Fitness Check

LDL cholesterol, often referred to as "bad cholesterol," transports cholesterol to the cells, but can deposit in the arterial walls at high levels and thus promote atherosclerosis. The laboratory value measures the concentration of LDL in the blood.

A LDL test is recommended for: Persons with familial hypercholesterolemia (genetically caused lipid metabolism disorder) Patients with cardiovascular diseases or high risk for it People with diabetes or metabolic syndrome Monitoring of cholesterol levels during a therapy with statins

The test serves to assess the risk of cardiovascular diseases. It is the most important value for monitoring cholesterol therapy and helps in adjusting medications and lifestyle changes.

A high LDL value is an essential risk factor for: Arteriosclerosis Heart attack Stroke A low value is generally unproblematic, but is monitored in patients with greatly reduced values (e.g. through statins).

The test should be carried out in a fasting state in order to increase the informative value, as meals can temporarily influence the values.

LDL cholesterol is often the target value in the treatment of cardiovascular patients. The calculation is often made from total cholesterol, HDL and triglycerides; however, direct measurements are more accurate. Trans fats in the diet increase LDL, while unsaturated fats (e.g. from olive oil) can lower it.

Lipoprotein A is a special form of LDL cholesterol that is genetically determined. The laboratory value measures the concentration of Lp(a) in the blood and is used to assess the cardiovascular risk, especially in familial lipid metabolism disorders.

Here is the translation: A Lp(a) test is recommended for: • Persons with a family history of cardiovascular disease • Patients with abnormal LDL levels despite a healthy lifestyle • People with premature heart attacks or strokes in the family • Patients with suspected genetically-related lipid metabolism disorders

The test serves to assess the cardiovascular risk and is particularly helpful for patients whose risk is not sufficiently explained by standard lipid profiles.

An elevated Lp(a) level is an independent risk factor for: • Arteriosclerosis • Heart attack or stroke • Valve diseases of the aorta (e.g. aortic valve stenosis) A low value is unremarkable and indicates a lower risk. Symptoms with elevated values often only occur in the advanced stage and can include chest pain or shortness of breath.

The testing can be carried out at any time of the day and is independent of food intake.

• Lp(a) is not influenced by lifestyle or medications such as statins, which is why specific therapies may be necessary. • A high Lp(a) value requires additional cardiovascular preventive measures. • If there is a suspicion of genetically caused lipid metabolism disorders, the entire family should be examined.

Creatine kinase (CK) is an enzyme that is mainly found in muscle cells and the brain. It is involved in the energy supply of the cells. The laboratory value measures the concentration of CK in the blood to diagnose muscle damage or diseases.

A CK test is recommended for: • People with symptoms such as muscle weakness, pain or cramps • Patients suspected of having muscle diseases such as myositis or muscular dystrophy • Diagnosis and monitoring of heart attacks (in combination with other markers) • Patients taking medications such as statins that can cause muscle damage • Athletes with unusually severe muscle pain after intense training

The test serves the diagnosis of muscle diseases, heart attacks and muscle damage due to overload or medication. It is also used for monitoring patients with chronic muscle diseases.

A raised CK value can indicate: • Muscle damage due to injury, overload or surgery • Inflammatory muscle diseases such as myositis • Heart attack (CK-MB as a specific subform) A low CK value has no clinical significance. Symptoms with elevated CK values can include: • Muscle pain or weakness • Dark urine (indication of rhabdomyolysis) • Chest pain in case of heart attack

The testing can be carried out at any time of the day, but ideally after avoiding strenuous physical exertion, as this can temporarily increase the CK value.

• There are various CK isoforms (CK-MM, CK-MB, CK-BB) that provide specific information about the origin of the enzyme (e.g. skeletal muscle, heart). • Intense physical activity, intramuscular injections or severe injuries can increase CK levels. • Statins and other medications can lead to elevated CK levels, which may indicate muscle damage.

Holo-Transcobalamin (Holo-TC) is the biologically active form of vitamin B12 that is bound to the transport protein Transcobalamin. The laboratory value measures the concentration of Holo-TC in the blood and provides early indications of a functional vitamin B12 deficiency.

A Holo-TC test is recommended for: People with non-specific symptoms such as fatigue, memory disorders or neurological complaints Patients with a normal or borderline vitamin B12 level, in whom a deficiency is suspected Persons with risk factors for vitamin B12 deficiency (e.g. vegans, elderly people) Patients with suspected pernicious anemia or malabsorption disorders

The test serves for the early detection of a vitamin B12 deficiency, before severe symptoms develop. It complements the classic vitamin B12 measurement and is particularly helpful in diagnosing functional deficiencies.

A low holo-TC value indicates a functional vitamin B12 deficiency, which can occur despite a normal serum B12 value. Symptoms are: Fatigue and concentration problems Tingling or numbness in the extremities Anemia or neurological disorders A normal value usually excludes a deficiency and makes further tests unnecessary.

The test is meaningful in case of non-specific complaints or in risk groups such as vegans and elderly people. Testing is also appropriate in case of suspected malabsorption or before starting supplementation.

Here is the translation: Holo-TC is a more sensitive marker than total cobalamin, as it only measures the biologically active form of vitamin B12. Alcohol abuse and medications can affect the Holo-TC level.