Lipid tests are used to assess an individual’s risk of heart attack or stroke. Lipid tests are the most important of the cardiac risk tests as they provide a clear indication of whether someone is likely to have a coronary event caused by a blockage of the blood vessels or atherosclerosis (narrowing of the arteries caused by build-up of fatty deposits).
A complete lipid profile involves routine tests such as Total Cholesterol, Triglycerides, HDL Cholesterol and LDL Cholesterol to measure the levels of triglycerides and cholesterol in the blood. An extended lipid profile measures emerging risk factors of cardiovascular disease (CVD).
Cardiovascular disease (CVD), the leading cause of death globally, is a heavy strain on our healthcare systems. Cardiovascular disease occurs as a result of reduced blood flow to the heart, brain or body and includes coronary heart disease, cerebrovascular disease and peripheral arterial disease (diseases of the blood vessels supplying the heart, brain and arms and legs). Reduced blood flow may be a result of a blood clot or due to a build-up of fatty acids in the arteries causing them to narrow and the impact may result in a heart attack or stroke.
Lipid tests are vital in the risk assessment of cardiovascular disease
Lipid tests aim to assess the risk of cardiovascular disease by screening for abnormalities of triglyceride and cholesterol levels in the blood. Triglycerides and cholesterol are types of fat in the blood. Triglycerides, the main constituent of body fat, is produced by the liver as well as obtained through diet (meats, dairy produce and cooking oils). Cholesterol is a fat-like substance found in all cells of the body and is produced by the liver for use by the body; its uses include making hormones, vitamin D, and substances that assist in food digestion. Triglycerides and cholesterol contribute to the build-up of fatty deposits, and thus lipid profiling enables preventative measures to be taken to maintain safe levels and reduce the chances of cardiovascular disease.
Early detection of risk factors means early intervention and often with lifestyle changes patients can combat the risks associated with Cardiovascular Disease.
Routine tests include a Total Cholesterol test assessing overall cholesterol levels, a HDL Cholesterol test to measure the level of ‘good cholesterol’ in the blood, an LDL Cholesterol test to measure the level of ‘bad cholesterol’ in the blood, and a Triglycerides test assessing triglyceride levels (of which high levels are associated with increased risk of developing cardiovascular disease).
Extended analysis of blood lipids and emerging risk factors
In addition to the conventional lipid profile Total Cholesterol, HDL Cholesterol, LDL Cholesterol and Triglycerides, we also have extended tests which can provide extra information on a patient’s lipid profile. This includes measurement of lipoproteins and their counterparts, apolipoproteins, which have the role of transferring triglycerides, cholesterol and other fats to appropriate cells for metabolism. Measurement of these allows investigation into why abnormal lipid levels may be occurring.
Apolipoprotein A-I (removes excess cholesterol from extra-hepatic tissues) test is used to find the cause of high lipid levels and discover if a disorder is causing Apo A-I deficiency
Apolipoprotein B (the main protein in LDL cholesterol aka ‘bad cholesterol’) test is used as an extended risk assessment of cardiovascular disease; elevated levels indicate increased risk even when total and LDL cholesterol levels are normal.
Apo A-I and Apo B are useful to assess patients with a personal or family history of high concentrations of lipids and/or heart diseases, for diagnosis of conditions causing elevated lipid levels, for monitoring the effectiveness of lipid lowering treatments, and, when used together they can determine Apo B/Apo A-I ratio as an alternative to total cholesterol/HDL cholesterol ratio when determining CVD risk.
Analysis of emerging risk factors also contributes to risk assessment of cardiovascular disease:
Lipoprotein (a) levels are genetically determined and remain fairly constant as they are not affected by lifestyle factors such as diet. High levels can occur in individuals with an otherwise normal lipid profile and can increase risk of cardiovascular disease. It is recommended that patients who have developed cardiovascular disease at a young age or those with a family history of premature heart disease be tested.
sdLDL Cholesterol, a subtype of LDL Cholesterol aka ‘bad cholesterol’ is a vital marker for heart attack; elevated levels are associated with a three-fold increased risk of heart attack
Apolipoprotein A-II, a major constituent of HDL Cholesterol, plays an important role in reverse cholesterol transport and lipid metabolism; the production of Apo A-II levels determine the distribution of Apo A-I in HDL (Apo A-I removes excess cholesterol), and therefore increased production of Apo A-II promotes atherosclerosis
Apolipoprotein C-II, an aid in the assessment of CVD; Apo C-II deficiency can lead to hypertriglyceridemia (elevated triglyceride levels) in patients
Apolipoprotein C-III, an aid in CVD risk assessment with elevated levels associated with both primary and secondary hypertriglyceridemia, in addition to being reported higher in patients with type 2 diabetes, hyperbilirubinemia, kidney deficiency and decreased thyroid function
Apolipoprotein E, responsible for the transport of triglycerides to the liver and distribution of cholesterol between cells; deficiency can lead to premature atherosclerosis
Benefits of Randox Lipid reagents
Enhanced convenience with liquid ready-to-use reagents (Triglycerides kits also come in lyophilised form)
Cost effectiveness for even small throughput labs – all lipid assays are stable to expiry when stored at 2-8⁰C (except for Triglyceride kits, stable for 21 days when stored at 2-8⁰C or 3 days at 15-25⁰C)
Wide measuring ranges able to comfortably detect abnormal lipid levels
Applications for a wide range of clinical chemistry analysers
Excellent correlation to reference methods for security of accurate results
Controls and calibrators available including a 5 point calibrator for Lp(a) to account for the wide variation of different isoforms
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