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Services
Dr. Hegele has a special interest and expertise in providing health care to patients
whose blood lipids - such as cholesterol and triglycerides - are out of balance.
As an endocrinologist, Dr. Hegele also provides health care to patients with diabetes
and other metabolic problems that sometimes occur together with lipid disorders.
Dr. Hegele conducts clinical trials of new medications that may not yet be available
for prescription. He also directs a research laboratory, and his team has discovered
the genetic basis of many different lipid disorders, inherited forms of diabetes
and other rare conditions. His research accomplishments have been recognized by
awards from societies such as the American Heart Association, the Canadian Diabetes
Association and the Heart and Stroke Foundation of Canada.
Dr. Hegele is also a Distinguished Professor of Medicine and Biochemistry in the
Schulich School of Medicine, University of Western Ontario.
**Below is a list of tests of the services we offer and a description of each, if
any questions arise or you would like to learn more about the tests feel free to
visit our Frequently Asked Questions page or contact us to
further answer any questions you may have.**
Tests that are performed on the first visit:
Several blood tests and other tests are routinely performed on your first visit
to the Lipid Genetics Clinic. The results will be discussed with you at your second
visit. These tests are shown in the Table below:
|
Test name |
Why is it done? |
* Lipid profile: total cholesterol, LDL and HDL cholesterol and triglycerides
[* This test is done after a 12-14 hour fasting period because our standards are
determined from fasting levels] |
- On first visit for diagnosis and a baseline level to determine need for and type
of treatment.
- On follow-up visits to determine how well treatment is working and whether adjustments
are required. |
|
TSH (thyroid test)
|
- To detect undiagnosed or untreated thyroid disease, since thyroid imbalance can
affect the lipid profile.
|
|
AST (aspartate transaminases), ALT (alanine transaminases), ALP (alkaline phosphatase)
|
- Tests of liver function, to obtain a baseline since these tests can increase in
rare patients on treatment.
- Also, to detect undiagnosed or untreated liver disease, since liver problems can
affect the lipid profile.
|
|
Urinalysis (for sugar and protein)
|
- Sugar in the urine can indicate diabetes, which can affect lipid profile.
- Protein in the urine can indicate a kidney condition.
|
|
Glucose (blood sugar)
|
- Improved glucose control in diabetes can help the lipid profile
- Suboptimal lipid profile in a diabetic patient needs to be managed aggressively.
|
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HbA1C (glycated haemoglobin)
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- A long term index of blood sugar control to determine how good blood sugar control
has been.
|
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Urea, creatinine
|
- Tests of kidney function, since kidney disorders can affect the lipid profile.
|
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CK (creatine kinase)
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- Muscle enzyme test, to obtain a baseline since the tests increase in rare treated
patients.
|
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ESR (erythrocyte sedimentation rate)
|
- A test of inflammation that some believe is associated with increased vascular
disease risk
|
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Serum electrolytes
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- A general test to rule out disturbances of blood salts
|
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Serum insulin
|
- High fasting insulin levels suggest insulin resistance, a risk factor for lipid
disorders and type 2 diabetes
|
Risk Factors:
|
Apolipoprotein A1
|
The protein component of the HDL particle; some feel it is a more precise test than
HDL.
|
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Apolipoprotein B
|
The protein component of the LDL particle; some feel it gives a better risk index
than LDL alone.
|
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Fibrinogen
|
A clotting factor in the blood that could increase risk; it is included in determining
risk level to guide management of the lipid profile.
|
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Lp(a)
|
A clotting factor in the blood that could increase risk; it is included in determining
risk level to guide management of the lipid profile.
|
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CRP (C-reactive protein)
|
A marker inflammation in the blood associated with increased risk; it is included
in determining risk level to guide management of the lipid profile.
|
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DNA analysis
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- This is done on a research basis, with informed consent of the patient.
|
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Carotid ultrasound
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- This is measured by a certified technologist and is routine for all patients seen
in the Lipid Genetics clinic. If plaques are seen, this will probably affect treatment.
|
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DNA testing
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Dr. Hegele has been studying DNA and heart disease risk for almost 20 years and
might request a small sample of your blood for research into genetic markers that
might increase the risk of a heart attack or stroke.
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