Obesity: the disease, the problems, and the power of prevention

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Obesity: the disease, the problems, and the power of prevention

Earlier this year the World Obesity Federation made the stark statement that: “The early diagnosis and treatment of childhood obesity could be considered similar to vaccination.”

Essentially, they want to see this condition treated in the same way as chicken pox, measles and mumps: tackled – in the hope of eradication – by a strategic approach founded on proactive policies and early prevention.

Obesity in children and adolescents has risen tenfold in the last 40 years, according to a recent study by The Lancet. In Britain, one in ten young people aged between 5 and 19 is obese. Worryingly, the prevalence of obesity is actually higher in younger children than older ones.

The WHO first called for obesity to be understood as a disease in 1948, but back then it wasn’t even considered a risk factor for cardiovascular disease. In 1997 the WHO held a special conference on obesity and stated that: “the global epidemic projections for the next decade are so serious that public health action is urgently required.”

Then it was alarmed that the prevalence of men with a BMI greater than 30 was 15% and 16.5% in women. To think that it has now risen dramatically to 67% for men and 57% for women, highlights just how serious a problem obesity poses to society.

The calls for more countries to officially recognise it as a disease is based on the position that obesity meets the definition of a chronic, relapsing, progressive disease that causes organ damage.

Women and men who are obese are 12.5 and 5.2 times (respectively) more likely to develop diabetes than people who are a healthy weight. 90% of people with Type 2 diabetes are obese.

People with diabetes are then at a greater risk of a range of chronic health conditions including cardiovascular disease, blindness, amputation, kidney disease and depression than people without diabetes. Diabetes leads to a two-fold excess risk for cardiovascular disease, and diabetic retinopathy is the leading cause of preventable sight loss among people of working age in England and Wales.  About one in twenty people have diabetes, yet people with diabetes account for one quarter to one third of hospital admissions for cardiovascular disease.

According to Government figures released this year, people who have Type 2 diabetes are 28.4% more likely to die early than their peers.

Getting in front of this wave of diabetes will not only bring down the numbers of people affected but also see a positive impact on the numbers of obese people. As with all conditions – the earlier they are identified, the better. To do this, new methods of diagnosis are being developed.

A radical new test for a protein found in our blood called adiponectin can identify pre-diabetes. This is a game-changing diagnostic tool that empowers people with the knowledge that they are at risk, but may be able to avoid it through relatively simple lifestyle changes.

The adiponectin test is available from Randox – both for clinical use and also through our Randox Health clinics.  We have developed the most comprehensive health checks available on the market. These are so sensitive that in a range of conditions including diabetes we are able to identify signs of pre-illness.  This enables clients to make often simple changes to stay healthy.

We know that prevention works. The NHS carried out a study in 2016 which revealed an average 26% reduction in new cases of Type 2 diabetes in those participating in a diabetes prevention programme, compared with usual care.

 

To find out more, click here.

For further information please email: randoxpr@randox.com


Sharing our preventive health message this World Diabetes Day

One of the fastest growing health threats of our times is diabetes. Type-2 diabetes is now among the most common long-term health conditions affecting people right across the globe. On World Diabetes Day we want to raise awareness of this particular condition – because it’s possible to spot warning signs and take steps to prevent it.

THE BACKGROUND

Since 1996, the number of people living with diabetes has more than doubled and type-2 diabetes is by far its most prevalent form. Though it is potentially reversible, using more advanced diagnostics, clinicians can diagnose pre-diabetes and enable patients to make lifestyle changes to avoid the condition from developing in the first place.

THE FUTURE

Adiponectin is a biomarker which can powerfully predict the development of pathologies such as Type 2 Diabetes Mellitus (T2DM) and cardiovascular disease (CVD). This biomarker can be tested as an automated biochemistry reagent from Randox.

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. Randox Adiponectin will enable physicians and clinicians to accurately evaluate more individuals, with a convenient format for routine clinical use.

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

OUR CASE STUDY – SIR AP MCCOY

Earlier this year Sir AP McCoy came to Randox Health. After a career dedicated to becoming the world’s most successful jockey, he was never going to leave the next stage of his life to chance. It was lucky he did: our advanced test for adiponectin was within the panel of tests run and  was able to identify that AP was pre-diabetic.

Don’t leave your health to chance. 70% of cases of type-2 diabetes are preventable by adopting a number of lifestyle changes, so take action today.

For further information phone the Randox PR Team on 028 9442 2413, or email randoxpr@randox.com 


Randox showcases future-proofing diagnostic technology at MEDICA 2017

Randox Laboratories, the world-leading medical diagnostics manufacturer, is showcasing advancements in laboratory technology at the 2017 MEDICA – World Conference for Medicine conference, being held November 13-16 in Dusseldorf, Germany.

Unveiling its state-of-the-art interactive exhibition stand, Randox will host a series of demonstrations of its innovative analysers including the Evidence Evolution and Rx modena, and a number of exciting advances in laboratory medicine, involving  increasing the test menu available to clinicians and improving the connectivity of laboratories across the world to improve overall quality.

“Through our advancements in laboratory innovation, we’re driving an industry-wide evolution” said Randox CEO, Dr Peter FitzGerald.

“Our products are leading the way in innovation and enabling laboratories to transform the way they operate. We will be hosting demonstrations of a wide range of our fully-automated analysers, which are packed with cutting-edge technology and intuitive software. The goal is to provide future-proof diagnostic technology that will create the most efficient and effective laboratories.”

Paving the way is Randox’s patented Biochip Array Technology (BAT). This multi-analyte testing platform is the product of a £250 million research and development project. The ceramic tile measuring 9×9 mm can currently run up to 49 assays simultaneously,100 assays in the near future.   This innovation allows the simultaneous quantitative or qualitative detection from a wide range of analytes from a single sample. It is suitable for use in a wide range of laboratories including clinical, research, hospital, veterinary and forensic and clinical toxicology.

To enhance the benefits of BAT, Randox introduced the Evidence Evolution to its stable of immunoassay analyser platforms. The Evidence Evolution is the world’s first fully automated random-access biochip testing platform, capable of delivering 2640 results in one hour, with the first delivered in just 37 minutes.

Joining the Evolution in Hall 3 stand A08 is the RX modena. This highly reliable, precise, fully automated clinical chemistry analyser can run 1200 tests per hour including ISE. When combined with its unrivalled RX series test menu, it offers a winning combination for all large, multi-disciplinary laboratories.

“We develop more new tests than any other diagnostics manufacturer, and one of the products that we’re showcasing at this year’s MEDICA is Adiponectin,” added Susan Hammond, Global Sales Manager at Randox.

“This novel biomarker is a powerful new weapon in the fight against some of the biggest health issues faced throughout the world including diabetes, cancers and cardiovascular disease. As it’s World Diabetes Day on Tuesday 14th November, it’s a great opportunity to draw attention to this array which labs can run as part of their routine testing panel.”

MEDICA attendees will also be among the first to experience the advancements delivered by the latest update for Randox’s Acusera 24.7. This online interlaboratory data management and peer reporting package is now smarter, faster and more powerful than ever before.

Acusera 24.7 is designed to help laboratories efficiently review QC data from all their lab instruments on one central platform, thereby allowing quick and easy identification of QC failures and emerging trends. Unique access to peer group data updated instantly in real-time from our global network of laboratory participants will speed up troubleshooting and help pinpoint the root cause of any QC failures by easily identifying if an issue is isolated or widespread.

 

The Randox team will be on hand throughout MEDICA 2017 at stand #3A08. To make an appointment in advance, contact them through the Randox MEDICA webpage.

Click here for more information on Randox, or to get in touch, phone the Randox PR Team on 028 9442 2413, or email randoxpr@randox.com 


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.


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).

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:


Randox supports calls from Oxford University for more accurate diagnosis of diabetes following report warning

Calls for more accurate diagnosis of people at risk of developing Type-2 diabetes have been supported by Randox, following a warning raised by an Oxford University study which looked into efforts to tackle the worsening epidemic of the condition.

The study, which was published in the British Medical Journal, examined results from the NHS’s programme which involves a screening test for pre-diabetes. The authors determined that the UK’s National Diabetes Prevention Programme is unlikely to have much impact because the blood tests used were inaccurate at detecting pre-diabetes, though these are currently the only ones available to doctors and patients. The study argues that if the screening is inaccurate then people will either be falsely reassured or receive incorrect diagnoses, which will not help the worldwide challenge to reduce people at risk of developing diabetes that continues to increase across the world.

It is estimated that Type-2 diabetes causes 22,000 early deaths every year in England alone. Across the UK over 3m people currently have the condition though experts say this will increase to 5m by 2025.

With current treatment taking up almost 9% of the annual NHS budget – roughly £8.8bn a year – the implications for future healthcare budgets are clear if this dangerous trend persists.

Global reagents Manger Susan Hammond said,

Although we wholly back the NHS’s belief that positive lifestyle changes make crucial differences in people’s health and lives, we also believe that unless earlier and more accurate diagnostic screening is employed on a twin-track of treatment, this epidemic will continue to worsen.  We welcome that this study highlights the fact that clinician’s s are currently limited in what they can use to tackle the threat posed by diabetes. There are emerging biomarkers   they could be given access to,  such as Adiponectin and determining a person’s risk of Metabolic Syndrome.”

Assessing Adiponectin levels allows doctors to calculate the amount of visceral fat stored around a patient’s organs. This deep fat, which is not visible to the naked eye, is linked to health problems including Type-2 diabetes. High levels of adiponectin equate to low levels of visceral fat which can be combated by improving your diet, exercise habits and even stress levels. Given that 70% of Type-2 diabetes can be prevented by lifestyle changes, there is strong correlation that by detecting low levels of Adiponectin and taking corrective and preventive action, it could results in a decrease in the numbers of people who develop the life altering condition.

In addition to a test for the Adiponectin biomarker, Randox Biosciences have created a Metabolic Syndrome Array that measures 12 markers associated with metabolic syndrome and cardiovascular disease. Metabolic Syndrome is a is a group of cardiovascular risk factors that affects over 20% of adults and  results in a person being three times more likely to have a stroke or heart attack, and five times more likely to develop diabetes.

Mrs Hammond concluded,

“We would ultimately like to see all medical professionals who are at the forefront of patient care armed with the most accurate diagnostic tools available. Updating traditional practice may not be easy but we believe it is imperative to do so, if we are to effectively challenge this global epidemic.”

Randox remains focused on providing early diagnoses and preventing illnesses by providing innovative diagnostics tests that will continue to revolutionise the healthcare landscape.

To find out more about our tests for metabolic arrays click here and Adiponectin click here.


What is Visceral Fat?

Visceral fat (or abdominal fat) is body fat which is stored within the abdominal cavity. It wraps around your vital organs including the liver, pancreas and intestines, and as a result can have a negative impact on your health. In fact, visceral fat has been linked to increased risk of health problems such as type 2 diabetes, heart disease and some cancers.

It is important to distinguish the difference between subcutaneous fat and visceral fat…

Subcutaneous fat is the fat we store under our skin. It is the tissue that we can feel when we pinch ourselves, and contains blood vessels in addition to fatty tissues. Visceral fat, on the other hand, cannot be felt in such a way as it is the extra fat stored around our organs. It is the most dangerous type of fat as it much harder to identify.

No matter what your shape or size, you may be carrying excess visceral fat!

Regardless of shape or size an individual can be carrying excess visceral fat. This means that whether your doctor tells you that you’re underweight, overweight, obese or of a healthy weight, you may be carrying excess visceral fat within your abdominal cavity.

That is why BMI is an inaccurate measurement of health…

Body Mass Index (BMI) is used by many as an indicator of health. It involves comparing your weight in relation to your height to give an indication of your weight status i.e. whether you are categorised as underweight, overweight, healthy or obese. It doesn’t take into account muscle mass, age, sex, ethnicity, general level of fitness or visceral fat. Therefore, even if you have a ‘healthy’ BMI you may still be carrying excessive visceral fat, and could still be at risk of the health complications associated with it.

As a result, relying on BMI could put you at risk of countless diseases…

Visceral fat is often referred to as ‘active fat’ due to the effect it has on our hormones and body functions. It can interrupt normal hormone communications between your vital organs, and can lead to insulin resistance and eventually type 2 diabetes. Additionally, it can affect the functions of your organs and puts you at higher risk of developing heart disease or cancers including breast cancer or colorectal cancer.

So, what can you do to protect yourself?

Factors which contribute to visceral fat levels include stress, diet and exercise habits in addition to age, ethnicity and gender. Living a healthy lifestyle will therefore reduce your chances of visceral fat accumulating in your abdominal cavity.

If you are worried about your visceral fat levels the waist-to-hip ratio (found by dividing waist width by hip width) can give an indication of total fat as well as the level of visceral fat, however the most accurate measurement of visceral fat is to measure adiponectin levels in the blood.

Adiponectin (a blood analyte) is closely linked with visceral fat; low levels of adiponectin indicate high levels of visceral fat. The Adiponectin test enables true measurement of visceral fat levels and allows for more accurate measurement of health than traditional BMI; if you have been diagnosed with unhealthy BMI and believe this to be an inaccurate diagnosis, testing your adiponectin levels can help determine your true measurement of health. Simply ask your doctor for the Adiponectin test!

For health professionals:

The adiponectin test from Randox can accurately assess levels of abdominal visceral fat, independent of age, race or fitness level.  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.  Contact us now for further information.


What is the relationship between kidney function and abdominal fat?

It is widely understood that hypertension and diabetes are two of the most common causes of chronic kidney disease (CKD), a long-term condition where the kidneys do not work effectively. But what about abdominal fat?

Abdominal fat contributes to risk of diabetes and hypertension, and with these being the most common causes of CKD, it’s natural to associate abdominal fat with CKD, isn’t it? A new study has recently been published which examines this.

The study(1) aimed to examine the relationship between kidney function and abdominal fat; the researchers wanted to discover if abdominal obesity is associated with early markers of CKD in a young healthy population, and whether these associations differ by race and/or ethnicity.

As symptoms of CKD are not usually present until the condition reaches an advanced stage, blood and urine tests are relied on to detect the condition at earlier stages, and enable treatment to begin as early as possible. The identification of more indicators to enable this condition to be detected as early as possible is of interest, particularly due to 10% of the world’s population being affected by CKD(2).

The study involved the analysis of data gained from The National Health and Nutrition Examination Survey (NHANES) in the US between 1999 and 2010. This included health, lifestyle and nutritional information from 6918 young adults aged 20-40 years; factors included height, weight, waist circumference, blood pressure and blood/urine samples for analysis of components including albumin, CRP, glucose, insulin, creatinine etc.

The researchers of the study defined abdominal obesity by gender criteria of waist circumference, and markers of CKD included estimated glomerular filtration rate and albuminuria ≥30 mg/g. Risk of CKD was analysed within strata of race and in subgroups of those with normal blood pressures, normal blood sugar levels and normal insulin sensitivity. Awareness of CKD was assessed in participants with albuminuria.

The study concluded that abdominal obesity in young adults, especially in Mexican-Americans, is independently associated with early markers of kidney dysfunction even in those with normal blood pressures, glucose levels and insulin sensitivity.

References:

  1. Sarathy H et al. (2016) Abdominal Obesity, Race and Chronic Kidney Disease in Young Adults: Results from NHANES 1999-2010. PLoS ONE 11(5): e0153588. doi:10.1371/journal.pone.0153588
  2. World Kidney Day (2016) Chronic Kidney Disease. Online at: http://www.worldkidneyday.org/faqs/chronic-kidney-disease/

Please note:

With the prevalence of obesity, greater awareness of CKD is needed to protect the youth from premature kidney dysfunction. Those at high risk of CKD should be screened every year. This includes patients with high blood pressure (hypertension), diabetes, or a family history of CKD. If symptoms are experienced visit your GP – symptoms of advanced CKD include tiredness; swollen ankles, feet or hands (due to water retention); shortness of breath; nausea; and blood in the urine.

For health professionals: The adiponectin test from Randox can accurately assess levels of abdominal visceral fat, independent of age, race or fitness level.  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.  Contact us now for further information.


Innovations in Gestational Diabetes testing

More and more women in the United States are waiting until they’re older to start having children.

The number of births to women aged 45–49 rose 14% in 2013 from 2012, according to the Centers for Disease Control and Prevention’s National Vital Statistics Report.  With this comes the responsibility by clinicians and laboratories to better assess those at risk of gestational diabetes and to aid better control of the condition for those who already have it.  Quick and precise detection of risk of gestational diabetes and associated complications by clinical labs will provide women with the autonomy to take control of their maternal health.

Innovations in maternal health testing have meant that analysis such as adiponectin and enzymatic fructosamine are now available in automated biochemistry formats and with more accurate methodologies; allowing laboratories to assess gestational diabetes risk, and evaluate control of the condition with ease, speed and accuracy.  Testing of such analytes have historically been non-routine and not easily accessible for clinical laboratories, and now with little adjustment within the laboratory, these can be added to the test menu allowing for detailed patient testing profiles.

Current innovations in the area of gestational diabetes testing will ultimately secure the health, both during and post-pregnancy, of mother and baby.

Randox Laboratories are a global manufacturer of automated adiponectin and fructosamine biochemistry assays.  For further information, download our brochure or contact reagents@randox.com


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