Lipids, overview

The lipid profile is perhaps the most important of the cardiac risk tests providing

a good indication of whether someone is likely to have a coronary event caused

by a blockage of the blood vessels or atherosclerosis. The MeDia Diagnostics lipid profile includes the following tests:

 

Total Cholesterol,  HDL Cholesterol, Triglycerides ,  LDL Cholesterol

direct bottle, plastic bottle, kit HDL DIRECT BOTTLES
direct kit, diagnostic, box HDL DIRECT KIT

Health factors leading to cardiovascular disease (CVD)

Gender , Age, Family History , Ethnicity, Smoking , Physical Inactivity ,Obesity, Diabetes, Hypertension, Diet

In addition to conventional risk factors such as the lipid profile there are several other emerging biomarkers associated with an increased risk of cardiovascular disease.

 

Extended lipid Profile                              üApolipoprotein A-I

üApolipoprotein B

Emerging risk factors                              üHigh sensitivity CRP

                                                                       üLipoprotein (a)

üsLDL

                                                                       üApolipoprotein A-II

                                                                       üApolipoprotein C-II

                                                                       üApolipoprotein C-III

                                                                       üApolipoprotein E

Cholesterol tests

Total Cholesterol

Total Cholesterol measures all lipoprotein sub-classes to assess a patient’s overall cholesterol level. High levels of cholesterol in the blood are associated with atherosclerosis and an increased risk of heart disease. As such cholesterol testing plays a vital role in preventative health care. Both the American National Cholesterol Education Programme (NCEP) and the European Society of Cardiologists (ESC) recommend levels below 5mmol/l.

The MeDia Diagnostics Total Cholesterol assay is based on the CHOD-PAP colorimetric method. All reagents are liquid ready-to-use and suitable for use on a wide range of chemistry analysers.

CHOLESTEROL TOTAL
CHOLESTEROL TOTAL insert kit
COLEST_MON_ CE_ UK_2.06_20062011.pdf
Documento Adobe Acrobat [117.6 KB]

Triglycerides

High triglyceride levels increase the atherogenicity of HDL and LDL cholesterol. Triglyceride levels are elevated immediately after a meal with high levels dramatically affecting the accuracy of HDL and LDL measurements. A triglyceride concentration below 1.7 mmol/L is desirable. Levels higher than this are not only associated with an increased risk of heart disease but also Type 2 diabetes, kidney disease, hypothyroidism and pancreatitis.

The MeDia Diagnostici Triglycerides assay is based on the GPO-PAP colorimetric method and is available in both liquid and lyophilised formats with fully automated applications available for a wide range of chemistry analysers.

TRIGLYCERIDES
TRIGLYCERIDES insert kit
TG-MR-650_CE_UK_2.04_20042011.pdf
Documento Adobe Acrobat [101.8 KB]

HDL Cholesterol

High-density lipoproteins (HDL-C) are one of the major classes of plasma lipoproteins. HDL-C is often referred to as ‘good cholesterol’ since it transports cholesterol from the tissues to the liver for removal from the body. High levels of HDL-C can lower an individual’s risk of developing heart disease. If HDL-C accounts for 20% of an individual’s total cholesterol then the risk of developing heart disease is less than average. The NCEP recommends the

following:

Low                      <1.01mmol/l

Borderline             1.01 – 1.54mmol/l

Desirable              1.54mmol/l

The MeDia Diagnostics HDL kit utilises a direct clearance method for superior performance. Furthermore all reagents are liquid ready-to-use with applications available for a wide range of chemistry analysers.

Benefits of the MeDia Diagnostics  Direct Clearance Method

Several methods have been developed for the direct measurement of HDL-C, although many of these direct methods perform well with normal samples. They show reduced specificity and often underestimate the concentration of HDL-C in samples containing abnormal lipoproteins e.g. those from patients with elevated triglycerides or liver damage.

The MeDia Diagnostics direct clearance method offers superior performance to these methods and works by completely removing all non-HDL components resulting in a high degree of accuracy and specificity even with abnormal samples.

HDL DIRECT
HDL DIRECT insert kit
TG-MR-650_CE_UK_2.04_20042011.pdf
Documento Adobe Acrobat [101.8 KB]

LDL Cholesterol

LDL-C, often referred to as ‘bad cholesterol’ transports cholesterol to the tissues and is linked to the development of atherosclerotic lesions.

Accurate measurement of LDL-C is therefore of vital importance in therapies which focus on lipid reduction to prevent or reduce the progress of atherosclerosis and to avoid plaque rupture. The NCEP recommends the following:

Optimal                          <2.56mmol/l

Near Optimal                  2.56 – 3.3mmol/l

Borderline High              3.3 – 4.0mmol/l

High                               4.1 – 4.85mmol/l

Very High                       >4.85mmol/l

The MeDia Diagnostics LDL-C kit utilises a direct clearance method for superior performance. Furthermore all reagents are liquid ready to use with applications available for a wide range of chemistry analysers.

Direct LDL vs. Friedewald Equation

Many laboratories choose to calculate LDL-C using the Friedewald equation. The Friedewald equation was initially used before commercial LDL-C assays were available. It enables the estimation of LDL when triglyceride and HDL levels are known however is only accurate if triglyceride levels are <400mg/dl, chylomicrons are not present and the sample does not contain beta-VLDL. 

LDL DIRECT
LDL DIRECT insert kit
TG-MR-650_CE_UK_2.04_20042011.pdf
Documento Adobe Acrobat [101.8 KB]

Extended Lipid Profile

Apolipoprotein A-I

The main role of Apolipoprotein A-I (Apo A-I) is in the removal of excess cholesterol from extra-hepatic tissues. Like HDL Cholesterol Apo A-I can be described as non-atherogenic showing an inverse relationship to cardiovascular disease risk. Individuals with cardiovascular disease generally have reduced levels of Apo A-I

and increased levels of Apo B.

The MeDia Diagnostics Apo A-I assay is based on an immunoturbidimetric method. All reagents are liquid ready-to-use and suitable for use on a wide range of chemistry analysers.

Apolipoprotein B

Apolipoprotein B (Apo B) is the main protein in LDL Cholesterol and is the ligand concerned with the uptake of cholesterol. Elevated levels of Apo B indicate an increased risk of cardiovascular disease even when total and LDL cholesterol levels are normal. Apo B is often tested alongside Apo A-I to determine the Apo B/Apo A-I ratio which is sometimes used as an alternative to the total cholesterol/HDL cholesterol ratio when determining cardiovascular

risk.

The Apo B assay is based on an immunoturbidimetric method. All reagents are liquid ready-to-use and suitable for use on a wide range of chemistry analysers

Lipoprotein (a)

Lipoprotein (a), (Lp(a)) in combination with other lipid tests can provide clinicians with much needed additional information on an individual’s risk of CVD. High levels of Lp(a) are known to occur in individuals with an otherwise normal lipid profile as such it is thought to contribute to an increased risk of CVD independent of other lipids. It is also of particular use in assessing the risk of coronary heart disease in specific populations as Lp(a) concentrations are genetically determined and vary with ethnic population.

Although not a routinely requested test the European Athersclerosis Society (EAS), the national cholesterol education programme and the national academy of clinical biochemistry recognise the usefulness of Lp(a) and recommend testing patients with a family history of premature CVD or those classified as moderate/high risk. The Lp(a) assay is based on an immunoturbidimetric method. All reagents are liquid ready to use and suitable for use on a wide range of chemistry analysers.

Why use the MeDia Diagnostics Lp(a) assay?

Lp(a) is an LDL like particle with a molecule of Apo B-100 linked by a disulphide bridge to Apo(a). Apo (a) is unique in that it is extremely heterogeneous in size due to the Kringle 4 Type 2 domain which can be present in up to 40 copies. This size heterogeneity of Apo(a) affects to varying degrees the outcome of many commercially available Lp(a) kits resulting in over estimation of samples containing large apo(a) molecules and an under estimation of samples containing small apo(a) molecules. Research has documented and shown the method to be one of only few to exhibit minimum size related bias.

LIPOPROTEIN (a)
LIPOPROTEIN (a) insert kit
LPA-TURBI_CE_ IT_0-20042011B.pdf
Documento Adobe Acrobat [69.1 KB]

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