Instant Insights: Streamlining Cardiometabolic Disease Assessment

Instant Insights: Streamlining Cardiometabolic Disease Assessment

[00:00:00] Welcome to Healthier World with Quest Diagnostics. Our goal is to prompt action from insight as we keep you up to date on current clinical and diagnostic topics in cardiovascular, metabolic, endocrine, and wellness medicine.

Maeson: Welcome to a special episode series called Instant Insights, a podcast episode designed to give you quick and highly impactful clinical pearls in just a few minutes. I'm Dr. Mason Latsko, and today we dive into a new and innovative solution for chronic disease prevention and diagnosis: a streamlined single panel designed to help healthcare providers focus on what matters most - early detection in management for interrelated cardiometabolic conditions. Let's dive in.

[00:01:00] We are at a crossroads in diagnostic medicine where we have the tools available to shift from reactive healthcare to early intervention, from sick care to true healthcare, using tests and data that aligned with the latest guidelines from the AACE, the ADA kdigo and the AHA. And at the heart of chronic disease in America lies common risk factors increasingly prevalent due to a rise in underlying metabolic dysfunction.

Metabolic dysfunction is characterized by a combination of metabolic disturbances, including obesity, insulin resistance, hypertension, and dyslipidemia.

And it poses significant risk for the development of chronic conditions such as cardiovascular disease, type 2 diabetes, chronic kidney disease, liver fibrosis, and even common endocrine disorders.

Let's explore these relationships deeper. Metabolic dysfunction contributes to the development of insulin resistance by overworking the pancreas leading to hyperglycemia, and eventually type 2 diabetes. But it doesn't stop there.

[00:01:57] Inflammation and atherosclerosis develop as a result of metabolic dysfunction and contribute to cardiovascular disease. And cardiovascular disease is the most prevalent cause of morbidity and mortality among people with diabetes.

In the liver. Metabolic dysfunction leads to fat buildup, inflammation and fibrosis. All key components of metabolic dysfunction associated stenotic liver disease, or MASLD. In fact, type two diabetes is the single greatest risk factor for the progression of MASLD.  

In the kidneys. components of metabolic dysfunction, including hypertension, hyperglycemia, and lipid abnormalities accelerate the development and the progression of kidney disease.

But beyond the heart, liver and kidneys, common endocrine disorders like hypothyroidism should be evaluated for as they can exacerbate risk factors that contribute to cardiometabolic disease.

These cardiometabolic conditions are interrelated. But they share something else beyond their risk factors.

[00:02:58] Each of these conditions are silent and can remain undetected for years. Historically screening for these conditions has been fragmented with providers needing to order six to seven separate tests to fully assess for cardiometabolic risk. This complexity often leads to delays and missed opportunities for early detection and intervention.

But the panel we're here to talk about today. The Cardiometabolic Disease Assessment Panel or CMDA panel provides a single and comprehensive panel that integrates guideline recommended diagnostics and risk enhancing biomarkers to streamline workups and guide personalized care.

[00:03:38] So what does this panel include? First, let's talk about glycemic control. For a comprehensive assessment of glycemic control, the panel includes HbA1C, but goes well beyond that by also including an insulin resistance panel with score.

[00:03:55] And this assessment combines C peptide and intact insulin to give you the likelihood of a patient being insulin resistant even when an HbA1C is normal. For cardiovascular risk, the CMDA panel includes both a standard lipid panel and an APO lipoprotein B, which quantifies lipid particles and more accurately reflects cardiovascular disease risk than an LDLC.

[00:04:20] For a comprehensive kidney disease assessment, the CMDA panel includes guideline recommended testing, including an EGFR, which assesses kidney function and the urine albumin creatinine ratio, which assesses kidney damage.

To address comorbid MASLD, the CMDA panel includes a fibrosis score, called the Fib-4, which is calculated from components of the CMP also included in the panel. And the analytics included in the fibrosis score include AST, ALT,  age and platelets.

Finally, the CMDA panel also includes A TSH which assesses for dysregulation of the thyroid in response to metabolic dysfunction.

[00:05:00] So in summary, the CMDA panel includes an HbA1C, an insulin resistance panel with score, an Apolipoprotein B, a standard lipid panel, a kidney profile, a CMP plus Fib-4 and a TSH. The CMDA panel also includes an enhanced report, which consolidates results and provides insights into appropriate follow-up testing.

[00:05:25] Together, these tests provide a comprehensive snapshot of a patient's cardiometabolic health, not only detecting current risk, but to provide a window into risk before the disease fully develops.

The relationship between MASLD, type 2 diabetes, cardiovascular disease, chronic kidney disease, and thyroid dysfunction are well documented.

By catching risk early in one system, this panel also helps us see the big picture so providers can take a more holistic approach to preventing and managing multiple interrelated conditions.

[00:05:59] As the prevalence of cardiometabolic disease continues to rise, tools like the Cardiometabolic Disease Assessment Panel can help us shift from managing disease to preventing, it using one streamlined order code.

If you'd like to dive deeper into what each component reveals for a patient, check out other Instant Insights episodes from our podcast series: Healthier World.

[00:06:27] That's a wrap on this episode of Healthier World with Quest Diagnostics.

Please follow us on your favorite podcast app and be sure to check out Quest Diagnostics Clinical Education Center for more resources, including educational webinars and research publications.

Thank you for joining us today as we work to create a healthier world, one life at a time.