These are the fats in your blood stream. They are naturally occurring substances that are required for many biologic functions such as building cells and making hormones. Historically, cholesterols (LDL, etc.) and triglycerides have been used as a basis for identifying people with “high” cholesterol that would cause plaque buildup on artery walls (atherosclerosis); putting them at risk for cardiovascular events such as heart attack. In recent years, science has realized this hypothesis is likely oversimplified -- leading to an overestimation of risk in some people, but underestimation in others. Many newer lipid markers (Apolipoprotein-B) have been found to be more effective at predicting heart attack risk than traditional cholesterol tests.
- HDL Cholesterol: The “good” type of cholesterol that helps clear away plaque from blood vessel walls.
- Non-HDL Cholesterol: An estimation of “bad” types of cholesterol (including LDL) that contributes to plaque building on blood vessel walls.
- Triglycerides: The fat particles in your bloodstream that transport cholesterol. It’s uncertain whether high triglycerides directly increase cardiovascular risk, but they often coincide with obesity and insulin resistance.
- Apolipoprotein(B): A binding protein found on “bad” cholesterol types that promotes plaque formation (atherosclerosis) in blood vessel walls.
- Lp(a): Lipoprotein (a) is a lipid bound protein molecule that is associated with increased risk of cardiovascular disease and of organ damage due to high blood pressure.
Plaquing of arteries, called atherosclerosis, is caused by a number of factors, including abnormal lipids (see above), high blood pressure, tobacco use, diabetes and genetics. Many studies have shown that inflammation in blood vessels plays a large role in formation of these plaques that can lead to coronary blockage (heart attack), stroke and peripheral artery disease. Several markers of inflammation, such as hs-CRP, have been linked to increased cardiovascular risk.
- hs-CRP: High Sensitivity C-Reactive Protein (hs-CRP) is an inflammatory marker that signifies increased cardiovascular risk. Very high levels (> 10) can also be seen with numerous problems (e.g. infection).
- Fibrinogen: This is an acute phase reactant and thus elevated levels are a sign of inflammation. If persistent, increased concentrations of fibrinogen are associated with an increased risk of atherosclerosis.
- Myeloperoxidase or MPO, a product of white blood cells, plays a role in the inflammation in the artery wall. MPO can accumulate in other inflamed area of the body as well such as joints or even gums. Large amounts of MPO can make people prone to heart attacks.
- Lp-PLA 2: Lipoprotein-associated phospholipase A (Lp-PLA 2 or PLAC) is an enzyme that is a vascular specific inflammatory biomarker. High levels have been linked to an increased risk of stroke.
- B-type natriuretic peptide: BNP (measured precisely with pro-BNP) is a hormone created in response to increased strain in heart muscle tissue. Very high levels can be found in heart failure but may also be a risk factor for stroke.
The human body’s management and storage of energy is mind-boggling complex. Glucose is the body’s primary source of energy via the aerobic processes (99.9% of the time!). The regulation of glucose levels is complicated, but resistance to insulin is what leads to type 2 diabetes (elevated blood sugars). There are strong genetic factors that increase risk of developing type 2 diabetes, but body weight, diet and fitness play a large role in that process.
- Glucose (fasting), aka “blood sugar”, is the primary source of energy for you body. Elevated levels can signify diabetes or risk of diabetes in the future.
- Hemoglobin A1c [%] is an estimation of average blood sugar over the past 120 days. A diagnosis of diabetes is made at 6.5, but higher than 5.6 is a risk for developing diabetes -- often called “pre-diabetes”.
- Insulin-to-glucose ratio, as expressed by the homeostatic model assessment (HOMA) model, is an indicator of insulin resistance. A higher value is associated with a risk of type 2 diabetes and cardiovascular events.
There are thousands of components of the human blood system. For the purposes of this testing, most are not relevant to fitness or wellness issues. Hemoglobin is the basis for the Hemoglobin A1c lab so we need to ensure hemoglobin is normal for correct interpretation. If hemoglobin is abnormally low or high, it can indicate a number of different medical problems.
- Hemoglobin: The protein molecule in red blood cells that carries oxygen and carbon dioxide to and from tissues. Having abnormal levels can be associated with a number of medical conditions (e.g. anemia)