The Kronos Science Cardiovascular Risk Assessment is designed to provide physicians with a complete evaluation and understanding of their patients’ cardiovascular risk and protection.
KS expands upon the traditional lipid panel of cholesterol and triglycerides, adding more precise indicators of potential risk factors including lapolipoproteins and homocysteine. KS also measures inflammatory markers such as High Sensitivity C-Reactive Protein and Fibrinogen, and evaluates protective agents such as ascorbate, coenzyme Q10, folic acid and vitamin B12.
To make these measurements more meaningful, KS scientists, in conjunction with physicians at the Kronos Optimal Health Centre, have developed Kronos Optimal Reference Ranges to supplement the standard reference ranges. Test results are compared with standard reference ranges and with KS proprietary optimal ranges, and are presented in an easy-to understand graphic format.
Cardiovascular Assessment (CODE 10040)
(Most tests are available individually)
|
Apolipoprotein A1
|
Fibrinogen
|
HDL |
|
Apolipoprotein B
|
Folic Acid
|
LDL, Direct |
|
Apo A1/Apo B Ratio
|
Glutathione |
LDL/HDL Ratio |
|
Ascorbate (Vitamin C)
|
Hemoglobin A1c |
Lp(a) |
|
Cholesterol, Total
|
Homocysteine |
Tocopherols (Alpha,Beta,Gamma)
|
|
Cholesterol/HDL Ratio
|
Iron |
Transferrin |
|
Coenzyme Q10
|
Iron Binding Capacity, Total (TIBC) |
Triglycerides
|
| C-Reactive Protein, High Sensitivity (hs-CRP) |
Iron Binding Capacity, Unsaturated (UIBC) |
Vitamin B12 |
|
Ferritin
|
Iron Binding % Saturation
|
|
Additional Testing
The following profiles can be added to the Cardiovascular Risk Assessment (or ordered separately) for an additional cost.
PANEL COMPONENTS
Cardiovascular Protection Markers
Apolipoprotein A1 – a protein particle that helps provide protection from arterial disease and is related to HDL.
Ascorbate – vitamin C; has been shown in a variety of studies to promote arterial relaxation and diminish oxidation of LDL, the harmful form of cholesterol that causes disease.
Coenzyme Q10 – an antioxidant vitamin, also known as ubiquinone; has been shown to have a positive effect on cardiovascular function.
Folic acid – one of the water-soluble vitamins; helps keep homocysteine levels low.
HDL Cholesterol – the body’s primary protein carrier of cholesterol; helps protect the arteries from damage.
Transferrin – the principal iron-binding and transport protein present in serum; has the ability to bind two atoms of iron and is directly related to Total Iron Binding Capacity. Transferrin is synthesized in the liver and, to a small extent, in the reticuloendothelial system and endocrine glands, such as the testes and ovaries.
Vitamin B12 – a commonly known water-soluble vitamin; helps to lower homocysteine levels, as higher levels can be damaging, thereby indirectly promoting arterial health.
Cardiovascular Risk Markers
Apolipoprotein B – a potentially harmful protein that is related to LDL. Excessive amounts of this protein markedly increase the risk for arterial disease.
ApoA1/ApoB ratio - Apolipoprotein A1 (ApoA1) is primarily found in HDL particles whereas over 90% of LDL particles are made up of Apolipoprotein B (ApoB). The ratio of ApoA1/ApoB therefore is a good indicator of the cholesterol clearing versus cholesterol depositing ability of the blood. A high ratio is better, indicating higher levels of ApoA1 than ApoB. A low ratio indicates higher levels of ApoB than ApoA1 indicating a higher risk of coronary artery disease.
Cholesterol – the cholesterol hypothesis of artery disease has now been well proven, although it alone as a single measure of risk is not capable of defining all people at risk for vascular disease.
Ferritin – the body’s primary iron binding protein; determines the various iron binding percentages.
Fibrinogen – one of the clotting factors. High levels are associated with cardiovascular risk and thrombosis.
Hemoglobin A1c – HbA1c is formed as hemoglobin is gradually glycosylated throughout the 120-day lifespan of red blood cells. Therefore, the amount of HbA1c in the blood provides a good measure of the average blood glucose level over the past two months. It is, perhaps, the best indicator of overall blood glucose control. Since HbA1c is an indication of glycoxidation of bodily proteins, blood levels should be as low as possible.
High Sensitivity C-Reactive Protein (hs-CRP) – elevated levels of c-reactive protein have been shown to correlate with arterial disease in healthy men and women. Anti-inflammatory medication may be indicated to help in decreasing arterial disease.
Homocysteine – a potent cause of arterial damage that may be responsible for as many as 20 percent of all cases of arterial disease and damage, second only to oxidized cholesterol as a cause of this #1 public health problem.
Iron – a very powerful pro-oxidant; has a strong role in promoting the oxidation of lipids and, in turn, leads to arterial inflammation and blockage.
Iron Binding – includes percent saturation, and total iron binding capacity (TIBC). Iron binding proteins function in the body to store iron and keep it from exerting its harmful, pro-oxidative effects.
LDL Cholesterol (Direct) – oxidation of LDL is a key component in arterial damage and blockage. Low LDL levels have been shown to decrease the risk arterial disease and damage, while elevated levels correlate with disease and damage.
Lp (a) – a rarely tested protein that is one of the most potent risk factors for arterial disease. Its importance has been validated in numerous scientific studies, yet it is infrequently measured and often explains why people with otherwise normal cholesterol panels develop arterial disease, accounting for up to 30 percent of all known cases.
Triglycerides – one of the two main components of body fat; have been shown to have a significant role in the promotion of arterial damage and disease.
LDL/HDL Ratio and Cholesterol/HDL Ratio - Research (such as the Framingham Heart Study) has shown that the LDL/HDL ratio is a better predictor of congestive heart disease than total cholesterol or LDL cholesterol. A low ratio indicates a lower risk of CHD whereas a high ratio indicates a higher risk of CHD. This ratio is a more specific measure of CHD risk than the Cholesterol/HDL Ratio since the latter ratio measures total cholesterol instead of LDL alone. Total cholesterol includes HDL, LDL, and VLDL cholesterol. However when LDL is not ordered, the Cholesterol/HDL Ratio provides an added measure of the patient’s risk of CHD.
Tocopherols - or vitamin E, are important antioxidants which exists in eight forms. Tocopherols are responsible for the proper functioning of the immune system, maintaining healthy eyes and skin and for cell protection throughout the body. Vitamin E rich foods include nuts, cereals, beans, eggs, cold-pressed oils and assorted fruits and vegetables. Dietary intake of the RDA of vitamin E is recommended for optimum health. Vitamin E deficiency can cause fatigue, concentration problems and a weakened immune system among other issues. It may also cause problems with vision and irritability. Low serum levels of vitamin E have also been linked to major depression.
Glutathione - plays an essential role in the health of organisms, acting as a powerful antioxidant. It is not an essential nutrient since it can be synthesized from the amino acids L-cysteine, L-glutamate and glycine. The liver is the principle site of glutathione synthesis. Glutathione deficiency results in tissue oxidative stress and can be seen in some pathological conditions. Oxidative stress caused by glutathione deficiency results in fragile RBC membranes, therefore lower levels of reduced glutathione leads to hemolytic anemia. Chronic functional glutathione deficiency is also associated with immune disorders and an increased incidence of malignancies.
KS Articles
Naftolin F, Taylor HS, Karas R, Brinton E, Newman I, Clarkson TB, Mendelsohn M, Lobo RA, Judelson DR, Nachtigall LE, Heward CB, Hecht H, Jaff MR, Harman SM. The Women's Health Initiative Could Not Have Detected Cardioprotective Effects of Starting Hormone Therapy During the Menopausal Transition. Fertil Steril. 2004 Jun;81(6):1498-501. (read article)
Harman SM, Brinton EA, Clarkson T, Heward CB, Hecht HS, Karas RH, Judelson DR, Naftolin F. Is the WHI Relevant to HRT Started in the Perimenopause? Endocrine. 2004 Aug;24(3):195-202. (read article)
Ensign W, Hill N, Heward CB. Disparate LDL Phenotypic Classification Among 4 Different Methods Assessing LDL Particle Characteristics. Clin Chem 2006; 52 (9):1722-7. (read article)