9 Essential Biomarkers for Preventive Cardiometabolic Health
The unvarnished reality is that if we fail to take personal responsibility, our health will not be a priority for anyone else.
The current healthcare approach predominantly centers around managing diseases, usually neglecting proactive measures until overt symptoms manifest and diseases start. This paradigm of disease management poses challenges to achieving a healthier population globally.
I came to a sobering realization of this harsh reality when I was diagnosed with metabolic disorders at a young age. I could successfully reverse my condition by assuming personal responsibility. Instead of allowing healthcare professionals to manage me, I learned to manage them in pursuit of my well-being.
The good news is the new-generation healthcare professionals and the concerned public recognize the predicament and collectively work toward a new paradigm emphasizing proactive, preventative, collaborative, and integrative health.
To facilitate a healthier and longer lifespan, extending the onset of diseases before they occur is imperative rather than merely elongating the duration of disease periods after they have manifested. Until this fundamental shift occurs, we must shoulder personal responsibility for implementing preventative measures.
In this article, I aim to create awareness for my readers to have meaningful conversations with their family doctors regarding cardiometabolic health. We need to proactively monitor our health by discussing and requesting relevant tests for our biomarkers.
Regular health check-ups are vital in identifying potential risk factors and detecting early signs of cardiometabolic conditions causing millions of yearly deaths and sicknesses.
We don’t have to wait to be sick to check critical biomarkers. The earlier, the better. Proactive and transparent discussions with family doctors can lead to appropriate referrals to specialists for relevant tests encompassing critical aspects of cardiometabolic health. As technology advances, we can do some essential tests at our convenience.
There are hundreds of biomarkers and associated tests used to diagnose cardiometabolic disorders. Mechanisms underlying biomarkers can vary depending on the specific markers assessed.
This article only covers the essential biomarkers at a high level. We don’t need to know scientific and technical details, but we need to understand the importance of some critical tests to have helpful conversations with our family physicians, who can refer us to relevant specialists.
5 Reasons for Checking Biomarkers for Cardiometabolic Health
Checking biomarkers for metabolic health can provide valuable insights into our health status. Addressing disorders after they occur can be very difficult. I briefly summarize the key benefits of checking biomarkers and their implications.
1 — Early Detection
Regular monitoring of biomarkers allows for the early detection of metabolic abnormalities before the onset of noticeable symptoms. Early detection enables prompt intervention and lifestyle modifications to effectively prevent or manage metabolic disorders.
2 — Risk Assessment and Management
Measuring biomarkers can provide a comprehensive picture of metabolic health. By identifying risk factors, we can proactively mitigate their risks and make informed decisions about our health.
3 — Personalized Interventions
Biomarker analysis can tailor interventions to our specific needs. It enables healthcare providers to develop personalized strategies for lifestyle modifications based on our unique metabolic profile.
4 — Motivation and Accountability
Tracking biomarkers can provide tangible progress and encourage us to make necessary lifestyle changes. Seeing improvements in biomarker levels can serve as a motivating factor to maintain healthy habits and adhere to treatment plans.
5 — Population Health Monitoring
Collecting and analyzing biomarker data at a population level can help identify trends and patterns in metabolic health. This information can guide public health initiatives, policy decisions, and targeted interventions to address metabolic disorders on a broader scale.
9 Types of Biomarkers for Cardiometabolic Health
Learning about the risks of cardiometabolic disorders can empower us to obtain relevant tests timely. I introduced seven risks in a previous article. Here are some commonly checked biomarkers and their significance for risk management and disease prevention.
1 — Blood Glucose Levels
I start with blood sugar, as it is the most influential marker for metabolic health. Several blood tests measure glucose in the body to detect prediabetes and diabetes.
Regular blood glucose testing allows us and healthcare providers to assess the state of blood sugar control and take appropriate measures to prevent or manage the progression of these conditions.
The Oral Glucose Tolerance Test measures blood sugar before and after a patient drinks sugar-containing liquids. The test is conducted in one, two, and three hours. It aims to detect abnormalities in how the body handles glucose after a meal before fasting blood glucose level becomes abnormal.
CDC states, “At 2 hours, a blood sugar level of 140 mg/dL or lower is considered normal, 140 to 199 mg/dL indicates prediabetes, and 200 mg/dL or higher indicates diabetes.”
Glycated Hemoglobin (HbA1c) measures the average blood sugar level over the past few months. Physicians use this as an essential tool for diagnosing, monitoring, and managing diabetes. Testing HbA1c is a good indicator of blood sugar to detect anomalies for diabetes diagnosis.
When glucose enters the bloodstream, it binds to hemoglobin which I introduced in a previous article. Hemoglobin is a protein in red blood cells that carries oxygen to other cells, tissues, and organs.
According to CDC, “an A1C below 5.7% is normal, between 5.7 and 6.4% indicates prediabetes, and 6.5% or higher indicates diabetes.”
Fasting Plasma Glucose tests measure the amount of glucose in the blood after an overnight fast. According to this lab, twelve hours is the optimal fasting period. Fasting longer than the recommended time might compromise test results.
According to CDC, “a fasting blood sugar level of 99 mg/dL or lower is normal, 100 to 125 mg/dL indicates prediabetes and 126 mg/dL or higher indicates diabetes.”
Physicians use FPG tests with HbA1c to confirm the diabetes diagnosis, monitor blood sugar control for their diabetic patients, or use them as an indicator for their treatment.
Random blood sugar tests measure the amount of glucose in the bloodstream when the patient is tested. This test does not require fasting. While physicians or caregivers can do this test, you can also do it at home with devices, as I introduced in a previous article.
Continuous Glucose Monitoring tests require wearing a device that measures blood glucose levels continuously during the day and night. This test is helpful for high-risk patients as they can see and review how their glucose levels change and understand trends.
2 — Fasting Insulin and Insulin Tolerance Tests
Insulin resistance and high fasting insulin levels are early signs of metabolic disorders. When the body becomes insulin-resistant, blood sugar levels can rise (hyperglycemia). Over time, if not properly managed, this can progress to diabetes.
Fasting insulin levels are helpful because they provide valuable insights into our insulin function and can identify early abnormalities in glucose metabolism. If fasting insulin levels are consistently high or if there is insulin resistance, it may prompt further investigation and intervention to prevent or manage metabolic disorders.
Insulin tolerance tests measure the body’s response to insulin by administering insulin and monitoring blood sugar levels. It is used to diagnose insulinoma and conditions associated with insulin production and regulation.
Fasting insulin levels can be used to diagnose hypoglycemia, insulin resistance, insulinoma (pancreas tumor), pancreatitis, and Cushing’s syndrome (a disorder of adrenal glands). You can learn about endocrine glands in this article.
As the pancreas creates insulin, its test can be valuable. In addition, testing pancreatic enzyme levels is helpful because elevated levels might indicate pancreatic inflammation or dysfunction.
3 — Inflammation Markers
Inflammation markers are molecules indicating an inflamed body. These markers are essential for diagnosing and monitoring inflammatory health conditions and assessing treatments' effectiveness.
The following markers are interpreted with clinical symptoms and other diagnostic tests to assess chronic inflammation comprehensively.
CRP is a protein produced by the liver in response to inflammation. Elevated CRP levels indicate systemic inflammation associated with cardiovascular disease, rheumatoid arthritis, and infections.
ESR measures how quickly red blood cells settle in a test tube over a specified time period. Increased ESR indicates inflammation. However, it is a nonspecific marker and does not indicate the cause of inflammation.
Procalcitonin levels rise in response to bacterial infections in the bloodstream. It is a helpful marker for distinguishing between bacterial and viral infections.
IL-6 and TNF-alpha are cytokines involved in immune response and inflammation. Elevated IL-6 levels are seen in rheumatoid arthritis, inflammatory bowel disease, infections, and cancers.
4 — Lipid (Fats) Profile
The lipid profile measures different fat molecules. They provide valuable information about our fat metabolism. The lipid profile helps assess risk, guide interventions, and monitor treatment progress.
The lipid profile is typically performed after fasting to ensure accurate measurements, as specific lipids can fluctuate after a meal.
Standard lipid tests include measurements of total cholesterol, LDL cholesterol, HDL cholesterol, the Apolipoprotein B-100, and triglycerides. Abnormal lipid levels can indicate dyslipidemia, a significant risk factor for cardiometabolic disorders.
Elevated triglyceride levels are linked to increased cardiovascular risks. LDL with inflammation can contribute to artery plaque formation. HDL can remove excess cholesterol from the bloodstream. I documented my perspectives on the cholesterol paradox in a previous article.
5 — Liver and Kidney Function Tests
The liver has many bodily functions. From a metabolic health perspective, two elevated liver enzymes indicate non-alcoholic fatty liver disease, which affects two billion people globally.
These enzymes are alanine aminotransferase (ALT) and aspartate aminotransferase (AST), biomarkers that reflect liver cell damage and inflammation.
When these enzymes are elevated, it suggests an underlying liver condition, like fatty liver disease, which involves the accumulation of excess fat in the liver.
As kidneys play a role in metabolic health, it will be useful to test Blood Urea Nitrogen, Creatinin, Glomerular Filtration Rate, Urinalysis, Albuminuria, Electrolyte levels, and Renal Imaging.
6 — Heart Function Tests
There are many tests to measure the health of the heart. One of the most common ones is blood pressure measurements. High blood pressure (hypertension) is a significant risk factor for heart disease. High or low blood pressure requires evaluation and management by physicians.
Cardiac Catheterization measures blood pressure and oxygen levels in the heart and can image and potentially treat blockages.
A Coronary Calcium Scan estimates the risk of coronary artery disease by assessing calcium deposits in the arteries.
Electrocardiogram is used to detect abnormal heart rhythms. It creates detailed images of the heart’s structure and function, evaluating pumping ability, detecting valve problems, and assessing blood flow.
The heart stress imaging test assesses the heart’s performance during physical exertion, helping diagnose coronary artery disease and determine exercise tolerance. It is a noninvasive modality for evaluating coronary artery disease, myocardium viability, and exercise capacity.
Cardiac CT Scan provides detailed images of the heart and blood vessels, detecting plaque buildup in the arteries and assessing heart structure.
Cardiac MRI produces detailed images of the heart using magnetic fields and radio waves, aiding in diagnosing heart conditions.
Cardiac Output is the amount of blood the heart pumps in one minute. It is calculated by multiplying the blood pumped with heartbeats and the heart rate. It is an essential metric for assessing heart function.
Holter Monitor records heart electrical activity continuously, capturing irregularities or arrhythmias over 24 to 48 hours.
Heart rate variability is the variation in the time intervals between consecutive heartbeats. It reflects the activity and balance between fight-or-flight and rest-and-digest, giving us valuable clues for cardiometabolic health.
Resting heart rate (RHR) measures the number of times our heart beats per minute while at rest. A lower RHR usually indicates a more robust and efficient cardiovascular system with a reduced risk of heart disease.
Homocysteine in the bloodstream indicates vitamin deficiencies and leads to cardiovascular issues. Between five to fifteen micromoles per liter of homocysteine is considered normal for healthy individuals.
However, if it gets higher than 50 mcmol/L for a prolonged time, it can damage the lining of arteries, cause blood clots or blood vessel blockages, and impact the oxygenation of the cells in the body.
As I covered in previous sections, lipid profile measures and inflammation markers are widely used to assess cardiovascular disease risk affecting the heart and the brain.
7 — Sex Hormone Tests
Testing sex hormones can provide valuable insights into our metabolic health. Sex hormone testing can identify hormone levels and imbalances.
Standard sex hormone tests are estradiol, progesterone, testosterone, Follicle-Stimulating Hormone (FSH), Luteinizing Hormone (LH), and Sex Hormone-Binding Globulin (SHBG).
Sex hormone levels can change throughout life due to aging, menopause, and andropause. Regular monitoring of sex hormone levels allows healthcare providers to track changes, identify potential issues, and adjust treatment plans accordingly.
Imbalances in sex hormones are associated with increased metabolic risk factors, including insulin resistance, type 2 diabetes, and dyslipidemia.
Hormonal imbalances can affect fertility and reproductive function. Hormone replacement therapy may be necessary for people with hormonal deficiencies or imbalances.
8— Thyroid Function Tests
Thyroid hormones are essential in metabolism. Abnormal thyroid function, indicated by TSH, T3, and T4 tests, can affect metabolic rate, causing involuntary weight gain or loss.
I introduced two conditions (hypothyroidism and hyperthyroidism), in a previous article. I highlighted the importance of iodine, which is also testable and associated with these disorders.
Early detection of thyroid function markers can help us identify relevant metabolic conditions at their initial stages, allowing for early intervention, treatment, and management.
9 — Body Composition (Fat, Muscles, Bones)
Body composition analysis determines the proportion of body fat, muscle mass, and bone density in relation to total body weight and structure.
Monitoring changes in body composition helps us set goals for fat loss, muscle gain, and a better physique. One of the most critical ones is meaning waist circumference used to identify the metabolic syndrome.
Bone density measurements assess the strength and density of bones. We can get them checked via DEXA scans showing muscle and fat ratios too. It can be valuable for detecting both sarcopenia and osteoporosis. Healthcare professionals can also use MRI for more complex bone health issues.
Metabolic markers, like blood lactate levels and respiratory exchange ratio (RER), provide insights into our metabolic response to exercise. Monitoring metabolic markers like lactate levels helps determine the energy system utilization, training intensities, and endurance capacity.
Conclusions
These biomarkers reflect underlying physiological processes related to metabolisms. Dysregulation of bodily processes can lead to metabolic disorders and associated complications. Metabolic disorders, if left undetected or unmanaged, can have severe consequences for healthspan and lifespan.
Checking biomarkers for metabolic health provides a proactive and personalized approach to healthcare. By identifying early warning signs and tailoring interventions, we can take control of our health, reduce the risk of complications, and improve our overall well-being.
Early diagnosis can lead to timely interventions, such as lifestyle modifications, medication, and targeted therapies, preventing and mitigating metabolic disorder risks and improving overall health outcomes.
To maintain holistic health, you may consider more health measures like sleep quality, stress, fitness, genetic (DNA), vitamins, minerals, and cognitive tests. Here are some additional tests you may consider.
Thank you for reading my perspectives. I wish you a healthy and happy life.
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