Biomarkers
A biomarker, or biological marker, generally refers to a measured characteristic which may be used as an indicator of some biological state or condition. [1] Some examples of biomarkers are serum cholesterol, fasting glucose, blood pressure, heart rate, body mass index (BMI), etc.
Biomarker Descriptions
Descriptions of various biomarkers and how they may be relevant to ApoE4 carriers.
LDL-C
Low density lipoprotein cholesterol. ApoE4 is associated with high LDL. [2]
LDL-P
LDL particle number. Recent research indicates LDL-P is a more accurate predictor of cardiovascular disease. [3] [4] LDL-P can be measured with the #NMR LipoProfile test.
Below is a sortable table of biomarkers
| Test | Category | Description |
|---|---|---|
| CARDIAC TROPONIN-1 | Cardiac Function | These proteins are released when the heart muscle has been damaged, such as occurs with a heart attack. The more damage there is to the heart, the greater the amount of troponin |
| NT-proBNP | Cardiac Function | NT-proBNP to detect heart stress and damage, is primarily used to help detect, diagnose, and evaluate the severity of heart failure. |
| Smc ENDOTHELIN | Inflammation/Oxidation | Endothelin implicated in the pathogenesis of hypertension, coronary vasospasm, and heart failure |
| SMC INTERLEUKIN-6 (IL-6) | Inflammation/Oxidation | Active in inflammation, and in B cell maturation. produced in the body, wherever there is inflammation, either acute or chronic. |
| SMC- INTERLEUKIN-17A (IL-71A) | Inflammation/Oxidation | Most notable role of IL-17 is its involvement in inducing and mediating proinflammatory responses. IL-17 is commonly associated with allergic responses |
| TNF-alpha | Inflammation/Oxidation | Primary role of TNF is in the regulation of immune cells. TNF stand for Tumor Necrosis Factor |
| PLAC® Test for Lp-PLA 2 | Inflammation/Oxidation | Measures the function of Lp-PLA2 in the artery wall— a vascular-specific inflammatory marker critical in the formation of rupture-prone plaquee |
| hs-CRP | Inflammation/Oxidation | hsCRP is a protein that increases in the blood with inflammation. useful test for determining risk of CVD, heart attacks, and strokes |
| HOMOCYSTEINE | Inflammation/Oxidation | Elevated levels of homocysteine in the blood appear to make for an elevated risk of cardiovascular (heart and vessel) disease. Homocysteine can damage blood vessels can also disrupt normal blood clotting mechanisms, increasing the risk of clots |
| VITAMIN B12 | Inflammation/Oxidation | Vitamin B12, like the other B vitamins, is important for protein metabolism. It helps in the formation of red blood cells and in the maintenance of the central nervous system. Many people over age 50 lose the ability to absorb vitamin B12 from foods |
| FOLATE | Inflammation/Oxidation | Folate and folic acid are forms of a water-soluble B vitamin. Folic acid is also of interest with respect to cognitive enhancement, cancer, psychiatric illnesses, and cardiovascular conditions |
| URIC ACID | Inflammation/Oxidation | Used to detect high levels of this compound in the blood in order to help diagnose gout. |
| Fibrinogen | Inflammation/Oxidation | A protein that is essential for blood clot formation |
| Lp-PLA2 | Inflammation/Oxidation | Lp-PLA2 is positively associated with coronary disease |
| Myeloperoxidase | Inflammation/Oxidation | Also known as MPO. MPO is usually stored in a certain type of white blood cell. These cells release MPO when blood vessels are injured or become inflamed. |
| TOTAL CHOLESTEROL | Lipid Management | total cholesterol score is calculated using the following equation: HDL + LDL + 20% of your triglyceride level |
| TRIGLYCERIDE | Lipid Management | Most common type of fat in the body. A high triglyceride level combined with low HDL cholesterol or high LDL cholesterol is associated with atherosclerosis, the buildup of fatty deposits in artery walls that increases the risk for heart attack and stroke |
| HDL | Lipid Management | "Good Cholesterol" higher levels are better |
| HDL2b | Lipid Management | Only about half of the variability in coronary heart disease risk can be attributed to conventional risk factors (i.e. LDL, HDL and triglyceride levels). Other, more specific risk factors, enhance predictive power of cardiovascular disease in individuals. HDL2b is one of these specific risk factors that may be independent of other lipid-related risk factors |
| LDL | Lipid Management | "Bad choleserol" A low LDL cholesterol level is considered good for heart health |
| sdLDL | Lipid Management | Small, dense form of your ‘bad’ LDL cholesterol; increased levels indicate build up of fatty materials in your arteries. |
| APO A-1 | Lipid Management | Levels of apo A-I tend to rise and fall with HDL(good) levels, and deficiencies in apo A-I correlate with an increased risk of developing CVD. |
| APO B | Lipid Management | ApoB is a count of actual LDL particles. Concentrations of apo B tend to mirror those of LDL-C. Associated with an increased risk of cardiovascular disease (CVD). |
| Lp(a) | Lipid Management | Lipoprotein(a) A particle similar to LDL; your level of Lp(a) is determined by your genes. You want a low amount |
| Apo B ratio to ApoA-1 | Lipid Management | ApoB/ApoA-I ratio represents the balance of proatherogenic and antiatherogenic lipoproteins. This ratio is considered better than LDL-C in predicting cardiovascular risk |
| LDL-C | Lipid Management | Low density lipoprotein cholesterol |
| LDL-P | Lipid Management | LDL particle number. Recent research indicates LDL-P is a more accurate predictor of cardiovascular disease |
| HDL-P | Lipid Management | Total HDL particle number concentration as a predictor of cardiovascular disease |
| ox-LDL | Lipid Management | Oxidized LDL is LDL cholesterol (the “bad” cholesterol) that has been modified by oxidation. Oxidized LDL triggers inflammation leading to the formation of plaque in the arteries. |
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Tests
Many tests can be ordered through a primary doctor and health insurance. Another option is to order them directly from a major national lab, like LabCorp, through DirectLabs.com or PrivateMDLabs.com.
NMR LipoProfile
Nuclear Magnetic Resonance lipoprotein profile. A LipoScience proprietary test that measures cholesterol particle numbers (e.g. LDL-P) and size, in addition to the standard lipid profile. e.g. MDLabTests NMR Lipoprofile
Peter Attia explains with his customary thoroughness and lucidity why the LDL-P from this test is valuable.
ApoE4-Community Test Results
If you would like to view or update the spreadsheet without causing your own personal Google account to be visible to other users of the spreadsheet, you can do so by opening the link in a private browsing window. The feature is called "incognito", "Private", and "InPrivate" in Chrome, Firefox, and Internet Explorer, respectively. In Chrome and Firefox, for convenience you can right-click on the link and open it directly in the private browsing window.
The Community Test Results are a Google Sheet that anyone can edit. The columns are intended to be narrow to view as much data as possible at one time - this means column titles are abbreviated.
Google Spreadsheet example to insert row sorted by LDL-P:
- left-click left-most row number with LDL-P just larger than new LDL-P number (the entire row will be highlighted)
- right-click Insert 1 above
- TC/H and TG/H are equations - select those cells above or below new ones, <Ctrl>-c to copy equation, select new cell and <Ctrl>-v to paste
Google Spreadsheet example for web link:
- right-click forum topic or reply link, select Copy shortcut
- in the following hyperlink example, select first field between double-quotes, right-click past, edit second field between quotes with desired display text
=hyperlink("apoe4.info/forums/viewtopic.php?f=5&t=259";"MarkES NMR Results") - select newly created hyperlink starting from = and ending in ), right-click copy, select spreadsheet cell location and keyboard <Ctrl>-v to paste
The Google Spreadsheet that was once visible on this webpage used the Google Spreadsheet Widget. The feature no longer works, but we're saving the widget code here ...
Actual test results of ApoE4 carriers. Spreadsheet is intended to be sorted by LDL-P.
{{#widget:Google Spreadsheet |key=1Zj39xxOV0mXb8_-RVpEag2Nniy3CWRbVBrDmpQ2nd8g |width=100% |height=700 }}
... and the instructions here until we figure out what happened:
The following items need to be done one time and are listed here as instruction for any new spreadsheets that may want to use this same method.
- Publish Google spreadsheet - the Google spreadsheet must be published to the web (File->Publish to the web..., click start publishing).
- Copy link key - the key value to use in the widget is shown in the File->Publish "Get a link to the published data" link.
- Optionally share doc to be public on the web - File->Share... who has access - public on the web