Lipids and Apolipoproteins

• Total Cholesterol (TC)
  Measures the amount of cholesterol in all cholesterol-containing lipoproteins
• Direct Low-Density Lipoprotein Cholesterol (LDL-C)
  Amount of cholesterol in the atherogenic low-density lipoproteins
• High-Density Lipoprotein Cholesterol (HDL-C)
  Amount of cholesterol in high-density lipoproteins (HDL)
  Higher levels of HDL are associated with reduced CVD risk, but not all HDL is good
• Triglycerides (TG)
  Elevated levels increase CVD risk by altering lipoprotein metabolism
• Apolipoprotein B (ApoB)
  A major protein in atherogenic particles
  Stronger predictor of CVD than LDL-C
• Lipoprotein(a) (Lp(a))
  Elevated levels, present in 20% of the population, are an independent risk factor for CVD

Lipid Ratio

• Total Cholesterol (TC) and High-Density Lipoprotein Cholesterol (HDL-C)
  TC/HDL-C is a stronger risk factor than either LDL-C or HDL-C
  Low HDL-C/TG is associated with insulin resistance
• Triglycerides (TG) and High-Density Lipoprotein Cholesterol (HDL-C)
  TG/HDL-C a key marker of insulin resistance, metabolic syndrome and small dense LDL

Inflammation

• High Sensitivity C-Reactive Protein (hs-CRP)
  Acute phase inflammatory protein
  Associated with atherosclerosis after excluding other causes

Metabolics

• Hemoglobin A1c (HbA1c)
  Assesses the average blood glucose over the last (three to four months or 120 days which is the average life of the red blood cell) two to three months
• Glucose
  Fasting glucose is a strong predictor of diabetes and CVD risk
• Insulin
  Detects insulin resistance years before glucose or HbA1c become abnormal
• HOMA-IR
  Calculated insulin-resistance score from fasting glucose + fasting insulin
• Vitamin D
  Low levels linked to cardiovascular and metabolic disease