The Global Burden of Obesity

The Global Burden of Obesity

Obesity is a condition where a person has abnormal or excessive fat accumulation that presents a serious risk to health.  This December, Randox are highlighting the health implications of this potentially deadly condition, especially throughout the midst of this festive season when it is all too easy to overindulge in fatty foods and sugary treats!

Worldwide obesity has almost tripled between 1975 and 2016, with over 650 million adults and 340 million children being recorded as obese in 2016 alone, highlighting that the prevalence of the condition is rapidly rising. Randox are dedicated to improving health and increasing the awareness and prevention of obesity and its consequences.

What are the causes and consequences of obesity?

With more people around the world adopting sedentary lifestyles and the increasing consumption of foods high in sugar and fat, there is a higher risk of an energy imbalance between calories consumed and calories expended, which is the fundamental cause of obesity. This increases the risk of a number of diseases such as cardiovascular disease, diabetes, musculoskeletal disease and some forms of cancer, with each condition having detrimental effects to your health.

One of the more serious consequences of obesity is type 2 diabetes mellitus (T2DM), where a resistance to insulin is developed causing blood sugar to rise higher than normal. This can lead to serious, long-term problems such as kidney damage, cardiovascular disease and blindness.

How are Randox supporting the battle against the world’s obesity crisis?

Through extensive investment in R&D, we are able to offer cutting-edge diagnostic tests to assess the risk of obesity-related diseases before they occur!

Randox offers the unique adiponectin test to assess the risk of developing T2DM.  Low adiponectin levels have also been linked with the risk of developing other pathologies including metabolic syndrome and cardiovascular diseases. The adiponectin test is applicable to both patients with diagnosed clinical obesity, and those deemed to have a ‘healthy’ BMI through a condition known as ‘abdominal obesity’.

This is because while it is widely recognised that people who are overweight or obese are at higher risk of developing T2DM, you don’t have to be overweight to be at risk of developing diabetes. When abdominal visceral fat is stored further underneath the skin and accumulates around major organs, a condition known as abdominal obesity, it greatly increases the risk of developing T2DM.   When abdominal visceral fat levels become increased, adipocytes which secrete the protein hormone adiponectin become reduced; this reduces the anti-inflammatory and insulin-sensitising properties of this powerful hormone.

The adiponectin test is available for use on hundreds of clinical biochemistry analysers, and can also be run on our world leading RX series range of clinical chemistry analysers. Find out more here: dev.randox.com/obesity/

Our world-renowned quality control products help ensure the accuracy of obesity-related testing!

When diagnosing and monitoring obesity-related complications such as cardiovascular disease (CVD) and T2DM, it is vital that laboratories have a robust quality control system in place to ensure the accuracy and reliability of the results produced. This is especially true considering, 70% of medical decisions are based on a laboratory test result.

It is estimated that over 90% of T2DM is related to obesity.  When monitoring diabetes, glycated haemoglobin (HbA1c) levels in the blood provide an indication of average blood glucose levels for the previous 3 months. It is therefore important that the chosen quality control will effectively challenge the test system across the patient reportable range, as an inaccurate result at the cut-off could mean a patient does not receive appropriate diabetes treatment. Our Acusera Liquid HbA1c control provides clinically relevant levels, not only helping to ensure accurate instrument performance but maximising laboratory efficiency.  Find out more here: dev.randox.com/obesity/

Obesity prevention

Thankfully, for those deemed to be at risk, obesity and related illnesses are largely preventable through engaging in regular physical activity (60 minutes daily recommended for adults), limiting energy intake from total fats and sugars and increasing the consumption of fruit and veg, whole grains and nuts. Knowing your risk allows you to stay in control of your health throughout this festive season!

Further to our clinical lab tests, our Randox Health clinics offer heart health, metabolic health and diabetes health testing as part of our Everyman, Everywoman and Signature packages to identify and assess risk of developing obesity-related diseases. Our clinics utilise the same cutting-edge tests and quality control that we have available to clinical laboratories globally, as well as our patented Biochip Array Technology (BAT).

For more information about our clinical diagnostic range of obesity-related products, visit dev.randox.com/obesity/

 


The Risk of Gestational Diabetes to Women – World Diabetes Day

Every year, Randox Reagents support World Diabetes Day on the 14th November. This year, the theme is ‘Women and diabetes – our right to a healthy future’ with the International Diabetes Federation running a campaign aiming to provide all women with diabetes with affordable and equitable access to care and education to better manage their diabetes and improve their health outcomes. A type of diabetes that affects women is gestational diabetes.

Gestational diabetes – what is it?

Gestational Diabetes Mellitus (GDM) is a form of diabetes which appears in pregnancy, characterised by high blood sugar due to the hormones produced in pregnancy, usually developing in the second or third trimester and disappearing after giving birth. This is a serious condition which can lead to the baby growing larger than usual and can coincide with premature birth, stillbirth and pre-eclampsia, which are detrimental to a mother’s health.

According to the International Diabetes Federation, 1 in 7 births is affected by gestational diabetes. In addition, approximately half of women with a history of GDM go on to develop type 2 diabetes within five to ten years after delivery.

Diagnosis and Monitoring of Gestational Diabetes

Due to the severe complications that can occur with gestational diabetes, it is extremely important to accurately diagnose and monitor the condition. Tests which are commonly used to diagnose diabetes include HbA1c and glucose, including fructosamine, which due to the shorter time span, is particularly useful to evaluate the effectiveness of medication changes and to monitor the treatment of gestational diabetes.

Complications associated with gestational diabetes include diabetic ketoacidosis, a serious complication of diabetes which occurs when blood sugar levels are consistently high and insulin levels are severely low, making it essential to measure D-3-Hydroxybutyrate levels. This is a niche test which is available from Randox Reagents – find out more here.

Preventing Gestational Diabetes

As well as diagnosing and monitoring gestational diabetes, it is important that women get tested early in order to put in place measures to help avoid developing diabetes, improving quality of life for themselves and their baby. Ways in which they can do this is through adopting a healthier lifestyle in terms of monitoring diet and getting regular exercise.

Randox offer an automated adiponectin test which predicts the risk of patients developing both gestational and Type 2 Diabetes Mellitus (T2DM). Therefore, it is important to measure adiponectin before pregnancy as low concentrations are associated with reduced glucose tolerance during pregnancy and can identify women at high risk for gestational diabetes.1

Innovations in diabetes testing has led to the ability to more accurately detect risk, diagnose and manage the complications of diabetes. Randox offer a wide range of diabetes reagents in an automated biochemistry format, allowing rapid and accurate assessment for both laboratory professionals and clinicians.

Join Randox Reagents on World Diabetes Day 2017 to help spread awareness and prevent gestational diabetes in women by providing them with access to education and improve their health outcomes!

 

Randox are dedicated to providing the highest quality tests for diabetes diagnosis, complications monitoring and risk assessment – download our diabetes brochure to find out more about what we have to offer!

For more information, please contact us at reagents@randox.com



World Heart Day 2017 – Randox Reagents

Join us as we celebrate World Heart Day on the 29th of September 2017. Randox Reagents aim to make a difference around the world and inspire millions to be heart healthy through offering a wide range of cutting edge cardiology and lipid reagents.

Cardiovascular disease (CVD) is responsible for 17.5million deaths per year worldwide, making it the leading cause of death (WHO, 2015). This figure is predicted to rise to 23.6million by 2030, emphasising the need for further risk assessment biomarkers to be taken into account in the assessment of CVD.

Some of our most unique cardiac assessment reagents include:

HDL3

HDL3 is our most recent addition to our cardiology testing panel. HDL3 is a sub-fraction of the HDL molecule, and enhances risk profiling of CVD due to its strong correlation with MI; elevated levels of HDL3 particles reflect abnormally increased triglyceride content of the HDL particle. This means that whilst a patient may have high levels of HDL, they may also have elevated levels of HDL3 which essentially renders the potentially potent protection factor of HDL as a cholesterol scavenger as almost useless.

Randox offers an automated HDL3 assay for the quantitative determination of HDL3 cholesterol in human serum or plasma. For more information, click here.

sLDL

sLDL is a subtype of LDL Cholesterol. It is more atherogenic due to its small size which makes it more susceptible to oxidation, and enables it to more readily permeate the inner arterial walls, causing damage and destruction. As such, the measurement of sLDL is extremely valuable as a vital risk marker of MI; in fact, elevated levels of sLDL are associated with a three-fold increased risk of MI.

Randox offers an automated sLDL assay with a wide measuring range of 0.189-22.2 mmol/l; therefore it will comfortably detect levels outside of the healthy limit of 4.90 mmol/l, ensuring a worthy addition for true assessment of CVD risk. For more information, click here.

Lp(a)

Lp(a) offers an excellent addition to the lipids profile, and should be considered due to its role in the assessment of genetically inherited risks of CVD. As genetically determined, Lp(a) remains fairly constant and is unaffected by lifestyle changes and some treatments. Elevated levels are associated with premature development of atherosclerosis and CVD, and are independent of other lipids. Testing for elevated levels is recommended for patients with a family history of premature CVD or elevated Lp(a), and for patients who have developed CVD at a young age.

Randox Lp(a) offers superior methodology, as it contains a very high density of isoform-insensitive antibodies and detection reagent. There is a five point calibrator available which takes into account the heterogeneity of the Lp(a) molecule for each of the levels, which results in excellent commutability of the calibrator with patient samples. For more information, click here.

 

You can download our cardiology & lipid testing brochure for a full list of our specialised reagents!

For more information, please contact us at reagents@randox.com



Why choose Randox Adiponectin?

During the second week of our adiponectin educational month, we begin to focus on the key features and benefits of Randox Adiponectin. Check back here every day to read about a different feature of our automated biochemistry reagent.

Read on to find out more!

A – Automated Biochemistry Assay

One of the most important features of Randox Adiponectin is that it is an automated biochemistry assay, removing the inconvenience and time consumption associated with traditional ELISA based testing. Moving from ELISA to automated methods also allows laboratories to expand their test offerings to patients and clinicians.

D – Decreased Serum Adiponectin Levels

Adiponectin is the most abundant protein secreted by adipose tissue and exhibits insulin-sensitising and anti-inflammatory properties, therefore decreased levels of serum adiponectin is an independent risk factor for progression to type 2 diabetes as well as being linked with other pathologies such as metabolic syndrome, cancer and cardiovascular disease.

I –  Increase in Adiponectin Levels

An increase in adiponectin levels is inversely associated with progression to type 2 diabetes mellitus (T2DM) and subsequently, a reduced risk of cardiovascular events and several obesity-associated cancers. Adiponectin levels can be increased through diet, physical activity and the reduction of abdominal visceral fat.

P – Preventing and Treating Obesity Related Diseases

Studies have highlighted that adiponectin exhibits anti-inflammatory, anti-atherogenic and anti-diabetic properties, with various functions possibly serving to prevent and treat obesity-related diseases and cardiovascular disease.

O – You Don’t Have to be Overweight to be at Risk

It is widely recognised that people who are overweight are a higher risk of developing T2DM, metabolic syndrome, cardiovascular disease and cancer. This is commonly assessed through measuring Body Mass Index (BMI), however it has limitations and varies in reliability based on age, sex and race. Risk is more accurately identified through abdominal visceral fat (AVF) levels.  Adiponectin levels have been shown to have a direct inverse correlation with AVF levels making adiponectin levels a much more reliable indicator of at-risk patients.

N – Niche Product from Randox

Randox automated Adiponectin is a niche product, meaning that we are one of the only manufacturers to supply this reagent in an automated biochemistry format. This is superior to traditional T2DM risk assessment methods.

E – Extensive Measuring Range

Randox Adiponectin has an extensive measuring range of 0.5-40µg/mL, which is vital for clinically accurate results. This ensures that low and high levels of adiponectin are detected within a sample, giving a more accurate assessment of T2DM risk.

C – Complementary Controls and Calibrators

Alongside our adiponectin reagent, we also have complementary controls and calibrators available, offering a complete testing package. Below are the details for our adiponectin controls and calibrators:

Adiponectin Control Level 2 AO2801 3x1ml
Adiponectin Control Level 3 AO2802 3x1ml
Adiponectin Calibrator AO2800 4x1ml

T – Time Consumption

Randox Adiponectin is an automated assay format, meaning that you save time in the laboratory and removes the inconvenience compared to traditional ELISA methods. In addition, when running ELISA methods, the risk of error and contamination is higher than automated methods, which can compromise clinical results.

I – Immunoturbidimetric (Latex Enhanced) method

Randox Adiponectin adopts a Latex Enhanced Immunoturbidimetric method which delivers high performance. This method works through measuring the absorbance of light, whereby inert microscopic particles enlarge the immune complexes, amplifying the reaction and significantly increasing the sensitivity of the reaction.

N – Normal weight

A normal body weight doesn’t mean you are not at risk of developing T2DM. Abdominal Visceral Fat (AVF) is stored deeper than subcutaneous fat and can be wrapped around the body’s major organs such as the liver. With higher levels of AVF inversely correlated with adiponectin levels, this makes adiponectin a strong predictor of T2DM risk and other pathologies such as metabolic syndrome, cancer and CVD.

Please contact us at reagents@randox.com for more information.



Measuring T2DM Risk with Randox Automated Adiponectin

During the first week of our adiponectin educational month, we focused on different aspects of our free white paper “Early Risk Assessment of Type 2 Diabetes Mellitus Through the use of the Biomarker Adiponectin”, which details the features and benefits of Randox automated Adiponectin, clinical significance and a comparison to traditional methods for diabetes risk assessment.

Randox Adiponectin is an automated biochemistry reagent, used as a biomarker which can powerfully predict the development of pathologies such as Type 2 Diabetes Mellitus (T2DM) and cardiovascular disease (CVD). With the global prevalence of diabetes continually rising in adults over 18 years of age, from 4.7% in 1980 to 8.5% in 2014, adiponectin should be an integral part of every laboratory’s testing panel. Offering an improved method for assessing risk, with a convenient format for routine clinical use, Randox Adiponectin will enable physicians to accurately evaluate more individuals.

Read on to find out more!

Monday 11th September

Traditional Methods for Diabetes Risk Assessment

Randox adiponectin offers a more improved, automated method for assessing Type 2 Diabetes Mellitus (T2DM) risk compared to traditional methods of diabetes risk assessment. Such methods include:

  • Fasting Plasma Glucose (FPG) – This is the most commonly used biochemical method of assessing T2DM, however, the specificity of this test is poor. Although many individuals are identified as having impaired fasting glucose (IFG), their absolute risk of conversion to diabetes is only 5-10% per year.
  • Oral Glucose Tolerance Test (OGTT) – This method is more accurate for risk assessment than other traditional methods, however, it is rarely used in practice as it is takes two hours to perform and is uncomfortable for patients.

Non-biochemical methods for assessing a patient’s risk of developing T2DM take into consideration gender, age, family history of T2DM, BMI, waist size and high blood pressure to give a risk score. Two of the most popular, traditional indicators include:

  • Waist circumference – measures abdominal fat reliably, but its association with visceral fat varies by gender and ethnicity.
  • Body Mass Index (BMI) – is another common method, however it has limitations in measuring athletes and varies depending on age, sex and race.

Given the limitations of OGTT and FPG, an improved method for assessing T2DM risk, with a convenient format for routine clinical use, would enable physicians to accurately evaluate more individuals. Randox adiponectin is an automated biochemistry test utilising a latex enhanced immunoturbidimetric method which removes the inconvenience and time consumption associated with traditional methods of testing, making it a superior method of testing T2DM.

 

Tuesday 12th September

Clinical Significance

Recent studies have advocated the testing of adiponectin in clinical settings. It has applications in assessing risk in several diabetes-related conditions including prediabetes, T2DM and GDM. These studies include:

BMJ (2016): Adiponectin levels predict prediabetes risk: the Pathobiology of Prediabetes in A Biracial Cohort

This study found that among health white and black adults with parental history of T2DM, adiponectin level is a powerful risk marker of incident prediabetes. Thus, the association of adiponectin with diabetes risk is evident at a much earlier stage in pathogenesis, during transition from normoglycemia to prediabetes.

Diabetes Care (2013): Low Pre-pregnancy Adiponectin Concentrations Are Associated With a Marked Increase in Risk for Development of Gestational Diabetes mellitus

This was a study carried out on 4098 women who had children within 6 years of initial blood sample and none of whom were pre-diabetic or diabetic. It was found that lower adiponectin concentration measured on average 6 years before pregnancy were associated with a 5-fold increased risk of developing GDM.

 

Implications for Clinicians

Adiponectin measurement is not yet a routinely run test in many laboratories worldwide and it is therefore not available for many clinicians to request. Yet the implications of this becoming widely available could be extremely valuable as it can help to assess:

  • Type 2 Diabetes Mellitus and Incident prediabetes
  • Cardiovascular events
  • Gestational Diabetes

When risk is identified via adiponectin measurement, it is essential for individuals to carry out lifestyle modification to reduce visceral fat levels and lowering T2DM risk. This will also help to prevent the development of cardiovascular diseases and metabolic syndrome through the improvement of adiponectin production. This indicates that Randox automated adiponectin should be a routinely run test across the world.

13th September 2017

Methods of Measuring Adiponectin

Randox adiponectin automated method has many benefits for the laboratory, as the only method of adiponectin measurement available beforehand was through the ELISA assay. The benefits of switching from ELISA to an automated method include efficiencies and expansion.

Efficiencies

The main drawback of using ELISAs for clinical testing within a laboratory is that it is time consuming and personnel consuming as it uses heavy resources with manual interaction. Switching from ELISA to an automated method for the detection of adiponectin increases time and personnel efficiency considerably which leads to cost effectiveness. This benefits laboratories through:

  • Ensuring quality in testing practices and confidence in clinical results
  • Lowering the risk of error and contamination avoiding compromising clinical results

 

Expansion

Laboratories can expand their test offerings to patients and clinicians by transitioning analytes which were historically only available on ELISA methods. Adiponectin being available in an automated biochemistry format allows laboratories to expand their test menu with ease and enables the inclusion of adiponectin into routine testing panels. It also allows for detailed patient testing profiles through increased testing range and without the manual restrictions placed by running ELISA techniques.

Randox is presently the only diagnostic manufacturer who has a globally available automated biochemistry test for adiponectin measurement.

14th September 2017

Randox Automated Adiponectin Assay

The Randox adiponectin assay principle:

  • The sample is reacted with a buffer and anti-adiponectin coated latex
  • The formation of the antibody-antigen complex during the reaction results in an increase in turbidity – this is measured as the amount of light absorbed at 570nm.
  • A sample with higher adiponectin levels will contain more adiponectin and so more antibody-antigen complexes will be formed and the increase in turbidimetry
  • By constructing a standard curve from the absorbance of the standards, the adiponectin concentration of the sample can be determined.

Benefits of Randox adiponectin:

  • A niche product meaning we are one of the only manufacturers to provide the adiponectin test in an automated biochemistry format
  • Automated assay removing inconvenience and time consumption associated with traditional ELISA testing
  • Applications available for a wide range of automated biochemistry analysers ensuring ease of programming and confidence in results
  • Latex Enhanced Immunoturbidimetric method delivering high performance
  • Extensive measuring range for measurement of clinically important results
  • Complementary controls and calibrators available offering a complete testing package

The Randox automated immunoturbidimetric adiponectin test offers an improved method for assessing T2DM risk, with a convenient format for routine clinical use, to enable physicians to accurately evaluate at-risk individuals.

Please contact us at reagents@randox.com for more information!

Download our white paper from the resource hub.


Lipoprotein(a) Foundation commend celebrity personal trainer, Bob Harper, as he speaks out about the risk of Lp(a)

The Lipoprotein(a) Foundation have commended health and fitness expert Bob Harper for speaking out after recently suffering a heart attack. The celebrity personal trainer and host of the US television series ‘The Biggest Loser’, has revealed that high levels of Lp(a) were responsible for the heart attack he suffered at the age of 51 at the beginning of this year.1

Harper had been completing a normal workout at his gym when he suffered full cardiac arrest. Luckily, two doctors were in the vicinity who saved his life by performing CPR and using an Automated External Defibrillator (AED). In an interview following his heart attack, Harper has said,

“I’ve learned a lot about the fact genetics does play a part in this, it is so important to know your health… I’m a guy that lives a very healthy lifestyle, very regimented, I work out all the time, but there were things going on inside of my body that I needed to be more aware of and I strongly encourage anyone that’s listening right now to go to their doctor, get their cholesterol checked, see what’s going on on the inside”.

Scroll down to watch the interview in full.

What is Lp(a)?

Lp(a) is a particle which is produced in the liver and found in the blood which carries cholesterol, fats and proteins. Levels of Lp(a) in individuals are genetically determined, and are not affected by diet, exercise or lifestyle changes.2

So how does a seemingly fit and healthy person have a heart attack at the age of 51?

Lp(a) is currently the strongest inherited risk factor for heart attack and stroke, with one in five people globally inheriting high Lp(a).1 Levels of Lp(a) are not routinely tested in standard cardiovascular assessments, and despite the particle itself being an altered form of LDL cholesterol, standard cholesterol tests do not reveal inherited Lp(a) levels as it is independent from total cholesterol and LDL levels.3

High Lp(a) can also be unrelated to other common risks factors of cardiovascular diseases for example, smoking, diet, diabetes, high blood pressure and lack of exercise. This is why seemingly healthy individuals can have high Lp(a) in their genes and still be at high risk of cardiovascular diseases.

Why is Lp(a) not routinely measured if high levels pose such a risk?

The widespread use of Lp(a) as an independent risk factor for cardiovascular disease risk has, until recently, been hindered by the lack of internationally accepted standardisation and the fact that many commercial Lp(a) methods suffer from apo(a) size related bias, potentially leading to patient misclassification.

The size of the apo(a) protein is genetically determined and varies widely hence, levels of Lp(a) can vary up to 1000-fold between individuals.4 To find out more about the clinical significance of Lp(a), please refer to the section below entitled ‘For Health Professionals’.

What can you do if you have high Lp(a)?

Research has shown that lowering Lp(a) could significantly reduce the impact of cardiovascular diseases. A recent study published in the American Heart Association journal, Arteriosclerosis, Thrombosis and Vascular Biology, found that reducing high Lp(a) could potentially prevent up to 1 in 14 cases of myocardial infarction (heart attack) and 1 in 7 cases of aortic valve stenosis.5 Of those studied, nearly one third of heart attacks and half of all cases of aortic stenosis were attributed to high Lp(a).6 This study demonstrates the clinical significance of measuring Lp(a), making it a major independent genetic risk factor for cardiovascular diseases.

Why test Lp(a)?

Lp(a) will be tested as part of a lipid profile if: there is a strong family history of CVD, a patient has existing heart or vascular diseases, a patient has an inherited predisposition for high cholesterol or if a person has had a stroke or heart attack but has normal lipid levels.7

Dr Christie Ballantyne, Chief of Cardiology at Baylor College of Medicine, has said “the most important part of knowing your Lp(a) level is understanding your overall risk and finding the right lifestyle modifications or medications to target all the other traditional risk factors. Those risk factors become even more important to monitor when your Lp(a) levels are high”.8

For patients

If you are concerned that you may be at risk of having elevated levels of Lp(a) due to your family history, ask your doctor or medical provider to test lipoprotein (a), along with other lipid tests, to clinically evaluate your risk of developing cardiovascular diseases.

For health professionals

Click below for information regarding the challenges associated with the measurement of Lp(a) and the clinical significance it holds.

The widespread use of Lp(a) as an independent risk factor for cardiovascular disease risk has, until recently, been impeded by the lack of internationally accepted standardisation and the fact that many commercial Lp(a) methods suffer from apo(a) size related bias, potentially leading to patient misclassification. The size of the apo(a) protein is genetically determined and varies widely hence, levels of Lp(a) can vary up to 1000-fold between individuals.4 

As a result, international criteria has been set to overcome these challenges. The International Federation of Clinical Chemistry (IFCC) Working Group on Lp(a) recommends that laboratories use assays which do not suffer from apo(a) size-related bias, in order to minimise the potential risk of misclassification of patients for coronary heart disease. The Lipoprotein(a) Foundation has referenced Marcovina and Albers (2016) as their recommendation for the best Lp(a) test.9 This recommendation is a result of the following conclusions:

  • Robust assays based on the Denka method are available, which are reported in nanomoles per litre (nmol/L) and are traceable to WHO/IFCC reference material
  • Five point calibrators with accuracy assigned target values will minimise the sensitivity to apo(a) size

A number of guidelines are in place for the testing of Lp(a) in patients.

-The European Guidelines for Management of Dyslipidaemia state that Lp(a) should be measured in individuals considered at high risk of CVD or with a strong family history of premature CVD.

-The European Atherosclerotic Society suggest that Lp(a) should be measured once in all subjects at intermediate or high risk of CVD/CHD who present with10 :

1. Premature CVD
2. Family hypercholesterolaemia
3. A family history of premature CVD and/or elevated Lp(a)
4. Recurrent CVD despite statin treatment
5.
≥3% 10-year risk of fatal CVD according to the European guidelines
6.  ≥10% 10-year risk of fatal and/or non-fatal CHD according to the US guidelines

-EAS Consensus Panel states the evidence clearly supports Lp(a) as a priority for reducing cardiovascular risk, beyond that associated with LDL cholesterol.  Clinicians should consider screening statin-treated patients with recurrent heart disease, in addition to those considered at moderate to high risk of heart disease.

  • The Randox Lp(a) assay is one of the only methodologies on the market that detects the non-variable part of the Lp(a) molecule and therefore suffers minimal size related bias – providing more accurate and consistent results. The Randox Lp(a) kit is standardised to the WHO/ IFCC reference material SRM 2B and is closest in terms of agreement to the ELISA reference method.
  • Five calibrators with accuracy-based assigned target values are provided – which accurately reflect the heterogeneity of isoforms present in the general population
  • Measuring units available in nmol/L upon request
  • Highly sensitive and specific – method for Lp(a) detection in serum and plasma
  • Applications are available for a wide range of biochemistry analysers – which detail instrument-specific settings for the convenient use of Randox Lp(a) on a variety of systems
  • Liquid ready-to-use reagents – for convenience and ease-of-use

For further information on Lp(a), click here or email: reagents@randox.com

Watch the interview with Bob Harper here:

1. Lipoprotein(a) Foundation, Lipoprotein(a) Foundation Thanks Bob Harper for Revealing High Lp(a) Levels Led to His Recent Heart Attack on The Dr Oz Show, 2017 Available from: http://www.businesswire.com/news/home/20170425006724/en/ [Accessed: 16 March 2017]

2. Lipoprotein Foundation, Understand Inherited Lipoprotein (a), Available from: https://goo.gl/bH5A8R [Accessed: 16 March 2017]

3. Kumar, V., Abbas, A. K. and Aster, J. C., Robbins and Cotran Pathologic Basic of Disease, (Philadelphia: Elsevier Saunders, 2015), p. 494 in Google books, https://goo.gl/VEnVX9 [Accessed 27th April 2017]

4. Kamstrup P.R., Tybjaerg-Hansen A., Steffensen R., Nordestgaard B.G. Genetically elevated lipoprotein (a) and increased risk of myocardial infarction. JAMA. Vol. 301, p. 2331-2339 (2009).

5. Afshar, M. Kamstrup, P.R., Williams, K., Snidermann, A. D., Nordestgaard, B.G., Thanassoulis, G., Estimating the Population Impact of Lp(a) Lowering on the Incidence of Myocardial Infarction and Aortic Stenosis – Brief Report., Ateriosclerosis, Thrombosis, and Vascular Biology, 2016;36:2421-2423, Available from: http://doi.org/10.1161/ATVBAHA.116.308271

6. The Lipoprotein(a) Foundation, Lipoprotein(a) Foundation Supports National Heart Valve Disease Month, Highlights Genetic Link between Lp(a) and Aortic Valve Disease, Business Wire. (2017), Available from: https://goo.gl/LhQFGj [Accessed: 16 March 2017]

7. Lab Tests Online, Lp(a), 2014, Available from: https://goo.gl/W2PWSN [Accessed: 16 March 2017]

8.Gutierrez, G., The heart attack risk factor you haven’t heard of, Baylor College of Medicine, 2017, Available from: https://goo.gl/9X4Xko [Accessed: 16 March 2017]

9. Marcovina, S.M. and Albers, J.J. Lipoprotein (a) measurements for clinical application. Lipid Res. Vol. 57, p. 526-37 (2016).

10. Nordestgaard, B. G., Chapman, M. J., Ray, K., Bore´n, J., Andreotti, F., Watts, G. F., Ginsberg, H., Amarenco, P., Catapano, A., Descamps, O. S., Fisher, E., Kovanen, P. T., Kuivenhoven, J. A., Lesnik, P., Masana, L., Reiner, Z., Taskinen, M. R., Tokgozoglu, L., and Tybjærg-Hansen, A., for the European Atherosclerosis Society Consensus Panel. Lipoprotein(a) as a cardiovascular risk factor: current status. European Heart Journal. Vol. 23, p. 2844-2853 (2010).

lipoprotein(a)


Celebrating the Randox Reagents R&D Team this Medical Laboratory Professionals Week!

Medical Laboratory Professionals Week (MLPW) is a week dedicated to increasing public understanding and appreciation for the clinical laboratory profession. During this week, we are taking the opportunity to celebrate the hard work of our Research and Development team. Allow us to provide you an insight into the life changing work of our scientists in the laboratories.

At Randox, our scientists work tirelessly to develop revolutionary diagnostic tests that are used in hospital and research laboratories across the globe.

We spoke to one of our biochemistry R&D Scientists to gain an insight into what working in a clinical chemistry laboratory entails. Emmett Donnelly, Clinical Chemistry R&D Scientist, is involved in the development of new reagents and the improvement of existing reagents. Emmett commented, “[My] role also involves the transfer and testing of existing chemistries onto new analyser platforms. Troubleshooting and resolving customer queries also forms part of a clinical analyst’s role”.  Emmett’s work is vital to ensure that patient tests are performing correctly, and to develop ground-breaking new technologies leading to better patient outcomes. To find out more about the work Emmett does, watch this video below.

Our scientists are committed to research and development and thrive knowing that their novel research is putting them at the forefront of clinical diagnostics.

In fact, prior to beginning work at Randox, Scott Paulin, Clinical Chemistry R&D team, took part in a three month expedition to Antarctica to intensely study human response-based research in athletes. A number of papers have been published in peer reviewed journals as a result of Scott’s research, as the findings have provided a useful insight into the physiological stress and responses associated with an Antarctic ultra-endurance race and nutritional counterstrategies to help maintain immune responses, function body weight and reduce stress markers. Read the full article here.

At Randox, our scientists are of the highest calibre, with vast experience and expertise which ensures we are producing the highest quality range of clinical diagnostic tests.

Excitingly as a result, American astronauts have enlisted our help to test their antioxidant levels before they go to space! This is essential as it ensures astronauts can survive long periods of time away from earth. To find out more about how important our Total Antioxidant Status (TAS) test is for astronauts, read our blog post here.

The invaluable work our scientists undertake in the laboratory is vital to ensure healthcare is advanced globally. Thanks to those in our Research and Development team, we are proud to be able to offer the widest range of clinical chemistry reagents and unique tests for medical diagnosis. Due to our scientist’s dedication to research, a continual focus is placed on developing tests that assess the risk of diseases, rather than diagnosing the illness after it has occurred. As a result, Randox are helping to change healthcare, as patients are provided the ability to take preventative action early. In the words of our R&D scientist Emmett Donnelly, “for me, my work supports the old saying prevention is better than cure”.

We hope you have enjoyed reading about our fantastic team of R&D Scientists! If you would like to find out more about the work of Randox Reagents, please get in contact by emailing: reagents@randox.com or click here to view our homepage.

laboratory


How Randox R&D Scientists are helping to change healthcare: Investing in prevention rather than cure with the Adiponectin test

The theme this year for British Science Week is change. At Randox, our R&D Scientists are helping to change healthcare. By investing heavily into research and development to develop unique diagnostics tests, Randox provide doctors with the ability to identify disease risk sooner- offering the opportunity to prevent illness, rather than the need to find a cure.

One unique test by Randox, adiponectin, is becoming an increasingly significant biomarker for health professionals. Low levels have been linked with several illnesses including metabolic syndrome, cancer and cardiovascular disease.


What is adiponectin?

Adiponectin is a protein hormone produced and secreted by fat cells called adipose tissue. Adiponectin is normally found in relatively high concentrations in healthy individuals. Its role in the body is to regulate the metabolism of lipids and glucose, which influences the body’s response to insulin and inflammation.


Adiponectin and abdominal visceral fat

Adiponectin levels are inversely correlated with abdominal visceral fat, meaning that lower levels of adiponectin are related to higher amounts of visceral fat in the body.¹ Visceral fat is stored around vital organs and higher levels of this type of fat can be associated with a range of conditions including insulin resistance, high blood pressure and high levels of cholesterol. These factors can subsequently increase a patient’s chance of developing metabolic syndrome, diabetes, cardiovascular disease and in some cases cancer. In fact, it has been found that patients with high abdominal visceral fat or low adiponectin levels have a three-fold increased risk of insulin resistance, with a combination of both doubling this probability.2


Adiponectin as a biomarker

Due to the protective properties of adiponectin, for example in increasing insulin sensitivity or preventing atherosclerosis, adiponectin has been classified as novel and important for a number of reasons.3 A range of studies have demonstrated why adiponectin levels should be considered as a routine test.

Adiponectin and Type 2 Diabetes

Increasing evidence suggests adiponectin is a valid biomarker related to type 2 diabetes.  In fact, one study suggests that adiponectin is a powerful marker of diabetes risk in subjects at high risk.4 Decreased adiponectin has been found to be an independent risk factor for the progression of type 2 diabetes.5

Other evidence shows that adiponectin is also a beneficial measure of diabetes treatment response. A recent study has emerged which has found that dipeptidyl peptidase-4 inhibitors, which are used for the treatment of type 2 diabetes, increase adiponectin levels and have a stronger effect in comparison to traditional oral antidiabetic drugs.6

Adiponectin and Gestational Diabetes

Adiponectin levels are also of interest during pregnancy. If a woman has lower adiponectin concentration during the first trimester of pregnancy, they are 3.5 times more likely to develop gestational diabetes.7,8

Adiponectin and Cardiovascular Disease

A range of evidence exists linking serum adiponectin concentration and cardiovascular diseases. Studies have found low levels of adiponectin can have an adverse effect, for example one study suggests adiponectin levels are an independent predictor of CHD in Caucasian men with no previous history of CHD.9 Low adiponectin concentrations have also been associated with myocardial infarction (a heart attack) in individuals below the age of 60, and also been linked with increased risk of new-onset hypertension in men and postmenopausal women.10,11

Adiponectin and Benign Prostatic Hyperplasia (BPH)

Studies have also been conducted to examine the relationship between adiponectin and BPH. BPH is a common condition which is usually associated with men over 50 years of age and causes enlargement of the prostate. Higher adiponectin levels have been associated with reduced risk of BPH, as adiponectin has a protective effect in the progression of BPH.12,13,14

Adiponectin and Cancer

Lower levels of adiponectin have been found to increase the risk of endometrial cancer in women, and also prostate and pancreatic cancer in men.14,15 Researchers have been able to identify that serum adiponectin is inversely linked to the risk of obesity-associated cancers including endometrial cancer, renal cancer, postmenopausal breast cancer, colon cancer and leukaemia.16,17, 18

 

Why measure adiponectin?

As demonstrated above, the clinical significance of adiponectin is widely studied and has been linked to a range of diseases in which overweight or obese patients are proven to be at higher risk of developing. Measuring serum concentration of adiponectin to determine visceral fat levels is proven to be a more reliable indicator of at-risk patients in comparison to conventional methods of determining whether a patient is overweight or obese, such as body mass index (BMI) or measuring waist circumference.19

Our commitment to research and development ensures that unique tests, such as adiponectin, are available for use by health professionals. Scientists at Randox are continuing to change healthcare every day with their research to develop revolutionary diagnostic solutions. By placing a continual focus on assessing the risk of diseases rather than diagnosing the illness after it has occurred and providing patients with the tools to take preventative action, Randox are helping to change healthcare globally.

For more information, email: reagents@randox.com

adiponectin

  1. Kishida, K., Kim, K. K., Funshashi, T., Matsuzawa, Y., Kang, H. C., Shimomura, I. Relationships between circulating adiponectin levels and fat distribution in obese subjects. Journal of Atherosclerosis and Thrombosis18(7):592-595 (2011)
  2. Medina-Urrutia, A., Posadas-Romero, C., Posadas-Sánchez, R., Jorge-Galarza, E., Villarreal-Molina, T., González-Salazar, M. C., Cardoso-Saldaña, G., Vargas-Alarcón, G., Torres-Tamayo, M. and Juárez-Rojas, J. G. Role of adiponectin and free fatty acids on the association between abdominal visceral fat and insulin resistance. Cardiovascular Diabetology, vol. 14, no. 20 (2015).
  3. Chandran, M., Phillips, S. A., Ciaraldi, T., Henry, R. R. Adiponectin: More than just another fat cell hormone? Diabetes Care. 26(8): 2442-2450 (2003)
  4. Daimon, M., Oizumi, T., Saitoh, T., Kameda, W., Hirata, A., Yamaguchi, H., Ohnuma, H., Igarashi, M., Tominaga, M., Kato, T. and Funagata Study. Decreased serum levels of adiponectin are a risk factor for the progression to type 2 diabetes in the Japanese population. Diabetes Care, vol. 26, no. 7, p. 2015-2020 (2003).
  5. Mather, K. J., Funahashi, T., Matsuzawa, Y., Edelstein, S., Bray, G. A., Kahn, S. E., Crandall, J., Marcovina, S., Goldstein, B., Goldberg, R. and Diabetes Prevention Program. Adiponectin, change in adiponectin, and progression to diabetes in the Diabetes Prevention Program. Diabetes, vol. 57, no. 4, p. 980-986 (2008).
  6. Liu, X., Men, P., Wang, Y., Zhai, S., Liu, G. Impact of dipeptidyl peptidase-4 inhibitors on serum adiponectin: a meta-analysis. Lipids in Health and Disease. 15:204 (2016)
  7. Lacroix, M., Battista, M.C., Doyon, M., Ménard, J., Ardilouze, J.L., Perron, P. and Hivert M. F. Lower adiponectin levels at first trimester of pregnancy are associated with increased insulin resistance and higher risk of developing gestational diabetes mellitus. Diabetes Care, vol. 36, no. 6, p. 1577-83 (2013).
  8. Hedderson, M. M., Darbinian, J., Havel, P. J., Quesenberry, C. P., Sridhar, S., Ehrlich, S. and Ferrara, A. Low prepregnancy adiponectin concentrations are associated with a marked increase in risk for development of gestational diabetes mellitus. Diabetes Care, vol. 36, no. 12, p. 3930-7 (2013).
  9. Tsimikas, S., Mallat, Z., MD, Talmud, P. J., Kastelein, J. J. P., Wareham, N. J., Sandhu, M. S., Miller, E. R., Benessiano, J., Tedgui, A., Witztum, J. L., Khaw, K. T. and Boekholdt, S. M. (2010). Oxidation-Specific Biomarkers, Lipoprotein(a), and Risk of Fatal and Nonfatal Coronary Events. JACC. 56:12, p. 946-955.
  10. Ai, M., Otokozawaw, S., Asztalos, B. F., White, C., Cupples, L. A., Nakajima, K., Lamon-Fava, S., Wilson, P. W., Matsuzawa, Y. and Schaefer, E. J. Adiponectin: an independent risk factor for coronary heart disease in men in the Framingham Offspring Study. Atherosclerosis. Vol. 217, p. 543-548 (2011)
  11. Persson, J., Lindberg, K., Gustafsson, T. P., Eriksson, P., Paulsson-Berne, G. and Lundman, P. Low plasma adiponectin concentration is associated with myocardial infarction in young individuals. Journal of Internal Medicine. Vol. 268, no. 2, p. 194-205 (2010).
  12. Fu, S., Xu, H., Gu,M., Liu, C., Wang, Q., Wan, X., Chen, Y., Chen, Q., Peng, Y., Cai, Z., Zhou, J. and Wang, Z. Adiponectin deficiency contributes to the development and progression of benign prostatic hyperplasia in obesity. Available from: 10.1038/srep43771
  13. Schenk, J. M., Kristal, A.R., Neuhouser, M.L., Tangen, C.M., White, E., Lin, D.W., Thompson, I.M. Serum adiponectin, C-peptide and Leptin and Risk of Symptomatic Benign Prostatic Hyperplasia: Results from the Prostate Cancer Prevention Trial. The Prostate, Vol 69 Issue 12 pp.1-15 (2009) Available from: 10.1002/pros.2097
  14. Izadi, V., Farabad, E., Azadbakht, L. Serum adiponectin level and different kinds of cancer: a review of recent evidence. ISRN Oncology Vol. 2012, (2012) Available from: 10.5402/2012/982769
  15. Messier V, Karelis AD, Prud’homme D, Primeau V, Brochu M, Rabasa-Lhoret R. Identifying metabolically healthy but obese individuals in sedentary postmenopausal women. Obesity, vol. 18, pp. 911-7 (2010).
  16. Dalamaga, M., Diakopoulos, K.N. and Mantzoros, C.S. The Role of Adiponectin in Cancer: A Review of Current Evidence. Endocrine Reviews. 2012 Aug; 33 (4): 547-594 (2012) Available from: 10.1210/er.2011-1015
  17. Kelesidis, I., Kelesidis, T. and Mantzoros, CS. Adiponectin and cancer: a systematic review. British Journal of Cancer (2006) 94, 1221-1225 Available from: 10.1038/sj.bjc.6603051
  18. Katira, A. and Tan, P.H. Evolving role of adiponectin in cancer-controversies and update. Cancer Biol Med 2016. Pp.101-119 (2016) Available from: 10.28092/j.issn.2095-3941.2015.0092
  19. Messier V, Karelis AD, Prud’homme D, Primeau V, Brochu M, Rabasa-Lhoret R. Identifying metabolically healthy but obese individuals in sedentary postmenopausal women. Obesity, vol. 18, pp. 911-7 (2010).

How Randox R&D Scientists are helping to change healthcare: An introduction to diagnostics for BSW 2017

In celebration of British Science Week 2017, we will be giving you an introduction to diagnostics, and exploring how Randox Scientists are helping to change healthcare.

 

You may or may not already know that Randox are one of the leading diagnostics companies globally.  But what exactly does clinical diagnostics involve?  It is one of the fundamental steps of finding out what is wrong with a person when they are ill.  Read on to find out a bit more about diagnostics, and how the Randox Reagents R&D Scientists are helping to change healthcare globally!

What is a diagnostic test?

A diagnostic test is any kind of analysis performed on a patient sample (a sample is typically blood, urine or cerebrospinal fluid (CSF)), to aid in the diagnosis or detection of disease.  The information found from a test can be used to:

  • Diagnose disease
  • Assess the extent of damage
  • Monitor the effectiveness of treatment
  • Confirm a person to be free from disease

Blood flows through all parts of the body, coming into direct contact with every organ and tissue.  Therefore a blood sample’s appearance and composition provide important information on what is happening in the various parts of the body!

So what exactly is being tested in the blood?

Examples of substances that may be tested for the blood include proteins, nutrients, waste products, antibodies, hormones, salts, trace elements or vitamins.  These are sometimes referred to as ‘analytes’, ‘markers’ or ‘biomarkers’.

This is where reagents come in…

A reagent is a substance which is mixed with the patient sample to create a chemical reaction to detect the biomarker.  These reactions are analysed by machines known as analysers.

Finally…

Using data gathered from both clinical symptoms and laboratory tests, the doctor will follow a sometimes painstaking process of analysis and elimination to perform a successful diagnosis!

 

Continue reading…


Randox Reagents celebrate World Kidney Day 2017

On 9 March 2017, Randox Reagents are celebrating World Kidney Day!  World Kidney Day is a global campaign aimed at raising awareness of the importance of our kidneys to our overall health. It aims to reduce the frequency and impact of kidney disease and its associated health problems worldwide.

This year, the World Kidney Day promotes education on the harmful consequences of obesity and its association with kidney disease, advocating healthy lifestyle and health policy measures that make preventive behaviours an affordable option.

With this in mind, throughout the week we have been sharing on social media some interesting facts on diagnostic tests which can help aid an early risk assessment of kidney disease in obese patients, allowing preventative action to be taken before any serious damage occurs.  The tests of focus this week included cystatin C, adiponectin and microalbumin

Cystatin C

The creatinine test is routinely run for patients who are suspected for deteriorating kidney function, however this test has limitations.  Cystatin C is an alternative test, and is particularly useful in patients where creatinine measurements are not suitable e.g. individuals who are obese, malnourished, have liver cirrhosis or reduced muscle mass. Importantly, unlike creatinine, cystatin C does not have a ‘blind area’ – up to 50% of kidney function can be lost before significant creatinine elevation occurs. Cystatin C is extremely sensitive to very small changes in kidney function and is therefore capable of detecting early stage kidney dysfunction.  The cystatin C test therefore allows preventative measures to be taken much earlier and before significant kidney function decline.

Adiponectin

There is substantial evidence that excess visceral fat is the main driving force for almost all of the disorders associated with the metabolic syndrome, including CKD.1,2 The adiponectin test from Randox can accurately assess levels of abdominal visceral fat, independent of age, race or fitness level.3,4  Assessing adiponectin, and therefore visceral fat levels, can help assess risk of CKD, as well as a range of other illnesses such as pre-diabetes, CVD and various cancers.

 

Microalbumin

The microalbumin test detects very low levels of a blood protein called albumin, in urine. The detection of albumin in urine can be an indicator of kidney injury and can result in irreversible damage if left untreated. Low albumin concentrations in the urine are the earliest marker of kidney damage and therefore enable preventative measures to be taken.  Microalbumin testing can identify individuals with diabetic nephropathy approximately 5-10 years earlier than proteinuria tests helping reduce the frequency of end stage renal disease.

Both World Kidney Day and Randox are working towards improving healthcare worldwide. With continuous investment in R&D, Randox are helping with the risk assessment and earliest detection of renal function problems. By assessing one’s risk of kidney problems (with the adiponectin test), it can give patients (obese and other) the tools to prevent kidney problems further on down the line.  With early diagnosis (through the cystatin C and microalbumin tests) it will be possible to keep kidney problems from getting worse, therefore lowering the number of those diagnosed with CKD worldwide.

For health professionals

If you are a clinician or lab interested in running renal function assays, Randox offers a large range of high quality routine and niche assays including:  Cystatin C, Creatinine Enzymatic and Jaffe, Microalbumin, Urinary Protein, Urea, Sodium, Potassium, Albumin, Ammonia, β2- Microglobulin, Calcium, Chloride, Glucose, HbA1c, IgG, LDH, Magnesium, Phosphorus (Inorganic), and Uric Acid. These can be run on most automated biochemistry analysers.

For more information, download our Diabetes Brochure or email reagents@randox.com.

References

  1. Hall JE, Henegar JR, Dwyer TM, et al. Is obesity a major cause of chronic renal disease?Adv Ren Replace Ther. 2004;11(1):41–54. [PubMed]
  2. Tchernof A, Després JP. Pathophysiology of human visceral obesity: an update.Physiol Rev. 2013;93(1):359–404. [PubMed]
  3. Matsuzawa, Y. The role of fat topology in the risk of disease.  Int J Obes.  2008;32:s83-s92.
  4. Frederiksen, L., Nielsen, T. L., Wraae, K., Hagen, C., Frystyk, J., Flyvbjerg, A., Brixen, K. and Andersen, M. Subcutaneous Rather than Visceral Adipose Tissue Is Associated with Adiponectin Levels and Insulin Resistance in Young Men.  JCEM, (2009) 94 (10): 4010-4015.

 

Further reading:


Clinical Laboratory Survey