TMAO (Trimethylamine N-oxide)

Cleveland HeartLab Metabolic, New Tests, T, Test

Gut microbes live symbiotically within the human digestive tract and play important roles in host defense, immunity, and nutrient processing and absorption. This diverse community is unique to each person and influenced by both acute and chronic dietary exposures to various food sources.

Nutrients such as phosphatidylcholine (also known as lecithin), choline, and L-carnitine are abundant in animal-derived products such as red meat, egg yolk and full-fat dairy products. When consumed, these nutrients are processed by gut bacteria resulting in the release of various metabolites including TMA (trimethylamine) into the blood. TMA is then transported to the liver where it is converted into TMAO (trimethylamine N-oxide) which has been shown to regulate various physiological processes involved in the development of atherosclerosis.
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GlycoMark®

Cleveland HeartLab G, Metabolic, New Tests, Test

The GlycoMark® test is a surrogate marker to detect frequent and high glycemic excursions in diabetic patients and measures blood levels of 1,5 anhydroglucitol (1,5-AG), a glucose-like sugar found in food.

When blood glucose levels are well controlled, most circulating 1,5-AG is reabsorbed in the kidneys instead of being excreted in the urine. In healthy individuals, circulating levels of 1,5-AG are high, with median values exceeding 20 µg/mL.

However, when blood glucose levels are high, 1,5-AG reabsorption is blocked and a majority is excreted in the urine. Blood glucose spikes of greater than 180 mg/dL result in 1,5-AG loss in the urine. Individuals with type 2 diabetes have low circulating levels of 1,5-AG2,4. Unlike HbA1c testing, which measures an individual’s average glucose over a 2-3 month period, the GlycoMark® test reveals more recent deteriorations in glucose control.
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Adiponectin

Cleveland HeartLab A, Metabolic, New Tests, Test

Adiponectin is an abundant hormone released by adipocytes (or fat cells), commonly referred to as an adipokine. Adiponectin plays a large metabolic role in the body, participating in the regulation of glucose levels, insulin sensitivity and lipid catabolism. Adiponectin also helps support proper endothelial functioning and has multiple anti-inflammatory properties, including inhibiting the transformation of macrophages to foam cells, one of the first steps of atherosclerosis.

Unlike other adipokines, adiponectin levels are lower in obese individuals. As adipocytes become larger with weight gain, they release less adiponectin. Among healthy individuals, women typically have higher adiponectin levels than men, and adiponectin levels tend to decrease as a person ages.
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Oral Glucose Tolerance Test (75g Glucose)

Cleveland HeartLab G, Metabolic, O, Test

CPT Code: 82951 Order Code:  C505 (includes Glucose, Glucose 1-hour and 2-hour after 75g Glucose challenge) ABN Requirement:  No Synonyms: Glucose Tolerance Test; GTT; OGTT Specimen: Serum Volume:  1.0 mL Minimum Volume:  0.5 mL Container: Gel-barrier tube (SST, Tiger Top) Collection: Serum: Collect and label fasting sample according to standard protocols. The sample must be labeled with the time of draw. After more »

Insulin, Total

Cleveland HeartLab I, Metabolic, Test

CPT Code: 83525 Order Code: Insulin: C146 ABN Requirement:  No Synonyms: Immunoreactive Insulin Specimen: Serum Volume: 0.5 mL Minimum Volume: 0.2 mL Container: Gel-barrier tube (SST, Tiger Top) Collection: Collect and label sample according to standard protocols. Gently invert tube 5 times immediately after draw. DO NOT SHAKE. Allow blood to clot 30 minutes. Centrifuge for 10 minutes. Patient Preparation: Patient more »

Hemoglobin A1C (HbA1c)

Cleveland HeartLab H, Metabolic, Test

CPT Code: Hemoglobin A1c: 83036 Hemoglobin A1c with Reflex to Glycomark: (If Hemoglobin A1c is >5.9% and <8.1%, then GlycoMark will be performed at an additional charge (CPT 84378).) Order Code: Hemoglobin A1c: C145 Hemoglobin A1c with Reflex to GlycoMark: C522 Includes: HbA1c and Estimated Average Glucose ABN Requirement:  No Synonyms: Hemoglobin A1c; HbA1c; HgbA1c; Glycohemoglobin; Glycated Hemoglobin; Glycosylated Hemoglobin Specimen: more »

Glucose

Cleveland HeartLab G, Metabolic, Test

CPT Code: 82947 Order Code: C101 ABN Requirement:  No Synonyms: Blood Sugar; Fasting Blood Sugar; FBS; Fasting Blood Glucose; FBG; Blood Glucose Specimen: Serum Volume: 0.5 mL Minimum Volume: 0.2 mL Container: Gel-barrier tube (SST, Tiger Top) Collection: Collect and label sample according to standard protocols. Gently invert tube 5 times immediately after draw. DO NOT SHAKE. Allow blood to clot more »

Fructosamine

Cleveland HeartLab F, Metabolic, Test

CPT Code: 82985 Order Code: C164 ABN Requirement:  No Synonyms: Glycated Serum Protein; GSP; Glycated Albumin; Protein Bound Glucose Specimen: Serum Volume: 1.0 mL Minimum Volume: 0.2 mL Container: Gel-barrier tube (SST, Tiger Top) Collection: Collect and label sample according to standard protocols. Gently invert tube 5 times immediately after draw. DO NOT SHAKE. Allow blood to clot 30 minutes. Centrifuge for more »

Cystatin-C

Cleveland HeartLab C, Metabolic, Test

CPT Code: 82610 Order Code: C307 ABN Requirement:  No Synonyms: Cys-C Specimen: Serum Volume: 0.5 mL Minimum Volume: 0.2 mL Container: Gel-barrier tube (SST, Tiger Top) Collection: Collect and label sample according to standard protocols. Gently invert tube 5 times immediately after draw. DO NOT SHAKE. Allow blood to clot 30 minutes. Centrifuge for 10 minutes. Transport: Store serum at 2°C more »

C-Peptide

Cleveland HeartLab C, Metabolic, Test

CPT Code: 84681 Order Code: C136 ABN Requirement:  No Synonyms: Connecting Peptide; Insulin C-Peptide; Proinsulin C-Peptide Specimen: Serum Volume: 0.5 mL Minimum Volume: 0.2 mL Container: Gel-barrier tube (SST, Tiger Top) Collection: Collect and label sample according to standard protocols. Gently invert tube 5 times immediately after draw. DO NOT SHAKE. Allow blood to clot 30 minutes. Centrifuge for 10 minutes. more »