Lipid Panel With GlycA (Inflammation)

Serum or plasma, shipped refrigerated

1 mL

0.5 mL (Note: This volume does not allow for repeat testing.)

Plain red-top tube (preferred); NMR LipoTube (black-and-yellow-top tube), lavender-top (EDTA-no gel) tube or green-top (heparin-no gel) tube is acceptable

Patient fasting is not required; however, in conditions where triglyceride values provide a priori diagnostic information, such as screening for familial hypercholesterolemia or early onset heart disease, pancreatitis, or confirming hypertriglyceridemia, the patient should be counseled to fast 12 to 14 hours prior to blood draw.

As an (1) aid in the identification and stratification of individuals at risk for future cardiovascular (CV) disease, (2) independent marker of prognosis for recurrent cardiovascular events in patients with stable coronary disease or acute coronary syndrome, (3) aid in the assessment of disease activity and risk of CV disease in adult Rheumatoid Arthritis (RA) and psoriasis patients, when used in conjunction with standard clinical assessment and for monitoring of anti-inflammatory treatment.

If triglyceride level is >800 mg/dL, LDL cholesterol will not be calculated.

GlycA measurements from EDTA plasma specimens are, on average, 3% to 5% lower than from serum samples. GlycA measurements from NMR LipoTube specimens are, on average, 5% to 6% higher than from serum samples collected in red-top tubes.

GlycA is an indicator for a wide range of disease processes and should not be interpreted without a complete clinical history. Recent medical events resulting in tissue injury, infections, or inflammation, which may cause elevated GlycA levels, should also be considered when interpreting results. Hemolysis may reduce GlycA concentrations more than 10%.

This test was developed and its performance characteristics determined by Labcorp. It has not been cleared or approved by the Food and Drug Administration.

Nuclear magnetic resonance (NMR)

Note: The NMR method for Triglycerides, unlike the routine chemical method, is not affected by endogenous glycerol, which might be found in very rare clinical conditions such as Hyperglycerolemia (glycerol kinase deficiency-GKD), an X-linked genetic disorder. Large quantitative differences in the chemical and NMR method results may be attributable to high blood glycerol.

The GlycA test quantifies an NMR signal that appears in a region of the NMR LipoProfile® test spectrum separate from that used for lipoprotein particle analysis. Data indicate that this signal is a marker of systemic inflammation, suggesting it may have clinical utility similar or complementary to high sensitivity C-reactive protein(hsCRP), fibrinogen, and other biomarkers of inflammation.^1,2 The NMR signal, named "GlycA," originates from the N-acetyl methyl groups of the N-acetylglucosamine moieties on the carbohydrate portions of circulating glycoproteins.^1,3 The measured amplitude of this signal reflects the extent of plasma protein glycosylation (not to be confused with nonenzymatic glycation reflecting glucose levels). Most acute phase proteins, released from the liver during an inflammatory response, are glycosylated, and some are glycosylated differentially as a function of inflammation. Acute-phase proteins, such as alpha-1-acid glycoprotein (also known as orosomucoid), haptoglobin, alpha-1- antitrypsin, alpha-1-antichymotrypsin, and transferrin circulate at high enough concentrations to make major contributions to the GlycA signal.¹ Therefore, GlycA is hypothesized to be a nonspecific measure of global inflammation status. Unlike existing biomarkers of inflammation that are discrete molecular species, such as CRP or inflammatory cytokines, GlycA is a composite biomarker that integrates the protein levels and glycosylation states of several of the most abundant acute-phase proteins in serum. This allows for a more stable measure of systemic inflammation with lower intra-individual variability of GlycA than hsCRP.¹ While guidelines recommend two serial measurements be taken at least two weeks apart when using hsCRP for CV disease risk assessment, only one measurement is necessary for evaluation of a patient's CV risk using the GlycA test.