What is Extended Lipid Plus?
Description:
A comprehensive tool to screen, diagnose and monitor dyslipidaemia.

Background:
Disorders of lipid metabolism are common and prominent in clinical practice, causing dyslipidaemia (abnormal lipid levels), which are traditionally classified based on patterns of elevation in lipids and lipoproteins in the blood.

The causes of dyslipidaemia are multifactorial ranging from primary genetic causes like familial hypercholesterolemia to secondary causes including endocrine problems of diabetes & hypothyroidism, Liver diseases, Chronic renal disorders (CKD) and even certain drug therapies.

The scientific evidence indicating strong association with several important health concerns stated below have led to the lipid profile to become the most commonly used diagnostic test across the spectrum of medical practitioners.

Dyslipidaemia is recognized as a prominent risk factor for cardiovascular (CV) disease. Primary prevention provides the greatest opportunity for reducing the burden of vascular disease, this approach is supported by extensive evidence from large, prospective studies.

What is Lipid Profile?

A lipid profileis a panel of blood tests that serves as an initial broad medical screening tool for abnormalities in lipids, such as cholesterol and triglycerides.

Why have you added so many tests in Lipid Profile?

Rationale behind ADL’s Extended lipid profile – driven by science towards patient care

  • Clinical routine lipid profile includes screening for total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C).
  • There have been varied recommendations on the inclusion of additional parameters in the conventional lipid profile including ApoA1, ApoB, lipoprotein A etc. which have significance in risk assessment of cardiovascular diseases.
  • A landmark paper P.M Ridker et al titled-” Non–HDL Cholesterol, Apolipoproteins A-I and B100, Standard Lipid Measures, Lipid Ratios, and CRP as Risk Factors for Cardiovascular Disease in Women” expanded the scope of the lipid profile.
  • Discovered in 1963 – Lipoprotein(a) is a genetic, causal risk factor for CVD. Population-based studies have determined that there is a continuous, graded association between Lp(a) levels and CV risk.
  • Studies demonstrated that the addition of hs-CRP to lipid-based measurements significantly improved risk prediction for CVDs and on treatment
  • CRP measurement showed potential to offer additive prognostic information.
  • Empowered by scientific evidence and clinical validation in 2006 ADL decided to extend the Lipid profile to include additional markers – Apo A1, Apo B, APOB/ APOA ratio, Lpa and hs-CRP.
  • At Anand Lab LDL cholesterol is measured directly thereby helping the treating Physician in accurately stratifying risk factors for Coronary heart disease.

A conventional lipid profile typically includes:

  • Low-density lipoprotein (LDL)
  • High-density lipoprotein (HDL)
  • Triglycerides (TRIG)
  • Total cholesterol (TC)

Using these values, a laboratory may also calculate:

  • Very low-density lipoprotein (VLDL)
  • Cholesterol: HDL ratio
  • The results of this test can determine approximate risks for cardiovascular disease (CVD), can identify genetic diseases, certain forms of pancreatitis, and various other diseases.

Some Definitions you should know:
Total cholesterol – a measure of the total amount of cholesterol in your blood, including low-density lipoprotein (LDL) cholesterol and high-density lipoprotein (HDL) cholesterol.

  • High blood cholesterol is a condition in which you have too much cholesterol in your blood. By itself, the condition usually has no signs or symptoms. So, many people don’t know that their cholesterol levels are too high.
  • People who have high blood cholesterol have a greater chance of getting coronary heart disease or coronary artery disease, which occur due to plaque build up (Chol, Ca etc.)
  • This phenomenon is called Atherosclerosis and can lead to serious problems, including heart attack, stroke, or even death

Lipoproteins are complex particles composed of multiple proteins, which transport all fat molecules (lipids) around the body within the water outside cells.

High-density lipoproteins (HDL) are one of the five major groups of lipoproteins. HDL transports cholesterol mostly to the liver or steroidogenic organs such as adrenals, ovary, and testes.

  • The cholesterol delivered to the liver is excreted into the bile and, hence, intestine either directly or indirectly after conversion into bile acids. Delivery of HDL cholesterol to adrenals, ovaries, and testes is important for the synthesis of steroid hormones.
  • This is sometimes called the “good” cholesterol because it helps carry away LDL cholesterol, keeping arteries open and your blood flowing more freely.

Non-HDL cholesterol. Non-high density lipoprotein cholesterol is the difference between total cholesterol and high-density lipoprotein cholesterol (HDL-C). Non-HDL-C includes cholesterol in lipoprotein particles that are involved in hardening of the arteries (atherosclerosis). This includes low-density lipoprotein (LDL), lipoprotein (a), intermediate-density lipoprotein and very-low-density lipoprotein. LDL cholesterol is sometimes called “bad” cholesterol. LDL can clog your arteries.

Low-density lipoprotein (LDL) – are carrier molecules which include all fat molecules with cholesterol, phospholipids, and triglycerides dominant. Lipoproteins can be sampled from blood for evaluation of atherosclerosis driving factors.

Low-density lipoprotein cholesterol is routinely calculated in laboratories world over by applying Friedewald formula for logistic reasons. A major disadvantage in calculating LDL-C is variability, which is a product of the combined variabilities of the three underlying measurements.

  • High levels of LDL-CHOL in your blood causes the accumulation of fatty deposits (plaques) in your arteries (atherosclerosis), which reduces blood flow and leads to vascular diseases.
  • Therefore “You want your LDL to be low. Too much LDL is linked to heart disease and stroke.”

Very low-density lipoproteins (VLDL) transport endogenous TRIGS, Phospholipids, Cholesterol and cholesteryl esters and functions as the body’s internal transport mechanism for lipids.

  • Very-low-density lipoprotein (VLDL) cholesterol is produced in the liver and released into the bloodstream to supply body tissues with a type of fat (triglycerides).
  • High levels of VLDL cholesterol have been associated with the development of plaque deposits on artery walls, which narrow the passage and restrict blood flow.
  • There’s no simple, direct way to measure VLDL cholesterol, which is why it’s normally not mentioned during a routine cholesterol screening. VLDL cholesterol is usually estimated as a percentage of your triglyceride value.
  • This estimate is less accurate if your triglycerides level is above 400 mg/dL

Anand Lab’s Preventive Healthcare focus:

  • At Anand Lab one of our primary foci is to enable preventive health care.
  • As we believe “The right preventive care strategy at every stage can help stay healthy, avoid or delay the onset of disease, keep previously diagnosed diseases from worsening, reduce health care costs and lead productive lives.”
  • We have been offering tests for lipid profiling since our inception in 1974.
  • As ADL has evolved our Lipid profile has also been evolving supported by scientific thinking and medical knowledge with the main goal of better patient care.
  • Today we have an Extended lipid plus a unique, comprehensive and customized screening tool for preventive health.
  • It provides clinical utility across a wide array of disorders including common lifestyle disorders, endocrine diseases and other health concerns.

Summary/ salient features:

The ADL extended lipid plus is a comprehensive tool which can

  • Accurately determine the extent of dyslipidaemia
  • Help in risk assessment for cardiovascular diseases
  • Help monitor inflammatory status
  • It is applicable across a wide spectrum of clinical conditions where lipid profiling is significant including diabetes, Hypothyroidism, CKD, drug therapy etc.

Extended Lipid+ Test Components: (WHD Price is 1100/-)

  • Total Cholesterol
  • Triglycerides
  • HDL Cholesterol, Direct
  • LDL Cholesterol, Direct
  • VLDL Cholesterol, Calculated
  • HDL: LDL Ratio
  • Total: HDL Rattio
  • Apolipoprotein A & B
  • HsCRP (High Sensitivity C Reactive Protien)
  • Lp(a) [Lipoprotein(a)]
  • HbA1c
  • TSH (Thyroid Stimulating Hormone)

References:

  • Miller Dyslipidaemia and cardiovascular risk: the importance of early preventionQ J Med 2009; 102:657–667 doi:10.1093/qjmed/hcp065https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2729130/
  • Ridker PM, Rifai N, Cook NR, Bradwin G, Buring JE. Non-HDL cholesterol, apolipoproteins A-I and B100, standard lipid measures, lipid ratios, and CRP as risk factors for cardiovascular disease in women. JAMA. 2005;294:326 –333.
  • Suk Danik J, Rifai N, Buring JE, Ridker PM. Lipoprotein(a), measured with an assay independent of apolipoprotein(a) isoform size, and risk of future cardiovascular events among initially healthy women. JAMA. 2006;296(11):1363-1370
Published On: November 6th, 2020 / Categories: Anand Diagnostic Laboratory, blog-post /

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