A newer testing, top of the line, next generation for lipids
is being performed. Fasting is not necessary and more info
is provided than before. This is an excerpt from the
companies VP Athertech,Inc.
The Vertical Auto Profile Cholesterol Test or VAP, is the
only lipoprotein panel that directly measures all National
Cholesterol Education Project (NCEP) Adult Treatment Panel
III(ATPIII) primary target, LDL-Cholesterol, as well as both
secondary treatment targets and all three ATPIII "emerging
lipid risk factors,"in a single test. This information
positions the VAP Cholesterol Test as a better, more
efficient cholesterol test for all patients at risk for
coronary artery disease, relative to the older lipid panel.
There are several decades of medical evidence supporting the
LDL-C and non-HDL-C therapy targets, the latter being a
superior detector of risk in women. In addition the VAP
Cholesterol Test serves as an early detector of the
Metabolic Syndrome through identification of the
dyslipidemia triad that presages onset of hyperglycemia.
Finally ATPIII considers Lp(a), small/dense LDL and the
Remnant Lipoprotein cholesterol as emerging lipid risk
factors which may be counted as an additional risk factor in
setting a lower LDL-C target. Presence of the emerging lipid
risk factors also helps clinicians decide when combination
lipid lowering therapy versus statin monotherapy will be
required. For these reasons, and because the VAP optimizes
compliance with the ATPIII guidelines, it is time to replace
the ordinary lipid panel with the VAP test. The VAP method
begins with non-equilibrium density gradient
ultracentrifugation to separate all five major lipoproteins:
HDL,Lp(a), R-LDL,IDL and VLDL, based on their size and
density characteristics. R-LDL-C, or "real-LDL" is defined
as the total LDL-C minus its Lp(a)-C and IDL-C components.
Ultracentifiugal separation is followed by enzymatic
determination of cholesterol in all lipoprotein fractions
with approximately 400 sequential spectrophotometric
measurements per sample. Thus, two key properties of all
lipoproteins are determined both relative density and
cholesterol concentration. The final stage of VAP analysis
employs proprietary software deconvolution software to
determine subfractions of HDL,LDL, and VLDL. All VAP testing
is performed at Atherotech,INC, a CDC-NHLBI standardized
cholesterol testing laboratory, which offers the VAP to
other laboratories for well under US$50. The VAP is
distributed by ARUP, LabCorp, the Mayo Clinic,
QuestDiagnostics, and Specialty Labs.................
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Separate handout
Diagnosis:
Elevated LDL-R
Elevated Lp(a)
Elevated IDL
LDL pattern Density shifts
Elevated VLDL and TG
Low HDL2
Metabolic Syndrome
Therapeutic lifestyle changes and drugs used for each
category are included.