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About the Clinic


Dr. Hegele is a specialist who 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 has over 1200 patients under his care.


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.


Why are you here?

You have been referred to Dr. Hegele by your family doctor because he or she has concerns about your cholesterol or triglycerides, called lipids or fats that are in your blood. These lipids need to be in balance for your arteries and heart to be healthy. Dr. Hegele will carefully consider your health history and assess your cholesterol levels to determine the best course of treatment for your individual issue.


What tests are performed on the first visit?

Several blood tests, ECG, and IMT 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:

**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.**

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.
HbA1C (glycated haemoglobin)
  • A long term index of blood sugar control to determine how good blood sugar control has been.
Urea, creatinine
  • Tests of kidney function, since kidney disorders can affect the lipid profile.
CK (creatine kinase)
  • Muscle enzyme test, to obtain a baseline since the tests increase in rare treated patients.
ESR (erythrocyte sedimentation rate)
  • A test of inflammation that some believe is associated with increased vascular disease risk
Serum electrolytes
  • A general test to rule out disturbances of blood salts
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.
Apolipoprotein B
  • The protein component of the LDL particle; some feel it gives a better risk index than LDL alone.
  • A clotting factor in the blood that could increase risk; it is included in determining risk level to guide management of the lipid profile.
  • A clotting factor in the blood that could increase risk; it is included in determining risk level to guide management of the lipid profile.
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.
DNA analysis
  • This is done on a research basis, with informed consent of the patient.
Carotid ultrasound
  • 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.
DNA testing
  • 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.