease. Diab Vasc Dis Res 2016;13(2):157–163.
  9. Rasgon NL, McEwen BS. Insulin resistance—a missing link no more. Mol Psychiatr 2016;21:1648–1652.
  10. Koene RJ, et al. Shared risk factors in cardiovascular disease and cancer. Circulation 2016;133:1104–1114.
  11. Becker DJ, et al. Simvastatin vs therapeutic lifestyle changes and supplements: randomized primary prevention trial. Mayo Clin Proc 2008;83(7):758–764.
  12. Diabetes Prevention Program Research Group. DPP Research Group 2015 Long-term effects of lifestyle intervention or metformin on diabetes development and microvascular complications over 15-year follow-up: the DPP outcomes study. Lancet Diabetes Endocrinol 2015;3(11):866–875.
  13. Lindström J, et al. Sustained reduction in the incidence of type 2 diabetes by lifestyle intervention: follow-up of the Finnish Diabetes Prevention Study. Lancet 2006;368:1673–1679.
  14. Perrault L, et al. Effect of regression from prediabetes to normal glucose regulation on long-term reduction in diabetes risk: results from the Diabetes Prevention Program Outcomes Study. Lancet 2012;379:2243–2251.
  15. Armato J, et al. Successful treatment of prediabetes in clinical practice: targeting insulin resistance and β-cell dysfunction. Endocr Pract 2012;18:342–350.