Elite Athlete Metrics Profile + CARDIO PROFILE

Vitamin D (D2, D3)

Vitamin D deficiency is common in obesity and is particularly associated with hyperinsulinemia and visceral fat. Whether by cause or effect, identifying and correcting vitamin D2 and D3 deficiency may improve insulin sensitivity.

Most people are familiar with vitamin D's role in preventing children's rickets and helping the body absorb calcium from the diet.

Recently, research has shown that vitamin D is vital in protecting the body from a wide range of diseases. Disorders linked with vitamin D deficiency include:

• Stroke
• Flu
• Cardiovascular disease
• Osteoporosis
• Osteomalacia
• Several forms of cancer
• Some autoimmune diseases, such as Multiple Sclerosis
• Rheumatoid Arthritis
• Type I Diabetes & Type II Diabetes
• Breast and Colon Cancer (linked to Vitamin D Deficiency)
• Depression and even schizophrenia

Vitamin D is actually a prohormone and not technically a vitamin: a vitamin is defined as a substance that is not made naturally by the body but must be supplied in the diet to maintain life processes. But in fact, we make most of our vitamin D by the action of ultraviolet light (sunlight) on the vitamin D originator found in our skin. We only get very small amounts of vitamin D from our diet, although increasingly, it is added to foods eaten by children in an attempt to prevent rickets in the population.

Insulin (IN) Fasting: High fasting insulin levels are a good indicator of insulin resistance, whether or not the patient shows glucose intolerance. Insulin resistance occurs when the cellular response to the presence of insulin is impaired, resulting in a reduced ability of tissues to take up glucose for energy production. Chronically high insulin levels are seen as the body attempts to normalize blood sugar levels. The normal range for fasting insulin is 1 – 15 μIU/ml, but levels between 1 and 8 μIU/mL are optimal.

Blood levels of insulin 2 hours after a meal are now becoming an important indicator of both diabetes progression and cardiovascular disease risk. In nondiabetics, elevated postprandial insulin may be a better marker of cardiovascular disease risk than fasting insulin. In individuals with diabetes, postprandial levels become lower as diabetes progresses, and beta-cell responsiveness deteriorates, indicating a worsening of blood sugar control. In nondiabetics, whose pancreatic beta-cell function is normal, insulin levels usually return to normal (1-15 μIU/mL) within 2 hours after eating a typical breakfast meal. Elevated postprandial insulin levels have been strongly linked with coronary artery disease risk in nondiabetics. 

Total Cholesterol (CH): Cholesterol is required by the body as a precursor to steroid hormone synthesis and as a component of cell membranes. However, in excessive amounts, it is a strong component of coronary heart disease risk because of its contribution to coronary atherosclerosis. Atherosclerotic plaque is largely composed of cholesterol. As with other risk factors, high blood cholesterol levels are more significant when other cardiometabolic parameters are already abnormal or in patients with diabetes or cardiovascular disease. The current National Cholesterol Education Program recommendations for total cholesterol levels are: <200 mg="" dl="borderline" 200="" -="" 239="" high="" data-mce-fragment="1">240 mg/dL = high.

High-Sensitivity C-Reactive Protein (hs-CRP): C-reactive protein (CRP) is an established marker of inflammation and has recently been suggested to be an important contributor to the pro-inflammatory and prothrombotic elements of cardiovascular disease (CVD) risk. Extremely high CRP levels are seen in acute inflammatory states, but the small elevations indicative of the pro-inflammatory and prothrombotic states implicated in the metabolic syndrome require high sensitivity assays and are thus referred to as hs-CRP levels. Levels below 3.0 mg/L are considered to be normal; 3.1—10 mg/L is elevated in the context of CVD risk, and above 10 mg/ L is very high, more likely indicating an acute inflammatory event due to infection or trauma.

Triglycerides (TG): Triglycerides enter the circulation as the end-product of digesting dietary fat, and they are also synthesized by the liver. They are an important energy source for the body and are stored in fat cells. Elevated blood levels, or hypertriglyceridemia, often found in untreated diabetes and obesity, are an established indicator of atherogenic dyslipidemia. The National Cholesterol Education Program defines fasting triglyceride levels of 150 mg/dL or above as one of the diagnostic criteria for metabolic syndrome, although some studies have shown that fasting levels lower than 100 mg/dL should be considered as a more optimal cutoff in coronary heart disease risk assessment. The inflammatory state leading to the development of atherosclerosis may be triggered by "postprandial dysmetabolism," a condition characterized by unusually high levels of glucose and triglycerides after a meal. Postprandial hypertriglyceridemia indicates the presence of remnant lipoproteins, which are believed to promote atherosclerosis and are also linked with insulin resistance and obesity. Several studies have found that triglyceride levels measured 2-4 hours after a meal are highly predictive of cardiovascular events, especially in women. Nonfasting levels >200 mg/dL are suggestive of postprandial dysmetabolism. 

HDL Cholesterol (HDL): Cholesterol bound to high-density lipoprotein (HDL) in the blood is known as HDL cholesterol. A low level of circulating HDL cholesterol is one of the established criteria for the diagnosis of metabolic syndrome and has long been regarded as a powerful predictor of cardiovascular disease in both diabetics and non-diabetics. In a large cohort from the Framingham Study, a high total cholesterol/HDL cholesterol or LDL cholesterol/HDL cholesterol ratio was associated with increased coronary heart disease risk, and a high HDL cholesterol level was associated with reduced risk in both men and women. Currently, the LDL cholesterol/HDL cholesterol ratio is regarded as a reliable tool for the evaluation of cardiovascular disease risk. While absolute values of each are still considered by the National Cholesterol Education Program (NCEP) as the optimal diagnostic indicators, the ratios that doctors and researchers currently accept are as follows: total cholesterol: HDL cholesterol ratio – optimally below 4; LDL cholesterol: HDL cholesterol ratio – optimally below 3. The current NCEP recommendation to reduce the risk of cardiovascular disease is to maintain an HDL cholesterol level >40 mg/dL in both men and women.

In women, controlled by a negative feedback loop involving several ovarian hormones, gonadotropin-releasing hormone (GnRH) is secreted in pulses from the hypothalamus, which stimulates LH production from the pituitary gland. In a normal menstrual cycle, a surge of LH production lasting around 48 hours occurs at the end of the follicular phase. This sudden burst of LH causes luteinization of the ovarian follicles and triggers ovulation.

In men, LH acts on the Leydig cells of the testes to stimulate the production of testosterone, which is necessary for sexual function and spermatogenesis. LH levels are useful for the clinical assessment of infertility: low levels in men can result in hypogonadism and insufficient sperm production, while in women, LH levels are used to determine the occurrence of ovulation for couples trying to conceive. High LH levels are seen in polycystic ovarian syndrome and in precocious puberty; levels are similar to those seen in reproductive-age individuals instead of the lower levels normally seen in children.

LH levels can also be used in diagnosing pathologies of the hypothalamus or pituitary. As women enter menopause, LH levels rise as ovarian hormone production declines, reducing the negative feedback effect on GnRH production. LH testing can help evaluate a woman's menopausal status. Ranges for blood spot LH in premenopausal women (luteal phase) are 0.5—12.8 U/ L, in premenopausal women (follicular phase) 1.6—9.3 U/L, in postmenopausal women 15—64 U/L, and in men 1.0—8.4 U/L