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Glossary of Terms



A

Alkaline Phosphatase
- an enzyme that is a complex protein that helps cells work.  You find ALP in high concentrations in the cells that make the bones and the liver.

ALT (Alanine Aminotransferase)
- Also known as Serum Glutamic Pyruvic Transaminase (SGPT), ALT is an enzyme that works with amino acid and carbohydrate metabolism.  High ALT  levels are found in muscle, liver, and brain and help to diagnose and follow liver disease.

Angina Pectoris
- a recurring pain or discomfort in the chest that happens when some part of the heart does not receive enough blood. It is a common symptom of coronary heart disease (CHD), which occurs when vessels that carry blood to the heart become narrowed and blocked due to atherosclerosis.

Apolipoprotein A1 (Apo A1)
- a major protein associated with HDL-C levels. It is an independent predictor of coronary heart disease (CHD) risk; increased levels are associated with reduced risk of CHD risk. Apo A1 levels are measured for the evaluation of CHD risk and for monitoring treatment when low levels and/or presence of CHD have been determined.

Apo (B)
- used in conjunction with VAP test to give the particle number; may be elevated even when LDL-C is low, particularly in patients with high triglycerides.

Arteries
- blood vessels that carry blood away from the heart.

AST (Aspartate Aminotransferase)
- Also known as Serum Glutamic-Oxaloacetic Transaminase  (SGOT), AST is an enzyme that works with amino acid and carbohydrate metabolism.  AST levels may indicate coronary artery disease or liver disease.

Atherosclerosis
- the buildup of cholesterol and other fat deposits, known as plaque, on the inner layer of an artery. 



B


Bile Acid Sequestrants
- a type of cholesterol-lowering medication. The sequestrants bind with cholesterol-containing bile acids in the intestines and remove them in bowel movements.

Body Mass Index (BMI)
- a reliable indicator of body fat (which is related to the risk of disease and death); an estimate of body composition (ratio of fat to muscle and bone) based on your height and weight (Multiply weight in pounds by 703, then divide by your height in inches, then divide again by your height in inches.)  BMI < 18.5 = underweight; BMI of 18.5-24.9 = normal weight; BMI of 25.0-29.9 = overweight; BMI  ≥ 30 = obese

Blood Pressure
- the pressure exerted by the blood against the walls of the arteries. A blood pressure of 120/80 would be considered ‘normal.’ "Blood pressure readings are usually given as two numbers: 110 over 70 (written as 110/70). The first number, called the systolic blood pressure, represents the maximum pressure exerted when the heart contracts. The second number (the lower number), called the diastolic blood pressure, represents the pressure in the arteries when the heart is at rest." MEDLINE plus Medical Encyclopedia,The National Institutes of Health Website (www.nlm.nih.gov)



C

Calories
- units that measure the amount of energy the body is able to get from food. Different nutrients in foods provide different amounts of calories.

Cardiovascular Disease - any disease of the heart or blood vessels, including peripheral, coronary, and cerebrovascular diseases.

Carotid Artery Disease (CAD) - a progressive disease involving the buildup of fatty material and plaque in the carotid arteries; can lead to a stroke.

Cerebrovascular Disease - any disease affecting the blood vessels of the brain.

Cholesterol - a waxy, fat-like substance present in every cell in the body and in many foods. Some cholesterol in the blood is necessary, but a high level can lead to heart disease.

CPK (Creatinine Phosphokinase) - found mostly in the heart and skeletal muscle and in the brain.  These levels go up with a heart attack or if there is an injury to these muscle or nerve cells

CRP (HsC-Reactive Protein) - a protein released into the bloodstream whenever there is serious inflammation in the body.  Increased CRP can indicate serious and ongoing arterial damage.



D

Diabetes
- a disease in which the body does not produce or properly use insulin. Insulin is a hormone that is needed to convert sugar, starches, and other food into energy.

Dyslipidemia
- an abnormal concentration of one or more lipids in the blood, such as an elevated LDL-C level or a depressed HDL-C level.



E

Enzyme - a type of protein produced by your body that acts as a catalyst to induce chemical changes in other substances without being changed themselves.


F


Familial hypercholesterolemia (FH) - an inherited condition characterized by abnormally high cholesterol levels in the blood. Affected individuals are unable to process LDL-C properly and are at increased risk for coronary heart disease.

Fasting Blood Glucose (Fasting Blood Sugar) - The measurement of the amount of sugar in the blood after no food or drink (except water) for a period  of 8-12 hours.  The expected result would be a fasting blood sugar of < 100 mg/dL.

Fat - one of the nutrients that supplies calories to the body. The body needs only small amounts of fat, 30-40 grams per day.  Fat can be categorized as saturated (found mostly in meat and dairy products) or unsaturated (found in vegetable oils, nuts, and fish).  Saturated fats can be produced by the body and an increased intake of saturated fat can lead to high cholesterol, heart disease, obesity, and other problems.  One type of saturated fat is trans fat, another contributor to LDL and cholesterol.  Starting January 1, 2006, food manufacturers are required to include the amount of trans fats on the food label.  Unsaturated fats are needed to keep the body healthy.  Unsaturated fats can be divided into monounsaturated (found in nuts) and polyunsaturated (found in olive and canola oils) fats.

Fibric Acids - one type of cholesterol-lowering drug. Fibric acids lower triglycerides and raise HDL.

Fibrinogen - a protein that plays a role in the normal process of blood clotting.  Elevated fibrinogen indicates that your blood is more prone to clotting.

Flaxseed Oil
- a source of Omega 3 fatty acids; however, flaxseed oil contains alphalinolenic acid (ALA) while fish oil contains eieosapentaenoic acid (EPA) and docosahexaenoic acid (DHA).   Research has shown that flaxseed oil is not as beneficial healthwise as fish oil is.

Folic Acid (B6) - One of the B vitamins, B6 works with Vitamin C and Vitamin B12 to help digest and utilize protein and make new cells.  Folic acid is known to lower homocysteine levels.



G

Genetic - of or relating to genetics or genes. High cholesterol may be part of your genetic makeup, which means it is possible for other members of your family to have high cholesterol too.

Glucose - the main sugar that the body makes from the three elements of food--proteins, fats, and carbohydrates-but mostly from carbohydrates.  Glucose with insulin is the major source of energy for living cells and is carried to each cell through the bloodstream.  Glycosylated hemoglobin is a powerful predictor of coronary heart disease events and mortality.

Glycemic Index
– a measure of the ability of foods to raise blood sugar.  The index compares the effect of the food eaten to pure glucose and is governed by the forms of carbohydrates and fiber, the degree of processing and cooking, and the amount of other substances such as protein and fat.  Low-glycemic-index foods have a glycemic index of 55 or less.

Glycemic Load – a related measurement that is reached by multiplying the glycemic index of a food by the amount of carbohydrate contained in a typical serving of that food.  The same food in different forms (e.g. carrots vs carrot juice) may have the same glycemic index but vary largely in the amount of carbohydrates (carrots = small amount of carbs and carrot juice = large amount of carbs).



H


HDL (High-Density Lipoprotein) Cholesterol - known as the "good cholesterol." HDL cholesterol carries “bad” LDL cholesterol to the liver for removal from the body.  The American Heart Association recommends an HDL of 50 or greater for women.

HDL2 - the best cholesterol.  Low HDL is a risk factor for Heart Disease in patients with normal cholesterol.

HDL3 - small, dense, and the least protective HDL.

Heart Attack (Myocardial Infarction) - a sudden loss of blood supply to an area of heart muscle, usually due to a blockage in a coronary artery. This lack of blood causes that area of heart muscle to die.

Heart Disease - an abnormal condition of the heart.

Hemoglobin A1c (HbA1c) - Hemoglobin carries oxygen to the red blood cells and sometimes joins with the glucose in the bloodstream.  A1c is a test that measures a person’s average blood glucose level over 2-3 months.  The test shows the amount of glucose that adheres to the red blood cell, which is proportional to the amount of glucose in the blood.

High-Density Lipoprotein (HDL) Cholesterol - known as the "good cholesterol." HDL cholesterol carries “bad” LDL cholesterol to the liver for removal from the body.  Higher levels of HDL are better and the American Heart Association recommends an HDL of 50 or greater for women.

High-sensitivity C-Reactive Protein (hs-CRP) - A protein that is produced by the liver in during episodes of acute inflammation, a marker for systemic infection and tissue damage.

HMG-CoA reductase inhibitor
- a class of cholesterol-lowering drugs (3-hydroxy-3-methylglutarylcoenzyme A reductase inhibitor) commonly referred to as statins. The rate-limiting step in the biosynthetic pathway involves the conversion of HMG-CoA to mevalonic (a precursor of cholesterol) by HMG-CoA reductase. The HMG-CoA reductase inhibitors are competitive inhibitors of HMG-CoA reductase in the liver. They inhibit the formation of mevalonate, thus reducing the amount of cholesterol produced in the body. The resulting decrease of endogenously produced cholesterol leads to an increase in the number of hepatic LDL receptors, resulting in increased clearance of LDL from the blood.

Homocysteine - an amino acid not related to cholesterol.  High values may promote plaque build-up in arteries.

Hormones - secreted proteins that circulate in body fluids and produce a specific effect on the activity of cells.

hs-CRP (high-sensitivity C-Reactive Protein) - A protein that is produced by the liver in during episodes of acute inflammation, a marker for systemic infection and tissue damage.

Hypercholesterolemia - a condition in which blood plasma cholesterol levels are elevated.

Hyperglycemia - high blood sugar, a condition that occurs when the body does not have enough insulin or when the body cannot use insulin properly.

Hyperlipidemia - a condition in which any or all lipid levels are elevated, including hypertriglyceridemia and hypercholesterolemia.

Hypertension - the force of blood through and against the walls of arteries causes blood pressure (BP) to rise and fall during the day. If BP remains elevated, it is diagnosed as high blood pressure or hypertension. A consistent blood pressure reading of 130/90 mm Hg or higher is considered hypertension.

Hypertriglyceridemia - a condition in which blood plasma triglyceride levels are elevated.



I


IDL Cholesterol - a strongly inherited independent risk factor for coronary heart disease and elevated in patients with a family history of diabetes.  IDL-C represents a unique treatment strategy compared to LDL-C.

Immunosuppresives - drugs that suppress the immune system in order to prevent the rejection of transplants.

Infarction - death of cells resulting from decreased blood supply to tissue; usually a result of ischemia.

Inflammation - the body’s response to injury.  Blood clotting is often part of that response.  Blood clots can slow or stop blood flow in the arteries, which can cause heart attacks and strokes.

Insulin resistance - a basic metabolic abnormality underlying type 2 diabetes.  Insulin resistance describes reduced insulin sensitivity of cells to the action of insulin.

Ischemia - a decrease of blood flow to tissue due to constriction or obstruction of a blood vessel, which can lead to cell death.  Myocardial ischemia (decreased blood supply to the heart) results from a constriction or obstruction of the coronary arteries.



L

LDL Cholesterol (Low-Density Lipoprotein Cholesterol) - the "bad cholesterol." Low-density lipoprotein (LDL) in high levels can deposit on the walls of the blood vessels and cause formation of plaques.

LDL Particle Number/Particle Concentration - The number and frequency of LDL in the blood.  When prioritizing treatment strategies, consider first reducing the LDL particle number.
Lipids-fats, oils, and waxes that serve as building blocks and energy sources for the body. Compound lipids include the glycolipids (lipid-sulfur combinations), lipoproteins (lipid-protein combinations), and phospholipids (lipid-phosphate combinations).

Lipoprotein - a component of the blood that serves to carry cholesterol throughout the body. It is composed of a fat molecule attached to a protein molecule. It appears in various forms, such as LDL and HDL. Lipoprotein Profile-a blood test that measures your total cholesterol, HDL-cholesterol, LDL-cholesterol, and triglyceride levels. The test requires fasting for 9 to 12 hours beforehand.

Lipoprotein (a) [Lp (a)] - a genetic marker that consists of LDL plus a protein called apo (a), also called the “heart attack” cholesterol. Elevated blood plasma levels are positively correlated with coronary heart disease. Low-Density Lipoprotein (LDL) Cholesterol-the "bad cholesterol." Low-density lipoprotein (LDL) in high levels can deposit on the walls of the blood vessels and cause formation of plaques.

Lp (a) [Lipoprotein (a)] - a genetic marker that consists of LDL plus a protein called apo (a), also called the “heart attack” cholesterol. Elevated blood plasma levels are positively correlated with coronary heart disease.



M


Menopause - a time marked by the end of menstruation in women, usually occurring between the ages of 45 and 55.

Metabolic Syndrome (elevated Triglycerides, Low HDL-C, & Small, dense LDL particles with normal or slightly elevated LDL-C levels) - characterized by a constellation of metabolic risk factors that raise risk.  Because of the high degree of association of these risk factors, this syndrome enhances the risk for coronary heart disease at any given LDL cholesterol level.

Myalgia - muscle ache or weakness without creatine kinase elevation.

Myocardial infarction (MI) - a heart attack, cell death of the myocardium (muscle of the heart’s walls) resulting from inadequate blood or oxygen supply.  Myocardial infarction is almost always a result of atherosclerosis of the coronary arteries and is associated with thrombosis.

Myopathy - any disease of muscles. Symptoms include limb and respiratory weakness. Myopathy can result from endocrine disorders, metabolic disorders, infection, or inflammation of the muscle.



N

Nausea - a feeling of sickness in the stomach causing an urge to vomit.

National Cholesterol Education Program (NCEP)
- launched in 1985 by the National Heart, Lung, and Blood Institute, the NCEP educates health professionals and the public on the importance of high blood cholesterol as a risk factor for coronary heart disease.  In 1988, the Adult Treatment Panel (ATP) issued recommendations for detecting, evaluating, and treating high blood cholesterol in adults, identifying LDL-C as the primary target for lipid intervention.  In 1993, the second Adult Treatment Panel (ATP II) issued revised guidelines stressing that elevated blood cholesterol, high blood pressure, and obesity, as well as smoking, are important modifiable risk factors for cardiovascular disease.  In 2001, ATP III provided for more intensive lipid-lowering treatment in a larger population, with special emphasis on those with multiple risk factors.

National Institutes of Health (NIH)
- the National Institutes of Health is one of the world's foremost medical research centers, and the Federal focal point for medical research in the United States. The NIH Web site is: www.nih.gov.

Niacin, B3 (Nicotinic Acid) - a cholesterol-lowering medicine that reduces total cholesterol, LDL cholesterol, and triglyceride levels while raising HDL-cholesterol levels.  This water-soluble derivative of vitamin B works in the liver by reducing production of triglycerides and VLDL.

Nicotinic Acid (Niacin, B3)
- a cholesterol-lowering medicine that reduces total cholesterol, LDL cholesterol, and triglyceride levels while raising HDL-cholesterol levels.  This water-soluble derivative of vitamin B works in the liver by reducing production of triglycerides and VLDL.

Non-HDL Cholesterol - the resulting number after subtracting the HDL cholesterol from the Total Cholesterol so it actually indicates all of the potential clotting particles.

Nuclear Magnetic Resonance Spectroscopy (NMR)
- advanced testing that provides a direct measure of the numbers of lipoprotein particles present in plasma, also capable of separately quantifying large and small LDL subclass particles and subclasses of VLDL and HDL.



O


Obesity - an increased body weight caused by excessive amounts of fat.  A BMI of 30 or greater is considered obese.

Omega-3 fatty acids
- unsaturated fatty acids that are present in marine animal fats and some vegetable oils. These fatty acids can increase the ratio of high-density to low-density lipoproteins while lowering overall plasma lipid levels, particularly TG. Research has shown that omega-3 fatty acids decrease risk of arrhythmias, thrombosis, TG levels, the growth rate of atherosclerotic plaque, and the risk for arrhythmias and thrombosis. They also improve the health of arteries, may slightly lower BP, and reduce the pain of arthritis.

Overweight - an increased body weight with a BMI of 25-29.9.



P

Palpitations - irregular, rapid beating of the heart.

Plant Stanol Esters - chemical compounds found naturally in very small quantities in many fruits, vegetables, nuts, seeds, cereals, legumes, and other plant sources.  A diet low in saturated fat and cholesterol that includes two servings of foods that provide a daily total of at least 3.4 grams of plant stanol esters in two meals may reduce the risk of heart disease.

Plant Sterols (phytosterols)
- one or more substances found in plants, free or esterified with fatty acids (Cholesterol is an example of a plant sterol.)

Pattern A-“Large Particle” - causes the least blockage of the LDL subclasses and is considered the “Least Dangerous.”

Pattern B-“Small Particle”
- causes intermediate blockage of the LDL subclasses and is considered the “Most Dangerous.”

Plaque - a buildup of excess cholesterol on artery walls.



R


Remnant lipoproteins - a breakdown of the by-product of VLDL which carries triglycerides in the blood, intermediate in size and density between LDL and VLDL lipoproteins.

Risk Factor - a condition such as high cholesterol levels, age, or diabetes, that can lead to a greater chance of developing a particular disease, a marker that occurs with unusual frequency among people with a particular disease.  Risk factors are not harmful in themselves, and having one or more risk factors does not mean a person is certain to or even likely to develop the disease.  It simply indicates a statistically higher risk to develop the disease.  Although some risk factors cannot be eliminated, there are many that can be controlled.



S


Saturated Fat - a type of fat found in animal products such as whole milk, eggs, and meats.  This fat hardens to a solid form when refrigerated.

Serum Creatinine - blood measurement of the energy source for muscle contraction

SGOT (Serum Glutamic Oxaloacetic Transaminase, AST) - a liver function test for the detection of liver disease; usually a sensitive indicator of biliary obstruction.

SGPT (Serum Glutamic Pyrurate Transaminase, ALT) - a liver function test for the detection of hepatocyte injury and useful in detecting liver disease.

Side Effect - an unintended symptom or event that may occur as a result of taking medication.

Starch - a carbohydrate, a naturally abundant nutrient commonly found in such foods as corn, wheat, and rice.

Statin - a class or type of cholesterol-lowering medication that lowers LDL cholesterol levels, lowers triglycerides, and raises HDL by limiting the amount of cholesterol the body can make.  A general term for an HMG-Co-A reductase inhibitor.



T


Thyroid Stimulating Hormone (TSH) - thyrotropin, a hormone released by the pituitary to stimulate the thyroid gland.

Total Cholesterol - the total amount of cholesterol carried in the blood, whether by HDL, LDL, or another carrier.

Total Cholesterol/HDL - this ratio should be less than 4.5mg/dL.

Triglycerides - dietary fat in the blood that increases after you eat. Elevated levels contribute to coronary heart disease.



U


Unsaturated Fat - a fat that is usually liquid at refrigerator temperature; typically a vegetable fat.



V


VAP (Vertical Auto Profile) - a patented vertical ultra centrifugation technique that provides all of the information found in a traditional lipid panel and extends testing to improve the ability to predict the risk of a patient developing cardiovascular disease.

VLDL Cholesterol - (very low-density lipoprotein)-the main carrier of triglycerides, and an independent risk factor for heart disease.

VLDL3 - the most dense sub-fraction of VLDL; constitutes a higher risk for heart disease.        





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