Metabolic Profiles and Heart Disease
Thousands of complex chemical processes are required to take today’s lunch and turn it into the innumerable molecules that are carried by the blood to nourish the cells of your body. We can examine a subset of markers that will help us understand how well your body affects these processes. These tests provide good insight into the presence and progress of heart disease and many other conditions.
Asymmetric dimethylarginine (ADMA) and Symmetric dimethylarginine (SDMA)
Elevated levels of ADMA provide an excellent indication of insulin resistance — the earliest form of a disease that can, untreated, become diabetes. About 70% of heart attacks show evidence of elevated ADMA levels. These results are closely tied to endothelial dysfunction; ADMA inhibits nitric oxide, a key to endothelial health. In addition, high levels of ADMA clearly predict heart disease deaths independent of commonly understood risk factors.
Hemoglobin A1c (HbA1c)
A test of your blood glucose gives us a clear indication of the current concentration of sugar in the blood. As you probably know, these levels go up and down all day long in response to the type and quantity of food you eat. But blood glucose levels are just a quick snapshot; they provide no indication of how well your body controls these levels over time. The HbA1c test is more like a movie than a photograph — it tells us about the average blood glucose levels in increments of three months. This test is an excellent way to check for prediabetes or to monitor how well those with diabetes are controlling the condition.
Insulin resistance forces the body to generate too much insulin, resulting in high levels in the blood. This changes the body’s lipid profile, increasing triglycerides and LDL cholesterol while decreasing HDL cholesterol. These changes in blood lipids can also increase the prevalence of plaque in the arteries, increasing the risk for heart attack and stroke. Prolonged elevated insulin can also create other problems: increased inflammation, increased risk of blood clots and increased blood pressure.
High levels of homocysteine in the blood have been associated with cardiovascular disease and its most severe manifestations: heart attack and stroke. This can be caused by low levels of B6, B12 and folic acid, but it may also indicate low levels of cysteine, a protein with a wide range of important functions.
25-Hydroxy Vitamin D
Vitamin D has long been associated with bone health, but a number of recent studies have begun to associate it with cardiovascular disease. Deficiency may be linked to strokes, high blood pressure, diabetes, congestive heart failure and peripheral artery disease. Women tend to be more prone to vitamin D deficiency, as do older populations. Understanding your level of vitamin D will give us one more indication of your overall risk factor and, if it is low, an easy and inexpensive way to begin improving overall health.
Comprehensive metabolic panel (CMP)
The CMP is to the metabolism what the complete blood count is to blood health and inflammation. This series of 14 individual tests give us the opportunity to examine a wide range of indicators. An abnormal result is not a diagnosis, but but can point us in a direction, indicating the need for further, more specific tests. This series includes: glucose, calcium, blood urea nitrogen, creatinine, sodium, potassium, chloride, carbon dioxide, calcium, total protein, albumin, bilirubin, alkaline phosphatase, aspartate amino transferase and alanine amino transferase.