Lipids:
LDL-C (low density lipoprotein) is the form of cholesterol that most of us have heard about – “bad cholesterol” which can deposit in plaques and is the main target of cholesterol-lowering therapy.
HDL-C (high density lipoprotein), known as “good cholesterol”, carries “bad cholesterol” ad way from the arteries and back to the liver, from where it can then be excreted as bile.
Triglycerides (TG), the most common type of fat in the body, have the function of storing excess energy from the diet. Triglycerides are a well-established marker of cardiovascular disease risk.
Total Cholesterol (TC) includes HDL, LDL and VLDL – very low density lipoprotein, produced by the liver to supply tissues with triglycerides.
Lipoproteins:
Apo A-1 is the main structural component of HDL and assists in reverse cholesterol transport.
Apo B is the main component of atherogenic lipoprotein particles.
The Apo B/Apo A-1 Ratio has been shown in multiple studies to have high predictive ability for metabolic syndrome, cardiovascular disease, obesity, insulin resistance, diabetes, heart attack and early atherosclerosis.
Lp(a) is a type of lipoprotein, primarily genetically determined, causes damage via inflammation and oxidative stress.
Cardiometabolic markers:
hsCRP is an important independent marker for inflammation. Elevated hs-CRP has been linked to a poor longterm prognosis for those with a recent history of a cardiac event.
Homocysteine, an amino acid, can rise in response to nutritional deficiencies of B12, folate, B6, or betaine. High levels of homocysteine have been linked to damaged endothelium, increased platelet aggregation, and the formation of atherosclerotic lesions.
Insulin:
Insulin, a hormone made by the pancreas, allows your body to use glucose for energy. Glucose is a type of sugar found in many carbohydrates.
How does the body utilise glucose?
Carbohydrates taken in in the form of food are broken down within the digestive tract and changed into glucose, which is then absorbed into your bloodstream through the lining of your small intestine. In the presence of bloodstream glucose, insulin signals cells throughout your body to absorb the sugar and use it for energy.
Insulin’s vital role is to balance your blood glucose levels: too much glucose in your bloodstream is mitigated by insulin telling your body to store the leftover glucose in your liver. This is then released when blood glucose levels decrease, such as between meals or when your body is stressed or needs an extra boost of energy.
Insulin and heart disease
Blood glucose levels should be in a low and steady range. Insulin resistance is the name given to the condition in which your cells aren’t reacting to insulin the way they’re supposed to (they’re resisting it), which means that sugar stays in your blood. This can then turn into diabetes – a one-point rise in your A1c, the test that measures blood sugar levels over time, can increase the likelihood of developing cardiovascular disease by up to 18%.
There’s also a link between insulin resistance and other aspects of your health, such as that of the heart. Arteries can become inflamed and damaged by high blood sugar, and blood vessel walls get stiffer, contributing to high blood pressure. High blood sugar and inflammation can also damage the nerves that control your heart.
Sex hormone marker:
Testosterone – there is a strong and persistent link between low levels of testosterone and a spectrum of conditions including inflammation, insulin resistance, dyslipidemia and atherosclerosis, right the way through to cardiovascular disease and type 2 diabetes.
Sex hormone binding globulin:
SHBG is a protein synthesised by the liver which binds to the sex hormones testosterone, oestradiol and DHT, transporting them in the blood in inactive form. Low levels of testosterone in asymptomatic men and male patients with coronary heart disease have been associated in several studies with a higher cardiovascular risk.