Extensive study confirms the benefit of testing apolipoproteins E, C-II and C-III to assess cardiac risk

Extensive study confirms the benefit of testing apolipoproteins E, C-II and C-III to assess cardiac risk

A study published on 21st February 2017 in the Journal of the American College of Cardiology has found that measuring apolipoproteins E, C-II and C-III can offer earlier detection of cardiovascular risk in comparison to routine apolipoprotein A-I and B tests.1

The lead author of the study, Professor Manuel Mayr, from King’s College London has said, “We directly compared the association of a broad panel of apolipoproteins to new onset of cardiovascular disease over a 10-year observation period, and found that while apoB was predictive, other apolipoproteins, namely apoE, apo C-II and apo C-III, were even better”. Professor Mayr further implied that the findings provide support that expanding current cardiac screening tests to include apolipoproteins could reduce risk of cardiovascular diseases.2


What are apolipoproteins?

Apolipoproteins are proteins that bind to lipids to form lipoproteins. Lipoproteins are made of proteins and fats, and serve the function of transporting insoluble fats, such as cholesterol and triglycerides, to be used by different cells. 3

There are six major types of apolipoprotein: A, B, C, D, E and H and the lipoproteins within these categories can vary in size, density and lipid composition. The study found that apolipoproteins E, C-II and C-III are linked to very low-density lipoproteins (vLDL) and have a stronger association with cardiovascular diseases in comparison to apolipoprotein A-I and apolipoprotein B.4

vLDL is strongly associated with the development of atherosclerosis, the build-up of fatty material inside the arteries, which is a major risk factor of cardiovascular diseases as it can lead to angina, heart attack, stroke or peripheral arterial disease.5


Why measure apo C-II, apo C-III and apo-E?


As highlighted by the authors of the study, cardiovascular risk assessment is commonly associated with only a few lipids within established lipoprotein classes, such as LDL.1 This emphasises the importance of carrying out detailed lipid testing to identify all subgroups to provide a complete cardiovascular risk assessment, as traditional biomarkers for lipids may only provide a limited overview. This can then allow for effective treatment to be provided at an earlier stage, which could subsequently reduce the risk of death by cardiovascular diseases.

Randox offer a range of routine and novel cardiac assays to provide a complete cardiac risk assessment, including: Apolipoprotein C-II / C-III / E / A-I / A-II /  B, Adiponectin, HDL Cholesterol, HDL3 Cholesterol, LDL Cholesterol, sLDL Cholesterol, Total Cholesterol, TxBCardio™, H-FABP, Homocysteine, hsCRP, Lipoprotein (a), sPLA2-IIA, and Triglycerides. For more information, email: reagents@randox.com.


References

1. Mayr, M. et al., Very-low-density lipoprotein-associated apolipoproteins predict cardiovascular events and are lowered by inhibition of APOC-III., Journal of the American College of Cardiology. Vol. 69, No. 7, 2017.

2. NIHR Biomedical Research Centre at Guy’s and St Thomas’ and King’s College London, Discovery could help doctors to spot cardiovascular disease at an earlier stage: Advanced technologies provide researchers with new insights into the warning signs for cardiovascular disease, ScienceDaily (2017) Available from: https://goo.gl/XkC23R [Accessed: 21 February 2017]

3. Kingsbury, K. J., Understanding the Essentials of Blood Lipid Metabolism, Medscape, (2017) Available from: https://goo.gl/AApW6S [Accessed: 23 February 2017]

4. Wallace, A., New technique could aid in earlier diagnosis of heart disease, UPI, (2017) Available from: https://goo.gl/xzxLdf [Accessed: 23 February 2017]

5. British Heart Foundation, Atherosclerosis, (2017) Available from: https://goo.gl/1qHxpk [Accessed: 23 February 2017}

Apolipoproteins may offer earlier detection of CVDs


Inflammatory Biomarker Series: Antioxidants

So far in our inflammatory biomarker series, we have considered the clinical significance of measuring rheumatoid factor (RF) and C-reactive protein (CRP) to detect inflammation. Inflammation, either chronic or acute, is the body’s immune response to protect against harmful stimuli such as damaged cells, irritants or pathogens and can be present in a range of diseases and conditions.1 Measuring inflammatory biomarkers can assist clinicians in the identification of a particular disease or can provide a marker of treatment response. In this blog, we consider the role of antioxidants and identify relevant biomarkers which may be linked to inflammatory states.

What is an antioxidant?

An antioxidant is a molecule that inhibits the oxidation of other molecules. Oxidation is a chemical reaction that produces free radicals, which are groups of very reactive molecules that can interrupt important cellular processes. Antioxidants are commonly referenced with regards to food, however antioxidants are also found in the body in the form of enzymes. Their purpose is to protect against the effects of oxidative stress to reduce damage from free radicals.

What is the link between antioxidants and inflammation?

Oxidative stress and the inflammation associated with it are the cause of most human disease. This would suggest that free radicals are implicated in many disease states for example rheumatoid arthritis, asthma, stroke, or cancer. Therefore antioxidants are important to protect against oxidative damage, thus reducing the risk of inflammation. There are a number of antioxidants which play a protective role the body, such as ferritin, superoxide dismutase, transferrin, uric acid and glutathione reductase.

Ferritin

Ferritin is responsible for storing iron and releasing it when required. Ordinarily, ferritin is found inside blood cells with only a small amount circulating in the blood. Ferritin is clinically significant at both high and low levels. Low levels of ferritin can highlight an iron deficiency which causes anaemia. Whereas elevated levels of ferritin can be a result of conditions such as rheumatoid arthritis, haemochromatosis, liver disease, metabolic syndrome, type 2 diabetes and renal failure.2 As ferritin is an acute phase reactant, levels will be elevated in any inflammatory state within the body.3

Transferrin

Transferrin is a protein that is responsible for binding and transporting iron in the blood. Transferrin acts as a preventative antioxidant as it binds with free iron, removing it from the bloodstream. This is a critical function, as free iron can stimulate the production of harmful free radicals. As transferrin is a negative acute phase protein, lower levels are associated with inflammatory conditions.7

Superoxide Dismutase

Superoxide is a by-product of oxygen metabolism and is one of the most damaging free radicals in the body as it can cause cell damage. Superoxide Dismutase (SOD) is an enzyme which catalyses the breakdown of superoxide into a less damaging oxygen or hydrogen peroxide. Therefore SOD preforms a vital defensive function to reduce oxidative stress.4 Extensive research exists which links oxidative stress to chronic inflammation, which can be a contributing factor to diabetes, arthritis, cardiovascular disease and cancer.5 Therefore if levels of superoxide dismutase are low, patients are at risk inflammation, for example, SOD levels are significantly less in rheumatoid arthritis patients.6

Glutathione Reductase

Glutathione reductase is found in red blood cells and plays a key role in maintaining cell function and preventing oxidative stress in human cells. Reduced levels of glutathione reductase can contribute to the prevalence of inflammatory states, suggesting that adequate levels of glutathione reductase are essential for optimal function of the immune system. 7, 8

Uric Acid

Uric acid is a waste product produced when the body breaks down chemical compounds called purines. It is a scavenging antioxidant that acts by inactivating free radicals. Elevated levels of uric acid is commonly associated with gout, a type of arthritis which is caused when crystals of sodium urate form inside joints causing rapid and painful inflammation.9 Other research has indicated that elevated levels of uric acid is associated with increased risk of cardiovascular disease.

Total Antioxidant Status (TAS)

TAS is a measurement of antioxidant function rather than quantity and considers the cumulative effect of all antioxidants present.  The antioxidant defence system has many components, and a deficiency in any of these components can cause a reduction in the overall antioxidant status of an individual.10 Reduction in total antioxidant status has been implicated in several disease states including cancer, CVD, Arthritis and Alzheimer’s disease.


As demonstrated above, different types of antioxidants can help reduce different types of inflammation.  Antioxidant tests can be requested from any doctor, who may also review dietary intake, investigate any symptoms and advise if testing is required. If antioxidant levels are found to be inadequate, improving them can be easily done through dietary changes, and can help reduce a body’s overall inflammation.

 


For health professionals

Randox Laboratories offer a range of diagnostic reagents for antioxidant testing to assist in the diagnosis of inflammatory diseases. Randox offer a complete diagnostic package with applications for a range of biochemistry analysers and a selection of kit sizes, controls and calibrators available. Available tests include: Ferritin, Transferrin, Superoxide Dismutase (Ransod), Glutathione Reductase, Uric Acid, and Total Antioxidant Status (TAS).


References:

  1. Nordqvist, C., Inflammation: Causes, Symptoms and Treatment. Medical News Today, 2015, https://goo.gl/rT4WS9 (accessed 16 January 2017)
  2. Koperdanova, M., Interpreting raised serum ferritin levels, British Medical Journal, 2015, https://doi.org/10.1136/bmj.h3692 (accessed 2 February 2017)
  3. Nall, R. Ferritin Level Blood Test, Health Line, 2015, https://goo.gl/XGcW9P (accessed 2 February 2017)
  4. Yasui, K. and Baba, A., Therapeutic potential of superoxide dismutase (SOD) for resolution of inflammation. Inflammation Research. Vol.55, No.9, pp.359-363, 2006, 1007/s00011-006-5195-y (accessed 2 February 2017)
  5. Reuter, S., Gupta, S.C., Chaturvedi, M.M., Aggarwal, B.B., Oxidative stress, inflammation and cancer: How are they linked? Free Radic Biol Med. 2010, 1; 49(11):1603-1616 https://goo.gl/Uez3JZ (accessed 2 February 2017)
  6. Bae SC, Kim SJ, Sung MK., Inadequate antioxidant nutrient intake and altered plasma antioxidant status of rheumatoid arthritis patients. J Am Coll Nutr. 2003 Aug;22(4):311-5
  7. Reynolds, B., Glutathione for inflammatory respsonse, FX Medicine, 2015, Available from: https://goo.gl/2YAv5l (accessed 3 February 2017)
  8. Morris, G., Anderson, G., Dean, O. et al., The glutathione system: a new drug target in neuroimmune disorders. Mol Neurobiol 2014;50(3):1059-1084, Available from: https://goo.gl/PDSgwv (accessed 3 February 2017)
  9. Malaghan Institute, Uric acid – a new look at an old marker of inflammation, Malaghan Institute of Medical Research, 2013, Available from: https://goo.gl/P6NfXP
  10. Li, Y., Browne, R.W., Bonner, M.R., Deng, F., Tian, L., Mu, L., Positive Relationship between Total Antioxidant Status and Chemokines Observed in Adults. Oxid Med Cell Longev. 2014, Available from: https://goo.gl/rmj5MB (accessed 9 February 2017)
Inflammatory Biomarker Series: Antioxidants


#LoveYourHeart this Valentine’s Day!

We are encouraging you to #LoveYourHeart this Valentine’s Day! Read on to find out why your heart health should matter to you this #HeartMonth!

Fact:  Did you know people with diabetes are 2 to 4 times more likely to develop cardiovascular disease than people without diabetes?¹

Good diabetes control is imperative!  If you have diabetes take control and monitor your treatment to ensure you are safe from complications such as cardiovascular disease…

Many complications associated with diabetes include kidney disease, eye disease, cardiovascular disease and diabetic ketoacidosis (a life threatening condition that can develop in insulin dependent diabetics).

If you have diabetes, being physically active and controlling your weight and blood pressure will help manage your blood sugar level; and therefore help manage the risk of cardiac diseases.

However a few simple routine tests may also be carried out to ensure normal kidney function.  Normal kidney function in a diabetic patient means that diabetes is being controlled well, however if kidney function begins to deteriorate then you will know that measures need to be taken to control diabetes better.

Speciality tests to assess kidney function which can be requested include:

  • Cystatin C a sensitive marker of kidney function used for detection of early renal dysfunction in diabetic patients. It is important to note that Creatinine is the routine test for renal dysfunction, however it has a blind range which means it is unable to detect elevated Creatinine levels found in stage 2 and halfway through stage 3 renal dysfunction; as a result 50% of kidney function can be lost before elevated Creatinine levels can be seen. The Cystatin C test is a much more sensitive marker and can detect early stages of renal dysfunction, allowing treatment to begin before it is too late.
  • Beta-2 Microglobulin – this test is used when kidney damage has occurred to distinguish between the two most commonly affected sites, glomeruli and renal tubules.

Fact:  Cardiovascular Diseases are the number one cause of death globally, with more people dying annually from CVDs than any other cause.²   In the UK alone, 41,000 people under the age of 75 die from CVD each year.³

If you are worried about your cardiovascular health, or whether you are at risk of a heart attack or stroke, ask your doctor for a cardiovascular risk assessment. Routinely they will run lipid tests such as Total Cholesterol, HDL Cholesterol, LDL Cholesterol and Triglycerides to assess your overall cholesterol and triglyceride levels, and allow corrective action to be taken.

Look out for hidden risk factors!

Specific tests you may also want to discuss with your doctor include:

  • sLDL Cholesterol and Lipoprotein(a) to assess for genetically inherited risks of cardiovascular disease – even if your cholesterol levels are safe you may still be at risk of cardiovascular disease as a result of familial traits
  • Adiponectin to assess the level of abdominal visceral fat, of which high levels can increase your cardiovascular risk. Please note that abdominal visceral fat levels or body fat cannot be determined by BMI score, which assesses whether weight is within a healthy range. As such, the Adiponectin test provides a clearer indication of health and is a good predictor of cardiovascular risk
  • TxBCardio to assess response to Aspirin therapy for the prevention of cardiovascular disease. Up to 30% of patients receiving Aspirin therapy suffer unknowingly from Aspirin resistance. This test enables treatment to be modified and corrected

Asking your doctor for these tests creates an opportunity for corrective action to be taken and can have significant benefits for your health.

Fact:  Approximately one woman dies from heart disease every minute, of which 64% had no previous symptoms.4

Sixty-four percent of women who die suddenly of coronary heart disease had no previous symptoms. Because these symptoms vary greatly between men and women, they’re often misunderstood. Media has conditioned us to believe that the telltale sign of a heart attack is extreme chest pain. But in reality, women are somewhat more likely to experience shortness of breath, nausea/vomiting and back or jaw pain. Other symptoms women should look out for are dizziness, lightheadedness or fainting, pain in the lower chest or upper abdomen and extreme fatigue.

Being aware of these signs can aid early detection, and greatly increase chances of surviving a heart attack!

 

So don’t forget to #LoveYourHeart this Valentine’s Day!  Randox can provide a vast range of specialised blood tests to allow the most accurate diagnosis of diabetes, cardiac risk and associated complications. From all of us here at Randox we wish you an enjoyable Valentine’s Day!

For health professionals:

Randox Laboratories manufacture a wide range of routine and niche biochemistry reagents suitable for both research and clinical use.  These include a wide variety of automated routine and niche diabetes and cardiac tests and our new HDL3-C assay.  Please contact reagents@randox.com for further information.

 

References

  1. World Heart Federation, Diabetes, https://goo.gl/e8WG86 Accessed: February 2017
  2. WHO, Cardiovascular diseases (CVD), https://goo.gl/fGO0bj, (2016), Accessed: February 2017
  3. British Heart Foundation, CVD Statistics – BHF UK Factsheet, https://goo.gl/6DEOdw (2017), Accessed: February 2017
  4. Reference: American Heart Association, Common Myths About Heart Disease, (2017),  https://goo.gl/NEz5gV, Accessed: February 2017

 

Further reading:


Inflammatory Biomarker Series: Rheumatoid Factor

What are inflammatory biomarkers?

The purpose of measuring an inflammatory biomarker is to detect inflammation, which can assist clinicians in the identification of a particular disease or provide a marker of treatment response. Inflammation, either chronic or acute, is the body’s immune response to protect against harmful stimuli such as damaged cells, irritants or pathogens.1 When inflammation occurs in the body, extra protein is released from the site of inflammation and circulates in the bloodstream.2 It is these proteins, or antibodies, which clinicians are testing for in the blood as they can indicate if inflammation is present.

Like many inflammatory biomarkers, such as rheumatoid factor (RF), C-reactive protein (CRP) or erythrocyte sedimentation rate (ESR), further tests will be required as testing for these tests alone does not provide a clearly defined diagnosis. However inflammatory biomarker tests can provide clinicians with a good indication of what may be wrong with a patient, which is why they are commonly tested for in a clinical setting.


What is Rheumatoid Factor?


Rheumatoid factor (RF) is an autoantibody which can target and damage healthy body tissue and in turn cause inflammatory symptoms.3 It is uncommon for this antibody to be present in healthy individuals, which is why it is a beneficial test to aid the diagnostic process. In particular, rheumatoid factor can be used as an inflammatory biomarker to assist in the diagnosis of rheumatoid arthritis (RA). However the rheumatoid factor antibody can also be present in healthy individuals or patients with systemic lupus erythematosus, liver cirrhosis, Sjögren’s Syndrome, Hepatitis and other conditions.4 If a test detects rheumatoid factor levels above 14 IU/ml, this is considered abnormally high.3

What is Rheumatoid Arthritis?

Rheumatoid arthritis is an autoimmune disease which attacks the lining tissue of joints, resulting in chronic inflammation. This disease commonly affects the hands, feet and wrists, with symptoms causing pain, fatigue and loss of bodily function and over time may even lead to multiple organ damage.5 Although diagnosis of rheumatoid arthritis requires a physical examination, testing for rheumatoid factor can be beneficial to assist in the diagnosis of this disease. Other blood tests that can be used to detect biomarkers associated with rheumatoid arthritis include C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), IgA, IgG, IgM and anti-cyclic citrullinated peptide (anti-CCP).

For health professionals

Randox Laboratories offer a leading portfolio of diagnostic reagents which includes a test for rheumatoid factor, with applications available for a range of biochemistry analysers. With a measuring range of 6.72 – 104 lU/ml, this assay can comfortably detect levels outside the normal range. Randox offer a complete diagnostic package for the screening of rheumatoid factor with a range of kit sizes, controls and calibrators available. Other inflammatory biomarker tests available from Randox include CRP, High Sensitivity CRP, Full Range CRP, IgA, IgG and IgM.

References:

1. Nordqvist, C. Inflammation: Causes, Symptoms and Treatment. Medical News Today, https://goo.gl/rT4WS9 (accessed 16 January 2017)
2. Harding, M., Blood Tests to Detect Inflammation, Patient, 2015, https://goo.gl/F4OGrz, (accessed 16 January 2017)
3. Shiel, W. C., Rheumatoid Factor (RF), MedicineNet, 2016, https://goo.gl/XPA69u 2016 (accessed 16 January 2017)
4. Rheumatoid Arthritis Organisation, Rheumatoid Factor Test, Rheumatoid Arthritis Organisation, 2016, https://goo.gl/JujE5a
5. Gibofsky, A. Overview of Epidemiology, Pathophysiology and Diagnosis of Rheumatoid Arthritis. The American Journal of Managed Care. Vol.18, No.13. p.295-302, 2012

Inflammatory Biomarker: Rheumatoid Factor


Inflammatory Biomarker Series: CRP

An inflammatory biomarker detects inflammation in the body. Inflammation is not just the immediate, short-term response of the body to an injury or infection. Inflammation within the body can be a long-term, chronic condition resulting in a number of health implications. In diagnostics, measurement of an inflammatory biomarker can not only detect acute inflammation but provide a marker of treatment response.

C-reactive protein (CRP) is an acute phase protein produced by the liver in response to inflammation, infection and tissue injury. CRP is a particularly beneficial inflammatory biomarker as it is detected much faster than other markers in the blood. Levels of CRP increase when inflammation occurs and therefore it can be a significant biomarker in a range of diseases, including the following.

Cardiovascular Disease

An increasing amount of research exists to suggest CRP is not only a useful, non-specific inflammatory biomarker, but it may have a direct influence on coronary heart disease and cardiac events1. Inflammation can occur when LDL cholesterol builds up in the artery walls causing atherosclerosis. Modifiable risk factors of atherosclerosis include smoking, diabetes, poor diet, high blood pressure and physical inactivity, all factors which subsequently increase the risk of heart attacks, ischemic stroke, peripheral artery disease and even vascular dementia2,3.

Studies have also shown that persistent low levels of CRP can contribute to a person developing CVD. Therefore using high sensitivity CRP as an inflammatory biomarker can detect low levels, helping to predict the likelihood of a patient developing CVD in the future.

Diabetes

Research suggests that inflammation in the body can influence the development of type 2 diabetes. With the ability to be managed through diet and exercise, type 2 diabetes is commonly associated with obesity. Research has shown that excess body fat can cause continuous chronic low-grade inflammation as a result of inflammatory cytokines and increased plasma levels of CRP. As a result, this chronic inflammation has the ability to cause insulin resistance leading to the development of type 2 diabetes4.

Rheumatoid Arthritis

A three year study which analysed the bone and joint health of 10,000 patient samples in India has found that inflammatory biomarkers, in particular CRP and ESR (Erythrocyte Sedimentation Rate) were raised in most of the samples compared to any other markers5. Although CRP is a non-specific inflammatory biomarker, it can be used alongside other tests, such as Rheumatoid Factor, to diagnose inflammatory joint diseases such as Rheumatoid Arthritis. Not only will CRP levels be higher due to chronic inflammation, but CRP levels can be monitored to assess levels of inflammation over time, allowing clinicians offer effective treatment.

Chronic Obstructive Pulmonary Disease (COPD)

COPD is a condition associated with inflammation of the lungs and airways. Studies have shown that measuring CRP levels is beneficial to detect exacerbations, when symptoms of COPD get suddenly worse and can last for several days. This is because CRP levels spike when exacerbations happen, causing lung function to deteriorate6.

Neonatal Bacterial Infections

CRP is one of the preferred and frequently used tests in neonatal units when diagnosing suspected bacterial infections, such as neonatal sepsis, in newborns who show signs on infection. Due to delayed synthesis during the inflammatory response, the sensitivity of CRP is lowest during early stages of infection. It is therefore critical that extremely low levels of CRP can be detected during diagnosis to distinguish whether symptoms are related to an infectious or non-infectious condition. This early detection then allows for rapid and appropriate neonatal treatment7.

Inflammatory Bowel Disease

Research suggests that using CRP as an inflammatory biomarker can help distinguish between Inflammatory Bowel Disorder (IBD) and Irritable Bowel Syndrome (IBS)8. Although IBD and IBS have some similarities in symptoms, IBD causes chronic inflammation, whereas IBS is a non-inflammatory condition. Therefore using CRP as a biomarker can allow clinicians to deliver a confident and accurate diagnosis.

For health professionals

Randox Laboratories manufacture a wide range routine and niche biochemistry reagents for use in both a research and clinical setting. With a wide measuring range, the Randox CRP assay will perform excellently to detect levels outside of the healthy range. Also available is a Full Range CRP assay particularly beneficial for use in a neonatal setting, and a High Sensitivity CRP assay, depending on your diagnostic requirements. For more information, please contact: reagents@randox.com

References:

  1. Shrivastava, A. K., Singh, H.V., Raizada, A. and Singh, S.K. C-reactive protein, inflammation and coronary heart disease. The Egyptian Heart Journal. 67, 89-97. (2015)
  2. American Heart Association. Inflammation and Heart Disease. Available from: https://goo.gl/d82Ynr  (2016)
  3. Harvard Health Publications. What you eat can fuel or cool inflammation. Harvard Health Publications. Available from: https://goo.gl/e8m3El (2007)
  4. Zeyda, M. and Stulnig, T. M.  Obesity, Inflammation, and Insulin Resistance – A Mini-Review. Gerontology 2009; 55:379-386 (2009)
  5. Mukherjeel, R.  Bone and joint health are crucial aspect, usually ignored by Indians. The Times of India. Available from: https://goo.gl/qluzhI (2016)
  6. Anderson, G. P.  COPD, asthma and C-reactive protein. European Respiratory Journal 2006; 27: 874-876. (2006)
  7. Hofer, N., Zacharias, E., Müller, W. and Resch, B.  An update on the Use of C-Reactive Protein in Early-Onset Neonatal Sepsis: Current Insights and New Tasks. Neonatology 2012; 102: 25-36 (2012)
  8. Silva, P.  Two Specific Proteins Allow the Exclusion of IBD in Patients with Irritable Bowel Syndrome. IBD News Today. Available from: https://goo.gl/pxMP53 (2015)
Inflammatory Biomarker: CRP


The scary facts about cholesterol!

Cholesterol is a fatty substance also known as a lipid. It is made by the liver but can also be found in some foods. It is essential to let the body function normally. You will be sad to hear that high levels can increase your risk of serious health conditions. There are two main types; high-density lipoproteins (HDL) and low-density lipoproteins (LDL). HDL is known as good cholesterol. It carries cholesterol back to the liver, where it is broken down. LDL on the other hand carries cholesterol to the cells however if there is a surplus it can build up in the artery walls increasing the chances of a heart attack or stroke occurring.

Here are some scary facts about cholesterol…

  1. You can’t live without it – Cholesterol has been in your body since the day you were born. It is a building block for all cells.  Not only that but all of our cells and hormones need it to function properly…unfortunately you are very unlikely to find good cholesterol in your typical trick-or-treat offerings.
  1. Not all patients on cholesterol-lowering medication respond optimally to it – In the recent past, aspirin (a drug used to reduce levels) was prescribed for people who had a perceived risk of a heart attack. However aspirin does not always work; up to 30% of patients could have a below optimum response to the drug and therefore be at a considerably increased risk of a recurrent cardiovascular event. This is may also be referred to as “aspirin resistance”.
  1. One third of adults have high cholesterol – Testing is advised every 5 years to monitor your levels to see any changes. To get the most accurate results tests should be carried out one week apart, however most testing facilities won’t follow this.
  1. High levels could be down to genetics – Diet you can change, genes you can’t! If your family has a history of high cholesterol then you are likely to have it as well. It has been suggested that 75% of cholesterol is due to genetics and the remaining 25% is down to diet and lifestyle choices.
  1. Women’s levels will fluctuate over their lifespan – Did you know that ladies? During the average woman’s lifespan, cholesterol levels will rise and fall due to pregnancy and menopause. During pregnancy levels will rise in order to help the baby develop. After birth the mother’s levels should return to normal however after menopause a woman’s LDL levels will rise to that higher of a man’s.

However it is not all doom and gloom this Halloween!  Randox are here to treat you to a vast range of specialised blood tests to allow the most accurate diagnosis of cholesterol levels, allowing you to gauge how many sweets you can sneak in this Halloween! We offer a large array of routine and niche tests. The most popular and widely tested are HDL, LDL, total cholesterol and triglycerides. Some further risk assessment cholesterol tests which are not routinely run include sLDL, HDL3, Lp(a). These cholesterol biomarkers are also affected by the usual risk factors such as age, weight, smoking, etc.; however they can also be a result of one’s genes. As mentioned before aspirin resistance is a big problem affecting up to 30% of all patients on aspirin therapy. However Randox offer the TxBCardio™ test which is a unique test to diagnose and assess the effectiveness of aspirin therapy.

From all of us here at Randox we wish you a safe and happy Halloween!

 


For health professionals

Randox Laboratories manufacture a wide range of routine and niche biochemistry reagents suitable for both research and clinical use.  These include a wide variety of automated routine and niche cardiac tests and our new HDL3-C assay.  Please contact reagents@randox.com for further information.

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Maintaining optimal brain health

Do you want to have optimal brain function later in life? We do. The majority of people focus on keeping their bodies in optimal condition but often forget about the most important organ, the brain. With more of us living until we’re much older, reduced brain function and Alzheimer’s are becoming increasingly more common; it is one of the most feared consequences of aging. We expect our bodies to age due to wear and tear; however there are easy ways to slow it, you will be glad to hear. Here are some top tips to keep your brain health at its peak.

  1. Get physical exercise

It is becoming an increasingly well-known fact by scientists that regular exercise may be the single most important thing you can do to ensure optimum brain health. The reason for this is that exercise increases the blood supply to your brain so therefore increases your brain capacity. Experts advise 30 minutes of exercise every other day to ensure good mental health. Exercise also helps with cholesterol levels, mental stress and diabetes.

  1. Eat, eat, eat

Good nutrition is also essential for good brain health. Your brain is no different to any other organ: the better the fuel it receives; the better it works, simple. As with everything it is important to keep your calories in check as it has been proven to reduce mental illness. We aim to reduce the consumption of saturated fats and cholesterol as these can decrease brain function. No matter who you are, vitamins are also very important to ensure not only a healthy brain, but a healthy body.  Vitamins of particular importance are folic acid, B6 and B12 which it is well-known can help lower your homocysteine levels. There is an ever-growing body of research which suggests that homocysteine levels have a strong correlation with Alzheimer’s and dementia. If you would like to read more about the link between homocysteine and Alzheimer’s, check out our previous blog post ‘How important is homocysteine research for Alzheimer’s disease?’

  1. Get enough sleep

Recent studies have suggested that a poor sleeping pattern is linked with cognitive decline in old age. A good night’s rest can actually double the chances of finding creative solutions to problems faced in everyday life! It has been proven that when we don’t sleep, proteins build up on the brain. These proteins build on the synapses, making it hard to think and learn new information; which is not conducive to good brain health.

  1. De-stress

Relaxation is key in a healthy lifestyle. Stress has a negative impact on the brain. It creates harmful chemicals to flow over areas of the brain that are in control of memory. Too much of these chemicals can lead to dementia and other memory loss related diseases, so maybe it’s not such a bad idea that you take that trip to the Bahamas you were thinking about!

  1. Improve you cholesterol

Cholesterol is commonly split up into good cholesterol (HDL) and bad cholesterol (LDL). There are loads of ways to improve your cholesterol levels such as exercise, weight control, dieting and avoiding tobacco. It is very important to keep you levels of LDL down as high levels can increase the risk of Alzheimer’s, dementia and cardiac problems in old age. At Randox we are constantly coming up with new and exciting ways of monitoring your cholesterol and the launch of our new HDL3 test is coming soon. For more information on HDL3, check it out here!

  1. Brain exercises

Challenging your mind from time to time is important for good brain health; it keeps your brain active and uses cognitive thought to try and learn or solve a problem. It is thought that a lack of education is a strong influence in cognitive decline. Challenging your brain improves memory, develops critical thinking and stimulates the whole brain ensuring brain health is kept to a maximum. It can often be done in fun ways like brain teasers, puzzles and jigsaws. Check out our recent brain teaser here!

 

These are only some of the ways in which to keep your brain in peak condition. Aging will take a toll on everyone and it is impossible to avoid; however these 6 techniques can help maintain optimal brain function!  We have been keeping up to date with Alzheimer’s in celebration of World Alzheimer’s Month. Remember a healthy brain is the key to success!

 


For health professionals

Randox Laboratories manufacture a wide range of routine and niche biochemistry reagents suitable for both research and clinical use.  These include an automated homocysteine test and our new HDL3 cholesterol assay.  Please contact reagents@randox.com for further information.


TAS & NEFA: Benefits for dairy cattle during the transition period

The transition period between late pregnancy and the onset of lactation requires quick metabolic adaption by dairy cattle as foetal growth, calving and the onset of lactation causes increased energy demands on the body. To support the increase in energy requirements, increased nutrients are required; however, limitations to dietary intake can occur as a result of reduced appetite caused by the growing foetus restricting the size of the rumen. In addition, during this period almost all glucose intake is utilised for lactose synthesis. As a result, during the transition period dairy cattle can be prone to negative energy balance.

Negative energy balance occurs when energy demands exceed dietary intake, and in cases where energy requirements are not met by diet, dairy cattle will utilise their own fat reserves as an energy source; this being non-esterified fatty acids (NEFA), a major component of triglycerides (fats) in the body. Excessive metabolism of NEFA, however, can result in accumulation of fat which can result in fatty liver disease (resulting in decreased liver function), and ketosis which can be toxic and damaging to the liver and kidneys (it has been associated with pregnancy complications, decreased milk production and hypoglycaemia).

Additionally, during the transition period, as a result of the increase in metabolic processes, dairy cattle are more susceptible to metabolic stress. This is due to the increase in Reactive Oxygen Species (ROS).

ROS are free radical by-products of normal metabolic processes which can be harmful and destructive to the cells in the body. To defend against them the body utilises antioxidants to inhibit the formation of free radicals, destroy free radicals or repair the damage caused by free radicals; however if there is an imbalance of antioxidants to ROS then the body’s natural defence system is decreased. This can result in free radical damage to surrounding cells, tissue and DNA.

Free radicals have been implicated in many disease states in addition to suppression of the immune response system. As a result, in the first 10 days after calving dairy cows are at maximum risk of infectious and metabolic disorders; in fact, approximately 75% of disease occurs in herds within the first month of lactation (Abuelo et al. 2014). Complications for dairy cattle suffering metabolic stress include not only fatty liver disease and ketosis, but also mastitis, retained foetal membranes, reduced milk production and increased risk of cancer, CVD, lung, liver and renal disease, inflammatory conditions such as arthritis, infectious conditions, and, neurological disorders.

How can the health and well-being of dairy cattle be protected during the transition period?

To ensure animal well-being, and indeed reduce economic impact for dairy farmers, dairy cattle should be monitored for their antioxidant capacity, particularly during pregnancy.  As the antioxidant defence system includes many components, the Total Antioxidant Status (TAS) test is used to assess overall antioxidant capacity. This test is beneficial in gaining an overall view of the body’s ability to defend against free radical attack; it can therefore help to determine if nutritional supplements are required to ensure good body condition during the transition period. Further antioxidant testing may be required to ensure nutritional requirements are fully understood before antioxidant supplementation begins.

In addition, the NEFA test indicates negative energy balance, and can therefore be used to monitor whether their nutrient intake is adequate for the high energy demands experienced during the transition period. Additionally, research (Li, H.Q et al. 2016) has found that supplementing dairy cattle with rumen-protected folic acid (RPFA) may benefit negative energy balance by decreasing plasma concentrations of NEFA and increasing glucose plasma. Results show increased milk protein levels and improved nutrient ingestion, milk production and reproductive performance.

Randox provides TAS and NEFA for a wide range of biochemistry analysers. For more information please contact reagents@randox.com.

References:

Abuelo A., Hernandez J. and Beneditor J.L (2014) The importance of oxidative status of dairy carrel in the periparturient period: revisiting antioxidant supplementation. Journal of Animal Physiology and Animal Nutrition. 99(6):1003-1016

Li, H. Q., et al. (2016) Effects of dietary supplements of rumen-protected folic acid on lactation performance, energy balance, blood parameters and reproductive performance in dairy cows. Animal Feed Science and Technology


How important is Homocysteine research for Alzheimer’s disease?

It is widely recognised that high homocysteine levels in the blood (hyperhomocysteinemia) can cause inflammation in the blood vessels, which in turn may lead to atherogenesis and ischemic injury.  High homocysteine levels are therefore a possible risk factor for coronary artery disease (CAD), or heart disease.

However a new study published in the Journal of Thrombosis and Haemostasis in April 2016 (conducted by Young Cheul Chung and colleagues, from Rockefeller University in New York City) has looked into the growing evidence to suggest that hyperhomocysteinemia is also correlated with Alzheimer’s disease and vascular dementia.  This study was undertaken to clarify the specific role of elevated homocysteine levels in Alzheimer’s disease pathophysiology.

The study was carried out on mice, and showed a promising link between high levels of homocysteine and Alzheimer’s disease.  It showed that diet-induced hyperhomocysteinemia in an Alzheimer’s disease mouse model leads to severe cerebral amyloid angiopathy and parenchymal amyloid-β deposition, as well as significant impairments in learning and memory, suggesting that elevated levels of plasma homocysteine and its metabolite, homocysteine thiolactone, contribute to Alzheimer’s disease pathology.

Commenting on an earlier study, Dr Susanne Sorensen, Head of Research at Alzheimer’s Society UK said that the molecule [homocysteine] is carried by everyone, but those who go on to develop some dementias appear to have higher levels of the compound.  She also stressed that research is needed to establish just what role if any homocysteine plays in the development of dementia and how best to keep levels of the molecule low.

Alzheimer’s disease is a progressive mental decline that can occur in middle to old age, due to a degeneration of the brain. It is the most common cause of premature senility, and is also the most common form of dementia, affecting 62% of those diagnosed.  Vascular dementia is another form, affecting 17% of those diagnosed.

Paul McGivern, Clinical Chemistry R&D Manager at global healthcare company Randox Laboratories, has commented

Dementia is a terminal condition and with 850,000 people living with dementia in the UK, there is an urgent need for further research into the link between Alzheimer’s disease and homocysteine levels.  If we can better establish this link, it may give future researchers the tools necessary to find a prevention, or even a cure to this condition.

With the number of dementia sufferers set to rise to over 1 million by 2025, soaring to 2 million by 2051, the need for further research into the link between homocysteine levels and Alzheimer’s disease has never been more pressing.

For health professionals

Randox Laboratories offer an automated test for the biochemistry measurement of homocysteine.  This is available for use on a wide range of manufacturer’s analysers.  Please contact reagents@randox.com for further information, or to request a kit insert or application.


Randox employee hosts bake sale in aid of the Cystic Fibrosis Trust

Randox employees enjoyed a bake sale yesterday at our headquarters in Crumlin. The bake sale was hosted by Randox employee Rachel Walls on behalf of her sister, Ursula McKenna, who will be running both the Dublin Marathon and Manchester half Marathon later this year in aid of the Cystic Fibrosis Trust.

Ursula McKenna has raised an impressive £3000 for the Cystic Fibrosis Trust and is set to continue her efforts in raising money for this great cause. Having run the London Marathon twice, with the last one completed on Sunday 24th April, her motivation stems from personal empathy of the condition;

Our cousin suffers from Cystic Fibrosis, and running a few marathons is easy compared to what he has to deal with on a daily basis’

Cystic Fibrosis is a genetic condition caused by a faulty gene that controls the movement of salt and water across the cell wall. This causes mucus to build up in the lungs and digestive tract, causing problems with breathing and digestion. An estimated 1 in 2,500 babies born in the UK have Cystic Fibrosis, with more than 2.5 million people in the UK carrying the faulty gene.  Currently there is no cure for Cystic Fibrosis, however there are treatments to help manage the symptoms.

Ursula’s dedication to the cause is evident and this extends to her family through their help and support. The bake sale hosted by Rachel yesterday at Randox included scrumptious treats made by the family, and helped raise £308! In addition to hosting fundraising events, her brother also ran the New York Marathon in 2014 and will be joining Ursula in running the Dublin Marathon in October. Hoping to beat her previous completion times of 4:27 in her first marathon and 4:07 in her second marathon, Ursula aims to complete the Dublin Marathon in less than 4 hours. Good luck!

Ursula McKenna, London Marathon 24th April '16

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