Protein hormone level may better predict CAD than standard cholesterol tests

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Researchers have identified a link between adiponectin, a protein hormone that modulates a number of metabolic processes, and heart disease progression, according to a study published in the May issue of Diabetes Care.

The Diabetes Genome Project, a single-center, prospective gene and biomarker banking registry, was designed to collect extensive clinical and anatomic information on patients undergoing coronary angiography. A sub-study included fasting blood samples from 185 patients undergoing coronary angiography and intravascular ultrasound (IVUS). 

The study results showed that low adiponectin levels are associated with small dense LDL cholesterol, increased plaque volume as measured by lipid-rich plaques and a higher prevalence of IVUS-derived thickening of the inner lining of blood vessels in non-diabetic patients.

The association between low adiponectin levels, abnormal lipids, and increased coronary atherosclerosis was confirmed using cholesterol-profiling capabilities of the VAP (Vertical Auto Profile) Test plus an adiponectin assay, according to the Birmingham, Ala.-based AtheroTech, makers of the VAP Test.

"The VAP Test allowed us to define the relationship between adiponectin and circulating lipids,” said Principal Investigator Steve Marso, M.D. “Had we not characterized the LDL subparticles we would not have found the association between adiponectin and small dense LDL, as there was not one between adiponectin and total LDL. This relationship between adiponectin and small dense LDL moieties may prove to be an important link in understanding the risk for patients to develop lipid laden atheroma.”

Cardiologist Michael D. Ozner said he has performed a VAP test for the first time on many patients who have already had heart attacks or strokes, or who have undergone heart procedures such as bypass surgery or placement of a coronary stent.

“The results have often led me to think that if a VAP test had been performed earlier, maybe the heart attack or stroke could have been prevented, or the surgery would not have been necessary,” Ozner wrote in the May 2007 issue of Life Extension magazine.

He also said that conventional cholesterol testing identifies only 40% of those at risk for coronary heart disease.

According to Ozner, the expanded information from the VAP test includes:

  • More accurate, direct measurement of LDL.
  • Measurement of LDL pattern density. This is important because small, dense LDL (“Pattern B”) triples the likelihood of developing coronary plaque and suffering a heart attack.
  • Measurement of lipoprotein subclasses, which include HDL2 and HDL3, intermediate-density lipoprotein (IDL), very-low-density lipoproteins (VLDL1, VLDL2, VLDL3), and lipoprotein(a) [Lp(a)], a particularly dangerous lipoprotein that can lead to heart attacks and strokes.