Vertical auto profile

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Vertical auto profile
Purposelipoprotein test

The Vertical Auto Profile (VAP) test is a blood analysis designed to accurately measure lipid and lipoprotein levels in the human body. [1] While traditional lipid panels provide basic information about total cholesterol, HDL, LDL, and triglycerides, the VAP test offers a much more precise assessment of lipid subfractions, including various types of LDL, VLDL, and IDL cholesterol. [2]

Contents

This test is especially useful in identifying cardiovascular risk factors that might not be detected through conventional analyses, thereby allowing for greater and more personalized prevention and treatment strategies. [2]

Description

The VAP test is an advanced analytical technique designed to identify cardiovascular risk factors not detected by traditional cholesterol tests. [1] Its main advantage is its ability to measure and report more risk parameters, making it considerably more accurate, even in patients with elevated triglyceride levels. [3] Unlike standard cholesterol tests, the VAP test does not require the patient to fast, which facilitates its use in everyday clinical settings.

A standout feature of the VAP test is its ability to assess 15 distinct components of the lipid profile, compared to the four parameters measured by traditional tests. This enables the detection of more than twice as many lipid abnormalities, particularly in individuals at high risk for cardiovascular disease. Among the components measured by the VAP test are the five classes of lipoproteins, including LDL, HDL, IDL, VLDL, and lipoprotein(a). [4] [5] Additionally, the test quantitatively defines the concentration of LDL-P particles, providing a more detailed view of lipid levels. These elements are critical for assessing more specific and personalized cardiovascular threats in high-risk patients. [6]

The test aligns with the guidelines of the American Diabetes Association and the American College of Cardiology, [7] which recommend a more comprehensive approach for patients at high risk for heart disease, such as those with type 2 diabetes. [8] These guidelines include the measurement of apolipoprotein B and other parameters beyond LDL to more accurately assess cardiovascular risk. [9]

Studies

Various studies have supported the efficacy of the VAP test. A study of 1.34 million patients at Johns Hopkins showed that up to 60% of cases were misclassified when using the conventional lipid panel, potentially leading to inadequate or even harmful treatments. [10] Other studies have highlighted the correlation between residual lipoproteins and cardiovascular risk, suggesting that the VAP test may be crucial for more accurate assessment and appropriate treatment in high-risk patients. [11] [12] [13] [14]

References

  1. 1 2 "Pruebas integrales de colesterol suministran claves para anormalidad metabólica". Labmedica.es. 14 November 2010. Retrieved 28 April 2025.
  2. 1 2 "¿Cuál es el test más efectivo para medir el colesterol?". Hospital Zafiro (in Spanish). 29 April 2019. Retrieved 28 April 2025.
  3. ↑ Kulkarni, Krishnaji R. (1 December 2006). "Cholesterol Profile Measurement by Vertical Auto Profile Method" . Clinics in Laboratory Medicine. 26 (4): 787–802. doi:10.1016/j.cll.2006.07.004. ISSN   0272-2712. PMID   17110240.
  4. ↑ Yeang, Calvin; Clopton, Paul C.; Tsimikas, Sotirios (1 November 2016). "Lipoprotein(a)-cholesterol levels estimated by vertical auto profile correlate poorly with Lp(a) mass in hyperlipidemic subjects: Implications for clinical practice interpretation of Lp(a)-mediated risk". Journal of Clinical Lipidology. 10 (6): 1389–1396. doi:10.1016/j.jacl.2016.09.012. ISSN   1933-2874. PMC   8545497 .
  5. ↑ Kulkarni, K. R.; Marcovina, S. M.; Krauss, R. M.; Garber, D. W.; Glasscock, A. M.; Segrest, J. P. (1 November 1997). "Quantification of HDL2 and HDL3 cholesterol by the Vertical Auto Profile-II (VAP-II) methodology". Journal of Lipid Research. 38 (11): 2353–2364. doi: 10.1016/S0022-2275(20)34949-X . ISSN   0022-2275. PMID   9392433.
  6. ↑ Chu, James W; Abbasi, Fahim; Kulkarni, Krishnaji R; Lamendola, Cynthia; McLaughlin, Tracey L; Scalisi, Janet N; Reaven, Gerald M (1 June 2003). "Multiple Lipoprotein Abnormalities Associated with Insulin Resistance in Healthy Volunteers Are Identified by the Vertical Auto Profile-II Methodology". Clinical Chemistry. 49 (6): 1014–1017. doi:10.1373/49.6.1014. ISSN   0009-9147.
  7. ↑ "Advanced Lipoprotein Testing: Strengths and Limitations". American College of Cardiology. Retrieved 28 April 2025.
  8. ↑ Wägner, A M; Pérez, A; Calvo, F; Bonet, R; Castellví, A; Ordóñez, J (1 May 1999). "Apolipoprotein(B) identifies dyslipidemic phenotypes associated with cardiovascular risk in normocholesterolemic type 2 diabetic patients" . Diabetes Care. 22 (5): 812–817. doi:10.2337/diacare.22.5.812. ISSN   0149-5992.
  9. ↑ REMMERS, LAURYN; BIRZNIEKS, CARISSA; CARRASCO, DIEGO; GROSS, SUSAN; SNELL-BERGEON, JANET K.; HALL, LUCY A.; NADEAU, KRISTEN J.; BJORNSTAD, PETTER; TOMMERDAHL, KALIE L. (20 June 2023). "408-P: Associations between Apolipoprotein B (apoB): Apolipoprotein A1 (apoA1) Ratio and Metabolic and Kidney Disease in Youth with Type 1 Diabetes" . Diabetes. 72 (Supplement_1): 408–P. doi:10.2337/db23-408-P. ISSN   0012-1797.
  10. ↑ Martin, Seth S.; Blaha, Michael J.; Elshazly, Mohamed B.; Brinton, Eliot A.; Toth, Peter P.; McEvoy, John W.; Joshi, Parag H.; Kulkarni, Krishnaji R.; Mize, Patrick D.; Kwiterovich, Peter O.; Defilippis, Andrew P.; Blumenthal, Roger S.; Jones, Steven R. (20 August 2013). "Friedewald-estimated versus directly measured low-density lipoprotein cholesterol and treatment implications". Journal of the American College of Cardiology. 62 (8): 732–739. doi:10.1016/j.jacc.2013.01.079. ISSN   1558-3597. PMID   23524048.
  11. ↑ Bittencourt, Marcio Sommer; Santos, Raul; Staniak, Henrique; Ray, Kausik; Jones, Steven; Martin, Seth; Toth, Peter; Blaha, Michael; Bensenor, Isabela; Lotufo, Paulo (5 April 2016). "Fasting remnant lipoprotein cholesterol is independently associated with subclinical atherosclerosis: the elsa-brasil study" . JACC. 67 (13_Supplement): 1902. doi:10.1016/S0735-1097(16)31903-9.
  12. ↑ Joshi, Parag H.; Toth, Peter P.; Lirette, Seth T.; Griswold, Michael E.; Massaro, Joseph M.; Martin, Seth S.; Blaha, Michael J.; Kulkarni, Krishnaji R.; Khokhar, Arif A.; Correa, Adolfo; D'Agustino, Ralph B.; Jones, Steven R.; Lipoprotein Investigators Collaborative (LIC) Study Group (January 2016). "Association of high-density lipoprotein subclasses and incident coronary heart disease: The Jackson Heart and Framingham Offspring Cohort Studies". European Journal of Preventive Cardiology. 23 (1): 41–49. doi:10.1177/2047487314543890. ISSN   2047-4881. PMC   4312248 . PMID   25062744.
  13. ↑ Joshi, Parag H.; Khokhar, Arif A.; Massaro, Joseph M.; Lirette, Seth T.; Griswold, Michael E.; Martin, Seth S.; Blaha, Michael J.; Kulkarni, Krishnaji R.; Correa, Adolfo; D'Agostino, Ralph B.; Jones, Steven R.; Toth, Peter P.; Lipoprotein Investigators Collaborative (LIC) Study Group (29 April 2016). "Remnant Lipoprotein Cholesterol and Incident Coronary Heart Disease: The Jackson Heart and Framingham Offspring Cohort Studies". Journal of the American Heart Association. 5 (5): e002765. doi:10.1161/JAHA.115.002765. ISSN   2047-9980. PMC   4889167 . PMID   27130348.
  14. ↑ Martin, Seth S.; Khokhar, Arif A.; May, Heidi T.; Kulkarni, Krishnaji R.; Blaha, Michael J.; Joshi, Parag H.; Toth, Peter P.; Muhlestein, Joseph B.; Anderson, Jeffrey L.; Knight, Stacey; Li, Yan; Spertus, John A.; Jones, Steven R.; Lipoprotein Investigators Collaborative (LIC) (1 January 2015). "HDL cholesterol subclasses, myocardial infarction, and mortality in secondary prevention: the Lipoprotein Investigators Collaborative". European Heart Journal. 36 (1): 22–30. doi:10.1093/eurheartj/ehu264. ISSN   1522-9645. PMC   4286318 . PMID   24980493.
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