Securing the future with in vitro diagnostic tests
Securing the future with in vitro diagnostic tests
The aim of Biomedical Science Day is to raise the public’s awareness of the importance of biomedical science and the vital role it plays in the world. Randox are dedicated to improving healthcare worldwide through placing a major focus on research and development. The Randox scientists work in pioneering research into a range of common illnesses such as cancer, cardiovascular disease and Alzheimer’s disease.
A recent blog from Doris-Ann Williams, the Chief Executive at BIVDA, explains how “increased funding is not enough to sustain the NHS” and how “we need to make better use of in vitro diagnostics to ensure a successful future”.
The National Health Service (NHS) is a publicly funded, primarily taxation, national healthcare system in the United Kingdom. It was first set-up on July 5th, 1948 by Aneurin Bevan as he believed that everyone, regardless of wealth, should have access to good healthcare. Whilst the NHS is an extremely important aspect of healthcare in the UK, in vitro diagnostics are the heart and soul of the healthcare system as healthcare professionals not only rely on blood tests to diagnose and treat patients, but also to rule out the different contributing causes to a disease state. In vitro diagnostics also plays a key role in monitoring chronic disease states. In vitro diagnostics can also aid in reducing hospital stays, reduce misdiagnosis and support patients in looking after their own health and to deliver personalised treatment plans.
The Randox scientists have developed several niche assays to improve patient diagnosis, monitor treatment and eliminate misdiagnosis.
Adiponectin
Adiponectin is a protein hormone secreted by adipocytes with anti-inflammatory and insulin-sensitising properties. It plays an important role in a number of metabolic processes including glucose regulation and fatty acid oxidation. Adiponectin levels are inversely correlated with abdominal visceral fat which have proven to be a strong predictor of several pathologies, including: metabolic syndrome, type 2 diabetes mellitus (T2DM), cancers and cardiovascular disease (CVD). For more information on the importance of testing Adiponectin levels, check out our Adiponectin Whitepaper.
Cystatin C
Cystatin C is an early risk marker for renal impairment. The most commonly run test for renal impairment is Creatinine. Creatinine measurements have proven to be inadequate as certain factors must be taken into consideration, including age, gender, ethnicity etc. The National Institute for Health and Care Excellence (NICE) have updated their guidelines, which now recommends Cystatin C as a more superior test for renal impairment due to its higher specificity for significant disease outcomes than those based on Creatinine. For more information on the importance of testing Cystatin C levels, check out our Cystatin C Whitepaper.
Small-dense LDL Cholesterol (sdLDL-C)
LDL Cholesterol (LDL-C) consists of two parts: the large and buoyant LDL Cholesterol and the small and dense LDL Cholesterol. Whilst all LDL-C transports triglycerides and cholesterol to bodily tissues, their atherogensis varies according to their size. As sdLDL-C is small and dense, they can more readily permeate the arterial wall and are more susceptible to oxidation. Research indicates that individuals with a predominance of sdLDL-C have a 3-fold increased risk of myocardial infarction. It has been noted that sdLDL-C carries less Cholesterol than large LDL, therefore a patient with predominately sdLDL-C particle may require nearly 70% more sdLDL-C particles to carry the same amount of cholesterol as the patient with predominately LDL-C particles. For more information on the importance of testing sdLDL-C levels, check out our sdLDL-C Whitepaper.
These three niche in vitro diagnostics tests developed by Randox scientists can aid in reducing NHS costs due to their higher performance compared to the traditional tests. Randox are constantly striving to improve healthcare worldwide.
For more information on the extensive range of Randox third-party in vitro diagnostic reagents, visit: https://www.randox.com/diagnostic-reagents/ or contact reagents@randox.com.
What is Visceral Fat?
Visceral fat (or abdominal fat) is body fat which is stored within the abdominal cavity. It wraps around your vital organs including the liver, pancreas and intestines, and as a result can have a negative impact on your health. In fact, visceral fat has been linked to increased risk of health problems such as type 2 diabetes, heart disease and some cancers.
It is important to distinguish the difference between subcutaneous fat and visceral fat…
Subcutaneous fat is the fat we store under our skin. It is the tissue that we can feel when we pinch ourselves, and contains blood vessels in addition to fatty tissues. Visceral fat, on the other hand, cannot be felt in such a way as it is the extra fat stored around our organs. It is the most dangerous type of fat as it much harder to identify.
No matter what your shape or size, you may be carrying excess visceral fat!
Regardless of shape or size an individual can be carrying excess visceral fat. This means that whether your doctor tells you that you’re underweight, overweight, obese or of a healthy weight, you may be carrying excess visceral fat within your abdominal cavity.
That is why BMI is an inaccurate measurement of health…
Body Mass Index (BMI) is used by many as an indicator of health. It involves comparing your weight in relation to your height to give an indication of your weight status i.e. whether you are categorised as underweight, overweight, healthy or obese. It doesn’t take into account muscle mass, age, sex, ethnicity, general level of fitness or visceral fat. Therefore, even if you have a ‘healthy’ BMI you may still be carrying excessive visceral fat, and could still be at risk of the health complications associated with it.
As a result, relying on BMI could put you at risk of countless diseases…
Visceral fat is often referred to as ‘active fat’ due to the effect it has on our hormones and body functions. It can interrupt normal hormone communications between your vital organs, and can lead to insulin resistance and eventually type 2 diabetes. Additionally, it can affect the functions of your organs and puts you at higher risk of developing heart disease or cancers including breast cancer or colorectal cancer.
So, what can you do to protect yourself?
Factors which contribute to visceral fat levels include stress, diet and exercise habits in addition to age, ethnicity and gender. Living a healthy lifestyle will therefore reduce your chances of visceral fat accumulating in your abdominal cavity.
If you are worried about your visceral fat levels the waist-to-hip ratio (found by dividing waist width by hip width) can give an indication of total fat as well as the level of visceral fat, however the most accurate measurement of visceral fat is to measure adiponectin levels in the blood.
Adiponectin (a blood analyte) is closely linked with visceral fat; low levels of adiponectin indicate high levels of visceral fat. The Adiponectin test enables true measurement of visceral fat levels and allows for more accurate measurement of health than traditional BMI; if you have been diagnosed with unhealthy BMI and believe this to be an inaccurate diagnosis, testing your adiponectin levels can help determine your true measurement of health. Simply ask your doctor for the Adiponectin test!
Further reading:
For health professionals:
The adiponectin test from Randox can accurately assess levels of abdominal visceral fat, independent of age, race or fitness level. 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. Contact us now for further information.
MYTH: Only overweight people get type 2 diabetes, right?
The answer to this common myth is no. Let us tell you why…
As a condition that usually manifests later in life, type 2 diabetes is viewed by many as a self-inflicted disease caused by eating too much sugar and being overweight. Although obesity is strongly associated with type 2 diabetes it isn’t the only cause. In fact, many people of a healthy weight have type 2 diabetes, and similarly many overweight people do not. This is because an individual’s metabolic health can be affected by factors other than their weight.
Firstly, let’s define metabolic health; metabolic health refers to the body’s health at a cellular function, and one aspect of this is the body’s ability to utilise nutrients for energy. Within this insulin has an important function; insulin is a hormone produced by the pancreas and used by the body to regulate how glucose is used and stored. In some individuals, however, this is not the case; their pancreas may either not produce enough insulin, or may not be able to effectively use the insulin it produces, known as insulin sensitivity. High blood sugar level and type 2 diabetes is the effect of this.
Whilst obesity and lack of exercise are 2 of the most common reasons affecting metabolic state and causing type 2 diabetes, it is important to note that approximately 1 in 3 type 2 diabetics are undiagnosed. Therefore the causal factors of these individuals are not included in the statistics and therefore not accounted for in this statement. Other causal factors include family history, ethnicity, age, stress, inflammation, poor diet and visceral fat.
Let’s talk about a few of these factors…
Family history & ethnicity – Do genetics play a role?
Risk factors of type 2 diabetes includes family history and ethnicity; research(1) has found that there is a 1 in 7 risk of type 2 diabetes for children whose parents were diagnosed before the age of 50, and 1 in 2 risk for children if both parents have type 2 diabetes. Furthermore, research(2) has linked genetic mutation of the HMGA1 gene to an increased risk of type 2 diabetes in white Europeans; the study found that defects in the HMGA1 gene led to a drop in the body’s ability to make insulin receptors, thus leading to insulin resistance. In fact, 1 in 10 study participants with type 2 diabetes had a genetic mutation of the gene. Furthermore certain ethnic groups have been linked to increased risk of type 2 diabetes i.e. African Americans, Native Americans, Hispanic Americans and Asian Americans; some believe this may be due to genetics.
Chronic Stress
When the body is under stress, stress hormones such as cortisol are released. These hormones can affect the body’s blood glucose levels; for example, one of the primary functions of cortisol is to provide an immediate source of energy for the body, resulting in an increase of glucose supply to the blood. Individuals suffering chronic stress therefore have a constant production of cortisol, and chronically increased blood glucose levels as a result. This increases the risk of type 2 diabetes.
Chronic stress can lead to inflammation, which is another risk factor in the development of type 2 diabetes.
Inflammation
As the body’s natural response to injury, inflammation is the initial step in the healing process. Opening the blood vessels to allow free movement of the body’s natural healing substances to the affected site, it offers the body protection and fights off foreign substances such as germs and toxins. Inflammation is necessary to rid infections and heal wounds, however if the body suffers a chronic state of inflammation it can have damaging effects; chronic inflammation is caused by autoimmune conditions, allergies, chronic stress and conditions such as Crohn’s disease, and is linked to major diseases such as heart disease, arthritis and certain cancers. The link with type 2 diabetes is a result of inflammation causing insulin resistance, increasing the risk of type 2 diabetes.
Abdominal visceral fat
Abdominal visceral fat is the fat which surrounds the internal organs in the abdominal cavity. High levels of abdominal visceral fat are associated with insulin resistance and therefore, high risk of diabetes. Abdominal visceral fat can be found in individuals of all shapes and sizes, and regardless of ‘healthy’ BMI high visceral fat levels can still occur. This is because BMI doesn’t take into account muscle mass or other factors including gender and ethnicity. This presents an issue as those with a ‘healthy’ BMI may unknowingly still be at risk of diabetes. Similarly those with high muscle mass, who are determined ‘overweight’ based on BMI, may worry that they are at risk of diabetes, when in fact their weight isn’t putting them at risk. Determining levels of abdominal visceral fat is a much better indication of health than BMI.
Overall risk of type 2 diabetes is correlated with genetic, environmental and lifestyle factors. Whilst some impact more than others, it is important to recognise that there are numerous factors related to type 2 diabetes, and rid the myth that obesity and a high sugar diet high are the only causal factors.
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References:
(1) American Diabetes Association (2014) Genetics of Diabetes. Found online at diabetes.org/diabetes-basics/genetics-of-diabetes.html
(2) Brunetti et al (2011) Functional Variants of the HMGA1 Gene and Type 2 Diabetes Mellitus. Journal of the American Medical Association (JAMA); 305 (9):903-912.
If you are worried about your blood glucose levels, or risk of diabetes, ask your doctor for these tests:
- Glucose, HbA1c and Fructosamine to assess your blood glucose levels
- CRP to determine chronic inflammation with additional testing of SPLA2-IIA levels to determine vascular inflammation
- Adiponectin to assess your level of abdominal visceral fat. High levels of abdominal visceral fat can indicate metabolic syndrome and pre-diabetes.
For more information on diabetes testing visit our dedicated diabetes reagents page.
For health professionals:
Adiponectin is a protein which regulates the metabolism of lipids and glucose and influences the body’s response to insulin. Low levels of Adiponectin are correlated with increased CRP (increased inflammation), higher levels of triglycerides and insulin resistance. As a result of increased insulin resistance and inflammation, low levels of Adiponectin can indicate metabolic syndrome.
For more information please visit our dedicated Adiponectin page or view our full range of diabetes tests.
SPLA2-IIA is a highly specific marker of atherosclerotic plaque inflammation, and has a direct role in the formation of rupture-prone atherosclerotic plaque. Increased concentrations of SPLA2-IIA have been linked with increased risk of cardiocerebrovascular events. As a highly specific marker of vascular inflammation, it complements tests such as hsCRP, and can be used to improve the risk assessment of patients with moderate to high risk of CVD, in particular those with metabolic syndrome such as insulin resistance.
Further reading: Sertić et al (2010) Does Lp-PLA2 determination help predict atherosclerosis and cardiocerebrovascular disease? Acta Med Croatica. 64(4):237-45
Randox SPLA2-IIA will be available soon. To register your interest please view our dedicated SPLA2-IIA page.
