← Healthier World with Quest Diagnostics
Loading summary
Transcript4 lines
- [00:00]
Narrator
Foreign.
- [00:04]
Host
Welcome to Healthier World with Quest Diagnostics. Our goal is to prompt action from Insight as we keep you up to date on current clinical and diagnostic topics in cardiovascular, metabolic, endocrine and wellness medicine.
- [00:19]
Guest Expert
Hey listeners, welcome to a special episode designed to give you instant insights on a test offering called the Metabolic Risk Panel. Today we'll be reviewing four components that are included in the Metabolic Risk panel, including an A1C insulin resistance panel with score, a lipid panel and an apolipoprotein B. This is perhaps my favorite test offering from a clinical perspective because it's addressing the need to identify individuals with metabolic dysfunction which is driven by insulin resistance and is becoming a huge epidemic in our current population. As a society, we are less active in eating more sugar, which is driving up our risk for insulin resistance. In fact, 30 million US adults have progressed to type 2 diabetes as a result of the increase in obesity and metabolic risk. There are costly related conditions that are also affected, namely cardiovascular disease, metabolic dysfunction, associated steatotic liver disease, chronic kidney disease and others. And in fact the increased rates of obesity and metabolic syndrome are driving up cardiovascular disease, which is the number one cause of death globally in both men and women. The consensus among experts is that early identification and intervention is crucial in order to delay and prevent disease progression. So what do we do? How do we catch risk? Early thinking about blood based markers that would predict issues with glycemic control and cardiovascular risk. It might be common for you to think of an HBA1C and a standard lipid panel. However, adding evidence based biomarkers like apolipoprotein B and an insulin resistance panel with a SCORE can better identify individuals at risk. Let's first start by talking about the Metabolic Risk Panel components that assess glycemic control, hemoglobin A1c or HbA1c is many providers frontline defense for assessing metabolic issues, especially now that the center of Medicare and Medicaid Services recognizes HBA1C as a cover diabetes screen in certain populations. But now we have better tools than just HbA1c alone. The foundation of glycemic control is a condition called insulin resistance, which is when insulin is working really hard to keep our HbA1C levels down. Eventually the body stops responding well to the signal of insulin and importantly, this is a condition that can be present up to 10 years before a type 2 diabetes diagnosis and well before you would see a rise in fasting glucose or a 1C. Thus, assessing a marker for insulin resistance is crucial. The Insulin Resistance panel with SCORE uses LC Ms. Technology and combines fasting insulin and C peptide to evaluate the likelihood of being insulin resistant. Now, insulin resistance panel with score and a 1C are both clear measures of glycemic control, but importantly, metabolic dysfunction can also influence lipids. Most providers are already ordering a standard lipid panel. The important thing to keep in mind is that lipids like cholesterol and triglycerides do not mix with blood. They're like oil and water and they need to be packaged into particles to get to where they need to go. Insulin resistance drives poor packaging and leads to an increase in the number of particles in circulation because it is the particles that get trapped in the artery wall and lead to atherosclerotic buildup. Wrist tracks with particles each risk carrying particle contains exactly one apolipoprotein B or APOB molecule on it. Thus, counting the APobs quantify the number of risk carrying particles in circulation. Apolipoprotein B is especially important in patients with high triglycerides above 150, metabolic syndrome and insulin resistance as these populations are at greater risk of having higher APOB than would be expected based on their standard lipid panel. The assessment of APOB is applicable for primary prevention patients as well as patients who are already on lipid lowering medications to better identify cardiovascular risk. The Metabolic Risk Panel is a comprehensive and powerful group of tests that take a standard evaluation like a lipid Panel and an HBA1C and adds depth by including an insulin resistance panel with SCORE and an apolipoprotein B to refine risk assessment. Having these tests together on the same panel helps to identify the root cause of cardiometabolic risk and helps to catch risk early. Don't forget to tune in to our previous episodes that take a deeper dive on apolipoprotein B and insulin resistance Panel with score. By understanding these biomarkers, you can take proactive steps to managing wellness and reducing risk for chronic conditions.
- [05:08]
Host
That's a wrap on this episode of Healthier World with Quest Diagnostics. Please follow us on your favorite podcast app and be sure to check out Quest Diagnostics Clinical Education center for more resources, including educational webinars and research publications. Thank you for joining us today as we work to create a healthier world one life at a time.