The Quick Guide to Cardiometabolic Testing

The Quick Guide to Cardiometabolic Testing

An Overview of Key Cardiometabolic Testing and Markers

Cardiovascular diseases are the leading cause of death globally, claiming just under 18 million lives a year, with heart attack and stroke the main causes of death. In recent decades, much of the blame has landed on high blood cholesterol levels and a resulting narrowing of the arteries, but 50% of heart attack victims have normal cholesterol levels. The latest research reveals that conventional markers are not an accurate predictor of heart disease. We have to dig deeper. 

When to Consider Cardiometabolic Testing

Clinical cases where one might consider Cardiometabolic testing may include patients with raised triglycerides or those with high waist circumference in the 35-40 age bracket, as these are the cases that could develop into high-risk patient within 10-15 years. 

Other factors that may indicate a consideration for testing include:

- Anyone with cardiovascular symptoms
- Anyone over 40
- Those with Metabolic Syndrome, Diabetes or elevated BMI
- Those with a family history of cardiac events or familial hypercholesterolemia
- Smokers or those with high alcohol intake
- Anyone with high blood pressure (hypertension)
- Those with elevated cholesterol, particularly those with a small particle number
- Those who have experienced recurrent miscarriage or a diagnosis of anti-phospholipid syndrome

By looking for those early signs of change in functional markers, we identify modifiable factors and implement early interventions to reduce risk of cardiovascular events in the future. Repeat testing of individual markers can then be used to track progress and monitor the effectiveness of interventions. 

Let’s explore three different levels of testing.

Introductory Testing

The first test we recommend is the Q702 CHL Initial Metabolic Profile. This test requires a blood draw, but for clients who are not able to arrange this, the Z706 Basic Metabolic Bloodspot Test is a useful alternative that can be done without a blood draw.

The Q702 CHL Initial Metabolic Profile is a great place to start. The panel includes inflammatory markers such as high-sensitivity CRP and oxLDL, lipids including LDL and HDL sizes and particle numbers, and routine markers including ALT, AST and ALP. This panel is particularly useful as it covers metabolic markers for insulin resistance and potential diabetes risk, and APOE Genotyping. A sample report is available here.

There are add-ons available with this panel, including CoQ10, Folate, B12, Vitamin D, Magnesium, OmegaCheck (fatty acid profile), Full Thyroid panel, GGT, and Anaemia/Iron Metabolism.

The Z706 Basic Metabolic Bloodspot Test also has vitamin D as an add-on, as well as the hormone trio of oestrogen, progesterone and testosterone.

Intermediate Testing

We recommend the Q703 CHL Advanced Cardio Profile, which is a blood draw test that includes markers such as APOE, Lipids, Adiponectin, TMAO, Lp(a), Lp-PLA2. We also offer the Q704 CHL Elite Profile, which is a blood draw that looks at some more in-depth markers including F2-Isoprostanes/Creatinine, ADMA, Lp-PLA2, OxLDL, hsCRP, Myeloperoxidase.

When it comes to understanding the significance of markers that may be new to you, such as TMAO (for which high levels have been correlated with an increased risk for adverse cardiovascular conditions) Colabs is happy to provide support calls. Despite the accumulating evidence, it is questioned whether TMAO is really a mediator or possibly just a bystander in the disease process, so it should be considered in light of the balance of evidence and in the context of other markers.

Genetics are part of the picture of cardiovascular risk, which is why the Q703 CHL Advanced Cardio Profile includes the ApoE genotype. This is a really useful part of the clinical picture as the E4 allele is associated with increased LDL-C levels and an increased risk of coronary heart disease.

The Q704 CHL Elite Profile, which also requires a blood draw, looks at some more in-depth markers. It is organised into three sections, depending on whether each marker relates to risk for disease, presence of disease or disease activity. Markers include F2-Isoprostanes/Creatinine, ADMA, Lp-PLA2, OxLDL, hsCRP, and Myeloperoxidase, with each marker explained in the report in terms of their association with cardiovascular risk.

Advanced Testing

Colabs is excited to offer the V710 SmartVascular Test (formerly known as the PULS Test). This panel also requires a blood draw and looks at specific cardiovascular event risk over a 5 year period. It includes IL-16, MCP-3, Eotaxin, CTACK, sFas, Fas Ligand, HGF, HDL, HbA1C. This is a sophisticated report that combines protein biomarkers with clinical risk factors to calculate a Cardiac Profile score, showing how each biomarker measures disease progression.  

Colabs also offers personalised and bespoke options for the CHL Metabolic, Advanced & Elite Profiles.  Our Q705 test is a combination of the Q702-704 tests for a truly comprehensive panel.

Coagulation Panels

We also offer several coagulation panels, including the Q300 CIRS Coagulation Panel, the PD501 GENIE Test (for gene expression), and the Q301 Advanced Coagulation Panel, if there are also coagulation concerns.

Support and More Information

According to the World Health Organisation (WHO), heart disease is 80% preventable, which can empower us as functional practitioners to focus on optimising cardiometabolic health for our clients. Cardiovascular risk could be viewed in a similar way to Dr Dale Bredesen’s ‘roof with 36 holes’ metaphor for Alzheimer's Disease - there are many different factors that combine to push someone in the direction of cardiovascular risk. We should consider the picture that an entire test panel illustrates for us rather than getting too focused on individual markers.

In summary, whatever stage of the health to disease continuum a patient is at, there is a suitable test that will provide clinically useful information that can then be addressed through appropriate interventions to modify the relevant risk factors. If you’d like to discuss testing options further, we’re always happy to help with a free support call. Drop us an email.