LabSafe News | Direct Access Lab Testing

The Who, What, Where, When, and Why of STD Testing

2008-05-05T07:52:00.000-07:00

In this day and age, we've all been told that STD testing is important for those who are sexually active, but there is a lot more to know about STD testing than "just do it." Who is a candidate for STD testing? What's involved in the process? When should you be tested for STDs? Why is it so important? Learn what everybody ought to know about STD testing and how getting tested for STDs has never been easier and more convenient.

STD Testing – The Basics

Everyone, sexually active or not, needs to have basic knowledge of STDs and STD testing.

Anyone who is sexually active should receive routine STD testing. This means anyone who participates in sexual activity of any kind, not just vaginal intercourse, is at risk. The risk of contracting a sexually transmitted disease is increased for those who have more than one sexual partner.

STD testing can be performed at your doctor's office or local lab. There are various types of STD tests, and not all doctors test for the same diseases. Some STDs may be tested for using blood tests, urine, or cell samples. You may need to have multiple tests depending on your sexual history and possible symptoms.

When it comes to STD testing, the sooner you have it done, the better. Like most diseases, the earlier it is caught, the easier it will be to treat. If you have symptoms of a sexually transmitted disease, the best thing to do is to have yourself and your partner tested. If you're thinking of becoming sexually involved with a new partner, both you and your partner should be tested first. If you have more than one sexual partner, STD testing is recommended yearly.

The Importance of STD Testing

STD testing is important to protect your health and the health of your partner and future partners. The truth is that most people who transmit STDs don't even know they have one. That knowledge can be obtained in a simple test and can help protect both you and your partner.

The spreading of STDs is preventable. Diseases such as Chlamydia, gonorrhea, and syphilis are easily curable with simple antibiotics. But in order to treat these STDs, you must be aware of them. STD testing is the first step.

You have a responsibility to receive STD testing, not only to protect your partner and to prevent the spreading of STDs, but also to yourself, your body, and your health.

Get a comprehensive STD Panel at LabSafe.com today.

APO-B | Apolipoproteins Blood Test

2008-04-23T09:30:00.000-07:00

Apolipoprotein B (APO B) is the primary apolipoprotein of low density lipoproteins (LDL or "bad cholesterol"), which is responsible for carrying cholesterol to tissues. While it is unclear exactly what functional role APO B plays in LDL, it is the primary apolipoprotein component and is absolutely required for its formation. What is clear is that the APO B on the LDL particle acts as a ligand for LDL receptors in various cells throughout the body (i.e. less formally, APO B "unlocks" the doors to cells and thereby delivers cholesterol to them). Through a mechanism that is not fully understood, high levels of APO B can lead to plaques that cause heart disease (atherosclerosis). There is considerable evidence that levels of APO B are a better indicator of heart disease risk than total cholesterol or LDL. However, primarily for practical reasons, cholesterol, and more specifically, LDL-cholesterol, remains the primary lipid target and risk factor for atherosclerosis. Apo B-100 levels may be ordered to monitor the effectiveness of lipid treatment.

This is a simple blood test. You must first fast 12 hours before going into lab. The American Heart Ass. established that APO B100 levels that are associated with coronary heart disease, are even a better predictor of it than is LDL level. Abnormal should be followed up by your primary MD.

To purchase an Apolipoproteins Blood Test or APO-B Test simply order online at LabSafe.com or call us toll-free at (888) 333-LABS

LabSafe November Newsletter

2007-11-09T11:35:00.000-08:00

Gonorrhea Testing

2007-08-31T09:58:00.000-07:00

Gonorrhea

Neisseria gonorrhea infection is the second most reported STD in the U.S ( Chlamydia is number one). While infection rates had been declining since 1996 a 42% increase was noted in eight western states during 2002-2005 as stated by the Center for Disease Control.

Gonorrhea infection increases the risk for pelvic inflammatory disease, infertility, ectopic pregnancy and the transmission of HIV. A simple urine test (no invasive swab) called NAAT (nucleic acid amplification test) is considered the most sensitive test available today, according to the CDC, more accurate than cultures or other methods. This test will also detect the presence of Chlamydia. Protect yourself and your loved ones and ask for the Chlamydia/Gonorrhea NAAT test today.

To purchase a Gonorrhea test and other STD testing simply order online at LabSafe at http://www.labsafe.com/lab-tests/test/120/ or visit our website at http://www.labsafe.com/

For more information, or to speak with a member of our professional Medical Staff, call LabSafe toll free at 1-888-333-LABS.

LabSafe Featured in DM Review

2007-08-28T14:34:00.000-07:00

LabSafe and SLI Systems Put Critical Medical Information in Customers' Hands More Quickly

Product Review published in DM Review MagazineJuly 2007 Issue

By Product Reviewer

Review of: SLI Learning Search and Site Champion from SLI Systems
REVIEWER: Brian Lunn, CEO of LabSafe.
BACKGROUND: LabSafe is an online laboratory products and services provider with a mission to expand the field of preventative medicine by increasing consumer access to affordable laboratory tests and testing education. LabSafe's previous site search solution didn't match search results to inquiries, which frustrated users who left the site. The company began looking for a search solution that could deliver relevant site search results and manage traffic from natural searches.
PLATFORMS: SLI Systems hosts LabSafe's search solutions via the Internet.
PROBLEM SOLVED: LabSafe turned to SLI Systems' hosted site search and automated search engine optimization solutions, Learning Search and Site Champion. Learning Search allows LabSafe to customize site search functionality so that if users misspell a search term, they'll still receive the correct results. Learning Search also automatically ranks search results by popularity so customers can easily find the right products. LabSafe employed Site Champion to attract more site traffic from natural search engines. Site Champion uses visitors' own site search terms to automatically create related search engine links for each page of the company's site, which are crawled by search-engine spiders. As a side benefit, the more search-bot hits that LabSafe.com receives, the higher LabSafe.com ranks on Google's or Yahoo!'s page rankings.
PRODUCT FUNCTIONALITY: Learning Search automatically learns from user behavior by tracking the search terms people use and the resulting items they click on to deliver search results based on popularity. This tells LabSafe which terms the company should link products to and include in product descriptions to improve search relevance. Site Champion integrates with Learning Search by tracking terms that LabSafe's visitors use during site search and generating keyword links relevant to each page on LabSafe.com. When users click on these related search links, they're presented with search results for that keyword from LabSafe.com. Since deploying Learning Search and Site Champion in September 2006, LabSafe has seen a steady increase in revenues, a 3.5 percent increase in site traffic and an 18 percent increase in online orders. Because SLI hosts the search offerings on their own servers, which has handled sites with more than 20 million-plus searches a day, LabSafe doesn't worry about their own servers becoming overloaded.
STRENGTHS: A strength is Learning Search's ability to track visitors' aggregate search terms and corresponding items clicked on and use that data to deliver more relevant results based on popularity. Site Champion automatically generates related searches from terms that LabSafe's visitors use daily during site searches. Rather than making LabSafe's Web team guess which search keywords to use, Site Champion turns customer search terms into a tool to improve search navigation.
WEAKNESSES: LabSafe.com allows customers to order individual products or bundle them. When the company first implemented Learning Search, some products showed up twice in search results - as individual products and parts of a package. So, SLI configured Learning Search to recognize and return duplicate product search results as only one product.
SELECTION CRITERIA: SLI Systems' products work with Google better than other site search vendors. Google can't endorse any companies, but in our meeting with them they said they couldn't find fault with SLI Systems and confirmed the company does not manipulate their engine to achieve unnatural search results.
DELIVERABLES: Learning Search provides LabSafe with comprehensive weekly reports on all aspects of search activity, including the areas that need attention. Accessible online or via email, the reports include standard information, such as the number of searches performed, and allow the site owner to drill down into an item for more information, including which keyword searches provided poor results, which spelling suggestions or sorting options were used and the most visited pages/products.
VENDOR SUPPORT: Support is excellent. LabSafe gives SLI Systems its highest accolades for customer support, especially for troubleshooting the original search-bot issue.
DOCUMENTATION: Because SLI hosts and manages LabSafe's search services, the company doesn't have to rely on the documentation.

Get a Blood Test or STD Testing done safely, easily and confidentially, without a doctor's visit at LabSafe.com

August Newsletter - Lyme Disease, Homocysteine, and PSA Testing

2007-08-10T11:46:00.000-07:00

What's new from LabSafe?

Ever wonder what those lab tests at your doctor's office are? We here at LabSafe think it's important to understand medical laboratory tests and we encourage everyone to have appropriate screening tests performed. In this newsletter you will find information on a few lab tests, written by our professional medical staff here at LabSafe.
LabSafe is a direct access, direct to consumer lab testing company, staffed by licensed Medical Doctors and Nurses. Direct access laboratory testing is a new concept. LabSafe has nationwide contracts with major CLIA-certified clinical laboratories. All of our laboratories are certified at both the federal and state level, are approved by the FDA, and perform the same standard tests that are offered through a hospital or doctor's office. Unlike "at home" kits, LabSafe's nationwide network of Patient Services Centers are actual laboratories and draw stations, staffed by certified phlebotomists, experts in blood drawing. With more than 7,000 draw stations nationwide, we are confident we can provide you with a convenient location. Call us toll free at 1-888-333-LABS to find the draw station nearest you.
Because we offer the same high quality tests as your doctor's office or hospital with an emphasis on convenience and privacy, you're more likely to schedule regular testing that could help you maintain or improve your health.
With LabSafe, there's no reason to wait for an opening in your doctor's schedule. Draw appointments can be scheduled on the same day of your call and typically take less than 30 minutes of you valuable time.
The next time you need to have a blood test or urine test, call us toll free at 1-888-333-LABS to check our low prices and receive and additional 10% off! You can also visit our website at www.labsafe.com to check prices and learn more about lab testing.
With LabSafe, testing is confidential, convenient, reliable, and affordable. Call us today at 1-888-333-LABS and take advantage of your LabSafe Preferred Membership!

Lyme disease

Lyme disease is an infection caused by a bacterium, Borrelia burgdorferi, which is carried primarily by the deer tick. People bitten by an infected tick develop this inflammatory disease, which first affects the skin and then may spread to the joints, nervous system, and other body systems. A rash may appear within 1-2 weeks. The rash usually is red and may surround the location of the tick bite in what is sometimes referred to as a "bull's eye" pattern. Other symptoms may include arthritis-like joint pain, fever, headache, muscle aches, fatigue, and stiff neck.
There are tests that can diagnose Lyme disease. One measures the levels of antibodies in the body that have developed against the Borrelia burgdorferi spirochete (bacterium). This test may appear negative if it is done in the first few weeks after infection. Therefore, if symptoms persist, the test should be repeated a few weeks later. A Western blot or DNA-based test also may be performed to confirm an initial screening test. The Western blot test is more accurate because it is used to examine the blood for antibodies specific to Borrelia burgdorferi. A DNA-based test based on the polymerase chain reaction (PCR) may also be done and is even more sensitive; it is used to detect the genetic material of the infecting bacteria.
If untreated, Lyme disease can lead to more severe symptoms can, including painful arthritis, joint swelling, heart problems, and central nervous system problems that could lead to mental disorders. Fortunately, with early detection and treatment, Lyme disease can be cured. There are several oral antibiotics available to treat this disease.

The American Lyme Disease Foundation had stated, “The ELISA screens for elevated blood levels of antibodies produced in response to Borrelia burgdorferi, the bacteria that cause Lyme disease. If performed at least 4 weeks after a tick bite, this test will identify virtually all patients with Lyme disease”.
As with all test the results should be reviewed with your Primary physician.

HOMOCYSTEINE

Homocysteine is an amino acid. Homocysteine is increasingly being recognized as an important risk factor for a number of common medical conditions. Elevated levels of homocysteine have been linked to increased risk of Cardiovascular Disease, Alzheimer’s disease, Osteoporosis, and Diabetes. According to WHO (World Health Organization) estimates, each year 16.7 million people die globally from cardiovascular disease. Those with dangerously high homocysteine levels increase their risk of a heart attack by 50%. Early identification of high homocysteine levels is important. A simple homocysteine blood test could save your life.Traditional risk factors for coronary artery disease (CAD) can only explain approximately two thirds of observed clinical events, such as heart attacks and strokes. Homocysteine is not a traditional risk factor but has been strongly implicated in CAD and is thought to play a significant role in the development of CAD. Epidemiological studies over the past 30 years have shown that increased concentrations of homocysteine are associated with vascular disease, including cardiovascular disease and peripheral arteriovascular disease. This link is independent of other risk factors, is consistent across many studies, and is strongly related to the concentration of homocysteine in the blood. That is, the higher the homocysteine level, the greater the risk of CAD. Homocysteine promotes injury to the walls of blood vessels by oxidants, thus contributing to the hardening of arteries and other blood vessels. Studies have shown that blood homocysteine levels can be reduced by dietary supplements of folic acid and B vitamins. Taking antioxidants has shown to be beneficial, and it is theorized that antioxidants may diminish homocysteine induced oxidant damage.

Prostate Specific Antigen (PSA)
PSA is a protein produced primarily by cells in the prostate, a small gland that encircles the urethra in males and produces a fluid that makes up part of semen. Most of the PSA that the prostate produces is released into this fluid, but small amounts of it are also released into the bloodstream. PSA exists in two forms in the blood: free (not bound) and complexed (bound to a protein). The most frequently measured PSA test is the total PSA, which measures the sum of the free PSA and the cPSA (PSA complexed with other plasma proteins). When a doctor orders a “PSA test,” he is referring to a total PSA. Free PSA and cPSA tests can also be ordered individually. The tests that measure them were developed to better differentiate between cancer-related and non-cancer-related PSA increases. Both of the tests operate on the principle that patients with prostate cancer frequently have altered ratios of the two forms of PSA - decreased amounts of free PSA and increased amounts of cPSA. A free PSA is primarily ordered when a patient has a moderately elevated total PSA that does not appear to be caused by a non-cancer-related condition. The results give the doctor additional information about whether a patient is at an increased risk of having prostate cancer and help with the decision of whether to biopsy the prostate. In some men, PSA may rise temporarily due to other prostate conditions, especially infection. A recent study found that in about half of men with a high PSA, values later return to normal. Some authorities recommend that a high PSA should be repeated (between 6 weeks and 3 months after the high PSA) before taking any further action. Some physicians will prescribe a course of antibiotics if there is evidence that there is infection of the prostate.May 1, 2001 -- Recently revised guidelines from the American Cancer Society identify Prostate Specific Antigen (PSA) as the most accurate method for early detection of prostate cancer-superior, even, to Digital Rectal Exam (DRE).

To purchase Lyme Disease testing, a Homocysteine blood test, or PSA test simply order online at LabSafe or visit our website at http://www.labsafe.com/

For more information, or to speak with a member of our professional Medical Staff, call LabSafe toll free at 1-888-333-LABS.

Testing For Lactose Intolerance

2007-05-23T10:31:00.000-07:00

Lactose Tolerance Test

A Lactose Tolerance Test is a test that measures the ability of your intestines to digest lactose. A naturally occurring enzyme called Lactase is needed for proper metabolism of Lactose (the sugar in milk and dairy products). An intolerance of lactose may cause excess gas, diarrhea, bloating and stomach aches. These symptoms, in turn, can lead to a poor diet and undernourishment. Furthermore, even with a great diet, diarrhea can prevent the body from having a chance to absorb needed nutrients, leading to undernutrition, malnutrition, fatigue and/or general malaise.

According to the University of Maryland many types of birth controll pills and non-dairy coffee creamers also contain lactose. Lactose intolerance can be very uncomfortable but yet is very easily treated. Awareness is the first step. Working with your physician through trail and error, you can determine what amount and type of lactose-containing products you can tolerate.

To purchase a Lactose Tolerance test simply order online at LabSafe at http://www.labsafe.com/lab-tests/test/464/ or visit our website at http://www.labsafe.com/

For more information, or to speak with a member of our professional Medical Staff, call LabSafe toll free at 1-888-333-LABS.

Homocysteine Blood Testing

2007-05-14T15:21:00.000-07:00

HOMOCYSTEINE TESTING

Homocysteine is an amino acid. Homocysteine is increasingly being recognized as an important risk factor for a number of common medical conditions. Elevated levels of homocysteine have been linked to increased risk of Cardiovascular Disease, Alzheimer’s Disease, Osteoporosis, and Diabetes. According to WHO (World Health Organization) estimates, each year 16.7 million people die globally from cardiovascular disease. Those with dangerously high homocysteine levels increase their risk of a heart attack by 50%. Early identification of high homocysteine levels is important. A simple homocysteine blood test could save your life.

Traditional risk factors for coronary artery disease (CAD) can only explain approximately two thirds of observed clinical events, such as heart attacks and strokes. Homocysteine is not a traditional risk factor but has been strongly implicated in CAD and is thought to play a significant role in the development of CAD. Epidemiological studies over the past 30 years have shown that increased concentrations of homocysteine are associated with vascular disease, including cardiovascular disease and peripheral arteriovascular disease. This link is independent of other risk factors, is consistent across many studies, and is strongly related to the concentration of homocysteine in the blood. That is, the higher the homocysteine level, the greater the risk of CAD.

Homocysteine promotes injury to the walls of blood vessels by oxidants, thus contributing to the hardening of arteries and other blood vessels. Studies have shown that blood homocysteine levels can be reduced by dietary supplements of folic acid and B vitamins. Taking antioxidants has shown to be beneficial, and it is theorized that antioxidants may diminish homocysteine induced oxidant damage.

To purchase a Homocysteine test simply order online at LabSafe at http://www.labsafe.com/lab-tests/test/438/ or visit our website at www.labsafe.com

For more information, or to speak with a member of our professional Medical Staff, call LabSafe toll free at 1-888-333-LABS.

Testing For Lead Exposure

2007-02-16T11:40:00.000-08:00

Lead

This test measures the current lead level in your blood. Lead is a soft metal present in the environment. When it is inhaled or ingested, lead can cause damage to the brain, organs, and nervous system. Even at low levels, it can cause irreversible damage without causing symptoms. In an infant, lead can cause permanent cognitive impairment, behavioral disorders, and developmental delays. Lead exposure can cause weakness, anemia, nausea, weight loss, fatigue, headaches, stomach pain, and kidney, nervous system, and reproductive dysfunction. Lead can be passed from mothers to their unborn children and can cause miscarriages and premature births.

In the past, lead was used in paints, gasoline, water pipes, and other household products such as the solder used in canned food. Although these uses have been limited in the U.S., lead is still used in many products and industrial processes both in the U.S. and around the world. The EPA (Environmental Protection Agency) has stated Homes built prior to 1978 is likely to contain lead-based paint and lead-contaminated household dust, especially if the house was built prior to 1950. Soil surrounding these houses may also be contaminated with lead. Lead-based pigments are available in the U.S. in the form of artistic paints and glazes.

There is not yet a national guideline for blood lead screening in adults as there is for children. The clinical cut-off values for elevated blood lead currently vary from state to state. According to the CDC’s Adult Blood Lead Surveillance program (ABLES), a national health objective is to reduce all blood levels in adults to less than or equal to 25 micrograms per deciliter.

Lead testing may be done when symptoms suggest potential lead poisoning. These symptoms are non-specific and may include fatigue, changes in mood, nausea, prolonged stomach distress, headache, tremors, weight loss, peripheral neuropathy, anemia, reproductive failure, encephalopathy, memory loss, seizures, and coma. Many children have no symptoms at the time of the exposure, but potentially permanent damage can still be occurring. Testing for lead exposure should be considered in children presenting with growth failure, anemia, sleep problems, hearing loss, or speech, language or attention deficits.

The higher the test result, the more lead is in your blood. However, the amount of lead in the blood does not necessarily reflect the total amount of lead in your body. This is because lead travels from the lungs and intestinal tract to the blood and organs, and then is gradually removed from the blood and organs and stored in tissues such as bones and teeth. Blood lead concentrations represent recent exposure or chronic exposure. The danger that a particular lead level represents depends on the age and health of the person, the amount of lead they are exposed to, and the amount of time that they are exposed to elevated lead.

As with any test, abnormal results must be followed up with a Physician.

To purchase a lead test simply order online at LabSafe at http://www.labsafe.com/lab-tests/test/468/ or visit our website at www.labsafe.com

For more information, or to speak with a member of our professional Medical Staff, call LabSafe toll free at 1-888-333-LABS.

Testing for Inflammatory Bowel Disease (IBD)

2007-01-05T09:35:00.000-08:00

Inflammatory Bowel Diseases

Inflammatory bowel diseases (IBD) are chronic disorders that affect about a million people in the United States. Characterized by swollen and damaged tissues in the lining of the intestinal tract, these conditions vary in severity from patient to patient and change over time. Periods of active disease may alternate with periods of remission. During a flare-up, a patient may experience frequent bouts of watery and/or bloody diarrhea, abdominal pain, weight loss, and fever. Between these flare-ups, symptoms frequently diminish. Many patients may go through extended periods of remission before another flare-up occurs.

The cause of IBD is not known, but these diseases are thought to be due to an autoimmune process that has been triggered by a genetic predisposition, a viral illness, and/or an environmental factor. IBD affects both sexes equally and is seen most frequently in Caucasians who live in industrialized countries. The most common inflammatory bowel diseases are Crohn disease (CD) and ulcerative colitis (UC). Both may affect anyone at any age.

Laboratory Tests that may be ordered to rule out other causes of diarrhea and inflammation include:

1. Stool culture to look for bacterial infection
2. O&P (Ova and parasite) to detect parasites
3. Clostridium difficile to detect toxin created by bacterial infection; may be seen following antibiotic therapy
4. Fecal occult blood to look for blood in the stool
5. Stool WBC to detect white blood cells in the stool
6. IBD test ASCA (Saccharomyces cerevisiae antibodies), IgG and IgA. ASCA IgG is found in 80% of CD patients and in about 20% of those with UC. ASCA IgA is found in 35% of CD patients but in less than 1% of those with UC.
7. Celiac Disease tests

The Crohn’s & Colitis Foundation stated “the more informed you are about IBD, the more equipped you'll be to participate as an active member of your treatment.”

To purchase an Inflammatory Bowel Disease Profile test simply order online at LabSafe at http://www.labsafe.com/lab-tests/test/450/ or visit our website at www.labsafe.com

For more information, or to speak with a member of our professional Medical Staff, call LabSafe toll free at 1-888-333-LABS.

Hormone Testing

2006-12-27T12:50:00.000-08:00

Pituitary disorders are characterized by an excess or deficiency in one or more of the hormones produced by the pituitary gland and/or by the symptoms caused by the compression of surrounding tissues when a pituitary tumor is present. The pituitary is a pea-sized gland located in the center of the head behind the sinus cavity. It is found at the bottom of the brain, below the hypothalamus. The hypothalamus and pituitary gland are part of the endocrine system, a group of glands that work together to produce and regulate hormones that affect tissues throughout the body. The hypothalamus communicates with the brain and nervous system. It senses the body’s need for a specific hormone and tells the pituitary when to initiate or increase production of that hormone.

The most common problem with the pituitary is the development of a tumor. While most are benign, they can produce excessive amounts of a specific pituitary hormone, crowd out the production of other hormones, and compress surrounding tissues. The pressure can cause headaches and visual disturbances. Other pituitary disorders can arise from inherited genetic mutations, be congenital, be due to trauma or an impaired blood supply, due to surgical or radiation treatment of a previous pituitary disorder, due to a malignant tumor (rare), or be due to causes that are not yet well understood. The hormone deficiencies and excesses from these disorders can produce a variety of symptoms depending on which hormones and target tissues are affected.

When the hypothalamus is dysfunctional, pituitary hormone production is often affected. Excess or deficient hormone production by the pituitary may also occur if the glands “downstream” from it are dysfunctional. For example, normally the hypothalamus detects thyroid hormone deficiency in the blood and stimulates the pituitary to produce TSH. TSH in turn stimulates thyroid hormone production by the thyroid gland. If the thyroid gland is dysfunctional and cannot produce adequate amounts, then blood thyroid hormone levels will remain below normal even though the hypothalamus and pituitary are promoting production. The result is excessive amounts of TSH and deficient thyroid hormone.

A list of both common and rare Pituitary Disorders as stated by The Pituitary Foundation:

1) Common Pituitary Disorders

Pituitary Tumors, Growth Hormone Deficiency, Hypopituitarism, Hyperprolactinemia,
Empty Sella Syndrome, and Diabetes.

2) Rare Pituitary Disorders

Acromegaly and Gigantism, Cushing’s Disease, Nelson’s Syndrome, Kallman’s Syndrome, Pituitary Infarction, and Sheehan’s Syndrome.

The goal with testing for pituitary disorders is to detect excess or deficient hormone production,
determine the cause, and evaluate the severity of the condition. Testing frequently includes both the hormones that the pituitary produces (such as TSH) and the hormones of other endocrine glands that the pituitary is responsible for stimulating (such as the thyroid gland hormone thyroxine). Since pituitary hormones are released as needed, concentrations may be relatively constant in the blood (such as TSH), may vary over the course of a day (such as GH), over a cycle (such as FSH and LH during the menstrual cycle), or be present in specific situations (such as prolactin in a lactating woman or ACTH as a response to a physical or emotional stress). This may lead to the need for suppression or stimulation challenge tests. Medications are given to stimulate or suppress hormone production so that the change can be measured. It may also lead to the measurement of a related test such as the measurement of IGF-1 (insulin-like growth factor-1), which reflects total GH production, along with the measurement of the hormone (GH).

Relevant Laboratory Tests:

Prolactin
LH (Luteinizing Hormone) and FSH (Follicle Stimulating Hormone)
TSH (Thyroid Stimulating Hormone) and Thyroxine
hCG (human chorionic gonadotropin) – to detect pregnancy
ACTH, Cortisol, and Glucose
GH and IGF-1

To purchase any of the above tests simply click on the link above and order online at LabSafe, or visit our website at www.labsafe.com

For more information, or to speak with a member of our professional Medical Staff, call LabSafe toll free at 1-888-333-LABS.

All abnormal labs should be evaluated by a Physican for treatment.

Syphilis - The Unexpectedly Emerging STD

2006-12-21T14:20:00.000-08:00

SYPHILIS

Syphilis is a bacterial infection that can be easily missed. The first symptom is a painless blister or sore that will disappear on its own. Syphilis can be treated with antibiotics. However, if left untreated, the disease can spread throughout your body over the course of many years and cause considerable organ damage.

The latent (hidden) stage of syphilis begins when secondary symptoms disappear. Without treatment, the infected person will continue to have syphilis even though there are no signs or symptoms; infection remains in the body. In the late stages of syphilis, it may subsequently damage the internal organs, including the brain, nerves, eyes, heart, blood vessels, liver, bones, and joints. This internal damage may show up many years later. Signs and symptoms of the late stage of syphilis include difficulty coordinating muscle movements, paralysis, numbness, gradual blindness, and dementia. This damage may be serious enough to cause death.

You should check for Syphilis if you have symptoms of a syphilis infection, if you have another STD, or are pregnant.

Syphilis is passed from person to person through direct contact with syphilis sore. Sores occur mainly on the external genitals, vagina, anus, or in the rectum. Sores also can occur on the lips and in the mouth.

Transmission of the organism occurs during vaginal, anal, or oral sex.

In the United States, The Center for Disease Control reported that over the past several years, increases in syphilis has been reported in various cities and areas, including Chicago, Seattle, San Francisco, Southern California, Miami, and New York City. In the recent outbreaks, high rates of HIV co-infection were documented, ranging from 20 percent to 70 percent. While the health problems caused by syphilis in adults are serious in their own right, it is now known that the genital sores caused by syphilis in adults also make it easier to transmit and acquire HIV infection sexually.

To purchase a Syphilis test simply order online at LabSafe at http://www.labsafe.com/lab-tests/test/246/ or visit our website at http://www.labsafe.com/

For more information, or to speak with a member of our professional Medical Staff, call LabSafe toll free at 1-888-333-LABS.

How Follicle Stimulating Hormone (FSH) Works in Women And Men

2006-12-15T11:06:00.000-08:00

Follicle-stimulating hormone

Follicle-stimulating hormone (FSH) is made by the pituitary gland in the brain. Control of FSH production is a complex system involving hormones produced by the gonads (ovaries or testes), the pituitary, and the hypothalamus. In women, FSH stimulates the growth and maturation of ovarian follicles (eggs) during the follicular phase of the menstrual cycle. This cycle is divided into two phases, the follicular and the luteal, by a mid-cycle surge of FSH and luteinizing hormone (LH). Ovulation occurs shortly after this mid-cycle surge of hormones. During the follicular phase, FSH initiates the production of estradiol by the follicle, and the two hormones work together in the further development of the egg follicle. During the luteal phase, FSH stimulates the production of progesterone. Both estradiol and progesterone help the pituitary control the amount of FSH produced. FSH also facilitates the ability of the ovary to respond to LH. At the time of menopause, the ovaries stop functioning and FSH levels rise. In men, FSH stimulates the testes to produce mature sperm and also promotes the production of androgen binding proteins. FSH levels are relatively constant in males after puberty.

For the medical lab test, a blood sample is drawn by needle from a vein in the arm. Sometimes, a random urine sample may be collected. A 24-hour collection of urine may be requested if your doctor wants to measure FSH levels produced over a 24-hour period. FSH is released intermittently throughout the day and a 24-hour urine collection eliminates problems due to that variation; a random sample might not show the actual activity of the hormone.

The Hormone Foundation stated, “Follicle-stimulating hormone should be evaluated especially in terms of fertility issues”.

To purchase a Follicle Stimulating Hormone (FSH) test simply order online at LabSafe at http://www.labsafe.com/lab-tests/test/359/ or visit our website at www.labsafe.com

For more information, or to speak with a member of our professional Medical Staff, call LabSafe toll free at 1-888-333-LABS.

Factors in Infertility

2006-12-01T15:04:00.000-08:00

Infertility

A woman’s fertility declines substantially by age 35 and even more so after age 40. Common factors in female infertility include blocked fallopian tubes, polycystic ovary syndrome (PCOS interferes with egg release), fibroids, endometriosis, autoimmune disorder (producing antibodies against fetal tissue), diabetes, hypothyroidism, eating disorders, excessive smoking and alcohol use, and gluten intolerance (celiac disease).

The woman’s fertility may also be affected by factors such as fluctuating or diminished hormone levels; inconsistent ovulation; or a poor reproductive environment that does not support proper fertilization of the egg, interferes with the sperm’s transport, or impairs retention of a fertilized egg.

The initial evaluation of a woman’s fertility includes a personal and family history with a thorough physical examination. A number of tests can be used to help diagnose the problem and aid in treatment.

Blood tests: Blood tests that measure the levels of various hormones, such as Luteinizing hormone (LH), follicle-stimulating hormone (FSH), prolactin (PRL), estradiol, and progesterone, aid greatly in determining the cause of infertility.

Because changes in pituitary or thyroid function can also affect the menstrual cycle and ovulation, blood tests that measure thyroid function (TSH and/or T4) and steroids, such as testosterone and DHEA-S (Dehydroepiandrosterone Sulfate is used in creating androgens and estrogens), are also informative.

To purchase a test simply order online at LabSafe by visiting our website at http://www.labsafe.com/

For more information, or to speak with a member of our professional Medical Staff, call LabSafe toll free at 1-888-333-LABS.

Prenatal Blood Testing - Which Tests Are Performed

2006-11-17T10:38:00.000-08:00

Prenatal Testing

The purpose of these tests is to diagnose existing problems that may affect the mother’s or baby’s health, identify and address problems as they arise, and to assess the risk of a baby having a chromosomal or genetic abnormality.

Most of the routine tests are associated with infections or conditions that should be resolved prior to a woman getting pregnant or, if she is already pregnant, should be resolved and/or monitored during her pregnancy.

The following pages contain information on many of these routine and some of the less routine tests. There may be, however, other tests that your doctor will recommend based on your personal medical history.

Pre-Conception (Pre-Pregnancy)
When a couple is considering having a child, they should consult with their doctor(s). Based on their family and medical histories, the health care professional(s) may recommend some or all of the following key routine laboratory tests:
Immunity to Rubella (German Measles)
HIV
Gonorrhea, chlamydia, and syphilis
Blood Type and Antibody screen
Hepatitis B screening
Hemoglobin
CBC (complete Blood count)

Rubella is caused by a virus that is passed from person-to-person by coughs or sneezes. Any contact with the nasal or throat secretions of an infected person can spread the virus. Women who have either had a Rubella infection or have received the vaccination will have an antibody in their blood that will usually prevent them from getting the infection a second time. This antibody also protects the unborn baby against the virus; this protection is called immunity.

HIV is the virus that causes AIDS (Acquired Immunodeficiency Syndrome). At least 90-95% of individuals who are infected with the HIV virus will, within three months of exposure, develop enough antibodies to have a positive HIV test; over 99% of HIV infected individuals will have a positive test within six months. A new HIV test, called the HIV Proviral DNA test, has been shown to be 99% accurate at detecting HIV at 28 days after infection. If a pregnant woman is infected with the HIV virus, it can be passed to and infect her baby.

Gonorrhea, Chlamydia, and Syphilis are three common sexually transmitted diseases (STDs). These diseases are caused by bacterial infections and can lead to a miscarriage or can infect the baby prior to or during delivery.

Blood types are either A, B, AB, or O, and Rh positive or negative. Both the mother and baby may experience problems if their blood types are different, or if the mother has antibodies (antiglobulins) that will react with antigens (proteins or factors) on the baby’s red blood cells.

The Hepatitis B screening test is called a Hepatitis B Surface Antigen. It detects a protein produced by the virus and can detect a Hepatitis B infection even before it is causing symptoms. If a woman who is considering getting pregnant tests positive for Hepatitis B, she should talk to her doctor about how long she should wait for the infection to resolve before becoming pregnant.

Hemoglobin is the protein in red blood cells (RBCs) that gives blood its red color. It binds to oxygen in your lungs, transports it throughout the body, and releases it to the cells and tissues. During pregnancy, a woman’s hemoglobin must transport enough oxygen to meet both her and her baby’s needs. If a woman has insufficient hemoglobin, she is said to be anemic. Many pregnant women will experience some degree of anemia. Anemia can be caused by decreased RBC production, increased RBC destruction, or by increased RBC (blood) loss.

Other less routine testing:
Varicella zoster viral testing for immunity to chicken pox
TORCH panel if herpes, CMV, or toxoplasmosis is suspected
Bacterial vaginosis

Testing that may be offered to both the woman and her partner to evaluate the risk of inherited diseases:
Genetic testing for inherited diseases
Genetic hemoglobin disorders

The American College of Obstetricians and Gynecologists has stated, “All pregnant women should do prenatal screening”.

For more information on these tests, visit www.LabSafe.com

Iron Overload - Facts On Hemochromatosis

2006-11-10T11:43:00.000-08:00

Hemochromatosis

Hemochromatosis (also known as hereditary hemochromatosis) is an inherited disorder of iron metabolism that occurs primarily in Caucasians. People with hemochromatosis absorb more iron than their body needs. As the body does not have a way to excrete excess iron, there is a progressive buildup of iron in tissues and organs. Eventually, the iron overload can lead to dysfunction and failure of several organs, notably the heart, liver, and endocrine portion of the pancreas. Complications include arthritis, diabetes, liver cirrhosis, heart arrhythmias and failure, and an increase in skin pigmentation termed "bronzing."

Risk factors
Having two copies of a mutated HFE gene is the greatest risk factor for hemochromatosis. Other risk factors include:

Family history. If you have a close relative, such as a parent or sibling, with hemochromatosis, you're more likely to develop the disease.

Ethnicity. People of Northern European descent — British, Dutch, German, Irish and French — are more prone to hemochromatosis than are people of other ethnic backgrounds. Hemochromatosis is less common in blacks, Hispanics and Asian-Americans.

Sex. Men are five times as likely as women are to develop iron overload, and they usually experience symptoms at an earlier age. Because women lose iron with menstruation and pregnancy, they tend to store less of the mineral than men do. After menopause or a hysterectomy, the risk for women increases.

Approximately 1 in 10 Caucasians have one abnormal (or mutated) copy of the gene associated with hereditary hemochromatosis and are called carriers. Carriers are not at risk for developing iron overload. About 1 in every 300 Caucasians has two mutated copies of the gene associated with HH and is at risk for developing iron overload and clinical symptoms. However, most people who carry two mutated genes never develop signs and symptoms of the disease. The reason for this is unknown, and research is ongoing to determine the percentage of individuals who eventually become sick with the disease.

The American Hemochromatosis Society has stated laboratory testing for hemochromatosis begins with two blood tests, iron and TIBC, from which the transferrin saturation is calculated. Serum ferritin is frequently measured as well to evaluate the body's iron stores and estimate the degree of iron overload. The values for both tests are elevated in patients with hemochromatosis. Follow-up evaluation in individuals with elevated saturated transferrin; detection of affected individuals and carriers of hereditary hemochromatosis is a
Hereditary Hemochromatosis, DNA Analysis test.

As with all test the results should be reviewed with your Physician.

To purchase an Iron with TIBC test simply order online at LabSafe at http://www.labsafe.com/lab-tests/test/512/ or visit our website at www.labsafe.com

For more information, or to speak with a member of our professional Medical Staff, call LabSafe toll free at 1-888-333-LABS

Research Studies That Have Used The NMR LipoProfile Test Method

2006-11-03T13:12:00.000-08:00

Literature References to Studies Using NMR Lipoprotein Subclass Profiles

1. Otvos JD, Jeyarajah EJ, Bennett DW. Quantification of plasma lipoproteins by proton nuclear magnetic resonance spectroscopy. Clin Chem 1991;37:377‑86.

2. Otvos JD, Jeyarajah EJ, Bennett DW, Krauss RM. Development of a proton NMR spectroscopic method for determining plasma lipoprotein concentrations and subspecies distribution from a single, rapid measurement. Clin Chem 1992;38:1632‑1638.

3. Otvos JD. Determination of lipoproteins and their subfractions by nuclear magnetic resonance. IN: Laboratory Measurement of Lipids, Lipoproteins, and Apolipoproteins (Rifai N, Warnick R, eds), AACC Press, Washington DC, 1994, pp 329-333.

4. Otvos J, Jeyarajah E, Bennett D. A spectroscopic approach to lipoprotein subclass analysis. J Clin Ligand Assay 1996;19:184-189.

5. Parsons SK, Skapek SX, Neufeld EJ, Kuhlman C, Young ML, Donnely M, Brunzell JD, Otvos JD, Sallan SE, Rifai N. Asparaginase-associated lipid abnormalities in children with acute lymphoblastic leukemia. Blood 1997;89:1886-95.

6. Otvos JD. Measurement of lipoprotein subclass profiles by NMR spectroscopy. IN: Handbook of Lipoprotein Testing (Rifai N, Warnick R, Dominiczak MH, eds), AACC Press, Washington DC, 1997, pp 497‑508.

7. Freedman DS, Otvos JD, Jeyarajah EJ, Barboriak JJ, Anderson AJ, Walker J. Relation of lipoprotein subclasses as measured by proton nuclear magnetic resonance spectroscopy to coronary artery disease. Arterioscler Thromb Vasc Biol 1998;18:1046‑53.

8. Giri S, Thompson PD, Taxel P, Contois JH, Otvos JD, Allen R, Ens G, Wu AHB, Waters DD. Low‑dose estrogen improves serum lipids, homocysteine concentrations, and markers of fibrinolysis in elderly men. Atherosclerosis 1998;137:359‑366.

9. Vadlamudi S, MacLean P, Israel RG, Marks RH, Hickey M, Otvos JD, Barakat H. Effects of oral combined hormone replacement therapy on plasma lipids and lipoproteins. Metabolism 1998;47:1222‑1226.

10. Lilley SH, Spivey JM, Vadlamudi S, Otvos J, Cummings DM, Barakat H. Lipid and lipoprotein responses to oral combined hormone replacement therapy in normolipemic obese women with controlled Type 2 diabetes mellitus. J Clin Pharmacol 1998;38:1107‑1115.

11. Otvos J. Measurement of triglyceride‑rich lipoproteins by nuclear magnetic resonance spectroscopy. Clin Cardiol 1999;22(6 Suppl):II21‑7

12. Grundy SM, Vega LG, Otvos JD, Rainwater DL, Cohen JC. Hepatic lipase activity influences high density lipoprotein subclass distribution in normotriglyceridemic men: genetic and pharmacological evidence. J Lipid Res 1999;40:229‑34.

13. Yu HH, Ginsburg GS, O'Toole ML, Otvos JD, Douglas PS, Rifai N. Acute changes in serum lipids and lipoprotein subclasses in triathletes as assessed by proton nuclear magnetic resonance spectroscopy. Arterioscler Thromb Vasc Biol 1999;19:1945‑9.

14. Nicklas BJ, Ryan AS, Katzel LI. Lipoprotein subfractions in women athletes: effects of age, visceral obesity and aerobic fitness. Int J Obes Relat Metab Disord 1999;23:41‑7.

15. Couture P, Otvos JD, Cupples LA, Wilson PWF, Schaefer EJ, Ordovas JM Association of the A-204C polymorphism in the cholesterol 7a-hydroxylase gene with variations in plasma low density lipoprotein cholesterol levels in the Framingham Offspring Study. J Lipid Res 1999;40:1883-1889.

16. Couture P, Otvos JD, Cupples LA, Lahoz C, Wilson PWF, Schaefer EJ, OrdovasJM. Association of the C-514T polymorphism in the hepatic lipase gene with variations in lipoprotein subclass profiles – The Framingham Offspring Study. Arterioscler Thromb Vasc Biol 2000;20:815-822.

17. Couture P, Otvos JD, Cupples LA, Wilson PWF, Schaefer EJ, Ordovas JM. Absence of association between genetic variation in the promoter of the microsomal triglyceride transfer protein gene and plasma lipoproteins in the Framingham Offspring Study. Atherosclerosis 2000;148:337-343.

18. Otvos JD. Measurement of lipoprotein subclass profiles by nuclear magnetic resonance spectroscopy. IN: Handbook of Lipoprotein Testing (Rifai N, Warnick GR, Dominiczak MH, eds), AACC Press, Washington DC, 2000, pp 609-623.

19. Ordovas JM, Cupples LA, Corella D, Otvos JD, Osgood D, Martinez A, Lahoz C, Coltell O, Wilson PWF, Schaefer EJ. Association of cholesterol ester transfer protein-TaqIB polymorphism with variations in lipoprotein subclasses and coronary heart disease risk: The Framingham Study. Arterioscler Thromb Vasc Biol 2000; 20:1323-1329.

20. MacLean PS, Vadlamudi S, MacDonald, Pories WJ, Houmard JA, Barakat HA. Impact of insulin resistance on lipoprotein subpopulation distribution in lean and morbidly obese nondiabetic women. Metabolism 2000;49:285-292.

21. Sartipy P, Camejo G, Svensson L, Hurt-Camejo E. Phospholipase A2 modification of low density lipoproteins forms small high density particles with increased affinity for proteoglycans and glcoaminoglycans. J Biol Chem 2000;274:25913-25920.

22. Isasi CR, Shea S, Deckelbaum RJ, Couch SC, Starc TJ, Otvos JD, Berglund L. Apolipoprotein epsilon2 allele is associated with an anti-atherogenic lipoprotein profile in children: the Columbia University BioMarkers Study. Pediatrics 2000;106:568-75.

23. Freedman DS, Bowman BA, Otvos JD, Srinivasan SR, Berenson GS. Levels and correlates of LDL and VLDL particles sizes among children: the Bogalusa Heart Study. Atherosclerosis 2000;152:441-449.

24. MacLean PS, Bower JF, Vadlamudi S, Green T, Barakat HA. Lipoprotein subpopulation distributions in lean, obese, and type 2 diabetic women: a comparison of African and white Americans. Obes Res 2000;8: 62-70.

25. Miller M, Dolinar C, Cromwell W, Otvos JD. Effectiveness of high doses of simvastatin as monotherapy in mixed hyperlipidemia. Amer J Cardiol 2001;87:232-234.

26. Tangney CC, Mosca LJ, Otvos JD, Rosenson RR. Oral 17-b-estradiol and medroxyprogesterone acetate therapy in postmenopausal women increases HDL particle size. Atherosclerosis 2001;155:251-260.

27. Freedman DS, Bowman BA, Srinivasan SR, Berenson GS, Otvos JD. Distribution and correlates of high‑density lipoprotein subclasses among children and adolescents. Metabolism 2001;50:370-376.

28. Kral BG, Becker LC, Yook RM, Blumenthal RS, Kwitterovich PO, Otvos JD, Becker DM. Racial differences in low density lipoprotein particle size in families at high risk for premature coronary heart disease. Ethn Dis 2001; 11:325-37.

29. Stein JH, Klein MA, Bellehumeur JL, McBride PE, Wiebe DA, Otvos JD, Sosman JM. Use of human immunodeficiency virus-1 protease inhibitors is associated with atherogenic lipoprotein changes and endothelial dysfunction. Circulation 2001;104:257-62.

30. McKenney JM, McCormick LS, Schaefer EJ, Black DM, Watkins ML. The effect of niacin and atorvastatin on lipoprotein subclasses in patients with atherogenic dyslipidemia. Am J Cardiol. 2001;88:270-4.

31. Russo GT, Meigs JB, Cupples LA, Demissie S, Otvos JD, Wilson PWF, Lahoz C, Cucinotta D, Couture P, Mallory T, Schaefer EJ, Ordovas JM. Association of the Sst-I polymorphism at the APOC3 gene locus with variations in lipid levels, lipoprotein subclass profiles and coronary heart disease risk: the Framingham offspring study. Atherosclerosis 2001;158:173-181.

32. Fusegawa Y, Kelley KL, Sawyer JK, Shah RN, Rudel LL. Influence of dietary fatty acid composition on the relationship between CETP activity and plasma lipoproteins in monkeys. J Lipid Res 2001;42:1849-57.

33. Vieira J, Gomes M, de Almeida A, Moriguchi EH. Changes in the profile of lipoprotein subfractions associated with hormone replacement therapy. Arq Bras Cardiol 2001;76:183-88.

34. Chan NN, Colhoun HM, Vallance P. Cardiovascular risk factors as determinants of endothelium-dependent and endothelium-independent vascular reactivity in the general population. J Am Coll Cardiol 2001;38:1814-20.

35. Schaefer EJ, Brousseau ME, Diffenderfer MR, Cohn JS, Welty FK, O'Connor J, Dolnikowski G, Wang J, Hegele RA, Jones PJ. Cholesterol and apolipoprotein B metabolism in Tangier disease.. Atherosclerosis 2001;159:231-36.

36. Oliver WR, Shenk JL, Snaith MR, Russell CS, Plunket KD, Bodkin NL, Lewis MC, Winegar DA, Sznaidman ML, Lambert MH, Xu HE, Sternbach DD, Kliewer SA, Hansen BC, Willson TM. A selective peroxisome proliferator-activated receptor delta agonist promotes reverse cholesterol transport. PNAS 2001;98:5306-5311.

37. Galluzzi JR, Cupples LA, Otvos JD, Wilson PW, Schaefer EJ, Ordovas JM. Association of the A/T54 polymorphism in the intestinal fatty acid binding protein with variations in plasma lipids in the Framingham Offspring Study. Atherosclerosis 2001;159:417-24.

38. van der Valk M, Kastelein JJP, Murphy RL, van Leth F, Katlama C, Horban A, Glesby M, Behrens G, Clotet B, Stellato RK, Molhuizen HOF, Reiss P. Nevirapine-containing antiretroviral therapy in HIV-1 infected patients results in an anti-atherogenic lipid profile. AIDS 2001;15:2407-2714.

38a Hurt-Camejo E, Paredes S, Masana L, Camejo G, Sartipy P, Rosengren B, Pedreno J, Vallve JC, Benito P, Wiklund O. Elevated levels of small, low-density lipoprotein with high affinity for arterial matrix components in patients with Rheumatoid Arthritis. Arthritis & Rheumatism. 2001;44:2761-67.

39. Rosenson RS, Shalaurova I, Freedman DS, Otvos JD. Effects of pravastatin treatment on lipoprotein subclass profiles and particle size in the PLAC‑I Trial. Atherosclerosis 2002;160:41-8.

40. Otvos JD. Measurement of lipoprotein subclass profiles by nuclear magnetic resonance spectroscopy. Clin Lab 2002;48:171-80.

41. Freedman DS, Bowman BA, Otvos JD, Srinivasan SR, Berenson GS. Black/white differences in the relation of obesity to serum triglycerides and VLDL subclass concentrations among children: the Bogalusa Heart Study. Am J Clin Nutrition 2002;75:827-33.

42. Colhoun HM, Otvos JD, Rubens MB, Taskinen MR, Underwood SR, Fuller JH. Lipoprotein subclasses and particle sizes and their relationship with coronary artery calcification in men and women with and without Type 1 diabetes. Diabetes 2002;51:1949-56.

43. Wilund KR, Ferrell RE, Phares DA, Goldberg AP, Hagberg JM. Changes in high density lipoprotein cholesterol subfractions with exercise training may be dependant on cholesterol ester transfer protein (CTEP) genotype. Metabolism 2002;51:774-778

44. Rosenson RS, Freedman DS, Otvos JD. Relations of lipoprotein subclass levels and LDL size to progression of coronary artery disease in the PLAC I trial. Amer J Cardiol 2002;90:89-94.

45. Kuller L, Arnold A, Tracy R, Otvos J, Burke G, Psaty B, Siscovick D, Freedman DS, Kronmal R. NMR spectroscopy of lipoproteins and risk of CHD in the Cardiovascular Health Study. Arterioscler Thromb Vasc Biol 2002;22:1175-80.

46. Brousseau ME, O'Connor JJ, Ordovas JM, Collins D, Otvos JD, Massov T, McNamara JR, Rubins HB, Robins SJ, Schaefer EJ. The CETP Taq1 B2B2 genotype is associated with higher HDL-C levels and lower risk for CHD end points in men with HDL deficiency – The Veterans Affairs HDL Cholesterol Intervention Trial. Arterioscler Thromb Vasc Biol 2002;22:1148-54.

47. Schaefer EJ, McNamara JR, Taylor T, Daly JA, Gleason JA, Seman LJ, Ferrari A, Rubenstein JJ. Effects of atorvastatin on fasting and postprandial lipoprotein subclasses in coronary heart disease patients versus control subjects. Am J Cardiol 2002;90:689-96.

48. Otvos JD, Jeyarajah EJ, Cromwell WC. Measurement issues related to lipoprotein heterogeneity. Amer J Cardiol 2002;90(suppl):22i-29i.

49. Blake GJ, Otvos JD, Rifai N, Ridker PM. LDL particle concentration and size as determined by NMR spectroscopy as predictors of cardiovascular disease in women. Circulation 2002;106:1930-37.

50. Davy BM, Davy KP, Ho RC, Beske SD, Davrath LR, Melby CL. High-fiber oat cereal compared with wheat cereal consumption favorably alters LDL-cholesterol subclass and particle numbers in middle-aged and older men. Am J Clin Nutr 2002;76:351-8.

51. Humphries SE, Berglund L, Isasi CR, Otvos JD, Kaluski D, Deckelbaum RJ, Shea S, Talmud PJ. Loci for CETP, LPL, LIPC, and APOC3 affect plasma lipoprotein size and sub-population distribution in Hispanic and non-Hispanic white subjects: The Columbia University BioMarkers Study. Nutr Metab Cardiovasc Dis 2002;12:163-172.

52. Kraus WE, Houmard JA, Duscha BD, Knetzger KJ, Wharton MB, McCartney JS, Bales CW, Henes S, Samsa GP, Otvos JD, Kulkarni KR, Slentz CA. Effects of the amount and intensity of exercise training on plasma lipoproteins. N Engl J Med 2002;347:1483-92.

53. Mackey RH, Kuller LH, Sutton-Tyrell K, Evans RW, Holubkov R, Matthews KA. Lipoprotein subclasses and coronary artery calcification in postmenopausal women from the Healthy Women Study. Amer J Cardiol 2002;90(8A):71i-76i.

54. Colhoun HM, Taskinen M-R, Otvos JD, van den Berg P, O'Conner J, Van Tol A. Relationship of phospholipid transfer protein activity to HDL and apolipoprotein B-containing lipoproteins in subjects with and without type 1 diabetes. Diabetes 2002;51:3300-3305.

55. Otvos JD. Why cholesterol measurements may be misleading about lipoprotein levels and cardiovascular disease risk – clinical implications of lipoprotein quantification using NMR spectroscopy. J Lab Med 2002;26:544-50.

56. Jenkins AJ, Lyons TJ, Zheng D, Otvos JD, Lackland DT, McGee D, Garvey WT, Klein RL. Serum lipoproteins in the DCCT/EDIC cohort: associations with gender and glycemia. Diabetes Care 2003;26:810-818.

57. Garvey WT, Kwon S, Zheng D, Shaughnessy S, Wallace P, Hutto A, Pugh K, Jenkins AJ, Klein RL, Liao Y. The effects of insulin resistance and Type 2 diabetes mellitus on lipoprotein subclass particle size and concentration determined by nuclear magnetic resonance. Diabetes 2003;52: 453-462.

58. Shea S, Aymong E, Zybert P, Berglund L, Shamoon H, Deckelbaum RJ, Basch CE. Fasting plasma insulin modulates lipid levels and particle sizes in 2- to 3-year-old children. Obes Res 2003;11:709-721.

59. Blake GJ, Albert MA, Rifai N, Ridker PM. Effect of pravastatin on LDL particle concentration as determined by NMR spectroscopy: a substudy of a randomized placebo controlled trial. Eur Heart J 2003;24:1843-47.

60. Soedamah-Muthu SS, Chang Y-F, Otvos J, Evans RW, Orchard TJ. Lipoprotein subclass measurements by nuclear magnetic resonance spectroscopy improve the prediction of coronary artery disease in Type 1 diabetes. A prospective report from the Pittsburgh Epidemiology of Diabetes Complications Study. Diabetologia 2003;46:674-682.

61. Ma K, Cilingiroglu M, Otvos JD, Ballantyne CM, Marian AJ, Chan L. Endothelial lipase is a major genetic determinant for high density lipoprotein concentration, structure, and metabolism. Proc Natl Acad Sci USA. 2003;100:2748-53.

62. Jenkins AJ, Lyons TJ, Zheng D, Otvos JD, Lackland DT, McGee D, Garvey WT, Klein RL. Lipoproteins in the DCCT/EDIC cohort: associations with diabetic nephropathy. Kidney Int 2003;64:817-828.

63. Hammad SM, Powell-Braxton L, Otvos JD, Eldridge L, Won W, Lyons TJ. Lipoprotein subclass profiles of hyperlipidemic diabetic mice measured by nuclear magnetic resonance spectroscopy. Metabolism 2003;52:916-21.

64. Morgan JM, Capuzzi DM, Baksh RI, Intenzo C, Carey CM, Reese D, Walker K. Effects of extended-release niacin on lipoprotein subclass distribution. Am J Cardiol 2003;91:1432-1436.

65. Barzilai N, Atzmon G, Schechter C, Schaefer EJ, Cupples AL, Lipton R, Cheng S, Shuldiner AR. Unique lipoprotein phenotype and genotype associated with exceptional longevity. JAMA 2003; 290:2030-2040.

66. Soedamah SS, Colhoun HM, Thomason MJ, Betteridge DJ, Durrington PN, Hitman GA, Fuller JH, Julier K, Mackness MI, Neil HAW, The CARDS investigators. The effect of atorvastatin on serum lipids, lipoproteins and NMR spectroscopy defined lipoprotein subclasses in type 2 diabetic patients with ischemic heart disease. Atherosclerosis 2003; 167:243-55.

67. Kuivenhoven JA, Hovingh GK, van Tol A, Jauhiainen M, Ehnholm C, Fruchart JC, Fruchart J, Brinton E, Otvos JD, Smelt AHM, Zwinderman AH, Hayden MR, Kastelein JJP. Heterozygosity for ABCA1 gene mutations: effects on enzymes, apolipoproteins and lipoprotein particle size. Atherosclerosis 2003;171:311-319.

68. Li Z, Otvos JD, Lamon-Fava S, Carrasco WV, Lichtenstein AH, McNamara JR, Ordovas JM, Schaefer EJ. Men and women differ in lipoprotein response to dietary saturated fat and cholesterol restriction. J Nutr 2003;133:3428-33.

69. Hays JH, DiSabatino A, Gorman RT, Vincent S, Stillabower ME. Effect of high sataturated fat and no-starch diet on serum lipid subfractions in patients with documented atherosclerotic cardiovascular disease. Mayo Clin Proc 2003;78:131-1336.

70. Schaefer EJ, McNamara JR, Tayler T, Daly JA, Gleason JL, Seman LJ, Ferrari A, Rubenstein JJ. Comparisons of effects of statins (atorvastatin, fluvastatin, lovastatin, pravastatin, and simvastatin) on fasting and postprandial lipoproteins in patients with coronary heart disease versus control subjects. Am J Cardiol 2004;93:31-9.

71. Belani SS, Goldberg AC, Coyne DW. Ability of non-HDL cholesterol and calculated IDL to identify nontraditional lipoprotein risk factors in dialysis patients. Am J Kidney Dis 2004;43:320-9.

72. Brousseau ME, Schaefer EJ, Wolfe ML, Bloedon LT, Digenio AG, Clark RW, Mancuso JP, Rader DJ. Effects of an inhibitor of cholesterol ester transfer protein on HDL cholesterol. NEJM 2004;350:1505-15.

73. Liao Y, Kwon S, Shaughnessy S, Wallace P, Hutto A, Jenkins AJ, Klein RL, Garvey WT. Critical evaluation of Adult Treatment Panel III criteria in identifying insulin resistance with dyslipidemia. Diabetes Care 2004;27:978-83.

74. Lyons TJ, Jenkins AJ, Zheng D, Lackland DT, McGee D, Garvey WT, Klein RL. Diabetic retinopathy and serum lipoprotein subclasses in the DCCT/EDIC cohort. Invest Ophthalmol Vis Sci 2004;45:910-8.

75. Freedman DS, Otvos JD, Jeyarajah EJ, Shalaurova I, Cupples LA, Parise H, D’Agostino RB, Wilson PWF, Schaefer EJ. Sex and age differences in lipoprotein subclasses measured by nuclear magnetic resonance spectroscopy: The Framingham Study. Clin Chem 2004;50:1189-1200.

76. Tsai MY, Georgopoulos A, Otvos JD, Ordovas JM, Hanson NQ, Peacock JM, Arnett DK. Comparison of ultracentrifugation and nuclear magnetic resonance spectroscopy in the quantification of triglyceride-rich lipoproteins after an oral fat load. Clin Chem 2004;50:1201-4.

77. Li Z, Lamon-Fava S, Otvos J, Lichtenstein AH, Velez-Carrasco W, McNamara JR, Ordovas JM, Schaefer EJ. Fish consumption shifts lipoprotein subfractions to a less atherogenic pattern in humans. J Nutrition 2004;134:1724-8.

78. Cromwell WC, Otvos JD. Low-density lipoprotein particle number and risk for cardiovascular disease. Curr Atheroscler Rep 2004;6:381-7.

79. Kwiterovich PO, Virgil DG, Garrett ES, Otvos J, Driggers R, Blakemore K, Cockrill SL, Macfarlane RD. Lipoprotein heterogeneity at birth: influence of gestational age and race on lipoprotein subclasses and Lp(a) lipoprotein. Ethn Dis 2004;14:351-59.

80. Jenkins AJ, Thorpe SR, Alderson NL, Hermayer KL, Lyons TJ, King LP, Chassereau CN, Klein RL. In vivo glycated low-density lipoprotein is not more susceptible to oxidation than nonglycated low-density lipoprotein in type 1 diabetes. Metabolism 2004;53:969-76.

81. Klein RL, McHenry MB, Lok KH, Hunter SJ, Le N-A, Jenkins AJ, Zheng D, Semler AJ, Brown WV, Lyons TJ, Garvey WT. Apolipoprotein C-III protein concentrations and gene polymorphisms in type 1 diabetes: associations with lipoprotein subclasses. Metabolism 2004;53:1296-1304.

82. Hanak V, Munoz J, Teague J, Stanley A, Bittner V. Accuracy of the triglyceride to high-density lipoprotein cholesterol ratio for prediction of the low-density lipoprotein phenotype B. Amer J Cardiol 2004;94:219-22.

83. Bhalodkar NC, Blum S, Rana T, Bhalodkar A, Kitchappa R, Kim K-S, Enas E. Comparison of levels of large and small high-density lipoprotein cholesterol in Asian Indian men compared with Caucasian men in the Framingham Offspring Study. Am J Cardiol 2004;94:1561-1563.

84. Seshadri P, Iqbal N, Stern L, Williams M, Chicano KL, Daily DA, McGrory J, Gracely EJ, Rader DJ, Samaha FF. A randomized study comparing the effects of a low-carbohydrate diet and a conventional diet on lipoprotein subfractions and C-reactive protein levels in patients with severe obesity. Am J Med 2004;117:398-405.

85. Ikewaki K, Tohyama J, Nakata Y, Wakikawa T, Kido T, Mochizuki S. Fenofibrate effectively reduces remnants, and small dense LDL, and increases HDL particle number in hypertriglyceridemic men – a nuclear magnetic resonance study. J Atheroscler Thromb 2004;11:278-285.

86. Ma K, Forte T, Otvos JD, Chan L. Differential additive effects of endothelial lipase and scavenger receptor-class B type I on high-density lipoprotein metabolism in knockout mouse models. Arterioscler Thromb Vasc Biol 2005;25:149-154.

87. Costacou T, Zgibor JC, Evans RW, Otvos J, Lopes-Virella MF, Tracy RP, Orchard TJ. The prospective association between adiponectin and coronary artery disease among individuals with type 1 diabetes. The Pittsburgh Epidemiology of Diabetes Complications Study. Diabetologia 2005;48:41-48.

88. Goff DC, D’Agostino RB Jr, Haffner SM, Otvos JD. Insulin resistance and adiposity influence lipoprotein size and subclass concentrations. Results from the Insulin Resistance Atherosclerosis Study. Metabolism 2005;54:264-270.

89. Mackey RH, Kuller LH, Sutton-Tyrrell K, Evans RW, Holubkov R, Matthews KA. Hormone therapy, lipoprotein subclasses, and coronary calcification. Arch Intern Med 2005;165:510-515.

90. Suter PM, Marmier G, Veya-Linder C, Hanseler E, Lentz J, Vetter W, Otvos J. Effect of orlistat on postprandial lipemia, NMR lipoprotein subclass profiles and particle size. Atherosclerosis 2005;180:127-135.

91. Kwiterovich PO, Cockrill SL, Virgil DG, Garrett ES, Otvos J, Knight-Gibson C, Alaupovic P, Forte T, Zhang L, Farwig ZN, Macfarlane RD. A large high-density lipoprotein enriched in apolipoprotein C-I: a novel biochemical marker of infants of lower birth weight and younger gestational age. JAMA. 2005; 293:1891-1899.

92. Dornbrook-Lavendar KA, Joy MS, Denu-Ciocca CJ, Chin H, Hogan SL, Pieper JA. Effects of atorvastatin on low-density lipoprotein cholesterol phenotype and C-reactive protein levels in patients undergoing long-term dialysis. Pharmacotherapy. 2005;25:335-344.

93. Ikewaki K, Noma K, Tohyama J, Kido T, Mochizuki S. Effects of bezafibrate on lipoprotein subclasses and inflammatory markers in patients with hypertriglyceridemia – a nuclear magnetic resonance study. Int J Cardiol 2005;101:441-7.

94. Festa A, Williams K, Hanley AJG, Otvos JD, Goff DC, Wagenknecht LE, Haffner SM. Nuclear magnetic resonance lipoprotein abnormalities in prediabetic subjects in the Insulin Resistance Atherosclerosis Study (IRAS). Circulation. 2005; 111:3465-72.

95. Costacou T, Lopes-Virella MF, Zgibor JC, Virella G, Otvos J, Walsh M, Orchard TJ. Markers of endothelial dysfunction in the prediction of coronary artery disease in Type 1 diabetes: The Pittsburgh Epidemiology of Diabetes Complications Study. J Diabetes Complications. 2005;19:183-93.

96. Goldberg RB, Kendall DM, Deeg MA, Buse JB, Zagar AJ, Pinaire JA, Tan MH, Khan MA, Perez AT, Jacober SJ. A comparison of lipid and glycemic effects of pioglitazone and rosiglitazone in patients with Type 2 diabetes and dyslipidemia. Diabetes Care. 2005;18:1547-54.

97. Bhalodkar NC, Blum S, Rana T, Bhalodkar A, Kitchappa R, Enas EA. Effect of leisure time exercise on high-density lipoprotein cholesterol, its subclasses, and size in Asian Indians. Am J Cardiol. 2005;96:98-100.

98. Deguchi H, Pecheniuk NM, Elias DJ, Averell PM, Griffin JH. High-density lipoprotein deficiency and dyslipoproteinemia associated with venous thrombosis in men. Circulation. 2005;112:893-9.

99. Thijssen MA, Mensink RP. Small differences in the effects of stearic acid, oleic acid, and linoleic acid on the serum lipoprotein profile of humans. Am J Clin Nutr. 2005;82:510-6.

100. Fagerberg B, Edwards S, Halmos T, Lopatynski J, Schuster H, Stender S, Stoa-Birketvedt G, Tonstad S, Halldorsdottir S, Gause-Nilsson I. Tesaglitazar, a novel dual peroxisome proliferators-activated receptor a/g agonist, dose-dependently improves the metabolic abnormalities associated with insulin resistance in a non-diabetic population. Diabetologia. 2005;48:1716-25.

101. Rosenson RS. Assessing risk across the spectrum of patients with the metabolic syndrome. Am J Cardiol. 2005;96:8E-10E.

102. Stein JH, Merwood MA, Bellehumeur JL, Aeschlimann SE, Korcarz CE, Underbakke GL, Mays ME, Sosman JM. Effects of pravastatin on lipoproteins and endothelial function inpatients receiving human immunodeficiency virus protease inhibitors. Am Heart J. 2004;147:E18.

103. Stein JH, Merwood MA, Bellehumeur JB, McBride PE, Wiebe DA, Sosman JM. Postprandial lipoprotein changes in patients taking antiretroviral therapy for HIV infection. Arterioscler Thromb Vasc Biol. 2005;25:399-405.

104. Ruano G, Seip RL, Windemuth A, Zollner S, Tsongalis GJ, Ordovas J, Otvos J, Bilbie C, Miles M, Zoeller R, Visich P, Gordon P, Angelopoulos TJ, Pescatello L, Moyna N, Thompson PD. Apolipoprotein A1 genotype affects the change in high density lipoprotein cholesterol subfractions with exercise training. Atherosclerosis. 2006;185:65-9.

105. Yishak AA, Costacou T, Virella G, Zgibor J, Fried L, Walsh M, Evans RW, Lopes-Virella M, Kagen VE, Otvos J, Orchard TJ. Novel predictors of overt nephropathy in subjects with type 1 diabetes. A nested case control study from the Pittsburgh Epidemiology of Diabetes Complications cohort. Nephrol Dial Transplant. 2006;21:93-100.

106. Shadid S, LaForge R, Otvos JD, Jensen MD. Treatment of obesity with diet/exercise versus pioglitazone has distinct effects on lipoprotein particle size. Atherosclerosis. 2005. epub ahead of print.

107. Westman EC, Yancy WS Jr, Olsen MK, Dudley T, Guyton JR. Effect of a low-carbohydrate, ketogenic diet program compared to a low-fat diet on fasting lipoprotein subclasses. Int J Cardiol. 2005. epub ahead of print.

108. Kathiresan S, Otvos JD, Sullivan LM, Keyes MJ, Schaefer EJ, Wilson PW, D’Agostino RB, Vasan RS, Robins SJ. Increased small low-density lipoprotein particle number: a prominent feature of the metabolic syndrome in the Framingham Heart Study. Circulation. 2006;113:20-9.

109. Otvos JD, Collins D, Freedman DS, Shalaurova I, Schaefer EJ, McNamara JR, Bloomfield HE, Robins SJ. LDL and HDL particle subclasses predict coronary events and are changed favorably by gemfibrozil therapy in the Veterans Affairs HDL Intervention Trial (VA-HIT). Circulation. 2006;113:1556-63.

110. Szapary PO, Bloedon LT, Samaha FH, Duffy D, Wolfe ML, Soffer D, Reilly MP, Chittams J, Rader DJ. Effects of Pioglitazone on lipoproteins, inflammatory markers, and adipokines in nondiabetic patients with metabolic syndrome. Arterioscler Thromb Vasc Biol. 2006;26:182-8.

111. Davy BM, Davy KP. Comparison of assessment techniques: plasma lipid and lipoproteins related to the metabolic syndrome. Lipids Health Dis. 2006;5:3. epub ahead of print.

112. Pennington JS, Pennington SN. Rat adult offspring serum lipoproteins are altered by maternal consumption of a liquid diet. Lipids. 2006;41:357-63.

113. Mora S, Szklo M, Otvos JD, Greenland P, Psaty BM, Goff DC Jr, O’Leary DH, Saad MF, Tsai MY, Sharrett AR. LDL particle subclasses, LDL particle size, and carotid atherosclerosis in the Multi-Ethnic Study of Atherosclerosis. Atherosclerosis. 2006. epub ahead of print.

114. Seip RL, Otvos J, Bilbie C, Tsongalis GJ, Miles M, Zoeller R, Lisich P, Gordon P, Angelopoulos TJ, Pescatello L, Moyna N, Thompson PD. The effect of apolipoprotein E genotype on serum lipoprotein particle response to exercise. Atherosclerosis. 2006. epub ahead of print.

115. Kuvi JT, Dave DM, Sliney KA, Mooney P, Patel AR, Kimmelsteil CD, Karas RH. Effects of extended-release niacin on lipoprotein particle size, distribution, and inflammatory markers in patients with coronary artery disease. Am J Cardiol. 2006. epub ahead of print.

116. Demissie S, Cupples LA, Shearman AM, Gruenthal KM, Peter I, Schmid CH, Karas RH, Housman DE, Mendelsohn ME, Ordovas JM. Estrogen receptor-alpha variants are associated with lipoprotein size distribution and particle levels in women: The Framingham Heart Study. Atherosclerosis. 2006. epub ahead of print.

Press Release RE: Keith Wasserstrom

2006-10-12T10:59:00.000-07:00

PRESS RELEASE

Hollywood City Commissioner Keith Wasserstrom surrendered himself to the Broward County Main Jail today regarding allegations stemming from a contract entered into by the City of Hollywood and Schwing-Bioset Technologies. Keith’s former law firm represented Normandy Group that was a consultant to Schwing-Bioset.

Before the vote on whether Hollywood should enter into the contract, Keith obtained clear advice from Hollywood City Attorney, Dan Abbott, regarding the potential for ethical conflict and the state of the law as to his involvement with Normandy Group. Attorney Abbott specifically advised Keith that, if he recused himself from voting on the contract, and if he disclosed to the board his relationship with Normandy, he would not breach his ethical duty or violate the law. Keith followed Attorney Abbott’s advice, recused himself from the vote regarding the contract with Schwing-Bioset, and with Attorney Abbott’s assistance, Keith prepared and filed conflict disclosure forms. Despite reports to the contrary, Keith received no financial benefit from the contract between the City of Hollywood and Schwing-Bioset.

Since receiving a degree from Wharton School of Business and his law degree from University of Pennsylvania in 1992, Keith has served the City of Hollywood as a dedicated commissioner, and as a board member for many organizations, including the Broward League of Cities, and the Florida League of Cities. Keith has also served on the executive board of The Jewish Federation of Broward County, served as chairman of the Broward County Jewish Community Relations Council, and served as the Florida State Chairman of the America-Israel Chamber of Commerce. He and his wife Jessica have three children.

Keith is confident that the charges levied against have no support in law or fact, and he will be cleared of these charges. He has not broken any law nor has violated any ethical obligations to his constituency and his community.

ISSUED BY: The Law Offices of Larry Davis, P.A.
1926 Harrison Street
Hollywood, Florida 33020
(954) 927-4249
For further information, please contact The Law Offices of Larry Davis, P.A.

New Research on Unsaturated Fats Using NMR LipoProfile Test

2006-10-06T14:29:00.000-07:00

Small differences in the effects of stearic acid, oleic acid, and linoleic acid on the serum lipoprotein profile of humans1–3

Myriam A Thijssen and Ronald P Mensink

ABSTRACT

Background: Studies have suggested that oleic and stearic acids, as well as oleic and linoleic acids, have comparable effects on the serum lipoprotein profile. If so, then substituting these three 18-carbon fatty
acids for each other would result in similar effects on the serum lipoprotein profile.

Objective: The aim of this study was to compare simultaneously the effects of stearic, oleic, and linoleic acids on the serum lipoprotein profile of healthy subjects.

Design: Forty-five subjects (27 women and 18 men) consumed in random order 3 experimental diets, each for 5 wk. The diets provided 38% of energy from fat, of which 60% was supplied by the experimental
fats. The dietary compositions of the diets were the same, except for 7% of energy, which was provided by stearic, oleic, or linoleic acid. At the end of each intervention period, serum lipid and lipoprotein concentrations were measured. In addition, LDL, HDL, and VLDL particle sizes and particle concentrations of lipoprotein subclasses were analyzed by nuclear magnetic resonance spectroscopy.

Results: No significant diet-induced changes in serum lipids and lipoproteins were found. Mean (SD) serum LDL-cholesterol concentrations were 3.790.91, 3.710.79, and 3.650.91 mmol/L with the high–stearic acid, high– oleic acid, and high–linoleic acid diets, respectively (P 0.137 for diet effects). Mean (SD) HDLcholesterol concentrations were 1.45 0.43, 1.46 0.45, and 1.46 0.44 mmol/L (P 0.866). LDL, HDL, and VLDL particle sizes and lipoprotein subclass distributions also did not differ significantly
between the 3 diets.

Conclusions: With realistic intakes of stearic, oleic, and linoleic acids, differences between their effects on the serum lipoprotein profile are small. Am J Clin Nutr 2005;82:510–6.

KEY WORDS Stearic acid, oleic acid, linoleic acid, total cholesterol, LDL cholesterol, HDL cholesterol, lipoprotein profile, humans

INTRODUCTION
It is well known that the various fatty acids in the diet exert different effects on serum lipid and lipoprotein concentrations. Saturated fatty acids are thought to increase cardiovascular disease risk because they elevate serum total and LDL-cholesterol concentrations relative to monounsaturated and polyunsaturated
fatty acids. These effects have been quantified by earlier wellcontrolled dietary studies (1, 2). Relative to an isoenergetic amount of carbohydrates, a mixture of saturated fatty acids elevated serum total cholesterol concentrations, monounsaturated fatty acids had comparable effects, and polyunsaturated fatty acids were hypocholesterolemic. In contrast with the other saturated fatty acids, stearic acid—a saturated fatty acid with 18 carbon atoms—had no effects on serum total cholesterol concentrations (1, 2). These earlier studies, however, did not examine the effects of fatty acids on specific lipoproteins, which is important because of the opposing effects of LDL and HDL cholesterol on cardiovascular disease risk. More recently, several studies have compared the effects of stearic acid on lipid and lipoprotein concentrations with those of unsaturated fatty acids. When stearic acid was substituted for oleic acid, effects on serum LDL- and HDL-cholesterol concentrations did not differ (3). Also, with realistic intakes of linoleic acid (13% of energy), oleic and linoleic acids had similar effects on the serum lipoprotein profile (4, 5). If these findings are true (3-5), then the consequence is that the effects of stearic, oleic, and linoleic acids on serum lipid and lipoprotein concentrations would be comparable. To examine this hypothesis, we compared the effects of diets enriched in these three 18-carbon fatty acids on serum concentrations of triacylglycerol and total, LDL, and HDL cholesterol in a controlled crossover study in healthy subjects. In addition, we investigated the effects of these diets on LDL, HDL, andVLDLparticle sizes and on the subclass distributions of these lipoprotein particles by nuclear magnetic resonance (NMR) spectroscopy.

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New Cholesterol Test Used In VA Hospital Research Study

2006-09-29T14:19:00.000-07:00

Low-Density Lipoprotein and High-Density Lipoprotein Particle Subclasses Predict Coronary Events and Are Favorably Changed by Gemfibrozil Therapy in the Veterans Affairs High-Density Lipoprotein Intervention Trial

James D. Otvos, PhD; Dorothea Collins, ScD; David S. Freedman, PhD; Irina Shalaurova, MD;
Ernst J. Schaefer, MD; Judith R. McNamara, MT; Hanna E. Bloomfield, MD, MPH; Sander J. Robins, MD

Background—Changes in conventional lipid risk factors with gemfibrozil treatment only partially explain the reductions in coronary heart disease (CHD) events experienced by men in the Veterans Affairs High-Density Lipoprotein Intervention Trial (VA-HIT). We examined whether measurement of low-density lipoprotein (LDL) and high-density lipoprotein (HDL) particle subclasses provides additional information relative to CHD risk reduction.

Methods and Results—This is a prospective nested case-control study of 364 men with a new CHD event (nonfatal myocardial infarction or cardiac death) during a 5.1-year (median) follow-up and 697 age-matched controls. Nuclear magnetic resonance (NMR) spectroscopy was used to quantify levels of LDL and HDL particle subclasses and mean particle sizes in plasma obtained at baseline and after 7 months of treatment with gemfibrozil or placebo. Odds ratios for a 1-SD increment of each lipoprotein variable were calculated with adjusted logistic regression models. Gemfibrozil treatment increased LDL size and lowered numbers of LDL particles (5%) while raising numbers of HDL particles (10%) and small HDL subclass particles (21%). Concentrations of these LDL and HDL particles achieved with gemfibrozil were significant, independent predictors of new CHD events. For total LDL and HDL particles, odds ratios predicting CHD benefit were 1.28 (95% CI, 1.12 to 1.47) and 0.71 (95% CI, 0.61 to 0.81), respectively. Mean LDL and HDL particle sizes were not associated with CHD events.

Conclusions—The effects of gemfibrozil on NMR-measured LDL and HDL particle subclasses, which are not reflected by conventional lipoprotein cholesterol measures, help to explain the demonstrated benefit of this therapy in patients with low HDL cholesterol. (Circulation. 2006;113:&NA;-.)
Key Words: coronary disease drugs lipoproteins risk factors spectroscopy
The Veterans Affairs High-Density Lipoprotein Intervention Trial (VA-HIT) demonstrated that the fibric acid derivative gemfibrozil reduced the 5-year rate of new coronary heart disease (CHD) events in men with known CHD and low levels of both high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C).1 Overall, HDL-C was raised 6% and triglycerides lowered 31% by gemfibrozil, but only the increased HDL-C predicted the reduction in CHD events.2 LDL-C concentrations neither predicted the development of new CHD events nor were lowered by gemfibrozil.
Editorial p ●●●
Clinical Perspective p ●●●
Individuals with low HDL-C and elevated triglycerides, such as those in VA-HIT, characteristically have LDL particles that are smaller and contain less cholesterol than average.
3,4 As a result, numbers of atherogenic LDL particles are frequently elevated even though LDL-C levels are not.5 CHD risk in several prospective studies has been found to be better explained by concentrations of LDL particles, assessed by nuclear magnetic resonance (NMR) or plasma levels of apolipoprotein B (apoB), than by LDL-C.6–13 Some evidence also suggests that LDL particle subclasses may differ in atherogenicity, with small, dense LDL usually,4 but not
always,14 associated with greater CHD risk than large, buoyant LDL. Angiographic trials with fibrates demonstrating reduced progression of coronary artery stenosis have shown that these
drugs, although not appreciably changing the concentration of LDL-C, increase LDL particle size and decrease plasma apoB Received May 27, 2005; revision received December 5, 2005; accepted January 13, 2006.
From LipoScience, Inc, Raleigh, NC (J.D.O., I.S.); Veterans Affairs Medical Center Cooperative Studies Program Coordinating Center, West Haven, Conn (D.C.); Division of Nutrition, Centers for Disease Control and Prevention, Atlanta, Ga (D.S.F.); Lipid Research Laboratory, Tufts University School of Medicine, Boston, Mass (E.J.S., J.R.M.); Center for Chronic Disease Outcomes Research, Veterans Affairs Medical Center, Minneapolis, Minn (H.E.B.); and Boston University School of Medicine, Boston, Mass (S.J.R.). Guest Editor for this article was Robert H. Eckel, MD. Correspondence to Sander Robins, MD, Framingham Heart Study, 73 Mt Wayte Ave, Framingham, MA 01702. E-mail sjrobins@bu.edu © 2006 American Heart Association, Inc. Circulation is available at http://www.circulationaha.org DOI: 0.1161/CIRCULATIONAHA.105.565135 1 Coronary Heart Disease levels.15–17 Furthermore, the increase in HDL-C brought about by fibrates results from increased levels of the smaller
HDL3 subclass.2,18,19 As yet, there have been no trials with fibrates showing that a reduction in major clinical CHD events with these drugs may be related to changes in LDL or HDL subclass concentrations or particle size distributions. In the present nested case-control substudy of VA-HIT, we assessed the effects of gemfibrozil treatment on LDL and HDL subclass particle numbers and mean particle sizes as measured by NMR spectroscopy. We also examined whether levels of these subclasses measured at baseline or during the trial were related to CHD events and whether these relations differed in subjects with diabetes or insulin resistance.
Methods
Subjects
The rationale, design, and methods for VA-HIT have been described previously.1 Briefly, men younger than 74 years with an established diagnosis of CHD were recruited at 20 Veterans Affairs medical centers throughout the United States. Lipid eligibility criteria were HDL-C 40 mg/dL, LDL-C 140 mg/dL, and triglycerides 300 mg/dL. A total of 2531 subjects were randomized to either gemfibrozil (1200 mg/d) or placebo and were treated for a median of 5.1
years. The primary end point was nonfatal myocardial infarction (MI) or CHD death.
For this analysis, the case subjects (n364) were those study participants who experienced a nonfatal MI or CHD death during the trial from whom baseline and follow-up stored plasma samples were available. The control subjects (n697) matched for age were selected from among the remaining study participants who remained free of CHD events during follow-up. An equal percentage (43%) of the 364 cases with a CHD event selected for this analysis and the 494
total CHD cases in the entirety of VA-HIT were treated with gemfibrozil. VA-HIT was approved by the Human Rights Committee of the Cooperative Studies Program Coordinating Center, by each of the 20 study site’s institutional review boards, and by the Cooperative Studies Program Evaluation Committee. All subjects gave written, informed consent. Laboratory Analyses
Blood samples were collected from subjects, after a 12- to 14-hour fast, into tubes containing 0.1% EDTA. Plasma was isolated, frozen, and sent to the VA-HIT central laboratory (Tufts University, Boston, Mass) for lipid analyses and for long-term storage at 80°C before
subsequent analyses of apolipoproteins in the central laboratory and lipoprotein particle subclasses at LipoScience, Inc (Raleigh, NC). Unlike the lipid values reported for the entire VA-HIT population,2 which were the averages of 2 baseline samples obtained 1 to 2 weeks
apart and 4 follow-up samples obtained at 4, 7, 12, and 18 months during the trial, values reported here represent a single baseline and 7-month follow-up measurement, except for the follow-up apolipoprotein values, which were obtained at the 12-month visit.
Total cholesterol, HDL-C, triglycerides, and glucose were measured by standardized automated methods, and LDL-C was calculated by the Friedewald equation.20 Insulin was determined as total immunoreactive insulin.21 ApoA-1 and apoB levels were determined with immunoturbidimetric assays.22,23 Diabetes was defined by history or by a fasting glucose 126 mg/dL. Insulin resistance was defined by a homeostasis model assessment of insulin resistance
value 10.2, as previously described.21 All insulin, glucose, and lipid assays had between-run coefficients of variation (CVs) of 5%. Between-run CVs were 7% to 11% for apoB and 4% for
apoA-1.22,23 LDL and HDL subclass particle concentrations and mean LDL and HDL particle diameters were measured with an automated NMR spectroscopic assay as previously described24,25 and recently modified. 26 In brief, the particle concentrations of lipoprotein subclasses of different size are derived from the measured amplitudes of the distinct lipid methyl group NMR signals they emit. Concentrations (nmol/L for LDL particles and mol/L for HDL particles) of the following subclasses were analyzed in this study: small LDL (18.0 to
21.2 nm), large LDL (21.2 to 23.0 nm), intermediate-density lipoprotein (IDL) (23.0 to 27.0 nm), large HDL (8.8 to 13.0 nm), medium HDL (8.2 to 8.8 nm), and small HDL (7.3 to 8.2 nm). Weightedaverage lipoprotein particle sizes in nanometers were calculated from the subclass levels, and the diameters were assigned to each subclass. Very low-density lipoprotein (VLDL) subclass data are not included in this analysis because there was evidence that NMR detection of
these triglyceride-rich particles was altered to a variable extent by the freeze-thaw cycles to which the plasma specimens were subjected. LDL and HDL subclass levels measured by NMR are unaffected by frozen storage25 and multiple freeze-thaw cycles (J.D. Otvos, PhD,
unpublished data, 2005). Reproducibility of the NMR-measured lipoprotein particle parameters
was determined by replicate analyses of plasma pools. Between-run CVs for low-normal concentrations were 4% for total LDL and HDL particle concentrations, 0.5% for LDL and HDL size, 8% for large and small LDL subclasses, and 5% for large and small HDL subclasses. Higher CVs for IDL (20%) and medium HDL (35%) subclasses reflect their typically low concentrations. For all biochemical and NMR analyses, samples were
handled in a fully blinded fashion such that investigators had no knowledge of case or control status. All results of laboratory analyses were sent to the VA Cooperative Studies Coordinating
Center (West Haven, Conn) and entered into the VA-HIT centralized database.
Statistical Analyses Baseline characteristics were compared between cases and controls,
and lipids, apolipoproteins, and NMR lipoprotein particle measures were compared by treatment with t tests. Odds ratios for 1-SD increments of baseline and on-trial concentrations of lipids, apolipoproteins, and NMR lipoprotein particle measures, as well as changes in these variables, were assessed with the use of logistic regression with adjustment for treatment group, age, hypertension, smoking, body mass index, and diabetes. Separate analyses were
performed on the subset of subjects (n395) with insulin resistance or diabetes (excluding those treated with insulin). Because of the multiple statistical tests that were performed, which could inflate the type 1 error rate, we used 0.01 as the criterion for statistical significance. To examine whether the relation of each lipid/lipoprotein variable to CHD differed by treatment group, we included interaction (product) terms in our regression models. The authors had full access to the data and take full responsibility for its integrity. All authors have read and agree to the anuscript as written.
Results
Baseline characteristics of the cases and controls, shown in Table 1, were similar to those of the entire VA-HIT population. As previously documented, a relatively large proportion of subjects in this trial had diabetes or insulin resistance, with a greater prevalence in cases compared with controls. Lipid and apolipoprotein changes in the gemfibrozil treatment group (Table 2) were virtually identical to those reported previously for the whole study population.2 Triglycerides
decreased 30%, HDL-C increased 6%, and LDL-C was minimally increased. Both plasma apoB and non–HDL cholesterol (non–HDL-C), reflecting the combined levels of VLDL and LDL, underwent small reductions. As Table 2 shows, the concentration of total LDL particles
(LDL-P) measured by NMR was decreased 5% by gemfibrozil. This reduction was caused by a significant 20% decrease in the number of small LDL particles, from 967 to 777 2 Circulation March 28, 2006 nmol/L, which was partially offset by a 36% increase in the number of large LDL particles. As a result of this alteration in LDL subclass composition, average LDL particle size increased significantly from 20.4 to 20.9 nm. Total HDL particles (HDL-P) in the gemfibrozil treatment group were increased as a result of increased numbers of small HDL
particles offsetting reductions in large- and medium-size HDL subclass particles.
Table 3 shows the odds ratios (ORs) for a new CHD event associated with a 1-SD increment of each lipid or lipoprotein particle variable measured at baseline and during the trial in
the combined gemfibrozil and placebo treatment groups, TABLE 1. Baseline Characteristics of Cases, Controls, and Entire VA-HIT Population
Characteristic Cases
(n364)
Controls
(n697)
Entire Population
(n2531) P*
Age, y 64.3 (7.1) 64.5 (6.9) 64.2 (7.2) 0.64 Body mass index, kg/m2 29.2 (4.7) 29.1 (4.9) 29.0 (4.8) 0.43 Waist, cm 103 (12) 103 (12) 103 (12) 0.48 Hypertension, % 56.6 58.4 56.9 0.57
Diabetes, % 37.1 28.8 30.4 0.006 Insulin resistance, % 35.2 27.8 30.0 0.002 Current smoker, % 22.0 17.7 20.4 0.09 LDL-C, mg/dL 113.3 (21.4) 110.8 (23.1) 111.1 (22.2) 0.10 HDL-C, mg/dL 30.9 (5.5) 31.5 (5.2) 31.8 (5.3) 0.05 Triglycerides, mg/dL 166.9 (72.8) 161.4 (66.9) 160.6 (68.0) 0.41 Glucose, mg/dL 119 (40) 114 (34) 115 (37) 0.03 Values are mean (SD) or percentage. The prevalences of hypertension and smoking were obtained by history. Diabetes was defined by history or by a fasting glucose 126 mg/dL. Insulin resistance was defined by a homeostasis model assessment of insulin resistance value 10.2 and does not include subjects with diabetes being treated with insulin.21 *P value is for the comparison of cases and controls. For body mass index and triglycerides, a nonparametric Wilcoxon test was used. For all other variables, t tests or 2 tests were used. TABLE 2. Treatment Effects on Lipids, Lipoprotein Particle Numbers, and Lipoprotein Particle Sizes Placebo (n546) Gemfibrozil (n515) Variable Baseline On-Trial* Baseline On-Trial P† Lipids and apolipoproteins LDL-C, mg/dL 111.6 (23.1) 112.1 (26.7) 111.7 (22.1) 114.7 (25.9) 0.14 HDL-C, mg/dL 31.2 (5.0) 31.3 (6.1) 31.5 (5.5) 33.4 (6.7) 0.0001
Triglycerides, mg/dL 167.1 (69.5) 176.7 (84.2) 159.3 (68.3) 111.3 (59.3) 0.0001 Non–HDL-C, mg/dL 144.6 (24.1) 147.0 (29.9) 143.6 (23.8) 137.0 (28.6) 0.0001 ApoB, mg/dL 96.8 (20.6) 93.6 (17.9) 95.4 (21.7) 89.0 (19.4) 0.0002 ApoA-1, mg/dL 105.9 (15.9) 108.8 (16.2) 104.9 (16.6) 107.8 (16.4) 0.35 NMR lipoprotein particle measures LDL particle No., nmol/L 1364 (315) 1463 (342) 1352 (316) 1290 (331) 0.0001 IDL particles, nmol/L 34 (25) 35 (27) 32 (24) 33(28) 0.29 Large LDL particles, nmol/L 346 (214) 345 (239) 354 (217) 480 (231) 0.0001 Small LDL particles, nmol/L 984 (391) 1083 (444) 967 (406) 777 (425) 0.0001
LDL particle size, nm 20.4 (0.7) 20.3 (0.8) 20.4 (0.8) 20.9 (0.7) 0.0001 HDL particle No., mol/L 25.2 (4.3) 26.6 (4.5) 25.1 (4.6) 27.6 (5.0) 0.0005 Large HDL particles, mol/L 2.7 (1.7) 2.3 (1.6) 2.7 (1.7) 2.3 (1.6) 0.71 Medium HDL particles, mol/L 1.9 (2.5) 2.0 (2.6) 1.9 (2.3) 0.7 (1.6) 0.0001 Small HDL particles, mol/L 20.7 (5.2) 22.4 (5.3) 20.4 (5.2) 24.6 (5.4) 0.0001 HDL particle size, nm 8.5 (0.3) 8.4 (0.3) 8.5 (0.3) 8.4 (0.3) 0.68 Values are mean (SD). *On-trial data are for samples obtained at the 7-month visit; apolipoproteins are the values at 12 months. †P values are for comparison of on-trial values in the placebo vs gemfibrozil groups. Otvos et al LDL and HDL Subclasses and Coronary Events 3
assessed by separate logistic regression models that were adjusted for major nonlipid CHD risk factors and treatment group. Models that included the interaction between treatment
and each lipid/lipoprotein variable indicated that the associations did not differ significantly between the placebo and gemfibrozil groups (data not shown). Neither baseline nor on-trial levels of HDL-C, triglycerides, or LDL-C were significant predictors of CHD risk. Among other lipid/apolipoprotein variables, baseline, but not on-trial, concentrations of apoA-1 and the ratios of apoB to apoA-1 and total cholesterol to HDL-C predicted a CHD end point. Among NMR lipoprotein measures, both baseline and on-trial levels of LDL-P and HDL-P were strong, independent predictors of a new CHD event. A 1-SD increment of LDL-P (350 nmol/L) during the trial was associated with an OR of 1.28 (95% CI, 1.12 to 1.47; P0.0003), whereas the
OR of a 1-SD increment of HDL-P (4.8 mol/L) was 0.71 (95% CI, 0.61 to 0.81; P0.0001). Further adjustment for LDL-C, HDL-C, and triglycerides did not appreciably change
these relations (data not shown). The small HDL-P subclass, which constituted the majority of the total HDL particles in VA-HIT men, was also a significant predictor of CHD end
points. On-trial numbers of small LDL particles were positively associated with events (P0.03) but did not achieve the P0.01 significance level. Neither the large nor the average LDL and HDL particle subclasses were related to CHD events (Table 3). Additional analyses (results not
shown) indicated that no change (by concentration or percentage) in any of the lipid, apolipoprotein, or lipoprotein particle variables was a significant predictor of CHD risk.
We also conducted separate analyses (not shown) identical to those in Tables 2 and 3 for the subset of subjects (n395) with diabetes or insulin resistance. In agreement with results
reported for the whole VA-HIT population,21 gemfibrozil induced a somewhat smaller increase in HDL-C (3% versus 6%) and a smaller decrease in triglycerides (26% versus 30%) in this subgroup. LDL-P also decreased less (2% versus 5%), and the increase in LDL size was smaller (0.3 versus 0.5 nm). However, the gemfibrozil-induced changes in HDL-P and the HDL-P subclasses were very similar to those seen in the entire study population. Furthermore, relations of lipid, apolipoprotein, and lipoprotein particle parameters to CHD events in the diabetes/insulin resistance subgroup were virtually identical to those shown in Table 3. None of the on-trial lipid or apolipoprotein variables predicted CHD events in this subgroup, whereas both LDL-P (OR1.30; 95% CI, 1.05 to 1.61) and HDL-P (OR0.68; 95% CI, 0.54 to 0.86) did.
To assess the independence of relations of LDL and HDL particle subclasses with CHD events and correct for any confounding caused by the intercorrelations among these variables, all 6 LDL and HDL subclasses (including IDL) TABLE 3. Lipids, Apolipoproteins, and Lipoprotein Particle Parameters as Individual Predictors of CHD Events Baseline On-Trial Variable OR* (95% CI) P OR (95% CI) P Lipids and apolipoproteins LDL-C 1.10 (0.97–1.25) 0.15 1.08 (0.95–1.23) 0.25 HDL-C 0.91 (0.80–1.03) 0.14 0.95 (0.83–1.08) 0.42 Triglycerides 1.07 (0.94–1.22) 0.29 1.04 (0.90–1.19) 0.63 Non–HDL-C 1.14 (1.00–1.30) 0.05 1.09 (0.96–1.25) 0.17
Total cholesterol:HDL-C ratio 1.19 (1.05–1.35) 0.008 1.14 (1.01–1.30) 0.05 ApoB 1.12 (0.99–1.27) 0.08 1.07 (0.94–1.23) 0.31 ApoA-1 0.84 (0.74–0.96) 0.01 0.91 (0.80–1.04) 0.18
ApoB:apoA-1 ratio 1.24 (1.10–1.41) 0.0008 1.14 (0.99–1.30) 0.06 NMR lipoprotein particle measures LDL particle No. 1.20 (1.05–1.37) 0.006 1.28 (1.12–1.47) 0.0003 IDL particles 0.99 (0.87–1.12) 0.84 1.17 (1.03–1.33) 0.02 Large LDL particles 1.08 (0.95–1.23) 0.27 1.06 (0.93–1.22) 0.35 Small LDL particles 1.11 (0.98–1.27) 0.11 1.17 (1.02–1.34) 0.03 LDL particle size 0.97 (0.85–1.10) 0.64 0.96 (0.84–1.10) 0.57 HDL particles 0.78 (0.69–0.90) 0.0004 0.71 (0.61–0.81) 0.0001 Large HDL particles 0.98 (0.86–1.11) 0.74 0.94 (0.83–1.07) 0.37
Medium HDL particles 0.96 (0.84–1.09) 0.54 1.04 (0.92–1.19) 0.52 Small HDL particles 0.82 (0.72–0.94) 0.004 0.74 (0.64–0.85) 0.0001 HDL Particle Size 1.00 (0.88–1.14) 0.97 0.91 (0.79–1.04) 0.15 *ORs (95% CIs) were calculated for a 1-SD increment in each lipid/lipoprotein variable in separate logistic regression models adjusted for treatment group, age, hypertension, smoking, body mass index, and diabetes. For placebo and gemfibrozil groups combined, n1061 subjects. 4 Circulation March 28, 2006 were included in the same regression models that were
additionally adjusted for treatment and other risk factors (Table 4). Both large and small LDL subclass particle numbers were now strongly and independently predictive of CHD outcomes, both at baseline and during the trial. ORs for small and large LDL-P during the trial were 1.41 (95% CI, 1.14 to 1.73; P0.001) and 1.34 (95% CI, 1.11 to 1.62; P0.002), respectively. Stronger associations with CHD events were also seen for all 3 HDL subclasses when these variables were considered jointly with LDL subclasses in the same model (Table 4) rather than individually in separate models (Table 3). The extent to which the risk of new CHD events is related to different measures of the ratio of atherogenic to antiatherogenic lipoprotein particles is shown in Table 5. The relative risk of those in the highest quartile of ratio of total cholesterol to HDL-C or ratio of apoB to apoA-1 was significantly elevated (relative risk1.5; 95% CI, 1.1 to 2.0 for both lipid ratios). However, a stronger, graded risk relationship was seen for the ratio of LDL-P to HDL-P (relative risk2.4 for the highest versus lowest quartile; 95% CI, 1.8 to 3.3). Similar results were obtained when the gemfibrozil and placebo groups were examined separately (results not shown). Discussion VA-HIT was undertaken to determine whether treatment aimed at raising HDL-C (and lowering triglycerides), rather than lowering LDL-C, would reduce CHD events in men with coronary disease. To simplify interpretation of the study results,
2 aspects of the study design were intended to “uncouple” HDL-C from LDL-C as contributors to any achieved treatment benefit.1 First, subjects recruited into the trial had not only low
HDL-C (mean, 32 mg/dL) but low-risk levels of LDL-C (mean, 111 mg/dL). Second, gemfibrozil was chosen as the treatment drug for its ability both to increase HDL-C and to not appreciably
change levels of LDL-C. VA-HIT achieved these objectives. Not only did this treatment produce a significant 22% reduction in CHD events, but this result was accomplished without a
decrease in LDL-C.1 Subsequent regression analyses confirmed TABLE 4. NMR Lipoprotein Subclass Particle Parameters as Multivariable Predictors of CHD Events Baseline On-Trial
Variable OR* (95% CI) P OR (95% CI) P Large LDL particles 1.31 (1.09–1.57) 0.003 1.34 (1.11–1.62) 0.002 Small LDL particles 1.44 (1.20–1.73) 0.0001 1.41 (1.14–1.73) 0.001
IDL particles 0.98 (0.86–1.12) 0.78 1.13 (0.97–1.30) 0.11 Large HDL particles 0.95 (0.82–1.11) 0.53 0.92 (0.79–1.07) 0.30 Medium HDL particles 0.82 (0.70–0.96) 0.02 0.82 (0.69–0.97) 0.02 Small HDL particles 0.71 (0.60–0.84) 0.0001 0.67 (0.57–0.79) 0.0001 *ORs (95% CIs) were calculated for a 1-SD increment in each lipoprotein subclass parameter at
baseline and on-trial with the use of logistic regression models that included all lipoprotein particle parameters in 1 model. All models were additionally adjusted for treatment group, age, hypertension, smoking, body mass index, and diabetes. TABLE 5. Risk of CHD Events According to Quartile of Lipid/Lipoprotein Ratios Quartile of Plasma Level Ratio 1 2 3 4 P for Trend
TC:HDL-C Median (range) 4.1 (2.1–4.6) 5.1 (4.6–5.5) 5.9 (5.5–6.5) 7.2 (6.5–12.5)
Relative risk* (95% CI) 1 1.3 (0.9–1.7) 1.2 (0.9–1.6) 1.5 (1.1–2.0) 0.27 P 0.13 0.27 0.01
ApoB:ApoA-1 Median (range) 0.66 (0.26–0.73) 0.79 (0.73–0.85) 0.90 (0.85–0.97) 1.1 (0.97–1.9) Relative risk (95% CI) 1 1.3 (0.9–1.8) 1.6 (1.2–2.2) 1.5 (1.1–2.0) 0.37
P 0.04 0.004 0.02 LDL-P:HDL-P Median (range) 34.4 (13.9–40.5) 46.4 (40.5–51.2) 55.3 (51.3–61.2) 71.0 (61.3–127.7) Relative risk (95% CI) 1 1.6 (1.2–2.3) 1.8 (1.3–2.6) 2.4 (1.8–3.3) 0.009 P 0.005 0.0005 0.0001 TC indicates triglycerides. *Logistic regression models used on-trial values of lipid/lipoprotein ratios and were adjusted for treatment group, age, hypertension, smoking, body mass index, and diabetes. Otvos et al LDL and HDL Subclasses and Coronary Events 5 that LDL-C levels at baseline and during the trial were not
related to new CHD events.2 In contrast, levels of HDL-C achieved with therapy predicted CHD outcomes and explained some of the gemfibrozil treatment benefit. Measuring the cholesterol content of LDL and HDL particles (LDL-C and HDL-C) is the traditional way that levels of these atherogenic and antiatherogenic lipoproteins are assessed. In this study we used an alternative
technique, NMR spectroscopy, which “counts” the numbers of LDL and HDL particles (LDL-P and HDL-P) and their subclasses.24 With this different measure of LDL and HDL concentration, we gained new insights into the lipoprotein particle altering effects of fibrate therapy in VA-HIT and how these alterations might affect clinical outcomes. Gemfibrozil significantly reduced total LDL particle numbers by changing the subclass distribution, lowering numbers of small LDL particles while raising to a lesser extent numbers of the larger, more cholesterol-rich particles (Table 2). Despite the decrease in LDL-P, LDL-C remained unchanged because the cholesterol content of the LDL had increased as a result of the gemfibrozil-induced shift toward larger particles. Similarly, although gemfibrozil raised HDL cholesterol levels only modestly (6%),
there was a more substantial 10% increase in total HDL particle number and a 21% increase in numbers of the small, relatively cholesterol-poor HDL subclass. Notably, we found that both LDL and HDL particle numbers measured during the trial had significant, independent
associations with new CHD events, whereas LDL and HDL cholesterol levels did not. A possible reason is that LDL and HDL cholesterol levels have more sources of variability, with levels differing either because of differences in cholesterol composition (amount of cholesterol
per particle due to particle size or core lipid compositional differences),5 differences in particle number, or some combination of the two. Because only men with low levels of LDL-C and HDL-C were enrolled in VA-HIT, the range of lipid levels was restricted compared with the general
population. As a result, the impact of lipoprotein cholesterol compositional heterogeneity on relations of lipid levels with CHD risk was likely magnified in this study population. Whatever the reason, our results clearly indicate that in this secondary prevention study of men with
low HDL and LDL, CHD risk is better reflected by numbers of lipoprotein particles than by the amount of cholesterol these particles contain. The same conclusion applies to the subset of men in VA-HIT who had diabetes or insulin resistance. It was shown previously that these subjects, despite experiencing smaller changes in HDL-C, derived substantially more benefit from gemfibrozil treatment than those without insulin resistance.21 We found that on-trial levels of HDL-P and LDL-P were equally predictive of CHD events in this subgroup and the study
population as a whole. Other studies have also reported that CHD risk appears to be more strongly related to the number of circulating LDL particles than to the measured concentration of cholesterol in LDL.6,11–13 Many of these have used plasma apoB concentration to approximate LDL particle number because, despite apoB being present on VLDL as well as LDL particles, at least 90% of apoB is on LDL even in hypertriglyceridemic patients.27 In VA-HIT, gemfibrozil comparably lowered levels of both apoB (6%) and NMR-measured LDL-P (5%), yet
in regression analyses previously conducted on the entire study population2 and in this nested case-control substudy, levels of apoB with gemfibrozil were not significantly related to the development of a CHD event. Two other studies in which both apoB and LDL-P were measured have also reported stronger disease associations for LDL-P.7,28 We are unsure why apoB is less strongly related to CHD outcomes than LDL-P in VA-HIT. One contributing factor may be the
greater analytic reproducibility of the LDL-P measurement compared with the apoB immunoassay. Another is that, as previously mentioned, plasma apoB provides only an estimate
of LDL particle number because some apoB resides on non-LDL particles. Of note, LDL-P and apoB were correlated less strongly in this study (r0.56) than in the Framingham Offspring Study (r0.86)22 and Women’s Health Study (r0.70),7 in part because the range of LDL concentrations in VA-HIT was more restricted. Although gemfibrozil appreciably increased average LDL particle size in VA-HIT by 0.5 nm, this parameter did not predict a significant reduction in CHD events. This observation is consistent with the results of several observational and intervention studies showing that quantitative measures of LDL particle number, assessed by either NMR or apoB measurement, are more strongly associated with CHD than is
small LDL size.6–8,10,16,17 Although large LDL-P in our study was not related to CHD events when considered individually (Table 3), it became strongly predictive when confounding
due to its correlations with small LDL-P and the HDL subclasses was overcome by inclusion of these interrelated variables in the same model (Table 4). Similar observations have been made by others.14 Our findings with regard to prediction of CHD events by LDL and HDL particle subclasses are highly concordant with those of the Bezafibrate Coronary Atherosclerosis Intervention Trial (BECAIT), an angiographic trial that studied a similar population of male CHD patients with low HDL-C.17 The only on-trial predictors of angiographic outcomes were levels of the small HDL subclass (HDL3-C) and apoB. Significantly, and in agreement with VA-HIT, despite the large impact of fibrate treatment on triglyceride levels and LDL particle size, neither of these parameters was related to the angiographic outcomes. In agreement with the results of other studies with fibrates, we found that increased levels of the small HDL subclass accounted for the increase in HDL-C18,19 brought about by drug treatment and that on-trial numbers of the small HDL particles, but not large HDL particles, predicted CHD events.17,29 Although it is unclear by which mechanism(s) the increase in numbers of HDL particles with this therapy leads to clinical benefit, it may be suggested that higher numbers of HDL particles might
promote greater cholesterol efflux and protection of LDL from oxidative changes.30
In this nested case-control substudy, HDL-C levels at baseline (31.5 mg/dL) and on-trial levels (33.4 mg/dL) 6 Circulation March 28, 2006 matched exactly the mean values reported for the entire study population of VA-HIT.2 However, although the findings in the whole trial showed that achieved levels of HDL-C were predictive of CHD events (RR0.89; 95% CI, 0.81 to 0.97),
we found a weaker, nonsignificant association (RR0.95) in this substudy. We have no certain explanation for this difference but speculate that it may be because we used only a single on-trial measure of HDL-C, whereas the original study used the mean of 4 on-trial determinations.2 Random measurement variability, which is partially offset by averaging multiple determinations, would be expected to attenuate associations with clinical outcomes.
In summary, this case-control substudy nested within VA-HIT shows that fibrate therapy produces favorable changes in the numbers of plasma LDL and HDL subclass particles that can occur independently of any change in the cholesterol content of these lipoproteins. These lipoprotein particle changes may help to explain the reduction in major CHD events and CHD death achieved in this trial. We believe this demonstration of a significant beneficial effect of fibrate therapy in a population with low LDL-C should provide impetus for considering the potential benefit of this kind of therapy even in the absence of substantial changes in conventional lipid measures.
Acknowledgments
VA-HIT was supported by the Department of Veterans Affairs Office of Research and Development Cooperative Studies Program, by a supplemental grant from Parke-Davis, and by an R03 grant, HL069111. We acknowledge the contributions of the VA-HIT investigators and study personnel and thank the VA-HIT subjects for their participation in this trial. Disclosures
Drs Otvos and Shalaurova are employees of LipoScience, Inc. Dr Schaefer has been a consultant to LipoScience, Inc. The other authors report no conflicts.
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CLINICAL PERSPECTIVE
A highly prevalent lipid abnormality in patients with coronary heart disease (CHD) is low high- density lipoprotein cholesterol (HDL-C) coupled with a relatively low low-density lipoprotein cholesterol (LDL-C). The Veterans Affairs HDL Intervention Trial (VA-HIT) has been one of the few clinical trials to address specifically the risk associated with low HDL-C in conjunction with low LDL-C. Men with established CHD and low levels of both HDL-C and LDL-C were treated with the fibric acid derivative gemfibrozil, which raised HDL-C and lowered triglycerides without affecting levels of LDL-C. This treatment resulted in a significant reduction in major CHD events, a benefit only partially explained by the HDL-C increase and triglyceride decrease. In this case-control substudy of VA-HIT, we used NMR spectroscopy to investigate the effects of gemfibrozil on numbers of LDL and HDL subclass particles. Despite having no effect on LDL-C, gemfibrozil markedly increased the size of LDL particles and reduced their overall number. LDL-C levels were unrelated to CHD events, but LDL particle numbers at baseline and during the trial were strong, independent predictors of a new CHD event. LDL particle size, in contrast, was not related to events. Total HDL particle numbers and numbers of the small HDL particle subclass were increased by gemfibrozil, and on-trial concentrations of both of these HDL particle parameters predicted CHD events. In summary, gemfibrozil produced favorable changes in both LDL and HDL particle numbers that were not reflected by changes in the cholesterol content of these lipoproteins but that predicted a significant reduction in CHD events. 8 Circulation March 28, 2006

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NMR LipoProfile Test Used in HIV Research

2006-09-22T14:28:00.000-07:00

ISSN: 1524-4636
Copyright © 2005 American Heart Association. All rights reserved. Print ISSN: 1079-5642. Online 7272 Greenville Avenue, Dallas, TX 72514
Arteriosclerosis, Thrombosis, and Vascular Biology is published by the American Heart Association.
DOI: 10.1161/01.ATV.0000152233.80082.9c 2004;
Arterioscler. Thromb. Vasc. Biol. 2005;25;399-405; originally published online Dec 2,
Donald A. Wiebe and James M. Sosman
James H. Stein, Michelle A. Merwood, Jennifer B. Bellehumeur, Patrick E. McBride,

HIV Infection
Postprandial Lipoprotein Changes in Patients Taking Antiretroviral Therapy for
http://atvb.ahajournals.org/cgi/content/full/25/2/399
located on the World Wide Web at:
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Downloaded from atvb.ahajournals.org by on August 3, 2006
Postprandial Lipoprotein Changes in Patients Taking
Antiretroviral Therapy for HIV Infection
James H. Stein, Michelle A. Merwood, Jennifer B. Bellehumeur, Patrick E. McBride,
Donald A. Wiebe, James M. Sosman
Objective—Dyslipidemia is common among patients receiving antiretroviral therapy for HIV infection. The purpose of this
study was to determine whether postprandial lipemia contributes to the dyslipidemia observed in HIV-positive patients
taking antiretroviral therapy.

Methods and Results—A standardized fat load was administered to 65 subjects (group 1 35 HIV-positive subjects receiving protease inhibitors [PIs]; group 2 20 HIV-positive subjects not receiving PIs; group 3 10 HIV-negative controls). Serum triglycerides, retinyl palmitate, and lipoproteins were measured using enzymatic and nuclear magnetic resonance spectroscopic techniques. Compared with HIV-negative controls, peak postprandial retinyl palmitate and
large very low-density lipoprotein (VLDL) levels occurred later in both HIV-positive groups, and a delayed decrease in serum triglycerides was observed. However, postprandial areas under the curve (AUCs) for triglycerides, retinyl palmitate, chylomicrons, and large VLDL were similar. Postprandial AUCs for intermediate-density lipoproteins (IDLs) and low-density lipoproteins (LDLs) were higher in group 1 than groups 2 and 3 (all P0.035).

Conclusions—Postprandial clearance of triglyceride-rich lipoproteins is delayed in HIV-positive individuals receiving antiretroviral therapy. Compared with HIV-positive individuals not on PIs, those taking PIs do not have increased postprandial triglyceride-rich lipoproteins but do have increased postprandial IDLs and LDLs. (Arterioscler Thromb Vasc Biol. 2005;25:399-405.)
Key Words: human immunodeficiency virus lipids lipoproteins metabolism protease inhibitors

The dramatic immunologic and clinical benefits associated with use of highly active antiretroviral therapy (HAART) have led to its widespread acceptance for treatment of patients with HIV infection.1 Although many patients taking HAART develop metabolic changes that may increase cardiovascular risk, it is unclear whether HAART, its pharmacological components, HIV infection per se, or agingassociated risk factors account for the increased risk of
cardiovascular disease observed in patients taking antiretroviral therapy.2–8
Patients taking HAART frequently have hypercholesterolemia and hypertriglyceridemia, and increased concentrations of very low-density lipoproteins (VLDLs) and intermediatedensity
lipoproteins (IDLs) have been observed in patients taking HIV protease inhibitors (PIs).9–11 In the pre-HAART era, decreases in cholesterol-containing lipoproteins were observed with hypertriglyceridemia that was, at least in part, related to disease progression and impaired clearance of triglycerides.12 Triglyceride-rich lipoproteins and their cholesterol-rich remnants promote accumulation of cholesterol in the arterial wall and adversely affect high-density lipoprotein (HDL) and low-density lipoprotein (LDL) composition and cholesterol concentrations.13,14 In individuals without HIV infection, postprandial lipemia is a risk factor for the development and progression of coronary artery disease (CAD).14
Subjects with CAD have delayed clearance of triglyceride rich lipoproteins and their remnants, resulting in postprandial lipemia.14–16
Several potential mechanisms by which HAART could lead to dyslipidemia have been proposed, including some related to decreased lipoprotein clearance; however, it is not known whether postprandial lipemia contributes to the dyslipidemia and increased cardiovascular risk observed in patients on HAART.2,17–19

Methods
Subjects
The University of Wisconsin institutional review board approved this study. Subjects included adults with HIV infection on a stable antiretroviral regimen for 3 months who had evidence of dyslipidemia, including serum triglycerides 150 mg/dL and either HDL cholesterol 40 mg/dL or LDL cholesterol 130 mg/dL. These subjects were recruited into 2 groups: group 1 (HIV positive and on antiretroviral therapy, including PIs) and group 2 (HIV positive and
on antiretroviral therapy without PIs for 6 months). A control set of HIV negative subjects also was recruited (group 3). Exclusion criteria included current use of lipid-lowering therapy, diabetes Original received September 3, 2004; final version accepted November 22, 2004.
From the University of Wisconsin Medical School, Madison.
Correspondence to James H. Stein, MD, University of Wisconsin Medical School, 600 Highland Ave, G7/341 CSC (MC 3248) Madison, WI 53792.
E-mail jhs@medicine.wisc.edu
© 2005 American Heart Association, Inc.
Arterioscler Thromb Vasc Biol. is available at http://www.atvbaha.org DOI: 10.1161/01.ATV.0000152233.80082.9c 399
mellitus, hypothyroidism, creatinine 2 mg/dL, current use of glucocorticoids or anabolic steroids, and malignancy or opportunistic infection in the past 12 weeks.
Oral Lipid Load
After a minimum of 12 hours of fasting (except medications), subjects were admitted to the General Clinical Research Center at 7:00 AM and drank 236 mL of water. Vital signs were measured and an 18-gauge intravenous catheter was placed. After blood was drawn
for fasting tests, subjects consumed a milkshake composed of heavy whipping cream (190 g; Sysco Grade A), ice cream (90 g; Babcock vanilla 12% butterfat), chocolate-flavored syrup (30 g; Richardson’s or Hershey’s), concentrated protein supplement (25 g; nonfat dry
milk powder), safflower oil (22 g), Lactaid (McNeil-PPC), and Aquasol (Amur Pharmaceuticals). The milkshake composition was adjusted to a body surface area of 2.0 m2. On average (SD), each milkshake contained 1175 (98) calories, with 101 (9) g of fat, 55 (5) g of carbohydrate, and 17 (1) g of protein. The average fat composition included 51 (5) g saturated, 6 (1) g polyunsaturated, and 38 (3) g monounsaturated fat, with 296 (25) g of cholesterol and 51
(4) g of sugar. Laboratory tests were repeated 2, 4, 6, 8, and 10 hours later.
Measurement of Lipids and Lipoproteins
Serum triglycerides were measured using a glycerol kinase– based enzymatic procedure on a Hitachi Modular DP. Retinyl palmitate levels were measured by high-performance liquid chromatography. Apolipoprotein E genotyping was performed using the polymerase
chain reaction with fluorescent monitoring. A blood sample was collected into a lavender-topped tube and immediately centrifuged at 3000 rpm for 15 minutes. Plasma was transferred to a cryovial, refrigerated at 4°C, and shipped within 24 hours in a refrigerated box
to LipoScience, Inc. for NMR spectroscopic lipoprotein analysis, which was performed within 48 hours of sample collection.13
Other Laboratory Tests
Serum glucose levels were measured using a colorimetric enzymatic procedure on a Hitachi Modular DP. Fasting serum insulin was measured using a chemiluminescent immunoassay on a Diagnostic Products Corporation Immulite 2000 analyzer. Homeostasis model assessment of insulin resistance (HOMA-IR) was calculated as fasting serum insulin (U/mL)fasting plasma glucose (after conversion to mmol/L)/22.5. CD4 cell counts were measured by flow
cytometry. Plasma HIV RNA titers were measured by b-DNA hybridization.
Data Analysis
All variables are described by meanSE unless otherwise noted. Baseline comparisons between the 3 groups initially were performed using 1-way repeated-measures ANOVA; however, subjects in group 3 were younger than in groups 1 and 2, so baseline betweengroup
differences were re-evaluated using analysis of covariance and Tukey–Kramer multiple comparison tests, adjusted for age. 2 or Fisher exact tests for proportions were performed for categorical data. Student t tests were used to compare pre-HAART data between groups 1 and 2. To evaluate response to the oral fat load, areas under the curve (AUCs) were calculated from plots of lipid and lipoprotein values that were measured at baseline and every 2 hours through
hour 10. Between-group AUC differences were evaluated by repeated-measures ANOVA, with group contrasts determined using the general linear model, adjusted for age. In addition, incremental AUCs were determined sequentially in a similar fashion (ie, hours 2 through 10, 4 through 10, 6 through 10, and 8 through 10). Preliminary analysis after recruitment of 49 subjects led to a revised sample size estimate that 62 subjects (including 32 in group 1) would
provide 80% power to show significant between-group differences in AUCs for chylomicrons and serum triglycerides (0.05).
Results
Subject Characteristics
Of 65 subjects, 35 were HIV positive and receiving PIs (group 1), 20 were HIV positive and not receiving PIs (group 2), and 10 were HIV negative (group 3) (Table 1). The mean age was 40.41.1 years, 54 (83%) subjects were men, 52 (80%) were white, 7 were black (11%), and the remainder were Hispanic or Asian. Subjects in group 3 were younger than those in groups 1 and 2 (P0.001); therefore all subsequent between-group comparisons were adjusted for age. Distributions of sex and race did not differ significantly between groups. A family history of premature CAD was reported in 11 (17%) subjects, 29 (45%) currently used cigarettes, and 12 (18%) had hypertension. The prevalences of these CAD risk factors were similar in all groups. Insulin levels and HOMA-IR were lower in group 3 than in either HIV-positive group; however, these differences were only significant compared with group 1. Group 1 also had the highest waist circumference (P0.028 versus group 2). The most common apolipoprotein E genotype was 3/3 (52%) followed by 3/4 (22%). No subjects had the 2/2 genotype. Apolipoprotein E allele frequencies did not differ between groups. The average duration of HIV treatment, CD4 cell count, and median HIV RNA titer, including the percentage completely suppressed (50 copies/mL; 46%), were similar in groups 1 and 2. In group 1, the most commonly used PI was
ritonavir (n20), which, in all subjects, was used to boost serum levels of another PI (12 lopinavir; 5 indinavir; 2 amprenavir; and 1 saquinavir). Remaining group 1 subjects were receiving nelfinavir (10), indinavir (4), and amprenavir (1). In group 1, 5 subjects also were taking nevirapine, and 1 was taking efavirenz. The most commonly used nucleoside reverse transcriptase inhibitors were lamivudine (83%), stavudine (57%), and abacavir (23%). Less than 20% were taking zidovudine, didanosine, or tenofovir. In group 2, 6 subjects were taking nevirapine (30%), and 7 were taking efavirenz (35%). The most commonly used nucleoside reverse transcriptase inhibitors in group 2 were similar to group 1: lamivudine 95%; stavudine 40%; zidovudine 50%; and abacavir 35%. Less than 20% were taking didanosine or tenofovir. There were no significant differences between groups 1 and 2 in the frequency of use of any individual nucleoside or non-nucleoside reverse transcriptase inhibitors. Before starting on HAART, total cholesterol levels (149.56.1 versus 152.510.1 mg/dL; P0.250), glucose
levels (89.76.1 versus 85.54.1 mg/dL; P0.372), weight (74.03.1 versus 68.4.43.7 kg; P0.303), and body mass index (23.50.9 versus 22.41.1 kg/m2; P0.491) were similar in both groups of HIV-positive subjects (group 1 versus group 2). Baseline Lipids and Lipoproteins
Baseline serum triglycerides and retinyl palmitate levels in groups 1 and 2 were not significantly different (P0.100) (Table 2). Serum triglycerides in group 1 were greater than in group 3 (P0.040). Retinyl palmitate levels were low in all groups but were marginally higher in group 1 than in group 3 400 Arterioscler Thromb Vasc Biol. February 2005 (P0.049). Baseline lipoprotein concentrations also were similar in groups 1 and 2. The only significant difference was in the concentration of LDL particles (P0.042), with significantly higher values in group 1 than in group 3 (P0.014) and a trend for higher values than in group 2 (P0.091). Other significant between-group differences were only when compared with the control group (group 3). Baseline particle sizes were similar in groups 1 and 2, with smaller LDL and HDL particles than group 3. Postprandial Changes in Lipids and Lipoproteins All 3 groups experienced parallel rises in serum triglycerides, retinyl palmitate, and large VLDL, with peak triglycerides and chylomicron concentrations observed at hour 4 (Figure 1 and Table 3). After hour 4, concentrations of these parameters decreased rapidly in group 3 but remained elevated in groups 1 and 2, with peak retinyl palmitate and large VLDL concentrations not occurring until hour 6 (Figure 1). The postprandial concentration curves for groups 1 and 2 were nearly superimposable for these parameters. Postprandial AUCs did not differ significantly between groups 1 and 2. However, the serum triglycerides postprandial AUC for group 1 was higher than for group 3 (P0.021; Table 3). Postprandial AUCs for medium VLDL were higher for both
HIV-positive groups than controls, but did not differ between groups 1 and 2 (Table 3). Thus, differences in postprandial triglyceride metabolism were not observed between groups 1
and 2, but delayed clearance was seen in both HIV-positive groups compared with HIV-negative controls. Significant between-group differences were noted in the postprandial AUCs for IDL (P0.020) and LDL particles (P0.031; Table 3). For these parameters, the postprandial
AUCs for group 1 were higher than for groups 2 and 3. For LDL particles, the postprandial curves were relatively flat, with slight decreases in the second and fourth postprandial
hours (Figure 2). Postprandial differences seemed to reflect baseline values; however, the differences between groups 1 and 2 increased enough to reach statistical significance
(P0.032). For IDL, postprandial levels increased in both HIV-positive groups, but more in group 1 than 2 (P0.020) or group 3 (P0.017; Figure 2). This difference was especially notable between the fourth and sixth postprandial hours, when IDL increased in group 1 but decreased in groups
2 and 3. The postprandial AUC for small LDL particles was highest among subjects in group 1 and was significantly higher than in group 3 (P0.030) but did not differ significantly
from group 2. Incremental Postprandial AUC Differences Between Groups 1 and 2
In incremental AUC analyses (numerical data not shown), differences in triglycerides, retinyl palmitate, chylomicrons, large VLDL, and small VLDL were not seen between groups
1 and 2 across any time increment. Between-group differences in medium VLDL postprandial AUCs trended toward significance at hours 2 through 10 and 4 through 10 only.
Postprandial AUC differences in IDL and LDL particle concentrations between groups 1 and 2 remained statistically significant throughout each time increment because of con-
TABLE 1. Subject Characteristics Group 1 (HIV, on PIs) Group 2 (HIV, not on PIs) Group 3
(HIV) P* n 35 20 10 — Age (years) 42.51.3 41.61.8 31.12.5 0.001 (1 vs 3, 0.001)
(2 vs 3, 0.001) Sex (% male) 83 85 80 0.794 Body surface area (kg/m2) 1.930.03 1.870.03 1.970.05 0.124 (2 vs 3, 0.038) Systolic blood pressure (mm Hg) 128.02.4 128.33.2 124.84.6 0.831 Hypertension (%) 26 15 0 0.101 Glucose (mg/dL) 96.61.9 95.02.4 89.83.4 0.233 Insulin (U/mL) 12.81.3 10.61.7 5.62.5 0.039 (1 vs 3, 0.012)
HOMA-IR (units) 3.20.4 2.50.5 1.20.7 0.052 (1 vs 3, 0.017) Waist circumference (cm) 90.91.6 83.82.1 89.32.9 0.028 (1 vs 2, 0.008) Diabetes mellitus (%) 3 5 0 0.770
Current smoking (%) 46 55 0 0.114 Family history of premature CAD (%) 23 15 10 0.124
Duration of HIV treatment (years) 5.70.5 5.10.7 — 0.453 CD4 cell count (cells/mL) 42345 47459 — 0.500 HIV RNA titer (median copies/mL, % undetectable) 75 (45.7) 67 (45.8) — 0.226 *Statistically significant between-group differences (P0.05) are in parentheses. Stein et al Postprandial Lipoproteins in HIV 401 sistently higher values among subjects in group 1. Consistent significant differences in postprandial AUCs were not observed
for LDL subclasses or lipoprotein particle sizes. Exploratory Analyses Exploratory analyses to determine whether there were differences in baseline and postprandial responses between the 12 subjects taking lopinavir/ritonavir (the most commonly used ritonavir-boosted PI) and the 10 subjects taking nelfinavir (the most commonly used nonritonavir-boosted PI) were
performed. These subjects were of similar age. Subjects taking nelfinavir had higher CD4 cell counts (P0.001) and a higher prevalence of hypertension (P0.028); however, no
significant differences or trends (P0.010) between the groups taking these PIs were observed for lipids or lipoproteins at baseline or after the fat load. Similar results were obtained when comparing all 20 subjects in group 1 who were taking ritonavir (the PI most implicated in hyperlipidemia), with the remaining 15 not taking this PI. Also, use of stavudine did not significantly influence postprandial AUCs for the parameters in Figures 1 and 2. Discussion
In this study, postprandial serum triglycerides, retinyl palmitate, chylomicrons, and large VLDL concentrations in HIVpositive individuals taking PIs were similar to HIV-positive individuals not taking PIs. However, compared with HIVnegative subjects, both HIV-positive groups had more persistent peak serum triglyceride concentrations and later peak concentrations of retinyl palmitate and large VLDL. For these markers of triglyceride metabolism, postprandial concentration curves for groups 1 and 2 were nearly superimposable, and the postprandial AUCs did not differ significantly. Between the fourth and sixth postprandial hours, the decreasing chylomicron concentrations with increasing large VLDLs/remnants and IDLs suggest that clearance of postprandial lipoproteins is delayed in HIV-positive patients on
antiretroviral therapy, with chylomicron triglycerides being hydrolyzed by lipoprotein lipases and subsequent conversion to chylomicron remnants, large VLDLs, and IDLs, with
delayed hepatic removal. The delayed peak in retinyl palmitate levels (at hour 6) in groups 1 and 2 also supports this conclusion. Evaluating postprandial chylomicron and triglyceride metabolism by measuring retinyl palmitate levels is based on the observation that in humans, retinyl esters circulate with chylomicrons and their remnants, are taken up by hepatocytes,
and do not recycle in VLDLs.20,21 Because of experimental evidence that retinyl esters can be transferred from chylomicrons to other lipoprotein fractions, we also assessed lipoprotein concentrations using NMR spectroscopy, another validated technique for assessing triglyceride-rich lipoproteins after an oral fat load.13,22,23 In agreement with the findings using retinyl palmitate levels, NMR assessment of TABLE 2. Baseline Lipids and Lipoproteins
Group 1 Group 2 Group 3 P* Serum triglycerides (mg/dL) 233.135.2 183.245.9 78.864.9 0.176 (1 vs 3, 0.040) Retinyl palmitate (mg/dL) 0.1160.029 0.0610.038 0.0000.053 0.170 Chylomicrons (mg/dL) 5.81.2 3.81.6 1.32.3 0.258 Large VLDL (mg/dL) 83.022.5 54.429.8 15.642.1 0.408 Medium VLDL (mg/dL) 81.211.0 72.414.5 20.720.5 0.071 (1 vs 3, 0.012) (2 vs 3, 0.044) Small VLDL (mg/dL) 11.42.0 11.42.7 10.43.8 0.978 LDL particles (mmol/L) 1470.187.3 1221.5115.4 996.8163.2 0.042
(1 vs 3, 0.014) IDL (mg/dL) 4.91.2 1.61.6 0.02.3 0.080 (1 vs 3, 0.032)
Large LDL (mg/dL) 42.07.4 30.39.8 43.613.9 0.602 Medium LDL (mg/dL) 37.86.2 47.68.2 43.411.6 0.629 Small LDL (mg/dL) 39.88.2 24.910.8 7.215.3 0.199
(1 vs 3, 0.066) Large HDL (mg/dL) 24.72.4 23.03.1 18.44.5 0.539 Small HDL (mg/dL) 15.30.9 17.81.1 18.21.6 0.123 VLDL size (nm) 57.82.0 53.52.7 51.53.8 0.261
LDL size (nm) 20.50.5 20.60.7 20.71.0 0.033 (1 vs 3, 0.005) (2 vs 3, 0.012)
HDL size (nm) 8.80.3 8.80.3 10.10.5 0.092 (1 vs 3, 0.020) (2 vs 3, 0.031)
* Statistically significant between-group differences (P0.05) are in parentheses.
402 Arterioscler Thromb Vasc Biol. February 2005 postprandial chylomicron and large VLDL remnant concentrations showed similar postprandial AUCs among both groups of HIV-positive patients. These findings also suggest that postprandial metabolism of chylomicrons and their remnants do not differ significantly between patients with HIV infection currently using or not using PIs. The only postprandial AUC differences observed between HIV-positive subjects receiving and not receiving PIs were in the concentrations of IDL and LDL particles. Postprandial curves for LDL particles initially reflected baseline differences between groups and were higher in group 1. Although this general relationship was maintained throughout the
postprandial period, differences between groups 1 and 2 increased, whereas the differences between groups 2 and 3 tended to decrease, so the postprandial AUCs for LDL particles were significantly higher in group 1 than in group 2 or 3. The LDL particle concentration is the most powerful of the NMR-derived lipoprotein concentrations for predicting cardiovascular risk in the fasting state; however, associations between CAD and postprandial lipoprotein measured using
NMR spectroscopy have not been described previously.13,24,25 Similarly, baseline IDL concentrations were highest among subjects taking PIs. After the lipid load, the increase in IDLs
was most dramatic and sustained in group 1, and the postprandial AUC for IDLs was significantly higher than in groups 2 and 3. Although disorders associated with increased
IDL levels (measured using other techniques) have been associated with atherosclerosis, associations with CAD have not been described between IDL concentrations measured by
NMR spectroscopy or postprandial IDL levels.13 Nevertheless, as a cholesterol-rich remnant lipoprotein, it is likely that increased IDL levels contribute to atherosclerosis. Overall, these findings suggest that HIV-positive subjects receiving antiretroviral therapy have impaired clearance of postprandial triglyceride-rich lipoproteins, but that the dyslipidemia observed in patients receiving PIs also may be related to impaired clearance of IDLs and LDLs.2,10 Increased postprandial lipemia predicts the development and progres-Figure 1. Age-adjusted postprandial changes in serum triglycerides, retinyl palmitate, chylomicrons, and large VLDL. For statistical significance, see text and Table 3. TABLE 3. Postprandial AUC Values Group 1 Group 2 Group 3 P* Serum triglycerides (mg/dL) 3389362 3092478 1565677 0.114
(1 vs 3, 0.021) Retinyl palmitate (mg/dL) 15.21.4 15.21.8 10.62.6 0.355 Chylomicrons (mg/dL) 44775 40899 267140 0.688 Large VLDL (mg/dL) 1231201 1026266 447376 0.265 Medium VLDL (mg/dL) 76884 653111 240157 0.036 (1 vs 3, 0.004)
(2 vs 3, 0.035) Small VLDL (mg/dL) 10015 11320 9628 0.841 LDL particles (mmol/L) 14362693 11846917 108241297 0.031 (1 vs 2, 0.032) (1 vs 3, 0.019) IDL (mg/dL) 5610 1514 519 0.020 (1 vs 2, 0.017) (1 vs 3, 0.020) Large LDL (mg/dL) 41766 31488 445124 0.588 Medium LDL (mg/dL) 36057 49275 487106 0.321 Small LDL (mg/dL) 38766 20887 78123 0.082 (1 vs 3, 0.030) Large HDL (mg/dL) 25527 23930 21542 0.732 Small HDL (mg/dL) 1387.0 1609.3 16013.1 0.126 *Statistically significant between-group differences (P0.05) are in parentheses. Stein et al Postprandial Lipoproteins in HIV 403 sion of CAD; however, postprandial lipoprotein metabolism is complex, and most studies have focused only on postprandial triglyceride metabolism.14–16,20–22 Patients with increased postprandial hypertriglyceridemia have disordered handling
not only of exogenous-derived triglyceride-rich lipoproteins but also hepatic-derived triglyceride-rich lipoproteins.26,27 Postprandial hypertriglyceridemia in hypertriglyceridemic
patients with CAD appears to be attributable to impaired metabolism of VLDLs rather than accumulation of chylomicrons and their remnants.27 In this context, it is interesting
that postprandial medium VLDL concentrations were higher in both HIV-positive groups than in HIV-negative controls. These findings also are consistent with a previous report of
decreased triglyceride clearance in patients with advanced HIV infection not on HAART.12
Strengths of this study include the use of an HIV-negative control group, demonstration of the expected postprandial curves for serum triglycerides and retinyl palmitate, and verification and elucidation of postprandial lipoprotein metabolism by the newer NMR technology.23 Other strengths include statistical validation of the AUC data by incremental AUC analysis and similar apolipoprotein E genotypes in all 3 groups. Also, age, body surface area, systolic blood pressure,
glucose, duration of HIV treatment, CD4 cell count, and HIV RNA titer (including percentage completely suppressed) were similar between both HIV-positive groups. Although subjects
in group 1 had larger waist circumferences, their fasting insulin and HOMA-IR levels were not significantly different from group 2.
Limitations
Because subjects with diabetes mellitus or on lipid-lowering medications were excluded, the magnitude of the dyslipidemia in this study was not as severe as in previous studies of HAART and lipoproteins. It is possible that differences in postprandial lipoprotein metabolism among patients taking HAART with more significant metabolic abnormalities were not detected.11 In this study, levels of apolipoprotein B-48, apolipoprotein B-100, and “triglyceride-rich remnant lipoproteins” using newer assays were not measured as in other studies of postprandial lipemia.12,20,21,26–28 Similarly, levels and activity of enzymes involved in triglyceride metabolism were not assayed. Although the HIV-negative controls were significantly younger than both HIV-positive groups, all between-group comparisons were adjusted statistically for
age. A fourth arm of HIV-positive individuals not on HAART was not included because impaired triglyceride clearance has already been demonstrated in this group, and the sample size for a 4-way comparison would have been prohibitive.12 Finally, the prevalence of stavudine use in this study was somewhat higher than current usage patterns; however, it did not appear to affect postprandial lipoprotein metabolism in group 1 or 2 and was reflective of nucleoside reverse
transcriptase inhibitor use when this study started (summer 2002).
Conclusions
Postprandial clearance of triglyceride-rich lipoproteins is delayed in HIV-positive individuals receiving antiretroviral therapy. Compared with HIV-positive individuals not on PIs, those taking PIs do not have increased postprandial triglyceride-rich lipoproteins but do have ncreased postprandial IDLs and LDLs. In this regard, postprandial hypertriglyceridemia
does not contribute to the increased cardiovascular risk observed among HIV-positive patients receiving PIs relative to HIV-positive subjects not taking PIs, but may contribute to the increased cardiovascular risk observed in patients with HIV infection per se. The finding that subjects taking HIV PIs had increased postprandial concentrations of atherogenic IDL and LDL particles is unique and merits further study.
Acknowledgments
This work was funded in part by the National Center for Research Resources (K23 RR16176) and the University of Wisconsin General Clinical Research Center (M01 RR03186-1551).
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25. Kuller L, Arnold A, Tracy R, Otvos J, Burke G, Psaty B, Siscovick D,
Freedman DS, Kronmal R. Nuclear magnetic resonance spectroscopy of
lipoproteins and risk of coronary heart disease in the cardiovascular
health study. Arterioscler Thromb Vasc Biol. 2002;22:1175–1180.
26. Karpe F, Steiner G, Olivecrona T, Carlson LA, Hamsten A. Metabolism
of triglyceride-rich lipoproteins during alimentary lipemia. J Clin Invest.
1993;91:748 –758.
27. Karpe F, Hellenius ML, Hamsten A. Differences in postprandial concentrations
of very-low-density lipoprotein and chylomicron remnants
between normotriglyceridemic and hypertriglyceridemic men with and
without coronary heart disease. Metabolism. 1999;48:301–307.
28. Havel RJ. Determination and clinical significance of triglyceride-rich
lipoprotein remnants. In: Rifai N, Warnick G, Dominiczak M, eds.
Handbook of Lipoprotein Testing. Washington, DC: AACC Press; 2000:
565–580.
Stein et al Postprandial Lipoproteins in HIV 405

To purchase a NMR LipoProfile test simply order online at LabSafe at http://www.lab-safe.com/lab-tests/test/532/ or visit our website at www.LabSafe.com

For more information, or to speak with a member of our professional Medical Staff, call LabSafe toll free at 1-888-333-LABS.

Breaking News: LabSafe Deploys SLI Systems' Search Solutions to Put Critical Medical Information in Customers' Hands More Quickly

2006-09-15T13:41:00.000-07:00

Breaking News: LabSafe Deploys SLI Systems' Search Solutions to Put Critical Medical Information in Customers' Hands More Quickly

Market Wire Press Release for LabSafe

2006-09-12T17:50:00.000-07:00

LabSafe Deploys SLI Systems' Search Solutions to Put Critical Medical Information in Customers' Hands More Quickly

Online Laboratory Products and Services Provider Generates More Sales Through SLI's Managed Site Search and Automated SEO Offerings

CUPERTINO, CA -- (MARKET WIRE) -- September 12, 2006 -- SLI Systems, Inc., a provider of on-demand search services for Internet and e-commerce sites, today announced that LabSafe (http://www.labsafe.com/), an online provider of medical laboratory products and services, has implemented the company's hosted site search and automated search engine optimization (SEO) offerings. Since deploying SLI Systems' Learning Search and Site Champion just a few months ago, LabSafe has seen a steady increase in revenues derived directly from the managed solutions, by delivering more relevant search results to site visitors and increasing its ranking on searches conducted on Internet search engines like Google and Yahoo!

LabSafe has experienced an added benefit from working with SLI Systems in eliminating frequent problems it encountered with its previous site search solution, stemming from too many search queries that overloaded the company's servers and brought them to a standstill. Because SLI's offerings are hosted entirely on SLI's own servers, which can handle upwards of 20 million searches a day, LabSafe no longer worries about the negative impact of abundant search-bot activity during peak traffic periods, and the issues with site performance have completely disappeared.

"Our mission is to expand the field of preventative medicine by increasing consumer access to affordable laboratory tests and laboratory testing education," said Brian Lunn, CEO of LabSafe. "If people can't find what they're looking for on our site, then we're not doing a good job of putting critical information in their hands. SLI Systems has been a life saver to us -- and our customers -- because they deliver the results people look for when searching on our site. The increases in sales and positive feedback we've seen are evidence."

About Learning Search and Site Champion
Based on SLI's patented "Learning Search" advanced analytics engine, the company's hosted site search and automated SEO solutions "learn" from user behavior by tracking the search terms people use on a retailer's site and the resulting items they click on. The SLI solutions give retailers greater insight into what terms they should be both linking products to and including in product descriptions, and which products are the most popular for various keywords. As a result, retailers can ensure the products people are searching for show up in the right searches -- whether those searches are conducted on their own sites or on an Internet search engine like Google.

Learning Search is a hosted site search solution that continually tracks visitors' aggregate search terms and the corresponding items clicked on, and uses that data to deliver results based on popularity. For example, if someone searches on "Blood Test," Learning Search automatically ranks the items so that those with historically higher click-rates are listed at the top. Learning Search also shows how many products exist and in what categories, and gives visitors the option to sort the results by ascending or descending prices, or filter by category. Learning Search is supplemented with a new, free Site Search Feedback Tool, which is designed to help e-commerce and other Web sites better understand the quality of their site search functionality based on customer input. More information is available at http://www.sli-systems.com/feedback.

Site Champion is an automated search engine optimization service that integrates with Learning Search, tracking visitors' search terms and using them to automatically create related search links for each page of a retailer's site. When visitors click on these 'related search' links they are presented with site search results for that term, directing them to additional relevant content and commerce opportunities -- making it easier for a site's visitors to find what they want, and helping retailers generate more sales. The links also drive more natural search traffic to the retailer's site by giving the retailer's results pages links that are crawled by search engine spiders.

"It's a good feeling to know we're helping companies like LabSafe that have such a worthwhile purpose," said Dr. Shaun Ryan, CEO of SLI Systems. " The benefit of our managed offerings is that there's no up-front or ongoing work for the retailer; they just get to sit back and watch the positive results come in. This makes it easy for companies like LabSafe to stay focused on the important work they do."

More than 100 online retailers and other companies are using SLI Systems' hosted offerings, including NBC, Tupperware, Fright Catalog, NRS (Northwest River Supplies), and many more.

About SLI Systems
SLI Systems is a leading provider of managed site search services for e-commerce and other Internet sites that learn from user behavior to improve visitors' search experiences. SLI Systems' hosted site search, and automated SEO and SEM solutions empower businesses to enhance customer satisfaction while increasing sales, reducing costs and yielding valuable customer information. Unlike traditional search software, SLI Systems' patented technology continuously "learns" from the behavior of visitors over time to deliver more relevant results. Current customers include Etronics.com, NBC, Tupperware, ULTA, Chiasso and others. SLI Systems is a privately held company, with offices in Silicon Valley, London, and Christchurch, New Zealand. For more information, visit http://www.sli-systems.com/.

FOR MORE INFORMATION, CONTACT:
Nancy MacGregor Hill
RealTime Communications
510-733-6228
Email Contact
SOURCE: SLI Systems, Inc.

LabSafe
1-888-333-LABS
Email Contact
website@LabSafe.com
SOURCE: LabSafe

Have You Been Exposed To Heavy Metals?

2006-09-08T11:35:00.000-07:00

Heavy Metal

Due to natural disasters and other recent catastrophes, we at LabSafe have had numerous inquires regarding heavy metal and other toxin exposures.

The Environmental Protection Agency (EPA) monitors the environment for health hazards and public safety. Heavy Metals include mercury, lead, arsenic and chromium to name a few. We are exposed to these toxins daily, and in low levels these toxins cause no problems. However, the EPA has issued warnings for Alabama, Louisiana, Mississippi, and Texas due to high levels of some of these toxins.

Some of the harmful effects of mercury are cancer, damage to the stomach and large intestines, permanent damage to the brain and kidneys, permanent harm to unborn children, lung damage, and increased blood pressure and heart rate.

Chromium exposure through the inhalation of insoluble chromium compounds may produce pneumoconiosis with impairment of pulmonary function. Exposure to the inorganic soluble salts can precipitate skin ulcerations, dermatitis, perforation of the nasal septum, and respiratory sensitization. Acute exposure to these salts may result in local tissue necrosis and kidney damage.

Symptoms of high levels of arsenic exposure include headache, feeling tired, confusion, hallucination, vomiting, diarrhea, digestive system bleeding seizures, and coma.

Symptoms of high lead exposure include fatigue, depression, heart failure, abdominal pain, gout, kidney failure, high blood pressure, wrist or foot weakness, reproductive problems, and anemia.

A heavy metal test panel, offered by LabSafe, can monitor exposure and detect if your levels are higher than the acceptable limits. Call LabSafe toll free at 1-888-333-LABS or visit us online at www.LabSafe.com (click on the category Testing For Toxins or simply follow this link: http://www.labsafe.com/lab-tests/test/483/ ) for more information. As with all tests the results should be reviewed with your Physician.

Facts About Menopause

2006-09-07T11:49:00.000-07:00

Menopause

A woman’s body goes through several changes during menopause. Some of the more common symptoms of menopause occur when estrogen levels start to drop. Women may experience:

1. hot flashes;
2. rapid mood swings ranging from depression to euphoria;
3. decreased libido and sex drive;
4. increased frequency or sudden urge to urinate;
5. vaginal dryness with pain during intercourse;
6. excessive bone loss, leading to a higher incidence of fractures of the hip and spinal column;
7. a higher risk for heart disease (because the levels of LDL “bad” cholesterol in the blood may rise).

A woman of menopausal age might have the following laboratory tests ordered:

1. Follicle-stimulating hormone (FSH) test, to learn whether she is approaching or has gone through menopause;

2. Estradiol test, to measure ovarian production of estrogen and to evaluate whether the menstrual cycle is normal and if she is fertile;

3. Thyroid function testing (free T4 and TSH tests) to test the function of the thyroid gland, which can slow with age;

4. Lipid profile, to test for triglycerides and the good (HDL) and bad (LDL) cholesterol levels in the blood to assess for cardiovascular disease;

5. Complete blood count (CBC), to determine the adequacy of the number of red and white blood cells in the blood;

6. Chemistry tests for liver and kidney function, to see if she can tolerate hormone replacement therapy; and

7. If a woman has risk factors or symptoms of diabetes, her doctor may also order a glucose test to learn whether the sugar levels in the blood are too high.

Knowing what is going on with your body is the first step in understanding menopause.

To purchase any of the above tests, click on their link where you may simply order online at the LabSafe website at www.LabSafe.com

For more information, or to speak with a member of our professional Medical Staff, call LabSafe toll free at 1-888-333-LABS.

Can Herbal Remedies or "Liver Flushes" Damage Your Liver?

2006-09-06T11:35:00.000-07:00

Liver Panel Test

A liver panel, also known as liver (hepatic) function tests or LFT, It is used to check for liver damage or disease. It includes:

• ALT – an enzyme mainly found in the liver; the best test for detecting hepatitis

• AST – an enzyme found in the liver and a few other places, particularly the heart and other muscles in the body; indicates liver damage

• Bilirubin – (especially significant if a person has jaundice); indicates if liver is filtering and processing properly

• Albumin-measures the main protein made by the liver and tells how well the liver is making these proteins

• Total protein- measures protein including antibodies made to help fight infection; can be an indicator of cirrhosis or other medical disorders.

The liver panel test may also be ordered when a person has been or may have been exposed to a hepatitis virus; has a family history of liver disease; has excessive alcohol intake; or is taking a drug that can cause liver damage. The liver is unique as the only internal human organ capable of natural regeneration of lost tissue. As little as 25% of a remaining liver can regenerate into a whole liver again. The liver is the largest organ in the body, weighing about three to four pounds, and making up about 2-3% of the total body weight. It is the “mother” of the body and does what most mothers do—a vast complex multi-systematic performance of coordination—including that of a ‘watchdog’, grocer, housekeeper, body-guard, bodybuilder, energy plant supervisor, and sanitation engineer - to name but a few.

The following list names just a few of the liver functions. The liver performs several roles in carbohydrate, protein, and lipid (fats} metabolism. It also aids in the breakdown of insulin and other hormones, toxic substances and most medicinal products. The liver aids in blood clotting. It stores nutrients, including glucose (in the form of glycogen), vitamin B12, iron, and copper. The liver also has an important role in vitamin storage. High concentrations of riboflavin or vitamin B1 are found in the liver. 95% of the body’s vitamin A stores are concentrated in the liver. The liver also contains small amounts of vitamin C, most of the body’s vitamin D stores, and vitamins E and K.

A liver test panel may be ordered when symptoms suspicious of a liver condition are noticed. These include: jaundice, dark urine, or light-colored bowel movements; nausea, vomiting, and/or diarrhea; loss of appetite; vomiting of blood; bloody or black bowel movements; swelling or pain in the belly; unusual weight change; or fatigue or loss of stamina. One or more of these tests may also be ordered when a person has been or may have been exposed to, or is taking a drug that can cause liver damage.

Liver flushes and herbal liver cleansers are available without a prescription and are gaining in popularity. Many people are concerned that their livers may be damaged or stressed, and they seek to detoxify their liver in order to be healthier, rid their body of toxins, and have higher energy levels. However, many herbal remedies can actually damage the liver and many others may provide little or no benefit. Taking a liver panel test before taking the herbal remedy can help you understand if your liver is healthy, and set a baseline for comparison afterwards. After taking the herbal remedy, a second, follow-up liver panel can be done to help understand if the remedy has hurt or helped your liver.

To purchase a Liver Function test simply order online at LabSafe at http://www.labsafe.com/lab-tests/test/412/ or visit our website at www.LabSafe.com

For more information, or to speak with a member of our professional Medical Staff, call LabSafe toll free at 1-888-333-LABS.

What is the Prostatic Acid Phosphatase Test?

2006-09-05T15:03:00.000-07:00

Prostatic Acid Phosphatase

Prostatic Acid Phosphatase (PAP) is an enzyme that is normally present only in small amounts in the blood. It may be found at higher levels in some patients with prostate cancer, especially if the cancer has spread beyond the prostate. However, blood levels may also be elevated in patients with certain benign prostate conditions or early stage cancer. Although PAP was originally found to be produced by the prostate, elevated PAP levels have since been associated with testicular cancer, leukemia, and non-Hodgkin’s lymphoma, as well as noncancerous conditions such as Gauchers disease, Paget’s disease, osteoporosis, cirrhosis of the liver, pulmonary embolism and hyperparathyroidism. A simple blood test is available to detect PAP levels.

Prostatic acid phosphatase is used as a prostate tumor marker. PAP in conjunction with PSA measurements are useful in assessing the prognosis of prostate cancer. Measurement of two markers allows identification of prostate cancer patients who have an elevation of PAP but not of PSA, and thus help monitoring the course of disease and response to treatment. PAP is more specific than PSA and less false-positives are seen due to Benign Prostatic Hyperplasia (BPH).

Source. MedlinePlus, National Institute of Health.

To purchase a Prostatic Acid Phosphatase test simply order online at LabSafe at http://www.labsafe.com/lab-tests/test/481/ or visit our website at www.LabSafe.com

For more information, or to speak with a member of our professional Medical Staff, call LabSafe toll free at 1-888-333-LABS.

Why Testosterone, Steroids, or Anti-Aging Drugs Can Be Dangerous

2006-09-01T12:45:00.000-07:00

Testosterone
Testosterone is often thought of as only being important in males. In men, the hormone is produced by the testicles and is responsible for the proper development of male sexual characteristics. However, testosterone is also important in females, and in both sexes it is essential for maintaining muscle mass, adequate levels of red blood cells, bone growth, sense of well-being and sexual function.

In men, the amount of testosterone in the body gradually declines with age. This natural decline starts after age 30 and continues throughout life. Other causes of lowered testosterone levels include, but are not limited to: injury or infection to the testes, pituitary gland dysfunction, stress, medications, and alcoholism. Advances in the medical field of Endocrinology have led many of our nation's top doctors to characterize the natural drop in male testosterone levels as a condition called "andropause." Simply put, andropause can be considered the male version of menopause in females.

Without adequate testosterone a man may lose his sex drive, experience erectile dysfunction, feel depressed, have a decreased sense of well-being, and have difficulty concentrating. Other changes that can occur are a decrease in muscle mass with an increase in body fat, changes in cholesterol levels, osteoporosis and mild anemia.

A testosterone blood test may help detect the andropause condition by measuring the amount of testosterone in the blood. The result is compared with the expected testosterone levels (based on a man's age).

LabSafe offers a simple and relatively inexpensive testosterone blood test that can give valuable insight into your current testosterone levels. Knowing your testosterone level may help you and your physician understand if medications such as Viagra, Human Growth Hormone, Testosterone Replacement Therapy, Anti Aging therapy, or other medications are appropriate for you.

If you are taking testosterone or steriods, it is imperative that you regularly have your testosterone blood levels tested. Testosterone therapy has been associated with serious heart disease and cardiovascular problems, gynecomastia (swelling and tenderness of the breasts in men), dangerous mood swings and emotional problems, and more. Taking supplemental testosterone when your body is already making enough testosterone can be very dangerous to your body. It can cause a man's testicles to shrink as the body cuts back natural testosterone production to adjust your testosterone levels back to normal.

If you are taking testosterone or steroids when your body is making enough natural testosterone, then you are "doping." Doping is very dangerous and unfortunately is often not taken seriously enough. Many people do it in an effort to enhance athletic performance, and some believe it will help their sex drive or make them feel "better." Young athletes often mistakenly believe that they are young and healthy enough that steroids won't cause them any harm, or that they can contol it with the option to stop taking steroids when they want. But a person can not see the damage that steroids can do to their internal body and often there are no immediate symptoms. For example, unnecessary steroids can cause the heart to change its structure, function, and tissue composition. You can't see these changes and most often you can't feel them either, but the effects are there and do indeed increase your cardiovascular risk, particularly for heart attacks. We often hear of strong young athletes who suddenly die of a heart attack.

However, your doctor has a wide variety of options to help you while at the same time using FDA approved, legal, proven, and safe therapies, which may include medications such as Viagra, vitamin and amino acid supplementation, or possibly even testoserone. Before you seek any testosterone, steriod or antiaging drug therapy it is imperative that you discuss this with your licensed Medical Doctor.

In the past several years there has been an increasing problem with internet based companies who sell steroids, Anti-Aging therapy, Human Growth Hormone (HGH), etc. Many of these outfits have a doctor who authorizes steroid or HGH therapy without ever seeing their patient. The patient feels a false sense of security because a doctor has written a prescription for them, but what they fail to realize is that these companies are simply in business to make money. Often times, the sales people they are talking to do not even have any medical training or background. To make matters worse, they often fail to tell their own doctor that they are taking steroids. Again, before you take any medications, consult your own doctor. If you presently fall into this category, consult your doctor immediately and your doctor can advise you if and how you should stop taking these medications. Suddenly stopping or starting medications can present risks and you should always consult your own doctor.

Symptoms people are experiencing that lead them to choose steroid therapy can often be caused by other underlying medical conditions. For example, a person may say they feel tired or just don't have the same stamina they used to have. Well, that could be due to a number of medical issues ranging from cancer to thyroid problems. Taking steroids may actually make some of these conditions worse. Again, it is essential that you consult your own doctor about symptoms you are having.

LabSafe does not sell or market any medications and therefore has no financial incentive for your blood test results to turn out one way or another. For this reason many people choose to have their HGH, IGF-1 (Insulin-like Growth Factor 1), or testosterone blood testing performed through LabSafe. As with all LabSafe lab tests, regardless of your test results you should share them with your own doctor.

To purchase aTestosterone test, IGF-1 test, or HGH test, simply order online at LabSafe at http://www.labsafe.com/lab-tests/test/74/ or visit our website at http://www.labsafe.com/

For more information, or to speak with a member of our professional Medical Staff, call LabSafe toll free at 1-888-333-LABS.

The New Cholesterol Test

2006-08-31T13:55:00.000-07:00

I KNOW MY CHOLESTEROL LEVEL, ISN'T THAT ENOUGH?

Actually, no! Studies show that HALF the people who had heart attacks had NORMAL
cholesterol levels (1). You see, cholesterol is carried by particles or containers in the blood
called lipoproteins. If you have too many of these particles they can build up in your arteries
and cause heart disease.

The higher the number of lipoprotein particles in your blood, the greater the risk you have for
developing Coronary Heart Disease.

The NMR LipoProfile® test measures your risk for heart disease more accurately
than a standard cholesterol test.

Since cholesterol is carried inside lipoprotein particles, it is helpful to think of cholesterol as a passenger and the lipoprotein particle as a vehicle. It’s not the number of passengers that
causes a traffic jam... it’s the number of vehicles! Similarly, it’s not the amount of cholesterol that causes heart disease - it’s the number of lipoprotein particles!

Only the NMR Lipoprofile® test actually counts the number of lipoprotein particles.

In the example below, two patients have the same cholesterol levels (same number of passengers on the road) but have different numbers of particles (cars on the road). Patient A's passengers are carpooling and riding buses, while Patient B's passengers are each driving their own car. Patient B is at higher risk for Coronary Heart Disease because they have more cars on the road, thus causing a "traffic jam" in their arteries...just like many cars can "clog" the road, many particles can cause clogged arteries.

Patient A
LESS RISK FOR HEART DISEASE:
Less Particles
Less Traffic
Same Cholesterol Levels (same number of passengers as Patient B)

Patient B
MORE RISK FOR HEART DISEASE:
More Particles
More Traffic
Same Cholesterol Levels (same number of passengers as Patient A)

A standard cholesterol test does not provide information on the nubmer of particles, but the NMR LipoProfile test does. That is why it is a superior test.

References:
1. Kannel, WB. Am J Cardiol 1995;69C-77C.

Let's compare the standard cholesterol test with the NMR LipoProfile test. The following explains what each of the two tests measures, and the patient goals for each test.

Test 1) Understanding the Standard Cholesterol Test:

A lipid panel is a standard cholesterol test. It is made up of four values: LDL-C (“bad” cholesterol), HDL-C (“good” cholesterol), triglycerides and total cholesterol.

The following are the goals for LDL-C:

160 = GOAL FOR LOW RISK PATIENTS
130 = GOAL FOR MODERATELY HIGH RISK PATIENTS
100 = GOAL FOR HIGH RISK PATIENTS

(standard units of measure for cholesterol numbers are expressed in mg/dL)

Test 2) Understanding Your NMR LipoProfile® Test - Understanding your LDL Particle Numbers:

Your LDL Particle number, called LDL-P number, is the most important value of the NMR LipoProfile report. The lower this number is, the less risk you face. Your LDL-P number can range from less than 1000 to more than 2000 nmol/L. Based on this number and your medical history, your doctor can advise you on a treatment plan designed to reduce your score to a low-risk level.

The following are the goals for LDL-P:

1600 = GOAL FOR LOW RISK PATIENTS
1300 = GOAL FOR MODERATELY HIGH RISK PATIENTS
1000 = GOAL FOR HIGH RISK PATIENTS

(standard units of measure for NMR cholesterol is expressed in nmol/L)

Final Assessment

Your risk level for heart disease is the number that is HIGHER (LDL-P or LDL-C) and should determine your overall risk.

The results of your test provide information about your heart health that you and your clinician can use to make more informed decisions about your risk for heart disease.

Be sure - because it is treatable. Get your NMR LipoProfile test today!

To purchase a NMR LipoProfile test simply order online at LabSafe at http://www.labsafe.com/lab-tests/test/532/ or visit our website at www.LabSafe.com

For more information, or to speak with a member of our professional Medical Staff, call LabSafe toll free at 1-888-333-LABS.

How Does a Blood Glucose Test Check for Diabetes?

2006-08-30T09:41:00.000-07:00

SIMPLY SUGAR

Glucose, also known as table sugar or blood sugar, is essential for providing energy to our bodies. Our brains run primarily on glucose and it is the fuel of choice for our bodies. However, just like the gas tank in our car can hold only so much gasoline, our bloodstream can only hold so much glucose, and running out of gas (glucose) leaves us feeling like we are broken down on the side of the road. That is why our pancreas functions to help control our glucose levels by secreting insulin to aid in and regulate glucose metabolism.

There are several disease processes relating to our blood glucose, including hypo (not enough) and hyperglycemia (too much). Diabetes is a blood sugar disorder that can be genetic (Diabetes Type I), and can be acquired (Diabetes Type II). Obesity is the number one preventable cause of diabetes. The American Diabetes Association recommends the fasting blood glucose test (a simple blood test) as a tool to help screen for a potential problem.

Blood glucose testing can be used to screen healthy individuals who may have no symptoms of diabetes, hyperglycemia, or hypoglycemia. Many people go undiagnosed because initial symptoms seem so harmless or may go completely unrecognized. LabSafe provides glucose testing as well as more advanced screening tests, such as the Hemoglobin A1c test. These simple tests could save your health and help prevent many harmful health factors related to abnormal blood sugar levels.

To purchase a glucose test simply order online at LabSafe at http://www.labsafe.com/lab-tests/test/36/ or visit our website at www.LabSafe.com

To purchase a Hemoglobin A1c test simply order online at LabSafe at http://www.labsafe.com/lab-tests/test/484/ or visit our website at www.LabSafe.com

For more information, or to speak with a member of our professional Medical Staff, call LabSafe toll free at 1-888-333-LABS.

Molds That Cause Allergies

2006-08-29T10:17:00.000-07:00

Allergen Profile: Mold Tests

As the modern world continues to evolve, it is becoming increasingly apparent that our indoor environment can have a huge impact on our health. Molds (also know as fungi) are ubiquitous in the environment and can concentrate in homes, offices and public buildings. This test will test for the most common mold that can cause respiratory problems.

This Allergen profile can be used to find a particular mold and can be used to rule in/out mold exposure as a potential causative factor with regard to chronic fatigue, depression, inability to concentrate (brain fog), Fibromyalgia, etc. It is primarily meant to document toxic mold exposure. It is important also to note that molds can destroy B-cells, hence lowering our humoral immunity.

Stachybotrys chartarum, Aspergillus fumigatus, Alternaria tenuis, Cladosporium herbarum and Penicillium notatum are all molds that are common in buildings and homes and will grow anywhere indoors where there is moisture. In water damaged or "problem" structures, mold levels in indoor air greatly exceed levels outdoors. Inhaled molds as well as molds, fungus and yeasts ingested in foods can colonize the gastrointestinal tract, the sinuses, Eustachian tubes and the oral cavity. Some people are sensitive to molds. For these people, exposure to molds can cause symptoms such as nasal stuffiness, eye irritation, wheezing, or skin irritation. Some people, such as those with serious allergies to molds, may have more severe reactions. Severe reactions may occur among workers exposed to large amounts of molds in occupational settings, such as farmers working around moldy hay. Severe reactions may include fever and shortness of breath. Some people with chronic lung illnesses, such as obstructive lung disease, may develop mold infections in their lungs.

LabSafe offers an allergy blood test panel that tests for the most commonly problematic molds, called the Allergen and Mold Profile. Specifically, the panel tests for the following molds: Alternaria tenuis; Aspergillus fumigatus; Candida albicans; Cladosporium herbarum; Epicoccum purpurascens; Fusarium moniliforme; Helminthosporium sativum; Hormodendrum hordei; Mucor racemosus; Penicillium notatum; Phoma betae; Pullularia pullulans; and Stemphylium solani.

The CDC (Centers for Disease Control) has recommended that if you test positive for mold you should consult a family or general health care provider who will decide whether you need referral to a specialist. Such specialists might include an allergist who treats patients with mold allergies or an infectious disease physician who treats mold infections. If an infection is in the lungs, a pulmonary physician might be recommended. Patients who have been exposed to molds in their workplace may be referred to an occupational physician.

This Allergen and Mold Profile can be the first step towards having a healthy home environment and lifestyle.

To purchase an Allergen and Mold Profile test simply order online at LabSafe at http://www.labsafe.com/lab-tests/test/488/or visit our website at www.LabSafe.com

For more information, or to speak with a member of our professional Medical Staff, call LabSafe toll free at 1-888-333-LABS.

What Causes Male Pattern Baldness?

2006-08-28T12:58:00.000-07:00

DHT, Testosterone, and Male Pattern Baldness

The most common form of hair loss is determined by our genes and hormones. By age 35 to 40, two thirds of Caucasian men experience some hair loss, and it is estimated that approximately 30% of Caucasian women are affected by hair loss before menopause.

Hair follicles produce hair in three phases. A growing (anagen) phase, which lasts from 2 to 6 years, a resting (catagen) phase, which lasts about three months, and a shedding (telogen) phase which allows the follicle to push a new hair to the surface.

Most modern medical research leans towards the position that a male hormone called dihydrotestosterone (DHT) is a primary factor in hair loss. DHT, which is converted from testosterone, binds to sites on hair follicles. DHT appears to make hair follicles go into their “resting” phase faster, which in turns leads to thinning hair. Studies show that balding men don’t have higher than average circulating levels of testosterone, but they do have above average amounts of DHT in the scalp follicles. Some other causes of hair loss that have been identified are a low-carb diet (a study funded by Dr. Atkins himself found about 10% suffered from hair loss), systemic lupus, and hypothyroidism. In addition, mercury toxicity (amalgam illness), vitamin A toxicity, iron deficiency and manganese deficiency have been associated with hair loss. Many of these conditions can be detected with a simple blood test and effective treatments may be available.

Medical studies have also associated DHT with a prostate condition known as Benign Prostatic Hyperplasia (BPH). BPH is a gradual enlarging of the prostate that occurs in men over time and may cause PSA test (Prostate Specific Antigen) values to increase.

To purchase a DHT test simply order online at LabSafe at http://www.labsafe.com/lab-tests/test/536/, or visit our website at www.LabSafe.com

For more information, or to speak with a member of our professional Medical Staff, call LabSafe toll free at 1-888-333-LABS.

What is a Diabetes Hemoglobin A1C Test?

2006-08-25T11:06:00.000-07:00

Glycated Hemoglobin: HbA1c

The glycated hemoglobin test (also called the glycosylated hemoglobin test, or hemoglobin A1c test) is used to monitor the overall sugar control of a diabetic over the course of several months. This test may also be used as a screening tool for early detection of diabetes, although the American Diabetes Association (ADA) has recommended that a less expensive (and less accurate) fasting plasma glucose test (FPG) be used for screening. The A1c test looks backward to give you an overview of your blood glucose control for the past 2-3 months.

In some ways, the A1c test is like a baseball player's season batting average. Both A1c and the batting average tell you about a person's overall success. Neither a single day's blood test results nor a single game's batting average gives the same big picture.

How does the A1c test look backward? Suppose your blood sugar was high last week. What happened? More glucose hooked up (glycated) with your hemoglobin. This week, your blood glucose may be back under control. Still, your red blood cells carry the 'memory' of last week's high blood glucose in the form of a higher percentage of glycated A1c. This record changes as old red blood cells in your body die and new red blood cells (with fresh hemoglobin) replace them. The amount of A1c in your blood reflects blood sugar control for the past 120 days, or the lifespan of a red blood cell.

People who have type 2 diabetes are two to six times more likely to develop coronary heart disease than people without diabetes. Diabetics are also at greater risk for high cholesterol, stroke and heart attacks. Diabetics may reduce their risks by maintaining well-controlled blood sugar levels. The ADA recommends that if you are a diabetic, you should have an A1c test performed every 3 months.

According to the CDC (Centers for Disease Control) there are 17 million Americans with diabetes. More than 200,000 people die each year from complications related to diabetes. The American Diabetic Association recommends early detection, improved care, and education on diabetes self-management as a preventive measure.

To purchase a Hemoglobin A1c test simply order online at LabSafe at http://www.labsafe.com/lab-tests/test/484/or visit our website at http://www.labsafe.com/

For more information, or to speak with a member of our professional Medical Staff, call LabSafe toll free at 1-888-333-LABS.

Helicobacter Pylori (H. Pylori)

2006-08-22T22:39:00.000-07:00

Helicobacter Pylori Test (H. pylori test)

The Helicobacter pylori (H. pyloric) test is a test that looks for evidence of an infection by a bacterium, known as Helicobacter pylori (H. pylori). H. pylori are actually a class of microorganisms called spirochetes. They got their name because they are spherical in shape, like spiral pasta shells. Their hard, acid resistant exterior allows them to survive inside your stomach amongst your strong stomach acid that is there to break down things you eat and acts as an important step in the digestive process. It is theorized that the spherical shape of the microorganisms may also help them burrow into your stomach lining. These microorganisms also make chemicals that alter the acidity (Ph balance) of your stomach. The stomach lining is genetically designed to withstand the acid that your body produces for food digestion, but when the lining is compromised, such as from H. pylori, then the regular cells underneath the lining are easily broken down by the same stomach acid that is there to break down the foods you eat, and this can result in ulcers and bleeding.

However, other things, such as aspirin and NSAIDS (Non-Steroidal Anti-Inflammatory Drugs) can also compromise the lining of your stomach. Common NSAIDS include ibuprofen, aspirin, and such brand names as Motrin, Voltaren, Naproxen, Advil, and just about anything you can buy over the counter in a drug store except for Tylenol. Tylenol is not an NSAID. Its generic name is acetaminophen and it acts to relieve pain in a different way than the other over the counter drugs aforementioned. However, for some pains and some conditions (such as certain liver diseases), many patients needed a better answer than Tylenol, and so many turned to NSAIDS, but it was discovered that with prolonged daily usage of NSAIDS, the stomach and gastrointestinal lining often became compromised. So, Drug Companies developed what was called "super-aspirins," such as VIOXX, with the intention that these super-aspirins would be easier on the gastrointestinal lining and cause fewer gastrointestinal bleeding incidents, including ulcers. It is important to note that opiate drugs such as codeine, hydrocodone, oxycodone and other morphine-like drugs do not seem to be associated so much with damage to the gastrointestinal lining. However, abuse of these drugs is unfortunately so common and such a problem that many physians are reluctant to use them or may use them as a last resort. Rashes and allergies are also common side effects of these drugs and may inhibit their usage.

So, what do H. pylori and pain relievers have in common? Well, if a pain medication compromises the integrity of the stomach lining, then it may make it easier for H. pylori to burrow in and take residence. From there, the problem can simply get worse. More and more damage to the stomach lining can occur, and more and more antacids (Pepcid, Zantac, famotidine, cimetidine, Tums, Rolaids, etc.) or analgesiecs (Maalox, Pepto-Bismol, etc.) seem needed to bring relief to hearburn and/or an upset stomach.

So, how could a H. pylori test help? Well, LabSafe tests for antibodies produced by your body to H. pylori. If your body is producing antibodies to H. pylori, then that is important information for your doctor because you most probably are infected with H. pylori, or you have been infected before and may be at risk for future infection. H. pylori infection can be treated and cured with a simple round of medications that include antibiotics. Clinical studies suggest that if the H. pylori infection is cured, and the gastrointestinal lining (including the stomach lining) is given enough time to heal, then the integrity of the stomach lining may be largely or even fully restored and then it may be o.k. to take NSAIDS again. It is important to remember that your physician should oversee and manage this process with you.

Many people who can not tolerate NSAIDS, do not want to take or can not take potentially addictive opiate drugs, do not find acetaminophen effective or can not or do not want to take it, and do not want to take "super-aspirins" (a subject of many lawsuits these days!); may find relief of their pain and a better lifestyle if they can identify antibodies to H. pylori, have their doctor evaluate them for active H. pylori infection and/or a damaged stomach lining, diagnose it and treat it and cure it, and then they may be able to better tolerate NSAIDS again.

*Disclaimer: Motrin, Voltaren, Naproxen, Advil, VIOXX, Maalox, Pepto-Bismol, Tums, Rolaids, Pepcid, Zantac, and Tylenol are each registered trademarks of their respective companies and are in no way associated with LabSafe or with this blog. LabSafe intentionally does not sell or promote any drugs and makes no claims on any drugs (prescription or otherwise) as to the safety, efficacy, or indications for usage of any drugs, be it by prescription, over the counter, or otherwise. Always consult your physician before you begin to use any medications; before you discontinue use of any medications prescribed by your doctor, and/or you choose to take or not take any medications. LabSafe is a medical laboratory testing company and is not a Drug Company, and is in no way associated with any Drug Company or Insurance Company. LabSafe's business concern is the health and well being of the American consumer as it relates only to laboratory tests and how those tests can help you and your doctor better manage your health.

H. pylori bacteria are now known to be a major cause of peptic ulcer disease. Helicobacter pylori is also associated with the development of gastric cancer. If you are experiencing gastrointestinal pain and symptoms of an ulcer, The Helicobacter pylori test may be ordered to determine if there is evidence of this disease. A positive test for Helicobacter pylori indicates that your gastrointestinal pain may be caused by this bacterium. Taking antibiotics and other medication(s) will kill the bacteria and may stop the pain and the ulceration. The American Cancer Society has stated that "people in families at high risk of developing stomach cancer may be even more likely to develop the disease if they are infected with a common bacteria known as Helicobacter pylori (H. pylori). According to a recent study, screening these people for the bacteria might save lives."

To purchase a H. pylori test simply order online at LabSafe at http://www.labsafe.com/lab-tests/test/404/ or visit our website at www.labsafe.com

For more information, or to speak with a member of our professional Medical Staff, call LabSafe toll free at 1-888-333-LABS.

Anti-Aging Laboratory Tests

2006-08-22T12:10:00.000-07:00

LabSafe Anti Aging Panel - Level 1

LabSafe offers three levels of Anti-Aging testing, and each level is designed for different needs. This article relates to the Anti Aging Level 1 testing. For information regarding Level 2 and Level 3 testing, please visit our website at www.labsafe.com or call us toll free at 1-888-333-LABS to speak with a Medical Counselor.

LabSafe does not sell or market steroids, testosterone, Human Growth Hormone (HGH) or related products. Therefore, when you test with LabSafe you can be sure that your best interests are in mind because we are not trying to sell you drugs (steroids, HGH, etc.), unlike other companies.

When we are young, our hormone systems function at their peak abilities. As we age, imbalances may occur that can lead to hormonal dysfunction, such as the underproduction of testosterone and estradiol. Testosterone begins to decline in men at about age 30- 40 yrs old. Low testosterone has a number of negative effects on mental, sexual, and physical health. Therefore, many people seek anti-aging therapy or hormone replacement. There is a basic set of laboratory tests required by a Medical Doctor to prescribe Hormone Replacement Therapy for either men or women. Having these lab tests performed before you seek a pharmaceutical prescription can save you money and time because your prescribing physician will know beforehand if your lab test results indicate such therapy is safe and appropriate for you.

In addition to providing a basic health check, the LabSafe Anti-Aging Panel Level 1 also checks your levels of free and total Testosterone, estradiol, and IGF-1. Because men and women produce different hormones at different levels, LabSafe has developed lab test panels for men and lab test panels specific for women. For example, the Level 1 Anti-Aging Therapy Panel For Men includes a Prostate-Specific Antigen (PSA), and Testosterone, free and total test. Because women do not have prostates, the test is not performed in the Level 1 Anti-Aging Panel For Women. The Level 1 Anti-Aging Panels for both men and women contain tests such as the Complete Blood Count, Cholesterol Profile, Estradiol, Metabolic Panel, Insulin-Like Growth Factor-1 (IGF-1) Testosterone, free and total, and a thyroid profile.

The American Heart Association’s recommendation is that hormone therapy should not be used for prevention of cardiovascular disease. Its use for other reasons should be cautiously considered with the advice of a physician.

To purchase an Anti-Aging Level 1 test simply order online at LabSafe at http://www.labsafe.com/anti-aging/ or visit our website at www.labsafe.com

For more information, or to speak with a member of our professional Medical Staff, call LabSafe toll free at 1-888-333-LABS.

Cancer Antigen 125 - CA 125 Test

2006-08-21T14:00:00.000-07:00

CA-125 Testing

Cancer Antigen 125 is a tumor marker. A tumor marker is a biochemical substance that is produced by some cancers. CA-125 (cancer antigen 125) is a tumor marker often used to help detect or track ovarian cancer and some types of lung cancer. The American Cancer Society has stated “90% of patients have levels above 30 u/ml when ovarian cancer is advanced." High levels of Ca 125 may also be found in women with endometriosis and in men and women with lung cancer.

Several different blood tests have been developed for early detection of ovarian cancer. The most successful appears to be the use of Ca-125 to help detect evidence of cancer in women in the earliest stages of the disease.

However, it is important to understand that a low or normal Ca-125 level does not exclude ovarian or other cancer, and as well an elevated level does not always suggest illness. To be clear, CA-125 is a marker for a tumor. It does not distinguish from a benign (non-cancerous) or malignant (cancerous) tumor. Therefore, CA-125 is often not considered a screening test for Ovarian cancer. However, some Physicians believe it is useful to establish a baseline CA-125 value, and the CA125 test can be very useful when used to follow patients who have been diagnosed with cancer and have been treated. The CA-125 test is in no way intended to replace a visit to your doctor and should be used in the proper clinical context.

To purchase a CA-125 test simply order online at LabSafe at http://www.labsafe.com/lab-tests/test/106/or visit our website at www.labsafe.com

For more information, or to speak with a member of our professional Medical Staff, call LabSafe toll free at 1-888-333-LABS.

Fats ARE Good For You!

2006-08-20T03:10:00.000-07:00

Good Fat and Bad Fat

Fats ARE good for you. This is contrary to what many of us have steered clear of in the past as we have consistently been told: “fat is bad for you."

However, there is such a thing as "good fat" and "bad fat." Some fats are essential to our body's normal metabolism, growth, development, and maintenance. If it were possible for a human to have absolutely no fats in their diet ever, that person would absolutely die (reference the movie Lorenzo's Oil). Fats are important components of the cells of our body as they form the outer cell wall that protects our DNA on the inside. They also give us energy when they are burned as fuel for our body. Furthermore, they are collected and set aside as important fuel depot reserves in case we should go hungry or starve, which fortunately is uncommon in American society today. Throughout many years of evolution, however, our bodies learned to put aside fats for tough times such as winter, famine, or disability.

The human body is very evolved in managing fats and has developed complex systems for fat management, storage, production, absoprtion from the foods we eat, and transporation to and from all parts of the body. This concept is perhaps best understood when we talk about two components of total cholesterol, HDL and LDL. HDL (High Density Lipoprotein) is often referred to as "good fat." LDL (Low Density Lipoprotein) is often referred to as "bad fat."

But why is HDL considered good while LDL is considered bad? The answer is simply about what these two are doing in the body...that is, what their job is...what they are there to do. HDL takes fat from throughout the body and transports it to the liver. The liver is "fat central." That is to say, the liver is the organ in the body that processes fat. The more fat that HDL brings to the liver, the more fat the liver processes. LDL on the other hand, takes fat from the liver to the body. The problem is that along the way LDL can and does get stuck in the arteries and blood vessels, much like chicken fat sticks to your fingers when you're preparing chicken for dinner. You literally have to wash your hands with soap and water to get it off and sometimes your hands still don't feel clean. You can just imagine how the smooth inner walls of your blood vessels would feel after 20, 30, 40 years etc. of the same kind of thing happening every single day of your life.

Recommendations from the American Medical Association (AMA) state that every American should have a cholesterol test at 25 years of age to learn a baseline cholesterol level. Sometimes, diet and exercise programs may be all that is needed to lower high cholesterol levels. Standard cholesterol tests include the HDL (good), LDL(bad), triglycerides (main components of fat stored in the body), and VLDL, which aides in transportation of triglycerides.

Inherited genes and diet are the two main components that determine our cholesterol levels. Early detection of potential high cholesterol can lower your risks for Coronary Artery Disease (CAD) and stroke.

Healthy fats include mono and polyunsaturated fats (such as olive oils, fish oils, nuts and seeds). Monounsaturated fats increase the HDL (healthy fats). Unhealthy fats include saturated and trans-fatty acids (fatty meats and hard vegetable oils).

A simple and inexpensive blood test called a lipid panel can determine your cholesterol levels, which includes HDL and LDL levels as well as total cholesterol.

LabSafe provides an inexpensive and convenient way to monitor your levels without the inconvenience of waiting for a doctor’s appointment, taking time off of work, etc.

To purchase a cholesterol test simply order online at LabSafe at http://www.labsafe.com/lab-tests/test/472/ or visit our website at www.labsafe.com

For more information, or to speak with a member of our professional Medical Staff, call LabSafe toll free at 1-888-333-LABS.

Syphilis Testing

2006-08-18T14:55:00.000-07:00

SYPHILIS TEST

Syphilis is a bacterial infection that can be easily missed. The first symptom is a painless blister or sore that will disappear on its own. Syphilis can be treated with antibiotics. However, if left untreated, the disease can spread throughout your body over the course of many years and cause considerable organ damage.

The latent (hidden) stage of syphilis begins when secondary symptoms disappear. Without treatment, the infected person will continue to have syphilis even though there are no signs or symptoms; infection remains in the body. In the late stages of syphilis, it may subsequently damage the internal organs, including the brain, nerves, eyes, heart, blood vessels, liver, bones, and joints. This internal damage may show up many years later. Signs and symptoms of the late stage of syphilis include difficulty coordinating muscle movements, paralysis, numbness, gradual blindness, and dementia. This damage may be serious enough to cause death.

You should check for Syphilis if you have symptoms of a syphilis infection, if you have another STD, or are pregnant.

Syphilis is passed from person to person through direct contact with syphilis sore. Sores occur mainly on the external genitals, vagina, anus, or in the rectum. Sores also can occur on the lips and in the mouth.

Transmission of the organism occurs during vaginal, anal, or oral sex. In the United States, The Center for Disease Control reported increases in syphilis over the past several years. Increases have been reported in various cities and areas, including Chicago, Seattle, San Francisco, Southern California, Miami, and New York City. In the recent outbreaks, high rates of HIV co-infection were documented, ranging from 20 percent to 70 percent. While the health problems caused by syphilis in adults are serious in their own right, it is now known that the genital sores caused by syphilis in adults also make it easier to transmit and acquire HIV infection sexually.

False postive Syphilis tests can occur are are usually associated with certain medical conditions. That is why at LabSafe a confirmation test is performed free of charge when a Syphilis test comes back positive.

To purchase a Syphilis test simply order online at LabSafe at http://www.labsafe.com/lab-tests/test/220/ or visit our website at www.labsafe.com

For more information, or to speak with a member of our professional Medical Staff, call LabSafe toll free at 1-888-333-LABS.

Genital Herpes Testing

2006-08-17T11:21:00.000-07:00

Genital Herpes

Genital herpes is a sexually transmitted disease (STD). This virus causes recurrent, periodic outbreaks of sores in the genital region and remains in your body for life. However, there are anti-viral therapies available that can shorten the duration of symptoms. Some research studies suggest that the anti-viral medications may also help prevent transmission of the disease.

Some sexually transmitted diseases will cause symptoms that should be brought to the attention of your doctor immediately. However, others may be "silent" - a person could have the disease but might not notice any symptoms of the infection. Therefore, it is important to be tested for STDs if you are sexually active.
The herpes simplex virus can be passed from person to person through skin contact while the sores are open and healing, and sometimes asymptomatically when there are no visible sores. Of the major classes of Herpes viruses, Herpes Type 1 (HSV-1) is known for causing cold sores; Herpes Type 2 (HSV-2) causes genital herpes, and Herpes Zoster causes chickenpox and shingles. HSV-2 is frequently a sexually transmitted disease but HSV-1 also may be acquired during oral sex and found in the genital area. Therefore it generally best to test for both HSV-1 and HSV-2 when concerned about STDs. LabSafe offers the Herpes Select blood tests, which are more sensitive and specific than older tests. These tests are the ones that are recommended by the Centers for Disease Control (CDC).

Many people who have herpes don’t know it because they never have symptoms or don’t recognize the symptoms they do have. When you are first infected, you may have obvious and painful lesions at the site of infection. These lesions appear within two weeks after the virus is transmitted and usually heal within two to four weeks. The vesicles can appear in the vaginal area, on the penis, around the anus, or on the buttocks or thighs. This primary episode can include a second outbreak of lesions and even flu-like symptoms of fever and swollen glands. However, you may not have any lesions or have symptoms that are so mild that you don’t notice them or mistake them for something else, such as insect bites or a rash.

Once someone is infected and the initial infection resolves, they will harbor the HSV in a latent form. During periods of stress or illness, the virus may reactivate. In most cases, HSV outbreaks are a painful annoyance rather than a health threat, but the virus can also cause neonatal herpes (an infant is infected by the mother during birth) and encephalitis (inflammation of the brain). These illnesses can be fatal and can cause serious permanent neurological problems in those who survive. Patients with conditions that cause their immune system to be suppressed, such as those with HIV/AIDS or those who have had an organ transplant, may have more frequent and serious outbreaks of HSV.

According to the American Social Health Association and their National Herpes Resource Center, about 50% to 80% of adults in the U.S. have HSV-1 and about 20% have HSV-2 (that is 1 in every 5 adults). Because symptoms may be mild, 90% of those who have HSV-2 may be unaware that they have been infected.

To purchase a Herpes Type I/II test simply order online at LabSafe at http://www.labsafe.com/lab-tests/test/429/or visit our website at www.labsafe.com

For more information, or to speak with a member of our professional Medical Staff, call LabSafe toll free at 1-888-333-LABS.

Hepatitis B Test

2006-08-15T12:33:00.000-07:00

Hepatitis B (HBV) Testing

Hepatitis B is caused by a virus that attacks the liver. The virus, which is called hepatitis B virus (HBV), can cause lifelong infection, cirrhosis (scarring) of the liver, liver cancer, liver failure, and death.
HBV is spread when blood from an infected person enters the body of a person who is not infected. For example, HBV is spread through having sex with an infected person without using a condom (the efficacy of latex condoms in preventing infection with HBV is unknown, but their proper use might reduce transmission), by sharing drugs, needles, or "works" when "shooting" drugs, through needlesticks or sharps exposures on the job, or from an infected mother to her baby during birth.

Hepatitis B is not spread through food or water, sharing eating utensils, breastfeeding, hugging, kissing, coughing, sneezing or by casual contact.

One out of 20 people in the United States will get infected with HBV some time during their lives.

How do you know if you have hepatitis B? Only a Hepatitis B blood test can tell for sure. At LabSafe, a panel of tests are performed to ensure Hepatitis B may be detected at any stage of infection. The LabSafe panel can also detect if you are immune to the Hepatitis B virus, typically due to vaccination.

According to the CDC (Centers for Disease Control), in 2003, an estimated 73,000 people were infected with HBV. People of all ages get hepatitis B and about 5,000 die per year of sickness caused by HBV.

To purchase a Hepatitis B test simply order online at LabSafe at http://www.labsafe.com/lab-tests/test/423/or visit our website at www.labsafe.com

For more information, or to speak with a member of our professional Medical Staff, call LabSafe toll free at 1-888-333-LABS.

HIV Testing

2006-08-14T12:25:00.000-07:00

HIV TEST

AIDS (acquired immunodeficiency syndrome) was first reported in the United States in 1981 and has since become a major worldwide epidemic. AIDS is caused by HIV (Human Immunodeficiency Virus). By killing or damaging cells of the body's immune system, HIV progressively destroys the body's ability to fight infections and certain cancers. People diagnosed with AIDS may get life-threatening diseases called opportunistic infections, which are caused by microbes such as viruses or bacteria that usually do not make healthy people sick.
More than 900,000 cases of AIDS have been reported in the United States since 1981. As many as 950,000 Americans may be infected with HIV, one-quarter of whom are unaware of their infection. The epidemic is growing most rapidly among minority populations and is a leading killer of African-American males ages 25 to 44. According to the Centers for Disease Control and Prevention (CDC), AIDS now affects nearly seven times more African Americans and three times more Hispanics than whites. In recent years, an increasing number of African-American women and children are being affected by HIV/AIDS. In 2003, two-thirds of U.S. AIDS cases in both women and children were among African-Americans. Clearly, HIV can not be thought of as a virus that infects only homosexual white males. This attitude is simply incorrect.

Because early HIV infection often causes no symptoms, it is often first found by testing your blood for the presence of antibodies (disease-fighting proteins) to HIV. However, HIV antibodies generally do not reach noticeable levels in the blood for 1 to 3 months following infection. It may take the antibodies as long as 6 months to be produced in quantities large enough to show up in standard blood tests (ELISA). The time point to antibody production differs from one person to another, and this process is called seroconversion. So, to determine whether you have been recently infected (acute infection), your blood can be screened for the presence of HIV genetic material using a test called the HIV Proviral DNA by PCR test. This test does not have to wait for the presence of HIV antibodies. Rather, it looks for the HIV virus DNA in your blood. Remember, your body first has to detect HIV DNA in your blood, and then it begins producing HIV antibodies, and this seroconversion can take up to 6 months.

Direct screening of HIV is extremely critical in order to prevent transmission of HIV from recently infected individuals.

Additionally, some studies suggest that it may be possible to prevent AIDS if the disease is caught early enough. For this reason, when Nurses or Doctors are accidenally exposed to HIV postive blood (like through an accidental needlestick from a needle that was used on a HIV positive patient), they often get the HIV Proviral DNA test and start a one month preventative course of anti HIV medications. Further testing typically occurs after the end of the prophylactic drug therapy, and/or at 6 months after exposure, just to be sure the Nurse or Doctor is still HIV negative.

*Editor's note: Having worked in the HIV field for 12 years, it seemed only a matter of time before I was directly exposed to HIV positive blood. My doctor tested me one week after exposure using the HIV Proviral DNA test, and the test was negative. I took a drug called combivir for 28 days and my doctor tested me again using the HIV Proviral DNA test. Again the test was negative. Six months later my doctor tested me using the HIV Antibody test, and I prayed to God every day and night for those six long months. Thanks be to God and my Doctor that I am HIV negative to this day.

To purchase a HIV Proviral DNA test simply order online at LabSafe at http://www.labsafe.com/lab-tests/test/436 or visit our website at www.labsafe.com

To purchase a standard HIV Antibody Test you can order online at LabSafe at http://www.labsafe.com/lab-tests/test/437

For more information, or to speak with a member of our professional Medical Staff, call LabSafe toll free at 1-888-333-LABS.

Prostate PSA Testing

2006-08-13T13:55:00.000-07:00

Prostate Specific Antigen

Prostate cancer will claim over 30,000 lives and 232.090 new cases will occur in the U.S. during 2005, according to the American Cancer Society. By the end of the 1970’s blood tests had been developed for several cancers, but only one marker has been discovered that allows for early detection of disease and is useful in testing for EARLY prostate cancer. That marker is the “prostate specific antigen”. Even in early prostate cancers the PSA level will rise so that most prostate cancers can be detected in their earliest stage.

PSA levels can be measured by a simple blood test. The FDA has approved the PSA test to help detect prostate cancer in men age 50 and older. The American Cancer Society has recommended that the PSA and DRE (digital rectal examination) be offered annually to men beginning at age 50. Men at high risk (African American men and men with a strong family history of 1 or more first degree relatives diagnosed with prostate cancer at an early age) should begin testing at age 45.

In addition to early detection, the PSA test is also useful in monitoring the effectiveness of treatment so it is important to know your baseline PSA value.

PSA levels may also be elevated in a prostate condition known as Benign Prostatic Hyperplasia (BPH). As the name implies, the condition is bening and therefore not cancerous. However, some studies have suggested an increased risk of prostate cancer in men who have BPH. In more that 50% of American men, BPH occurs naturally as men age. There are several well established medications to treat this condition, so knowing you have the condition is the first step to getting help.

Another common condition in which PSA levels may be elevated is prostatitis. Prostatitis is often a result of infection of the prostate with common bacteria such as E. coli, or sexually transmitted disease bacteria such as chlamydia and gonorrhea. As with BPH, there are several well establsihed medications to treat prostatitis and a visit to your doctor can help him or her understand which condition you have and what to do next. The PSA test, as with all laboratory tests, must be evaluated in a clinical context with your private physician or clinic.

To purchase a PSA test simply order online at LabSafe at http://www.labsafe.com/lab-tests/test/480/ or visit our website at http://www.labsafe.com/

For more information, or to speak with a member of our professional Medical Staff, call LabSafe toll free at 1-888-333-LABS.

Genetic Screening Tests for Glaucoma and Macular Degeneration

2006-08-11T15:07:00.000-07:00

Glaucoma & Macular Degeneration DNA Analysis

Age related macular degeneration is the leading cause of blindness for people over 55 years of age in the US and glaucoma is the second leading cause of blindness. Regular eye exams and awareness can greatly help in early diagnosis. If an individual has a genetic profile that predisposes him or her to Glaucoma, the disease can be treated if identified early enough. Once the disease has progressed, it is very difficult to treat or to reverse.

With Macular Degeneration, individuals can take preventative action to delay or avoid the possible onset. The disease is stress related and complicated by dietary deficiencies and other risk factors.

While Glaucoma is not preventable, early intervention is the key to successful treatment.

LabSafe offers a simple screening test, the Glaucoma & Macular Degeneration DNA Analysis. It is designed to help identify the risk factors that can adversely affect healthy eyesight with these two commonly occurring eye diseases.

Taking the test is virtually painless. All you have to do is swab the inside cheek of your mouth with a cotton swab. The few cells that collect on the cotton are then analyzed using advanced DNA analyses.

To purchase a Glaucoma & Macular Degeneration DNA Analysis test simply order online at LabSafe at http://www.labsafe.com/lab-tests/test/525/ or visit our website at www.labsafe.com

For more information, or to speak with a member of our professional Medical Staff, call LabSafe toll free at 1-888-333-LABS.

*Editor's note: My Mother has taken this test. My Grandmother (my Mom's Mom) struggled with the progressive loss of eyesight due to Macular Degeneration over the last decades of her life. This test identified that my Mom does indeed have the same genes and is at risk. She has shared the test results with her eye doctor and is now taking vitamins and changing her diet to help prevent the onset of the diseaese. Her eye doctor now knows to check for it at every doctor's visit and is keeping close watch. She thanks me for getting this test for her almost every time I talk to her and her new diet, vitamins, and latest news from the eye doctor are now regular topics of conversation. Fortunately for me, I inherited my Dad's genes on this because according to the test I don't have these same Macular Degeneration genes. I hope everybody who has a loved one with Macular Degeneration gets screened. It worked for my family.

Genetic Screening Test for Osteoporosis

2006-08-10T13:36:00.000-07:00

Osteoporosis DNA Analysis

Osteoporosis is a major public health threat. The National Osteoporosis Foundation describes it as "a debilitating disease that can be prevented and treated." Osteoporosis currently affects 28 million Americans in women and men. The estimated national expense is 13.8 billion per year (38 million each day) and the cost is rising. The ability to take proactive measures can delay the onset or may even prevent Osteoporosis. Researchers have found a gene that may help identify individuals at high risk for osteoporosis. A simple test can determine if someone is at risk. LabSafe is pleased to announce that we now offer a genetic screening test for Osteoporosis genes. Knowing your genetics can help you prevent osteoporosis through early intervention.

Osteoporosis is a disease that causes bones to become fragile and more likely to break. If not prevented, or if left untreated, Osteoporosis can progress painlessly until a bone breaks. These broken bones, also known as fractures, occur typically in the hip, spine, and wrist.

Osteoporosis is a preventable disease and the Osteoporosis DNA Analysis can identify if a person is at risk of the disease and help guide them through their available options.

To purchase an Osteoporosis genetic screening test simply order online at LabSafe at http://www.labsafe.com/lab-tests/test/527/ or visit our website at www.labsafe.com

For more information, or to speak with a member of our professional Medical Staff, call LabSafe toll free at 1-888-333-LABS.

Wellness Test For Women

2006-08-09T16:57:00.000-07:00

Women’s Health Wellness and Sexuality

As a women ages many changes take place within the body:

-Thyroid changes
-Increased risk of high cholesterol
-Heart disease
-Vitamin and Mineral deficiency
-Drop in iron levels

Just as you think nothing else can go wrong, menopause begins.

What Are the Stages of Menopause?

Menopause is a gradual process. The events proceeding and following menopause amount to a huge change for women both physically and socially. Physically, this process has four stages:

1) Premenopause. Although some doctors may refer to a 32 year-old woman in her childbearing years as premenopausal, this is not really an appropriate label. The term premenopause ideally refers to women on the cusp of menopause. Their periods have just started to get irregular, but they do not yet experience any classic menopausal symptoms such as hot flashes or vaginal dryness. A woman in premenopause is usually in her mid-to-late 40s. If your doctor tells you that you're premenopausal, you might want to ask him or her how he or she is using this term.

2) Perimenopause. This term refers to women who are in the thick of menopause. Their cycles may be erratic, and they may begin to experience hot flashes and vaginal dryness. On average, women are about 47 when they hit the perimenopause stage.

3) Menopause. This refers to your final menstrual period. You will not be able to pinpoint your final period until you've been completely free from periods for one year. Then, you count back to the last period you charted, and that date is the date of your menopause. Note: After more than one year of no menstrual periods due to menopause, any vaginal bleeding is now considered abnormal.

4) Posttmenopausal. This term refers to the last third of most women's lives, ranging from women who have been free of menstrual periods for at least one year to women celebrating their 100th birthday and beyond. In other words, once you're past menopause, you'll be referred to as postmenopausal for the rest of your life.

When menopause occurs naturally, it tends to take place anywhere between the ages of 48 and 52, but it can occur as early as your late 30s, or as late as your mid-50s. When menopause occurs before 35, it is considered premature menopause, which means genetically predetermined. Here is a list of the most common signs and symptoms.

-Mood swings
-Decreased sex drive
-Hot flashes
-Sweating
-Racing heart (palpitations)
-Headaches
-Vaginal dryness and soreness
-Trouble sleeping
-Bone thinning (osteoporosis)

It is very important at this time in a women’s life she takes control and monitor for any changes. Here is a list of some of the recommended blood tests:

CBC (complete blood count)
Lipid Panel
Thyroid Panel with TSH
Hepatic Function Panel
Iron
Uric Acid
C-Reactive Protein
Homocysteine
CA-125
IGF-1
Sex Hormone Binding Globulin
Testosterone, Free and Total
Estradiol

For details, or to purchase any of these tests simply click on the test name for the link to the test page. Or, you can visit the LabSafe home page at www.labsafe.com

For more information, or to speak with a member of our professional Medical Staff, call LabSafe toll free at 1-888-333-LABS.

LabSafe Direct Lab Services

2006-08-09T16:01:00.000-07:00


Safe, Reliable, Private and Affordable Laboratory Testing. Same Day Lab Tests, Nationwide, At a Location Near You. Call LabSafe Toll Free at 1-888-333-LABS or Simply Order Online at www.labsafe.com

Hepatitis C Tesing

2006-08-08T12:59:00.000-07:00

HEPATITIS C VIRUS TESTING - HCV Test, Hepatitis C Virus Antibody Test

Hepatitis C is a virus that can infect and damage the liver. In most cases, it is contracted through exposure to blood (usually from sharing contaminated needles while injecting drugs or, before 1992, through a blood transfusion) or through sexual relations, and it can be passed from mother to baby. Hepatitis C antibody is produced in response to exposure to the hepatitis C virus (HCV). The most common test for Hepatitis C looks for these antibodies in your blood.
The Centers for Disease Control (CDC) recommends the following persons have a Hepatitis C test

1. IV drug users, including persons who have just done it once
2. People with undiagnosed liver problems
3. Healthcare workers and public safety workers
4. Recipients of blood and/or solid organs
5. People having unprotected sex
6. Recipients of clotting factors

Eighty percent of people with Hepatitis C have no signs or symptoms. There is no vaccine to prevent hepatitis C. The CDC estimates 3.9 million Americans have been infected with HCV, of whom 2.7 million are chronically infected. If you fall into one of these high-risk categories, early detection by a simple blood test could help save your life.

To purchase a screening test for Hepatitis C, simply order online at LabSafe at http://www.labsafe.com/lab-tests/test/426/ or visit our website at http://www.labsafe.com/

For more information, or to speak with a member of our professional Medical Staff, call LabSafe toll free at 1-888-333-LABS.

Kidney Function Test (Renal Function Test)

2006-08-07T09:11:00.000-07:00

Kidney Function Test (Renal Function Test)

Kidney disease often proceeds silently over many years, with no signs or symptoms the patient can recognize or with signs that are too general for the patient to suspect kidney trouble. For that reason, routine blood and urine tests are especially important; these screening tests may detect blood or protein in the urine and abnormal chemical levels in the blood.

Any diseases that affect the blood vessels, including diabetes, high blood pressure, and atherosclerosis (hardening of the arteries), can impair the kidneys’ ability to filter blood and regulate fluids in the body. Disease and infection in other parts of the body can also trigger a kidney disorder. Because kidney impairment can be life-threatening, disorders and diseases that may affect the kidney deserve prompt attention. Kidney disease often causes no symptoms until late in its course and can lead to end-stage kidney failure, which is fatal unless a dialysis machine is used.

Risk factors include older age, family history of kidney disease, African-American ethnic background, diabetes, and high blood pressure. The National Kidney foundation suggests patients and doctors should think about risk factors for kidney disease as part of usual care. Patients who have risk factors should be tested at least once a year for kidney disease. People with existing kidney problems may also use this test to monitor themselves. A simple blood test could help save your life.

To purchase a Kidney function test simply order online at LabSafe at http://www.labsafe.com/lab-tests/test/459/ or visit our website at www.labsafe.com

For more information, or to speak with a member of our professional Medical Staff, call LabSafe toll free at 1-888-333-LABS.

Genetic Thrombosis Screening Test

2006-08-06T13:04:00.000-07:00

Thrombosis DNA Analysis

According to the American Heart Association, Deep Vein Thrombosis (DVT) occurs in about 2 million Americans every year. More people suffer from DVT annually than heart attack and stroke. Up to 600,000 people are hospitalized in the U.S. each year for DVT. Fatal Pulmonary Embolism may be the most common preventable cause of hospital death in the United States . Thrombosis or DVT is a PREVENTABLE condition and a Thrombosis DNA Analysis can lead you to make lifestyle changes or to consider becoming a candidate for medication, possibly saving your life.

Of those who develop a Pulmonary Embolism (PE) from DVT, up to 200,000 will die each year. More people die in the United States from PE than breast cancer and AIDS combined. These significant statistics do not account for DVT related stroke or heart attack. DVT is the leading cause of maternal death during child birth.
However, using the power of genetic testing, a genetic test panel can examine a number of genetic factors that may indicate a predisposition to Thrombosis or blood clotting problems. These gene mutations combined with other factors such as smoking, frequent air travel, sustaining a sports injury, hospitalization – and, in the case of women, the use of oral contraceptives, hormone replacement therapy or pregnancy – could put an individual at a much higher risk of DVT. The more risk factors an individual has, the greater the likelihood of developing DVT.

For more information, or to order a genetic test for Thrombosis, visit the LabSafe website at http://www.labsafe.com/lab-tests/test/526/ or call LabSafe toll free at 1-888-333-LABS.

LabSafe Direct Lab Services - www.labsafe.com

Chlamydia & Gonorrhea Testing - Should A Urinalysis Be Done Too?

2006-08-04T10:56:00.000-07:00

Chlamydia, Gonorrhea Test - Why Add a Urinalysis?

Chlamydia is the most prevalent STD in the U.S. It is most common among people in their late teens and early twenties and can coexist with gonorrhea and other STDs. It is estimated that one in five college students are infected with Chlamydia. The infection is most commonly transmitted through sexual intercourse. If Chlamydia is left untreated, women can develop Pelvic Inflammatory Disease (PID). There is also an increased danger of having an ectopic pregnancy if Chlamydia is left untreated.

People with Chlamydia do not necessarily know that they are infected. Sixty to eighty percent of women and ten percent of men who have Chlamydia exhibit no symptoms. In women, symptoms include: genital itching and burning, vaginal discharge, dull pelvic pain, bleeding between periods, and cervical inflammation. In men, symptoms include: mucus discharge from the penis (gradual onset five to twenty-one days after exposure) and painful urination. Again, these symptoms may be so mild that a man may not notice them. Some times urinary tract infections may be missed due to similar symptoms.

Bacteria that may cause urinary tract infections include E. coli and species of: Proteus, Klebsiella, Enterococcus and Staphylococcus. Occasionally, a urinary tract infection may be due to yeast, such as Candida albicans; urethritis is often due to a sexually transmitted disease such as herpes, chlamydia, or gonorrhea. Infection with more than one microorganism can and often does occur.

Urine does not normally contain microorganisms, but if it is obstructed from leaving the body or retained in the bladder it provides a good environment for bacteria to grow. Most urinary tract infections are due to bacteria that are introduced into the opening of the urethra. They stick to the walls of the urethra, multiplying and moving up the urethra to the bladder. Most urinary tract infections remain in the lower urinary tract (urethra or bladder) where they cause annoying symptoms, such as a burning sensation during urination, but are more easily treated. A routine Urinalysis preformed with your Chlamydia/Gonorrhea test can detect these microorganisms. While these infections are easily treated in most cases, if inadequately treated, the infection may spread up through the ureters, and into the kidneys. A kidney infection is more dangerous, and can lead to permanent kidney damage in those with diabetes and those with other underlying kidney diseases. In some cases a urinary tract infection may lead to an infection in the bloodstream (sepsis, septicemia) that can be life-threatening. Treatment with an antibiotic is usually successful. Some people choose to be retested after the course of treatment has been completed.

A Chlamydia and Gonorrhea urine test only checks for the presence of these two bacteria. An inexpensive urinalysis, performed with the Chlamydia/Gonorrhea test can detect other microorganisms. Sometimes a person can have a negative Chlamydia & Gonorrhea test yet symptoms persist and they can't figure out why. In these cases, the person is often infected with a simple urinary tract infection, such as E. coli which could have been detected with an inexpensive urinalysis.

To purchase a Chlamydia & Gonorrhea test simply order online at LabSafe at http://www.labsafe.com/lab-tests/test/120/ or visit our website at www.labsafe.com

To purchase a Urinalysis test, visit our website at http://www.labsafe.com/lab-tests/test/286/

For more information, or to speak with a member of our professional Medical Staff, call LabSafe toll free at 1-888-333-LABS.

Prostatitis, Thyroid, and Blood Disorders

2006-08-03T08:43:00.000-07:00

Did you know?
A simple and inexpensive lab test could save your life. Call LabSafe toll free at 888-333-LABS or visit us online at www.LabSafe.com

PROSTATITIS
Prostatitis is an inflammation of the Prostate gland. The prostate is a small organ about the size of a walnut that lies below the bladder and surrounds the urethra (the tube that carries urine from the bladder). Its function is to produce a fluid that becomes part of the semen.

The term “prostatitis” encompasses four specific conditions. 1) acute bacterial prostatitis, 2) chronic bacterial prostatitis, 3) nonbacterial prostatitis, and 4) prostadynia. Prostatitis is very common in men and accounts for up to 25% of medical visits by young to middle age men complaining of urinary and genital problems. Signs and symptoms include but are not limited to difficulty urinating, pain or burning during urination, pelvic or lower back pain.
Acute bacterial prostatitis is the least common but the easiest to diagnose and treat. A laboratory test can be performed to detect white blood cells and bacteria in the urine. Chronic bacterial prostatitis is also uncommon and usually includes and underlying defect in the prostate. Non bacterial prostatitis is the most common and believed to occur eight times more often than bacterial prostatitis and effects men of any age. Prostatodynia is similar to nonbacterial prostatitis, however there seem to be no objective findings such as the presence of infection fighting white blood cells in the urine. Remember, prostatitis is a treatable condition so always consult a Health Care Professional.

A PSA test may be an early detector of prostate problems, such as prostatitis, enlarged prostate (BPH), or prostate cancer. You can get a PSA screening test at http://www.labsafe.com/lab-tests/test/480/

Blood Disorders
A blood disorder is any disorder that disturbs the regular or normal function of the blood. There are a number of conditions and diseases that can impact the blood cells such as anemia, sickle cell, thalassemia, hemophilia, leukemia, lymphoma, and blood coagulation.
A simple blood test called a CBC (complete blood count) measures the different components in the blood. White blood cells protect the body against infection. Red blood cells carry oxygen from the lungs to the rest of the body. An abnormal CBC can be the first sign of a problem. One of the most common blood disorders is anemia. According the U.S. Center for Disease Control & Prevention, anemia affects approximately 3.4 million Americans, people of all ages and from all walks of life.
It's important to note that a low or abnormal blood test does not always suggest illness and should be followed up with a doctor.

You can get an inexpensive and safe CBC test at LabSafe. Visit our CBC test page at http://www.labsafe.com/lab-tests/test/118/

The Thyroid
The thyroid is a gland located at the base of the neck, whose main job has to do with the metabolism. The thyroid stimulating hormone (TSH) is controlled by the pituitary gland which controls hormone production. The TSH levels are the main test ordered by doctors to detect Hypothyroidism, Hyperthyroidism and to also monitor thyroid replacement therapy. The American Thyroid Association recommends the TSH levels be used as a screening device for adults. The TSH levels are also important in monitoring treatment for any know disorders.
At LabSafe we provide a fast and easy method to make testing and monitoring as convenient as possible. A simple thyroid panel includes TSH levels as well as other indicators of potential problems or abnormalities. Visit our Thyroid Panel with TSH page at http://www.labsafe.com/lab-tests/test/261/

This, as with all laboratory tests, must be evaluated in a clinical context with your private physician or clinic.

Monthly Promotion:
Get a free Blood Sugar test when you purchase any other LabSafe test!

To purchase a screening test for prostatitis, blood disorders, or thyroid problems, simply order online at the LabSafe website www.labsafe.com

For more information, or to speak with a member of our professional Medical Staff, call LabSafe toll free at 1-888-333-LABS.

Gamma Glutamyl Transferase - GGT

2006-08-01T15:56:00.000-07:00

Gamma-glutamyltransferase (GGT) has been identified as a possible independent risk factor for cardiovascular death, according to an October 4 article in Circulation, a journal published by the American Heart Association. GGT is an enzyme that is present in the liver, blood, and also on the surface of many cells. A test for GGT levels is included in most panels to test liver function, as GGT levels are commonly elevated in alcohol abuse, or in other conditions affecting the liver.

This study used data from an analysis of 163,000 Austrian adults who were monitored over a course of 17 years. The analysis demonstrated a statistically significant link between elevated GGT and death from chronic forms of heart disease, stroke, and congestive heart failure. Interestingly, the link was strongest among adults younger than 60 years. There was also a link between acute heart attack and GGT in this group, but only among women.

Can GGT be confidently added to other serum markers for cardiovascular disease or mortality, such as C-reactive protein, homocysteine, lipid subfractions, or cholesterol? Further study is indicated. This study had some limitations noted by the authors. For example, the study population was predominately white. The authors refer to other studies that demonstrated possible ethnic differences in regard to elevated GGT, alcohol consumption and liver disease.

To purchase a GGT test, simply order online at LabSafe at http://www.labsafe.com/lab-tests/test/365/ or visit our website at www.labsafe.com

For more information, or to speak with a member of our Medical Staff, call LabSafe toll free at 1-888-333-LABS.

CyGene Laboratories and LabSafe Sign Distribution Agreement for Genetic Testing Products and Services

2006-07-19T15:13:00.000-07:00

CyGene Laboratories and LabSafe Sign Distribution Agreement for Genetic Testing Products and Services
6/27/2006 10:58:00 AM EST
BIOWIRE
CyGene Laboratories, Inc. (OTC:CYGE), an emerging leader in direct-to-consumer genetic testing services, has signed a product distribution agreement with LabSafe LLC, one of the nation's largest online e-commerce laboratory screening test providers. Through this distribution agreement, the two companies have established a strategic business relationship to deliver genetic testing products and services via e-commerce.
"The relationship between CyGene and LabSafe is very synergistic," said Martin Munzer, CyGene's president and CEO. "LabSafe has a well-established distribution system that is a great fit with our product line and our patent-pending product distribution business model."
Brian Lunn, LabSafe's president and CEO, added, "The market for predictive genomic testing is poised for tremendous growth. We are pleased to partner with CyGene Laboratories to distribute the company's innovative products and services. We look forward to serving this rapidly-expanding market together."
About CyGeneDIRECT
CyGeneDIRECT is an online consumer website that provides individuals with education and the opportunity to decide whether genetic testing is right for them. Individuals are able to purchase genetic test kits from a third party fulfillment center and retrieve their results anonymously in a comprehensive personalized report available on a secure server. The reports help them to understand how their personal genetics affect certain risks, how other factors contribute in combination with their genetic profile, and how to modify these factors to decrease their risk. For more information on CyGeneDIRECT, please visit http://www.cygenedirect.com.

For more information on LabSafe, please visit http://www.labsafe.com/

About CyGene Laboratories, Inc.
CyGene Laboratories Inc., based in Coral Springs, Florida, is a biotechnology company focused on commercializing genetic and diagnostic testing, as well as developing therapies for infectious, genetic and autoimmune diseases. CyGene's scientific base rests on its Haystack Processing technologies, which it has been developing since 1995. As a result of its work on Haystack Processing, the Company has achieved significant technological breakthroughs that have led to the discovery of its other platform technologies. CyGene believes its patented technologies have promise in the discovery, development and utilization of cutting edge diagnostics based on synthetic DNA and therapeutics based on the rapid clearance of pathogens from the blood.
About LabSafe LLC
LabSafe LLC, based in Hollywood, Florida, is one of the nation's largest direct-to-consumer providers of laboratory products and services. Its mission is to expand access to affordable laboratory tests and to provide laboratory testing consumer education. By providing superior laboratory products and value-added service, LabSafe strives to expand the field of preventative medicine, while assisting in the achievement of population screening testing goals.
Forward-Looking Statements:
The statements made in this news release are forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995 (the "Act"). Additionally words such as "seek," "intend," "believe," "plan," "estimate," "expect," "anticipate" and other similar expressions are forward-looking statements within the meaning of the Act. Some or all of the results anticipated by these forward-looking statements may not occur. Factors that could cause or contribute to such differences include, but are not limited to, when or whether the audits of our financial statements will be completed and audit opinions issued, due to unforeseen circumstances or unforeseen issues that may arise during the course of such audits. CyGene Laboratories Inc. has no duty and undertakes no obligation to update such statements. You should independently investigate and fully understand all risks before making investment decisions.