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Lipid Panel (Heart Health) with hsCRP (Inflammation Assessment) and HbA1c (Diabetes Risk Assessment)

Test ID: A899

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Introduction

Maintaining normal levels of cholesterol and triglycerides are important for good cardiovascular health. In addition, elevated C-reactive protein (CRP) levels can be indicative of cardiovascular disease and elevated glycated hemoglobin (HbA1c) is associated with an increased risk of diabetes as well as poor cardiovascular health.

CHOLESTEROL:
Cholesterol is a waxy type of fat (lipid), which travels around the body in the blood. It is an essential molecule, as it is required for building cells, producing bile for digestion, and making vitamins and hormones. Although it is important to have enough cholesterol, excess cholesterol can cause health complications. 

HDL CHOLESTEROL:
Cholesterol carried by high-density lipoproteins (HDL cholesterol) is considered “good” cholesterol. HDL collects cholesterol from around the body, and delivers it to the liver for recycling or excretion. HDL also carries cholesterol to other organs, where it is used to produce hormones. In addition, HDL cholesterol plays a role in protecting and maintaining the inner walls of the blood vessels by repairing damaged sites.

LDL CHOLESTEROL:
Cholesterol carried by low-density lipoproteins (LDL cholesterol) is often called “bad” cholesterol. LDL deposits excess cholesterol in blood vessel walls, where it accumulates, leading to hardening of the arteries, atherosclerosis, and blood clots. LDL cholesterol levels are often considered to be the best predictor of the risk of heart disease.

TRIGLYCERIDES:
Triglycerides are the main form of fat in the body. They are produced from the digestion and breakdown of fats in foods, as well as from the breakdown of other energy sources, such as carbohydrates. Triglycerides can be used as an immediate energy source or be stored for later use. Elevated triglycerides are associated with an increased risk of health complications, including cardiovascular disease, type 2 diabetes, and metabolic syndrome.

C-REACTIVE PROTEIN:
C-reactive protein (CRP) concentration rises non-specifically in response to inflammation. Measurements of CRP are useful for detecting infections and other medical conditions. A high-sensitivity C-reactive protein (hs-CRP) test is a very sensitive test that is useful for detecting small increases, which can be indicative of an increased risk of coronary artery disease.

GLYCATED HEMOGLOBIN:
HbA1c is glycated hemoglobin, which forms when hemoglobin within red blood cells joins with glucose. HbA1c levels reflect the average blood glucose level during the preceding 2-3 months. Measurement of HbA1c is useful for assessing diabetes risk, diagnosis, and control, as well as part of an evaluation of cardiac health.

Pricing

$99

How to order a test

What is Included?

  • Measurement of total cholesterol levels by enzymatic methodology.
  • Measurement of high-density lipoprotein (HDL) cholesterol levels by accelerator selective detergent methodology.
  • Measurement of low-density lipoprotein (LDL) cholesterol levels by measured, liquid selective detergent methodology.
  • Measurement of triglyceride levels by glycerol phosphate oxidase methodology.
  • Calculation of the cholesterol ratio (total cholesterol / HDL)
  • Measurement of C-reactive protein by high sensitivity assay to aid in the assessment of cardiac health and inflammation.
  • Measurement of hemoglobin A1c (HbA1c) and total hemoglobin (THb) levels in a blood sample by enzymatic methodology. These two concentrations are used to determine the %HbA1c.

Turnaround Time

1 – 3 business days
The turnaround time is not guaranteed. The average turnaround time is 1 – 3 business days from the date that the sample arrives at the laboratory. Shipping time for the sample is not included. Additional time is required if the case requires confirmatory or reflex testing, or if the sample is insufficient, or if a recollection is required.

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SPECIMEN REQUIREMENTS 

Preparation Before Specimen Collection

  • Follow a normal diet for two weeks prior to specimen collection.
  • Avoid taking any drugs for 3 – 4 weeks prior to specimen collection if possible.
  • Fasting for 8 – 12 hours is recommended for an accurate interpretation of triglyceride results.

  • For an accurate interpretation of CRP results in relation to cardiovascular risk, it is recommended that two samples are collected, two weeks apart in metabolically stable people. Any CRP results >10 mg/L should be disregarded for a cardiovascular risk assessment and alternative sources of inflammation or infection should be investigated.

  • Do not consume any alcohol in the 24 hours prior to collecting your sample for this test.

Specimen Type

Blood

Volume

50 μL in a microtainer

Container

Microtainer (regular blood tube)

Collection Method

This test requires a blood sample from a finger prick. All supplies for sample collection are provided in the kit.

  1. First wash and dry hands. Warm hands aid in blood collection.
  2. Clean the finger prick site with the alcohol swab and allow to air dry.
  3. Use the provided lancet to puncture the skin in one quick, continuous and deliberate stroke.
  4. Wipe away the first drop of blood.
  5. Massage hand and finger to increase blood flow to the puncture site. Angle arm and hand downwards to facilitate blood collection on the fingertip.
  6. Drip blood into the microtainer tube.
  7. Dispose of all sharps safely and return sample to the laboratory in the provided prepaid return shipping envelope.

NOTES: Avoid squeezing or ‘milking’ the finger excessively. If more blood is required and blood flow stops, perform a second skin puncture on another finger. Do not touch the fingertip.

Specimen Storage

Maintain specimen at temperatures between 2°C and 30°C during storage and transport.

Specimen Stability

Blood samples can be refrigerated or kept at room temperature for up to 7 days.

Causes for Rejection

  • Incorrect or incomplete patient identification
  • Incorrect specimen collection
  • Inappropriate storage and transport conditions
  • Incorrect specimen volume
  • Gross lipemia
  • Gross hemolysis

TEST DETAILS

Purpose

To measure cholesterol and triglyceride levels in a blood sample for the evaluation of cardiac and liver health, intestinal absorption, and biliary and thyroid function.

To measure C-reactive protein (CRP) levels in a blood sample for the evaluation of cardiac health and inflammation.

To measure hemoglobin A1c (HbA1c) levels in a blood sample for the evaluation of glucose control to assess diabetes risk, diagnosis, and control. Evaluation of HbA1c levels is also beneficial in the evaluation of cardiac health.

Limitations

  • This report is not intended for use in medico-legal applications. 
  • These results should be interpreted in conjunction with other laboratory and clinical information.
  • Correct specimen collection and handling is required for optimal assay performance. 
  • Interferences from medication or endogenous substances may affect results.
  • Cholesterol and triglycerides may be elevated during pregnancy.
  • Abnormal liver function can affect lipid metabolism and cholesterol levels.
  • Elevated concentrations of N-acetyl-L-cysteine may lead to falsely low HDL levels in this assay.
  • Females taking estrogens or high estrogen oral contraceptives may have increased triglyceride levels.
  • CRP levels can also be elevated in noncardiovascular etiologies.
  • Gammopathy, particularly of the monoclonal IgM type may interfere with the hsCRP assay.
  • Hematocrit disorders may interfere with HbA1c assay results.
  • HbA1c levels are decreased in cases of shortened red blood cell survival, including due to haemolytic anemia, sickle cell disorders, pregnancy, and significant blood loss. Hence, this assay cannot be used to diagnose diabetes in individuals from each of these categories.
  • Severe chronic hepatic and renal disease, and malignancies may interfere with the HbA1c assay.
  • Abnormal amounts of fetal hemoglobin (HbF) will interfere with the HbA1c assay.

Methodology

Enzymatic (Alinity c Cholesterol assay)

Accelerator selective detergent (Alinity c Ultra HDL assay)

Measured, liquid selective detergent (Alinity c Direct LDL assay)

Glycerol phosphate oxidase (Alinity c Triglyceride assay)

Turbidimetric/Immunoturbidometric (Alinity c CRP Vario assay)

Enzymatic (Alinity c Hemoglobin A1c assay)

Reference Intervals

Lipid Panel 

Total Cholesterol Desirable < 200 mg/dL
Borderline 200 – 239 mg/dL
High ≥ 240 mg/dL
HDL Cholesterol Major risk factor for heart disease < 40 mg/dL
Negative risk factor for heart disease ≥ 60 mg/dL
LDL Cholesterol Optimal < 100 mg/dL
Near or above optimal 100 – 129 mg/dL
Borderline high 130 – 159 mg/dL
High 160 – 189 mg/dL
Very high ≥ 190 mg/dL
Triglycerides Normal < 150 mg/dL
Borderline high 150 – 199 mg/dL
High 200 – 499 mg/dL
Very high ≥ 500 mg/dL
Cholesterol Ratio Normal < 5.0

These reference ranges were obtained from the Alinity c package inserts (listed in Methodology section above), which follow recommendations from the National Cholesterol Education Program (NCEP) Adult Treatment Panel III Report.


hsCRP

  Average hs-CRP level (mg/L)
Low risk of cardiovascular disease < 1.00
Average risk of cardiovascular disease 1.00 – 3.00
High risk of cardiovascular disease > 3.00

These reference ranges were obtained from Pearson et al. (2003) from the Centers for Disease Control and Prevention (CDC) and American Heart Association.


HbA1c

  %HbA1c
Normal < 5.7
Prediabetes (increased risk of diabetes) 5.7 – 6.4
Supports a diabetes diagnosis ≥ 6.5
Recommended goal for diabetic adults < 7.0

These reference ranges were obtained from the Alinity c Hemoglobin A1c package insert, which follow recommendations from the American Diabetes Association (ADA).