University of Alberta researchers have found a new, more effective way to measure future heart disease and diabetes risk in youth.
By testing the blood for remnant cholesterol (RC), made by the body during the day as food is consumed, researchers were able to show that this non-fasting type of cholesterol is a strong predictor of health risk in young people with obesity.
The lipid measure is an improvement over the more common method of testing the blood for levels of low-density lipoproteins (LDL) or “bad” cholesterol, usually before breakfast in the morning. LDL levels typically don’t change as meals are consumed during the day, so they are less sensitive in detecting metabolism risk in youth, said Spencer Proctor, a professor in the Division of Nutrition in the Faculty of Agricultural, Life & Environmental Sciences (ALES) and a member of the Alberta Diabetes Institute.
RC, which was shown to be higher in youth with obesity than in their peers, indicates early risk of heart disease by acting as a marker for fat intolerance—a condition that occurs when the body takes longer to clear dietary fats from the blood.
“This is the first time we’ve shown that youth with obesity have higher measures of this particular cholesterol marker, while all other classic fasting lipid measures show as normal,” Proctor said.
“If you aren't taking blood samples during the day, you are missing that information. The RC lipid measure helps ensure at-risk youth aren’t overlooked from a metabolic point of view.”
The finding highlights the importance of identifying health risk in youth with obesity much earlier in front-line medicine, Proctor said.
One in seven children in developed countries is living with obesity, which can persist into adulthood and increases risk of developing heart disease and Type 2 diabetes.
“This research can change the understanding of not only the lipid specialist, but the general practitioner who sees a lot of community-based medical problems,” Proctor noted. “If we can find ways to identify and implement lifestyle changes, say, 10 years earlier than we are currently doing, we can make appropriate clinical recommendations and educate patients to make lifestyle changes to prevent Type 2 diabetes or heart disease.
“We can potentially save thousands of lives, we could increase longevity and we will certainly increase quality of life. This is particularly relevant for those youth who may be at risk of developing Type 2 diabetes.”
Proctor and his colleagues plan to build on their findings to deploy a new handheld device so physicians and their patients can easily track RC levels during the day, similar to how a glucose monitor is used for diabetes.
“Such devices will enable point-of-care health-care workers to measure RC levels immediately with a simple finger prick, without the need for a formal blood draw via clinical analytical laboratories. This will increase the frequency and ease of RC measures,” Proctor said.
The researchers also hope an animated video on the U of A’s Edmonton Remnant Cholesterol Protocol research website, describing their latest findings, will be an easy way to reach health-care professionals.
Created by Faculty of Science student Basel Moukaskas through an internship with the Peter Lougheed Leadership College Stretch Experience program, the two-minute video is the second in a series designed to reach doctors, nurses, dietitians and other health-care professionals involved in treating people with obesity, Proctor said.
“All of these audiences are very involved in the health problems brought on by obesity, and this series is the beginning of what we are trying to do to identify different audiences—to translate basic messaging to the clinical realm.”
The research was published in Pediatric Obesity. Co-authors include Jacqueline Krysa for her PhD candidacy in ALES, Donna Vine in ALES, and Geoff Ball and Mary Jetha in the Faculty of Medicine & Dentistry.
The scientists and their research were supported by various grants, scholarships, funds, facilities, programs and networks through the Stollery Children's Hospital Foundation through the Women and Children's Health Research Institute, Alberta Health Services Maternal Newborn Child & Youth Strategic Clinical Network, Alberta Diabetes Institute and Alberta Diabetes Foundation.