Diagnosing diabetes with the RX series

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Diagnosing diabetes with the RX series

Diabetes is a lifelong condition that causes a person’s blood sugar level to become too high.

If you have diabetes, your body is unable to break down glucose into energy. This is because there’s either not enough insulin to move the glucose, or the insulin produced doesn’t work properly [1] which can lead to serious health complications.

The RX series range of analysers have one of the largest test menus available on the market which includes an extensive diabetes testing panel. Tests within the RX series diabetes panel allow for Diagnosis, Monitoring and Risk Assessment of Diabetes.

Adiponectin

An adiponectin test system is a device intended for the quantitative in vitro determination of adiponectin concentration in human serum or plasma.

Adiponectin is a protein hormone, produced and secreted by fat cells (adipocytes), which is normally found in reasonably high concentrations within the blood. Adiponectin regulates the metabolism of lipids and glucose and influences the body’s response to insulin and inflammation.

Adiponectin levels are inversely correlated with abdominal visceral fat (AVF) levels, which have proven to be a strong predictor of several pathologies including metabolic syndrome, type 2 diabetes mellitus (T2DM), cancers and cardiovascular disease (CVD). It is widely recognised that people who are overweight are at a higher risk of developing T2DM, however measure waist circumference and Body Mass Index (BMI) are not enough. As such adiponectin levels are a much more reliable indicator of at-risk patients.

A number of key publications have advocated the testing of adiponectin in clinical settings and concluded that higher adiponectin levels are associated with a lower risk of T2DM across diverse populations.[2]

Fructosamine

A fructosamine test system is a device intended for the quantitative in vitro determination of glycated protein (fructosamine) concentration in human serum or plasma.

Fructosamine is a mid-term indicator of diabetic control as it can provide information on a person’s averge blood glucose levels over the preceding 14-21 days.

 Due to the shorter time span of fructosamine, it is often used to evaluate the effectiveness of medication changes and to monitor the treatment of gestational diabetes.

HbA1c

A Haemoglobin A1c test system is a device intended for the quantitative in vitro determination of Haemoglobin A1c concentration in whole blood.

 In a diabetic patient, where blood glucose levels are abnormally elevated, the level of HbA1c also increases proportionally to the level of glucose in the blood and has been widely accepted as an indicator of the mean daily blood glucose concentration over the preceding 6-8 weeks. It is therefore, a long term indicator of diabetic control.

Read our poster on Randox’s development of a new latex enhanced immunoturbidimetric assay for the rapid direct measurement of glycated haemoglobin (HbA1c) applicable to RX series analysers by clicking here. 

 Diagnosing diabetes with the RX series

The RX series range of clinical chemistry analysers have many benefits when testing patients for diabetes. With analysers ranging from the RX misano semi-automated analyser to the RX modena which can perform up to 1200 tests per hour the RX series analysers offer a suitable platform for your laboratory, ensuring results are received in a time efficient manner. Windows based software and easily recognisable icons ensure that the RX series analysers are easy to use and allows for an enhanced laboratory productivity. Laboratory cost savings can also be achieved with a low water consumption available on each RX series analyser.

Other RX series analyser features include:

Diabetes Test Menu:

Consolidate your testing with a comprehensive diabetes testing panel available on the RX series analysers. A large number of tests can be carried out on one platform, including direct HbA1c testing, providing consolidation opportunities and real cost savings.

Accurate Testing:

High quality results are achieved first time, every time. This saves operator time and avoids unnecessary additional costs of repeat testing and reduces the possibility of patient misdiagnosis.

Unrivalled performance:

Built in inventory management system automatically calculates remaining reagent volume and the number of tests available. Superior performance means minimal downtime and swift reporting of results.

If you would like more information in relation to the RX series testing capabilities please contact us by emailing: theRXseries@randox.com


Managing diabetes complications with Randox Reagents

The prevalence of diabetes is steadily increasing across the world, with approximately 422million people worldwide with diabetes and is currently one of the leading causes of death in the world. A diabetes diagnosis comes in three forms; Type 1 Diabetes Mellitus, Type 2 Diabetes Mellitus and Gestational Diabetes. Each type of diabetes can have long-term, detrimental effects to your health if it is not controlled, with some of the key complications being heart disease, kidney damage, retinopathy and even limb amputations.

Diabetes can be controlled through maintaining a healthy diet and regular exercise, however in situations where complications occur, innovative testing can aid in the prevention and management of detrimental consequences to patients.  Randox Reagents offer a range of high performance and unique tests which can be used to manage complications of diabetes such as:

Diabetic Nephropathy

Kidney disease is a life threatening complication of diabetes, commonly called diabetic nephropathy in patients with diabetes. Around 40% of people with diabetes develop diabetic nephropathy, characterised through prolonged periods of high glucose levels in the blood. To effectively monitor diabetic nephropathy, it is essential to test cystatin C levels in patients, which is a useful indicator of renal function in patients where creatinine measurements are unreliable. Unlike creatinine, cystatin C does not have a ‘blind area’ – up to 50% of renal function can be lost before significant creatinine elevation occurs. This makes cystatin C capable of detecting early stage kidney dysfunction in patients with diabetic nephropathy.

Microalbumin testing is also important to identify patients with diabetic nephropathy approximately 5-10 years earlier than proteinuria tests, helping to reduce the incidence of end stage renal disease. This is because low albumin concentrations in the urine are the earliest market of renal damage and therefore enable preventative measures to be taken.

Metabolic Syndrome

Metabolic syndrome is a severe complications of uncontrolled diabetes which contains a number of conditions which occur together, increasing your risk of heart disease, stroke and diabetes. Metabolic syndrome can be monitored through measuring Non-Esterified Fatty Acids (NEFA), which are molecules released from triglycerides by the action of the enzyme lipase and are transported in the blood bound to albumin. NEFA contributes a small proportion of the body’s fat, however they provide a large part of its energy, with elevated concentrations having adverse effects on both carbohydrate and lipid metabolism.

With the global burden of diabetes rising year on year, diabetes complications monitoring has never been more important. Randox Reagents offer a wide range of innovative testing to laboratories, to help clinicians accurately diagnose and monitor diabetes complications.

 

Download our diabetes brochures to find out about our full range of diabetes reagents

Randox reagents are available for a wide range of clinical chemistry analysers. For more information, please contact reagents@randox.com


Sharing our preventive health message this World Diabetes Day

One of the fastest growing health threats of our times is diabetes. Type-2 diabetes is now among the most common long-term health conditions affecting people right across the globe. On World Diabetes Day we want to raise awareness of this particular condition – because it’s possible to spot warning signs and take steps to prevent it.

THE BACKGROUND

Since 1996, the number of people living with diabetes has more than doubled and type-2 diabetes is by far its most prevalent form. Though it is potentially reversible, using more advanced diagnostics, clinicians can diagnose pre-diabetes and enable patients to make lifestyle changes to avoid the condition from developing in the first place.

THE FUTURE

Adiponectin is a biomarker which can powerfully predict the development of pathologies such as Type 2 Diabetes Mellitus (T2DM) and cardiovascular disease (CVD). This biomarker can be tested as an automated biochemistry reagent from Randox.

With the global prevalence of diabetes continually rising in adults over 18 years of age, from 4.7% in 1980 to 8.5% in 2014, adiponectin should be an integral part of every laboratory’s testing panel. Randox Adiponectin will enable physicians and clinicians to accurately evaluate more individuals, with a convenient format for routine clinical use.

When risk is identified via adiponectin measurement, it is essential for individuals to carry out lifestyle modification to lower T2DM risk. This will also help to prevent the development of cardiovascular diseases and metabolic syndrome. This indicates that Randox automated adiponectin should be a routinely run test across the world.

OUR CASE STUDY – SIR AP MCCOY

Earlier this year Sir AP McCoy came to Randox Health. After a career dedicated to becoming the world’s most successful jockey, he was never going to leave the next stage of his life to chance. It was lucky he did: our advanced test for adiponectin was within the panel of tests run and  was able to identify that AP was pre-diabetic.

Don’t leave your health to chance. 70% of cases of type-2 diabetes are preventable by adopting a number of lifestyle changes, so take action today.

For further information phone the Randox PR Team on 028 9442 2413, or email randoxpr@randox.com 


Diabetes – World Diabetes Day (14th Nov 2017)

World Diabetes Day

With World Diabetes Day on Tuesday 14th November 2017, we take a look at what diabetes is and why quality control is so important.

What is Diabetes?

Diabetes is a life-long condition which occurs when the glucose level in the blood is too high because it can’t enter the body’s cells to be used as fuel. There are two types of diabetes: type 1 and type 2. They are distinct conditions and must be treated and managed differently.

Type 1 Diabetes

Type one diabetes is an autoimmune condition in which the body attacks insulin-producing cells, this causes a lack of insulin, leading to an increased blood glucose level. Around 10% of people with diabetes has type 1.

Type 2 Diabetes

A mixture of genetic and environmental factors causes type 2 diabetes. The body doesn’t make enough insulin or the insulin it does create does not work correctly, leading to a glucose build up in the blood. It’s thought that up to 58% of type 2 diabetes can be prevented or delayed through healthy lifestyle choices.

Role of Quality Control

Quality control plays a crucial role in ensuring accurate and reliable diabetes monitoring. 70% of medical decisions are based on a laboratory test result and QC is vital in ensuring the results the laboratory report are both accurate and reliable.

Want to know what makes a good HbA1c control? Read on to find out.

Clinically Relevant Levels

In the diagnosis of diabetes, glycated haemoglobin (HbA1c) in blood provides an indication of average blood glucose levels in the previous three months. HbA1c is the recommended standard of care for type 2 diabetes monitoring. HbA1c is measured using the range below:

HbA1c – Clinically Relevant Levels
HbA1cmmol/mol%
NormalBelow 42 mmol/molBelow 6.0%
Prediabetes42 to 47 mmol/mol6.0% to 6.4%
Diabetes48 mmol/mol or over6.5% or over

It is important to assess the full clinical range of an assay, i.e. the range between the lowest and highest results which can be reliably reported. 48 mmol/mol is the cut-off for diabetes diagnosis, it is crucial that this can be measured accurately because any inaccuracy could mean the difference between being diagnosed and treated and not.

In terms of accreditation, ISO 15189:2012 states, ‘The laboratory should choose concentrations of control materials wherever possible, especially at or near clinical decision values, which ensure the validity of decisions made’.

Benefits of Third Party Controls

The importance of third party controls is evident. Third party controls can help identify instrument, reagent, and procedural errors. Unchecked these errors could lead to incorrect patient results, further leading to misdiagnosis.

Third party quality control material has not been designed or optimised for use with any instrument, kit, or method. This complete independence enables the quality control material to closely mirror the performance of patient samples, and in doing so, provide an unbiased, independent assessment of analytical performance across multiple platforms.

Again, in terms of accreditation, ISO 15189 states – “use of independent third party control material should be considered, either instead of, or in addition to, any control materials supplied by the reagent or instrument manufacturer.”

Many laboratories perform HbA1c testing on a dedicated machine and as a result, are not always using a third party control.

Controlling Waste

Wastage is a common issue when running HbA1c due to the pre-treatment step required for many HbA1c controls and poor stability of some controls on the market. Look out for controls with an extended open vial stability to help reduce waste and keep costs low.

How can Randox help?

To help you get your QC in check for World Diabetes Day, Randox Acusera HbA1c control contains both HbA1c and Total Haemoglobin, with a reconstituted stability of 4 weeks to reduce waste and reduce costs. To find out more about our HbA1c control visit the page using the button below or fill out the form above.

World Diabetes Day

References

Diabetes: The basics. (2017). Diabetes UK. Retrieved 3 November 2017, from https://www.diabetes.org.uk/diabetes-the-basics

Khan, H et al. (2016). Significance of HbA1c Test in Diagnosis and Prognosis of Diabetic Patients. Biomarker Insights, 95. http://dx.doi.org/10.4137/bmi.s38440


Measuring T2DM Risk with Randox Automated Adiponectin

During the first week of our adiponectin educational month, we focused on different aspects of our free white paper “Early Risk Assessment of Type 2 Diabetes Mellitus Through the use of the Biomarker Adiponectin”, which details the features and benefits of Randox automated Adiponectin, clinical significance and a comparison to traditional methods for diabetes risk assessment.

Randox Adiponectin is an automated biochemistry reagent, used as a biomarker which can powerfully predict the development of pathologies such as Type 2 Diabetes Mellitus (T2DM) and cardiovascular disease (CVD). With the global prevalence of diabetes continually rising in adults over 18 years of age, from 4.7% in 1980 to 8.5% in 2014, adiponectin should be an integral part of every laboratory’s testing panel. Offering an improved method for assessing risk, with a convenient format for routine clinical use, Randox Adiponectin will enable physicians to accurately evaluate more individuals.

Read on to find out more!

Monday 11th September

Traditional Methods for Diabetes Risk Assessment

Randox adiponectin offers a more improved, automated method for assessing Type 2 Diabetes Mellitus (T2DM) risk compared to traditional methods of diabetes risk assessment. Such methods include:

  • Fasting Plasma Glucose (FPG) – This is the most commonly used biochemical method of assessing T2DM, however, the specificity of this test is poor. Although many individuals are identified as having impaired fasting glucose (IFG), their absolute risk of conversion to diabetes is only 5-10% per year.
  • Oral Glucose Tolerance Test (OGTT) – This method is more accurate for risk assessment than other traditional methods, however, it is rarely used in practice as it is takes two hours to perform and is uncomfortable for patients.

Non-biochemical methods for assessing a patient’s risk of developing T2DM take into consideration gender, age, family history of T2DM, BMI, waist size and high blood pressure to give a risk score. Two of the most popular, traditional indicators include:

  • Waist circumference – measures abdominal fat reliably, but its association with visceral fat varies by gender and ethnicity.
  • Body Mass Index (BMI) – is another common method, however it has limitations in measuring athletes and varies depending on age, sex and race.

Given the limitations of OGTT and FPG, an improved method for assessing T2DM risk, with a convenient format for routine clinical use, would enable physicians to accurately evaluate more individuals. Randox adiponectin is an automated biochemistry test utilising a latex enhanced immunoturbidimetric method which removes the inconvenience and time consumption associated with traditional methods of testing, making it a superior method of testing T2DM.

 

Tuesday 12th September

Clinical Significance

Recent studies have advocated the testing of adiponectin in clinical settings. It has applications in assessing risk in several diabetes-related conditions including prediabetes, T2DM and GDM. These studies include:

BMJ (2016): Adiponectin levels predict prediabetes risk: the Pathobiology of Prediabetes in A Biracial Cohort

This study found that among health white and black adults with parental history of T2DM, adiponectin level is a powerful risk marker of incident prediabetes. Thus, the association of adiponectin with diabetes risk is evident at a much earlier stage in pathogenesis, during transition from normoglycemia to prediabetes.

Diabetes Care (2013): Low Pre-pregnancy Adiponectin Concentrations Are Associated With a Marked Increase in Risk for Development of Gestational Diabetes mellitus

This was a study carried out on 4098 women who had children within 6 years of initial blood sample and none of whom were pre-diabetic or diabetic. It was found that lower adiponectin concentration measured on average 6 years before pregnancy were associated with a 5-fold increased risk of developing GDM.

 

Implications for Clinicians

Adiponectin measurement is not yet a routinely run test in many laboratories worldwide and it is therefore not available for many clinicians to request. Yet the implications of this becoming widely available could be extremely valuable as it can help to assess:

  • Type 2 Diabetes Mellitus and Incident prediabetes
  • Cardiovascular events
  • Gestational Diabetes

When risk is identified via adiponectin measurement, it is essential for individuals to carry out lifestyle modification to reduce visceral fat levels and lowering T2DM risk. This will also help to prevent the development of cardiovascular diseases and metabolic syndrome through the improvement of adiponectin production. This indicates that Randox automated adiponectin should be a routinely run test across the world.

13th September 2017

Methods of Measuring Adiponectin

Randox adiponectin automated method has many benefits for the laboratory, as the only method of adiponectin measurement available beforehand was through the ELISA assay. The benefits of switching from ELISA to an automated method include efficiencies and expansion.

Efficiencies

The main drawback of using ELISAs for clinical testing within a laboratory is that it is time consuming and personnel consuming as it uses heavy resources with manual interaction. Switching from ELISA to an automated method for the detection of adiponectin increases time and personnel efficiency considerably which leads to cost effectiveness. This benefits laboratories through:

  • Ensuring quality in testing practices and confidence in clinical results
  • Lowering the risk of error and contamination avoiding compromising clinical results

 

Expansion

Laboratories can expand their test offerings to patients and clinicians by transitioning analytes which were historically only available on ELISA methods. Adiponectin being available in an automated biochemistry format allows laboratories to expand their test menu with ease and enables the inclusion of adiponectin into routine testing panels. It also allows for detailed patient testing profiles through increased testing range and without the manual restrictions placed by running ELISA techniques.

Randox is presently the only diagnostic manufacturer who has a globally available automated biochemistry test for adiponectin measurement.

14th September 2017

Randox Automated Adiponectin Assay

The Randox adiponectin assay principle:

  • The sample is reacted with a buffer and anti-adiponectin coated latex
  • The formation of the antibody-antigen complex during the reaction results in an increase in turbidity – this is measured as the amount of light absorbed at 570nm.
  • A sample with higher adiponectin levels will contain more adiponectin and so more antibody-antigen complexes will be formed and the increase in turbidimetry
  • By constructing a standard curve from the absorbance of the standards, the adiponectin concentration of the sample can be determined.

Benefits of Randox adiponectin:

  • A niche product meaning we are one of the only manufacturers to provide the adiponectin test in an automated biochemistry format
  • Automated assay removing inconvenience and time consumption associated with traditional ELISA testing
  • Applications available for a wide range of automated biochemistry analysers ensuring ease of programming and confidence in results
  • Latex Enhanced Immunoturbidimetric method delivering high performance
  • Extensive measuring range for measurement of clinically important results
  • Complementary controls and calibrators available offering a complete testing package

The Randox automated immunoturbidimetric adiponectin test offers an improved method for assessing T2DM risk, with a convenient format for routine clinical use, to enable physicians to accurately evaluate at-risk individuals.

Please contact us at reagents@randox.com for more information!

Download our white paper from the resource hub.


Product Focus: Randox HbA1c

This month’s product spotlight is our new Liquid HbA1c Control. Over the next few weeks, we will be taking a look at some of the QC solutions available from Randox for HbA1c.

Haemoglobin is an oxygen-transporting protein found inside Red Blood Cells (RBC). Glycated Haemoglobin is simply a haemoglobin with a glucose molecule attached. The higher the level of glucose in the blood the more glycated haemoglobin is formed. Red Blood Cells live for around 2-3 months, because of this the HbA1c test is used by clinicians to get an overall picture of average blood sugar levels for the last 2-3 months. For people with diabetes this is important as the higher the HbA1c, the greater the risk of developing diabetes-related complications. It is suggested that an individual’s HbA1c target should be under 48mmol/mol or below 6.5%. By lowering your HbA1c, you help reduce the risk of long-term health problems.

HbA1c is used to monitor patients with diabetes providing an indication of how well the condition is controlled. A measurement of less than 6% of HbA1c in the sample indicates good glucose control and a lower risk of diabetic complications for the majority of diabetics.

Week 1: HbA1C Quality Control

The Randox Acusera HbA1c control is designed for use in the quality control of both HbA1c and Total Haemoglobin assays. Assayed instrument and method specific target values and ranges are provided for all major systems and methods including HPLC. A reconstituted stability of 4 weeks keeps waste to a minimum and helps to reduce costs.

Main Features and Benefits:

Lyophilised for enhanced stability
100% human whole blood
Assayed target values provided for 2 parameters
Convenient bi-level pack containing two clinically significant levels of control
Stable to expiry date at 2°C – 8°C
Reconstituted stability of 4 weeks at 2°C – 8°C

Week 2: Liquid HbA1C Quality Control

The Randox Acusera Liquid HbA1C control is conveniently supplied in a liquid ready-to-use format and is ideally suited to both clinical laboratories and POCT helping to significantly reduce preparation time. With a stability of 30 days, waste and costs are also kept to a minimum.

Main Features and Benefits:

Liquid ready-to-use
Human based whole blood
Convenient bi-level pack covering clinically relevant decision levels
Stable to expiry date at  2°C – 8°C
Open vial stability of 30 days at  2°C – 8°C

Week 3: RIQAS HbA1C Programme

RIQAS is the largest international External Quality Assessment Scheme, with more than 40,000 participants in over 124 countries. World renowned for reducing the number of individual programmes required by even the most demanding laboratories, RIQAS covers 360 parameters across 32 flexible multi-parameter programmes.  Effective consolidation in this way will not only deliver real cost savings but free up storage space and ultimately reduce the time spent preparing multiple samples at each survey.

The RIQAS Glycated Haemoglobin (HbA1c) EQA programme is designed to monitor the performance of HbA1c and Total Haemoglobin assays.

Main Features and Benefits:

Accredited to ISO/IEC 17043 designed to meet ISO 15189 requirements
Lyophilised for enhanced stability
100% whole blood ensuring a matrix similar to the patient sample
Monthly reporting allowing identification of any system errors sooner
Submit results and view reports online via RIQAS.Net
Register up to five instruments at no extra cost


How Randox R&D Scientists are helping to change healthcare: Investing in prevention rather than cure with the Adiponectin test

The theme this year for British Science Week is change. At Randox, our R&D Scientists are helping to change healthcare. By investing heavily into research and development to develop unique diagnostics tests, Randox provide doctors with the ability to identify disease risk sooner- offering the opportunity to prevent illness, rather than the need to find a cure.

One unique test by Randox, adiponectin, is becoming an increasingly significant biomarker for health professionals. Low levels have been linked with several illnesses including metabolic syndrome, cancer and cardiovascular disease.


What is adiponectin?

Adiponectin is a protein hormone produced and secreted by fat cells called adipose tissue. Adiponectin is normally found in relatively high concentrations in healthy individuals. Its role in the body is to regulate the metabolism of lipids and glucose, which influences the body’s response to insulin and inflammation.


Adiponectin and abdominal visceral fat

Adiponectin levels are inversely correlated with abdominal visceral fat, meaning that lower levels of adiponectin are related to higher amounts of visceral fat in the body.¹ Visceral fat is stored around vital organs and higher levels of this type of fat can be associated with a range of conditions including insulin resistance, high blood pressure and high levels of cholesterol. These factors can subsequently increase a patient’s chance of developing metabolic syndrome, diabetes, cardiovascular disease and in some cases cancer. In fact, it has been found that patients with high abdominal visceral fat or low adiponectin levels have a three-fold increased risk of insulin resistance, with a combination of both doubling this probability.2


Adiponectin as a biomarker

Due to the protective properties of adiponectin, for example in increasing insulin sensitivity or preventing atherosclerosis, adiponectin has been classified as novel and important for a number of reasons.3 A range of studies have demonstrated why adiponectin levels should be considered as a routine test.

Adiponectin and Type 2 Diabetes

Increasing evidence suggests adiponectin is a valid biomarker related to type 2 diabetes.  In fact, one study suggests that adiponectin is a powerful marker of diabetes risk in subjects at high risk.4 Decreased adiponectin has been found to be an independent risk factor for the progression of type 2 diabetes.5

Other evidence shows that adiponectin is also a beneficial measure of diabetes treatment response. A recent study has emerged which has found that dipeptidyl peptidase-4 inhibitors, which are used for the treatment of type 2 diabetes, increase adiponectin levels and have a stronger effect in comparison to traditional oral antidiabetic drugs.6

Adiponectin and Gestational Diabetes

Adiponectin levels are also of interest during pregnancy. If a woman has lower adiponectin concentration during the first trimester of pregnancy, they are 3.5 times more likely to develop gestational diabetes.7,8

Adiponectin and Cardiovascular Disease

A range of evidence exists linking serum adiponectin concentration and cardiovascular diseases. Studies have found low levels of adiponectin can have an adverse effect, for example one study suggests adiponectin levels are an independent predictor of CHD in Caucasian men with no previous history of CHD.9 Low adiponectin concentrations have also been associated with myocardial infarction (a heart attack) in individuals below the age of 60, and also been linked with increased risk of new-onset hypertension in men and postmenopausal women.10,11

Adiponectin and Benign Prostatic Hyperplasia (BPH)

Studies have also been conducted to examine the relationship between adiponectin and BPH. BPH is a common condition which is usually associated with men over 50 years of age and causes enlargement of the prostate. Higher adiponectin levels have been associated with reduced risk of BPH, as adiponectin has a protective effect in the progression of BPH.12,13,14

Adiponectin and Cancer

Lower levels of adiponectin have been found to increase the risk of endometrial cancer in women, and also prostate and pancreatic cancer in men.14,15 Researchers have been able to identify that serum adiponectin is inversely linked to the risk of obesity-associated cancers including endometrial cancer, renal cancer, postmenopausal breast cancer, colon cancer and leukaemia.16,17, 18

 

Why measure adiponectin?

As demonstrated above, the clinical significance of adiponectin is widely studied and has been linked to a range of diseases in which overweight or obese patients are proven to be at higher risk of developing. Measuring serum concentration of adiponectin to determine visceral fat levels is proven to be a more reliable indicator of at-risk patients in comparison to conventional methods of determining whether a patient is overweight or obese, such as body mass index (BMI) or measuring waist circumference.19

Our commitment to research and development ensures that unique tests, such as adiponectin, are available for use by health professionals. Scientists at Randox are continuing to change healthcare every day with their research to develop revolutionary diagnostic solutions. By placing a continual focus on assessing the risk of diseases rather than diagnosing the illness after it has occurred and providing patients with the tools to take preventative action, Randox are helping to change healthcare globally.

For more information, email: reagents@randox.com

adiponectin

  1. Kishida, K., Kim, K. K., Funshashi, T., Matsuzawa, Y., Kang, H. C., Shimomura, I. Relationships between circulating adiponectin levels and fat distribution in obese subjects. Journal of Atherosclerosis and Thrombosis18(7):592-595 (2011)
  2. Medina-Urrutia, A., Posadas-Romero, C., Posadas-Sánchez, R., Jorge-Galarza, E., Villarreal-Molina, T., González-Salazar, M. C., Cardoso-Saldaña, G., Vargas-Alarcón, G., Torres-Tamayo, M. and Juárez-Rojas, J. G. Role of adiponectin and free fatty acids on the association between abdominal visceral fat and insulin resistance. Cardiovascular Diabetology, vol. 14, no. 20 (2015).
  3. Chandran, M., Phillips, S. A., Ciaraldi, T., Henry, R. R. Adiponectin: More than just another fat cell hormone? Diabetes Care. 26(8): 2442-2450 (2003)
  4. Daimon, M., Oizumi, T., Saitoh, T., Kameda, W., Hirata, A., Yamaguchi, H., Ohnuma, H., Igarashi, M., Tominaga, M., Kato, T. and Funagata Study. Decreased serum levels of adiponectin are a risk factor for the progression to type 2 diabetes in the Japanese population. Diabetes Care, vol. 26, no. 7, p. 2015-2020 (2003).
  5. Mather, K. J., Funahashi, T., Matsuzawa, Y., Edelstein, S., Bray, G. A., Kahn, S. E., Crandall, J., Marcovina, S., Goldstein, B., Goldberg, R. and Diabetes Prevention Program. Adiponectin, change in adiponectin, and progression to diabetes in the Diabetes Prevention Program. Diabetes, vol. 57, no. 4, p. 980-986 (2008).
  6. Liu, X., Men, P., Wang, Y., Zhai, S., Liu, G. Impact of dipeptidyl peptidase-4 inhibitors on serum adiponectin: a meta-analysis. Lipids in Health and Disease. 15:204 (2016)
  7. Lacroix, M., Battista, M.C., Doyon, M., Ménard, J., Ardilouze, J.L., Perron, P. and Hivert M. F. Lower adiponectin levels at first trimester of pregnancy are associated with increased insulin resistance and higher risk of developing gestational diabetes mellitus. Diabetes Care, vol. 36, no. 6, p. 1577-83 (2013).
  8. Hedderson, M. M., Darbinian, J., Havel, P. J., Quesenberry, C. P., Sridhar, S., Ehrlich, S. and Ferrara, A. Low prepregnancy adiponectin concentrations are associated with a marked increase in risk for development of gestational diabetes mellitus. Diabetes Care, vol. 36, no. 12, p. 3930-7 (2013).
  9. Tsimikas, S., Mallat, Z., MD, Talmud, P. J., Kastelein, J. J. P., Wareham, N. J., Sandhu, M. S., Miller, E. R., Benessiano, J., Tedgui, A., Witztum, J. L., Khaw, K. T. and Boekholdt, S. M. (2010). Oxidation-Specific Biomarkers, Lipoprotein(a), and Risk of Fatal and Nonfatal Coronary Events. JACC. 56:12, p. 946-955.
  10. Ai, M., Otokozawaw, S., Asztalos, B. F., White, C., Cupples, L. A., Nakajima, K., Lamon-Fava, S., Wilson, P. W., Matsuzawa, Y. and Schaefer, E. J. Adiponectin: an independent risk factor for coronary heart disease in men in the Framingham Offspring Study. Atherosclerosis. Vol. 217, p. 543-548 (2011)
  11. Persson, J., Lindberg, K., Gustafsson, T. P., Eriksson, P., Paulsson-Berne, G. and Lundman, P. Low plasma adiponectin concentration is associated with myocardial infarction in young individuals. Journal of Internal Medicine. Vol. 268, no. 2, p. 194-205 (2010).
  12. Fu, S., Xu, H., Gu,M., Liu, C., Wang, Q., Wan, X., Chen, Y., Chen, Q., Peng, Y., Cai, Z., Zhou, J. and Wang, Z. Adiponectin deficiency contributes to the development and progression of benign prostatic hyperplasia in obesity. Available from: 10.1038/srep43771
  13. Schenk, J. M., Kristal, A.R., Neuhouser, M.L., Tangen, C.M., White, E., Lin, D.W., Thompson, I.M. Serum adiponectin, C-peptide and Leptin and Risk of Symptomatic Benign Prostatic Hyperplasia: Results from the Prostate Cancer Prevention Trial. The Prostate, Vol 69 Issue 12 pp.1-15 (2009) Available from: 10.1002/pros.2097
  14. Izadi, V., Farabad, E., Azadbakht, L. Serum adiponectin level and different kinds of cancer: a review of recent evidence. ISRN Oncology Vol. 2012, (2012) Available from: 10.5402/2012/982769
  15. Messier V, Karelis AD, Prud’homme D, Primeau V, Brochu M, Rabasa-Lhoret R. Identifying metabolically healthy but obese individuals in sedentary postmenopausal women. Obesity, vol. 18, pp. 911-7 (2010).
  16. Dalamaga, M., Diakopoulos, K.N. and Mantzoros, C.S. The Role of Adiponectin in Cancer: A Review of Current Evidence. Endocrine Reviews. 2012 Aug; 33 (4): 547-594 (2012) Available from: 10.1210/er.2011-1015
  17. Kelesidis, I., Kelesidis, T. and Mantzoros, CS. Adiponectin and cancer: a systematic review. British Journal of Cancer (2006) 94, 1221-1225 Available from: 10.1038/sj.bjc.6603051
  18. Katira, A. and Tan, P.H. Evolving role of adiponectin in cancer-controversies and update. Cancer Biol Med 2016. Pp.101-119 (2016) Available from: 10.28092/j.issn.2095-3941.2015.0092
  19. Messier V, Karelis AD, Prud’homme D, Primeau V, Brochu M, Rabasa-Lhoret R. Identifying metabolically healthy but obese individuals in sedentary postmenopausal women. Obesity, vol. 18, pp. 911-7 (2010).

Randox Reagents celebrate World Kidney Day 2017

On 9 March 2017, Randox Reagents are celebrating World Kidney Day!  World Kidney Day is a global campaign aimed at raising awareness of the importance of our kidneys to our overall health. It aims to reduce the frequency and impact of kidney disease and its associated health problems worldwide.

This year, the World Kidney Day promotes education on the harmful consequences of obesity and its association with kidney disease, advocating healthy lifestyle and health policy measures that make preventive behaviours an affordable option.

With this in mind, throughout the week we have been sharing on social media some interesting facts on diagnostic tests which can help aid an early risk assessment of kidney disease in obese patients, allowing preventative action to be taken before any serious damage occurs.  The tests of focus this week included cystatin C, adiponectin and microalbumin

Cystatin C

The creatinine test is routinely run for patients who are suspected for deteriorating kidney function, however this test has limitations.  Cystatin C is an alternative test, and is particularly useful in patients where creatinine measurements are not suitable e.g. individuals who are obese, malnourished, have liver cirrhosis or reduced muscle mass. Importantly, unlike creatinine, cystatin C does not have a ‘blind area’ – up to 50% of kidney function can be lost before significant creatinine elevation occurs. Cystatin C is extremely sensitive to very small changes in kidney function and is therefore capable of detecting early stage kidney dysfunction.  The cystatin C test therefore allows preventative measures to be taken much earlier and before significant kidney function decline.

Adiponectin

There is substantial evidence that excess visceral fat is the main driving force for almost all of the disorders associated with the metabolic syndrome, including CKD.1,2 The adiponectin test from Randox can accurately assess levels of abdominal visceral fat, independent of age, race or fitness level.3,4  Assessing adiponectin, and therefore visceral fat levels, can help assess risk of CKD, as well as a range of other illnesses such as pre-diabetes, CVD and various cancers.

 

Microalbumin

The microalbumin test detects very low levels of a blood protein called albumin, in urine. The detection of albumin in urine can be an indicator of kidney injury and can result in irreversible damage if left untreated. Low albumin concentrations in the urine are the earliest marker of kidney damage and therefore enable preventative measures to be taken.  Microalbumin testing can identify individuals with diabetic nephropathy approximately 5-10 years earlier than proteinuria tests helping reduce the frequency of end stage renal disease.

Both World Kidney Day and Randox are working towards improving healthcare worldwide. With continuous investment in R&D, Randox are helping with the risk assessment and earliest detection of renal function problems. By assessing one’s risk of kidney problems (with the adiponectin test), it can give patients (obese and other) the tools to prevent kidney problems further on down the line.  With early diagnosis (through the cystatin C and microalbumin tests) it will be possible to keep kidney problems from getting worse, therefore lowering the number of those diagnosed with CKD worldwide.

For health professionals

If you are a clinician or lab interested in running renal function assays, Randox offers a large range of high quality routine and niche assays including:  Cystatin C, Creatinine Enzymatic and Jaffe, Microalbumin, Urinary Protein, Urea, Sodium, Potassium, Albumin, Ammonia, β2- Microglobulin, Calcium, Chloride, Glucose, HbA1c, IgG, LDH, Magnesium, Phosphorus (Inorganic), and Uric Acid. These can be run on most automated biochemistry analysers.

For more information, download our Diabetes Brochure or email reagents@randox.com.

References

  1. Hall JE, Henegar JR, Dwyer TM, et al. Is obesity a major cause of chronic renal disease?Adv Ren Replace Ther. 2004;11(1):41–54. [PubMed]
  2. Tchernof A, Després JP. Pathophysiology of human visceral obesity: an update.Physiol Rev. 2013;93(1):359–404. [PubMed]
  3. Matsuzawa, Y. The role of fat topology in the risk of disease.  Int J Obes.  2008;32:s83-s92.
  4. Frederiksen, L., Nielsen, T. L., Wraae, K., Hagen, C., Frystyk, J., Flyvbjerg, A., Brixen, K. and Andersen, M. Subcutaneous Rather than Visceral Adipose Tissue Is Associated with Adiponectin Levels and Insulin Resistance in Young Men.  JCEM, (2009) 94 (10): 4010-4015.

 

Further reading:


#LoveYourHeart this Valentine’s Day!

We are encouraging you to #LoveYourHeart this Valentine’s Day! Read on to find out why your heart health should matter to you this #HeartMonth!

Fact:  Did you know people with diabetes are 2 to 4 times more likely to develop cardiovascular disease than people without diabetes?¹

Good diabetes control is imperative!  If you have diabetes take control and monitor your treatment to ensure you are safe from complications such as cardiovascular disease…

Many complications associated with diabetes include kidney disease, eye disease, cardiovascular disease and diabetic ketoacidosis (a life threatening condition that can develop in insulin dependent diabetics).

If you have diabetes, being physically active and controlling your weight and blood pressure will help manage your blood sugar level; and therefore help manage the risk of cardiac diseases.

However a few simple routine tests may also be carried out to ensure normal kidney function.  Normal kidney function in a diabetic patient means that diabetes is being controlled well, however if kidney function begins to deteriorate then you will know that measures need to be taken to control diabetes better.

Speciality tests to assess kidney function which can be requested include:

  • Cystatin C a sensitive marker of kidney function used for detection of early renal dysfunction in diabetic patients. It is important to note that Creatinine is the routine test for renal dysfunction, however it has a blind range which means it is unable to detect elevated Creatinine levels found in stage 2 and halfway through stage 3 renal dysfunction; as a result 50% of kidney function can be lost before elevated Creatinine levels can be seen. The Cystatin C test is a much more sensitive marker and can detect early stages of renal dysfunction, allowing treatment to begin before it is too late.
  • Beta-2 Microglobulin – this test is used when kidney damage has occurred to distinguish between the two most commonly affected sites, glomeruli and renal tubules.

Fact:  Cardiovascular Diseases are the number one cause of death globally, with more people dying annually from CVDs than any other cause.²   In the UK alone, 41,000 people under the age of 75 die from CVD each year.³

If you are worried about your cardiovascular health, or whether you are at risk of a heart attack or stroke, ask your doctor for a cardiovascular risk assessment. Routinely they will run lipid tests such as Total Cholesterol, HDL Cholesterol, LDL Cholesterol and Triglycerides to assess your overall cholesterol and triglyceride levels, and allow corrective action to be taken.

Look out for hidden risk factors!

Specific tests you may also want to discuss with your doctor include:

  • sLDL Cholesterol and Lipoprotein(a) to assess for genetically inherited risks of cardiovascular disease – even if your cholesterol levels are safe you may still be at risk of cardiovascular disease as a result of familial traits
  • Adiponectin to assess the level of abdominal visceral fat, of which high levels can increase your cardiovascular risk. Please note that abdominal visceral fat levels or body fat cannot be determined by BMI score, which assesses whether weight is within a healthy range. As such, the Adiponectin test provides a clearer indication of health and is a good predictor of cardiovascular risk
  • TxBCardio to assess response to Aspirin therapy for the prevention of cardiovascular disease. Up to 30% of patients receiving Aspirin therapy suffer unknowingly from Aspirin resistance. This test enables treatment to be modified and corrected

Asking your doctor for these tests creates an opportunity for corrective action to be taken and can have significant benefits for your health.

Fact:  Approximately one woman dies from heart disease every minute, of which 64% had no previous symptoms.4

Sixty-four percent of women who die suddenly of coronary heart disease had no previous symptoms. Because these symptoms vary greatly between men and women, they’re often misunderstood. Media has conditioned us to believe that the telltale sign of a heart attack is extreme chest pain. But in reality, women are somewhat more likely to experience shortness of breath, nausea/vomiting and back or jaw pain. Other symptoms women should look out for are dizziness, lightheadedness or fainting, pain in the lower chest or upper abdomen and extreme fatigue.

Being aware of these signs can aid early detection, and greatly increase chances of surviving a heart attack!

 

So don’t forget to #LoveYourHeart this Valentine’s Day!  Randox can provide a vast range of specialised blood tests to allow the most accurate diagnosis of diabetes, cardiac risk and associated complications. From all of us here at Randox we wish you an enjoyable Valentine’s Day!

For health professionals:

Randox Laboratories manufacture a wide range of routine and niche biochemistry reagents suitable for both research and clinical use.  These include a wide variety of automated routine and niche diabetes and cardiac tests and our new HDL3-C assay.  Please contact reagents@randox.com for further information.

 

References

  1. World Heart Federation, Diabetes, https://goo.gl/e8WG86 Accessed: February 2017
  2. WHO, Cardiovascular diseases (CVD), https://goo.gl/fGO0bj, (2016), Accessed: February 2017
  3. British Heart Foundation, CVD Statistics – BHF UK Factsheet, https://goo.gl/6DEOdw (2017), Accessed: February 2017
  4. Reference: American Heart Association, Common Myths About Heart Disease, (2017),  https://goo.gl/NEz5gV, Accessed: February 2017

 

Further reading:


Randox supports calls from Oxford University for more accurate diagnosis of diabetes following report warning

Calls for more accurate diagnosis of people at risk of developing Type-2 diabetes have been supported by Randox, following a warning raised by an Oxford University study which looked into efforts to tackle the worsening epidemic of the condition.

The study, which was published in the British Medical Journal, examined results from the NHS’s programme which involves a screening test for pre-diabetes. The authors determined that the UK’s National Diabetes Prevention Programme is unlikely to have much impact because the blood tests used were inaccurate at detecting pre-diabetes, though these are currently the only ones available to doctors and patients. The study argues that if the screening is inaccurate then people will either be falsely reassured or receive incorrect diagnoses, which will not help the worldwide challenge to reduce people at risk of developing diabetes that continues to increase across the world.

It is estimated that Type-2 diabetes causes 22,000 early deaths every year in England alone. Across the UK over 3m people currently have the condition though experts say this will increase to 5m by 2025.

With current treatment taking up almost 9% of the annual NHS budget – roughly £8.8bn a year – the implications for future healthcare budgets are clear if this dangerous trend persists.

Global reagents Manger Susan Hammond said,

Although we wholly back the NHS’s belief that positive lifestyle changes make crucial differences in people’s health and lives, we also believe that unless earlier and more accurate diagnostic screening is employed on a twin-track of treatment, this epidemic will continue to worsen.  We welcome that this study highlights the fact that clinician’s s are currently limited in what they can use to tackle the threat posed by diabetes. There are emerging biomarkers   they could be given access to,  such as Adiponectin and determining a person’s risk of Metabolic Syndrome.”

Assessing Adiponectin levels allows doctors to calculate the amount of visceral fat stored around a patient’s organs. This deep fat, which is not visible to the naked eye, is linked to health problems including Type-2 diabetes. High levels of adiponectin equate to low levels of visceral fat which can be combated by improving your diet, exercise habits and even stress levels. Given that 70% of Type-2 diabetes can be prevented by lifestyle changes, there is strong correlation that by detecting low levels of Adiponectin and taking corrective and preventive action, it could results in a decrease in the numbers of people who develop the life altering condition.

In addition to a test for the Adiponectin biomarker, Randox Biosciences have created a Metabolic Syndrome Array that measures 12 markers associated with metabolic syndrome and cardiovascular disease. Metabolic Syndrome is a is a group of cardiovascular risk factors that affects over 20% of adults and  results in a person being three times more likely to have a stroke or heart attack, and five times more likely to develop diabetes.

Mrs Hammond concluded,

“We would ultimately like to see all medical professionals who are at the forefront of patient care armed with the most accurate diagnostic tools available. Updating traditional practice may not be easy but we believe it is imperative to do so, if we are to effectively challenge this global epidemic.”

Randox remains focused on providing early diagnoses and preventing illnesses by providing innovative diagnostics tests that will continue to revolutionise the healthcare landscape.

To find out more about our tests for metabolic arrays click here and Adiponectin click here.


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