In this special episode designed to give you Instant Insights, we explore how protein in the urine is a powerful marker for both kidney and cardiovascular health. We break down how albumin leaks into the urine when the kidney’s filtration barrier is damaged, review traditional cut points for albumin-to-creatinine ratio (uACR), and discuss emerging evidence showing that even “normal” or low-level albuminuria predicts vascular dysfunction, chronic kidney disease progression, and increased cardiovascular risk. This episode will Explain how albumin appears in the urine and what this indicates about kidney damage (1:00) Discussed different nomenclature used for albuminuria (1:45) Interpret the clinical significance of uACR values (2:15) Describe why albumin levels in the upper end of the normal range may still represent vascular or renal dysfunction (3:00) Recognize that any degree of proteinuria signals increased risk for chronic kidney disease and cardiovascular events (4:30)   To learn more, please review the additional resources below for information on our cardiovascular, metabolic, endocrine, and wellness offerings as well as educational resources and insights from our team of experts. At Quest Diagnostics, we are committed to providing you with results and insights to support your clinical decisions. Date: 11/2025 Speaker(s):  Maeson Latsko, PhD Contributor(s): Maeson Latsko, PhD; Trisha Winchester, PhD, Millicent Kee, MSN, FNP-BC, Nathan Adamo     Additional Resources   Quest Diagnostics Clinical Education Center [Link]     Ordering information:  Albumin, Random Urine with Creatinine Kidney Profile   References:   Verma A, Schmidt IM, Claudel S, Palsson R, Waikar SS, Srivastava A. Association of Albuminuria With Chronic Kidney Disease Progression in Persons With Chronic Kidney Disease and Normoalbuminuria : A Cohort Study. Ann Intern Med. 2024 Apr;177(4):467-475. doi: 10.7326/M23-2814. Epub 2024 Apr 2. PMID: 38560911; PMCID: PMC12124184

One in three adults worldwide are affected by fatty liver disease, and most are unaware that they have it. Today’s conversation between Andrew Hunt and Maeson Latsko, PhD will dive into Metabolic Associated Steatotic Liver Disease (MASLD), a new terminology that replaces NAFLD, emphasizing the close relationship with metabolic risk factors like obesity, diabetes, and dyslipidemia. We focus on the importance of identifying patients at risk for advanced fibrosis early—before irreversible liver damage occurs. A key tool in this early identification is the use of a fibrosis 4 (FIB-4) score, which is a noninvasive blood-based biomarker that uses age, AST, ALT, and platelet count to estimate fibrosis risk and guide next steps in management. We discuss follow-up testing for some at-risk patients using the Enhanced Liver Fibrosis (ELF) test and the need for continued monitoring  of comorbid cardiometabolic conditions. This episode will Explain the shift in terminology from NAFLD to MASLD (4:00) Highlight the importance of early identification of fatty liver disease using the FIB-4 score (5:45) Outline appropriate follow-up testing, including the use of the ELF test to assess liver fibrosis (9:00) Explore the link between MASLD and other cardiometabolic conditions (12:10)   To learn more, please review the additional resources below for information on our cardiovascular, metabolic, endocrine, and wellness offerings as well as educational resources and insights from our team of experts. At Quest Diagnostics, we are committed to providing you with results and insights to support your clinical decisions. Date: 10/2025 Speaker(s):  Andrew Hunt; Maeson Latsko, PhD Contributor(s): Maeson Latsko, PhD; Andrew Hunt; Trisha Winchester, PhD, Millicent Kee, MSN, FNP-BC     Additional Resources   Quest Diagnostics Clinical Education Center [Link]  ELF test detail  FIB4 test summary  2022 AACE algorithm for fatty liver assessment   Ordering information:  CMP + Fib4  Enhanced Liver Fibrosis Score    References:   Ciardullo S, Vergani M, Perseghin G. Nonalcoholic fatty liver disease in patients with type 2 diabetes: Screening, diagnosis, and treatment. J Clin Med. 2023;12(17):5597. doi:10.3390/jcm12175597  Rinella ME, Neuschwander-Tetri BA, Siddiqui MS, et al. AASLD Practice Guidance on the clinical assessment and management of nonalcoholic fatty liver disease. Hepatology. 2023;77(5):1797-1835. doi:10.1097/HEP.0000000000000323  Cusi K, Isaacs S, Barb D, et al. American Association of Clinical Endocrinology Clinical Practice Guideline for the Diagnosis and Management of Nonalcoholic Fatty Liver Disease in Primary Care and Endocrinology Clinical Settings: Co-Sponsored by the American Association for the Study of Liver Diseases (AASLD). Endocr Pract. 2022;28(5):528-562. doi:10.1016/j.eprac.2022.03.010  Stern C, Castera L. Identification of high-risk subjects in nonalcoholic fatty liver disease. Clin Mol Hepatol. 2023;29(Suppl):S196-S206. doi:10.3350/cmh.2022.0431 

This special episode of Healthier World designed to give you Instant Insights discusses the importance of screening and managing fatty liver disease, a condition affecting 1 in 3 Americans and over 70% of patients with type 2 diabetes. The episode covers the transition from the term NAFLD to MASLD, discusses the AACE-recommended testing algorithm for MASLD using the fibrosis-4 (FIB-4) score and the enhanced liver fibrosis (ELF) and highlights the importance of early identification and intervention for proper management of underlying metabolic conditions. This episode will Review the implications of the shift in terminology from NAFLD to MASLD (1:00) Discuss the progression of MASLD (1:25) Walk through the testing algorithm for MASLD, starting with the first-line screening assessment using the FIB-4 and when the follow up with the ELF score is recommended (2:30) Highlight the importance of early identification and prevention in managing MASLD and comorbid cardiometabolic conditions (5:45) To learn more, please review the additional resources below for information on our cardiovascular, metabolic, endocrine, and wellness offerings as well as educational resources and insights from our team of experts. At Quest Diagnostics, we are committed to providing you with results and insights to support your clinical decisions. Date: October 2025 Speaker(s):  Maeson Latsko, PhD Contributor(s): Maeson Latsko, PhD; Trisha Winchester, PhD; Millicent Kee, MSN, FNP-BC   Additional Resources Quest Diagnostics Clinical Education Center [Link] ELF test detail FIB4 test summary 2022 AACE algorithm for fatty liver assessment Ordering information: CMP + Fib4 Enhanced Liver Fibrosis Score   References:   Ciardullo S, Vergani M, Perseghin G. Nonalcoholic fatty liver disease in patients with type 2 diabetes: Screening, Diagnosis, and Treatment. J Clin Med. 2023;12(17):5597. doi:10.3390/jcm12175597 Rinella ME, Neuschwander-Tetri BA, Siddiqui MS, et al. AASLD Practice Guidance on the clinical assessment and management of nonalcoholic fatty liver disease. Hepatology. 2023;77(5):1797-1835. doi:10.1097/HEP.0000000000000323 Cusi K, Isaacs S, Barb D, et al. American Association of Clinical Endocrinology Clinical Practice Guideline for the Diagnosis and Management of Nonalcoholic Fatty Liver Disease in Primary Care and Endocrinology Clinical Settings: Co-Sponsored by the American Association for the Study of Liver Diseases (AASLD). Endocr Pract. 2022;28(5):528-562. doi:10.1016/j.eprac.2022.03.010 Stern C, Castera L. Identification of high-risk subjects in nonalcoholic fatty liver disease. Clin Mol Hepatol. 2023;29(Suppl):S196-S206. doi:10.3350/cmh.2022.0431

Coronary calcium scores are highly utilized to spot hidden cardiovascular risk, and  new research suggests that timing is important. Today’s conversation between Maeson Latsko, PhD and Millicent Kee, MSN, FNP-BC will break down how timing plays a role in proper assessment of calcium scoring, and how biomarker testing such as Apolipoprotein B, Myeloperoxidase, Lp-PLA2, and hs-CRP can be paired with physiological assessments like calcium scoring to help guide patient care, especially when calcium scoring doesn’t tell the full story. This episode will Review what calcium scoring is (1:30) Discuss how timing of calcium scoring can influence interpretation of results (3:15) Explain why statin-treated patients should not monitor their risk using a calcium score (7:00) Discuss ways biomarker testing such as ApoB, MPO, Lp-pla2, and hs-CRP can reveal hidden risk outside of the window indicated for calcium scoring (11:30; 14:30)   To learn more, please review the additional resources below for information on our cardiovascular, metabolic, endocrine, and wellness offerings as well as educational resources and insights from our team of experts. At Quest Diagnostics, we are committed to providing you with results and insights to support your clinical decisions.   Date: 9/2025 Speaker(s):  Maeson Latsko, PhD; Millicent Kee, MSN, FNP-BC Contributor(s): Maeson Latsko, PhD; Millicent Kee, MSN, FNP-BC; Trisha Winchester, PhD; Kathryn Morales, MS     Additional Resources: Apolipoprotein B | Test Detail | Quest Diagnostics hs-CRP | Test Detail | Quest Diagnostics Lp-pla2 | Test Detail | Quest Diagnostics Myeloperoxidase | Test Detail | Quest Diagnostics

In this episode of Healthier World designed to give you instant insights, we introduce the Cleveland HeartLab and its role as a Center of Excellence for cardiometabolic, endocrine, and wellness testing at Quest Diagnostics. In this episode, Dr. Maeson Latsko hosts a segment featuring various leaders from Cleveland HeartLab and Quest Diagnostics, including Marc Penn, MD, PhD, Mouris Saghir, PhD, Tim Collier, PhD and Jim Davis. They discuss their mission to improve heart disease prevention and associated metabolic conditions through cutting-edge research and personalized care. This episode will  Discuss the need for better chronic disease prevention (1:40) Review the cardiometabolic approach to healthcare (2:15) Highlight the technology behind Cleveland Heartlab testing (2:45) Introduce Cleveland Heart Lab as the center of excellence (3:30)   To learn more, please review the additional resources below for information on our cardiovascular, metabolic, endocrine, and wellness offerings as well as educational resources and insights from our team of experts. At Quest Diagnostics, we are committed to providing you with results and insights to support your clinical decisions. Date: 8/2025 Speaker(s):  Maeson Latsko, PhD Contributor(s):  Maeson Latsko, PhD; Trisha Winchester, PhD, Millicent Kee, NP

Obesity affects over 40% of adults in the United States. Glucagon-like peptide-1 (GLP-1) receptor agonists, a class of medications initially developed for the treatment of type 2 diabetes, have shown significant efficacy in promoting weight loss and are increasingly prescribed for obesity management. In today’s episode, Millicent Kee, MSN, FNP-BC, Clinical and Education Specialist, and Patty Bianchi, MS, RDN, CDCES, Clinical Educator at Quest Diagnostics Center of Excellence at Cleveland HeartLab, will discuss GLP-1 receptor agonists, their actions in the body, and the important role of nutrition, exercise, and lifestyle alongside these medications. This episode will Discuss the actions of GLP-1 receptor agonists in the body (1:38) Discuss how GLP-1s influence appetite and hunger (3:18) Discuss the role of nutrition, exercise, and lifestyle while on GLP-1 therapy (6:38) Discuss how weight loss may also improve cardiometabolic health and lower insulin resistance utilizing a patient example (18:00) To learn more, please review the additional resources below for information on our cardiovascular, metabolic, endocrine, and wellness offerings as well as educational resources and insights from our team of experts. At Quest Diagnostics, we are committed to providing you with results and insights to support your clinical decisions. Date: 8/2025 Speaker(s):  Millicent Kee, MSN, FNP-BC; Patricia Bianchi, MS, RDN, CDCES Contributor(s): Millicent Kee, MSN, FNP-BC; Patricia Bianchi, MS, RDN, CDCES; Maeson Latsko, PhD; Trisha Winchester, PhD   Additional Resources Quest Diagnostics Clinical Education Center [Link]   References: Neff LM, Kushner RF. Emerging role of GLP-1 receptor agonists in the treatment of obesity. Diabetes Metab Syndr Obes. 2010 Jul 20; 3:263-73. doi: 10.2147/dmsott. s6816   Stierman B, Afful J, Carroll MD, et al. National Health and Nutrition Examination Survey 2017–March 2020 prepandemic data files development of files and prevalence estimates for selected health outcomes. Natl Health Stat Report. 2021;158. doi: 10.15620/cdc:106273   Related Content: FAQ CardioIQ® Insulin Resistance Panel with Score | Quest Diagnostics   Additional Resources Weight management and cardiometabolic health | Quest Diagnostics   Audio Podcast Instant Insight: Metabolic Risk Panel | Quest Diagnostics Action From Insight: Tackling Insulin Resistance | Quest Diagnostics   Conference Presentation Measures of Insulin Resistance (IR) Increase with Increasing BMI in a Population of Normoglycemic Working Adults | Quest Diagnostics   On-Demand Webinar Detecting and Managing Insulin Resistance | Quest Diagnostics

In this special episode of Healthier World designed to give you Instant Insights, we review a panel that takes a deeper look at cardiovascular, renal, hepatic, endocrine, and metabolic health—a network of systems that work together to determine a person’s long-term health. Today we will break down what this panel includes and how it can help prevent the onset of chronic disease years before symptoms start. This episode will Explain why this panel was created (1:10) Examine how the panel provides a comprehensive view of cardiovascular, metabolic, endocrine, renal, and hepatic risk (3:35) Discuss the clinical relevance of this panel in prevention screening and risk stratification for cardiometabolic conditions (5:30) To learn more, please review the additional resources below for information on our cardiovascular, metabolic, endocrine, and wellness offerings as well as educational resources and insights from our team of experts. At Quest Diagnostics, we are committed to providing you with results and insights to support your clinical decisions. Date: 8/2025 Speaker(s):  Maeson Latsko, PhD Contributor(s): Maeson Latsko, PhD; Trisha Winchester, PhD; Millicent Kee, MSN, FNP-BC; Kathryn Morales; Abhi Patel   Resources Quest Diagnostics Clinical Education Center [Link] Podcast: The Cardiometabolic approach to modern disease risk assessment   Ordering information: Cardiometabolic Disease Assessment (CMDA) Panel | Test Detail | Quest Diagnostics    

In this special episode of Healthier World designed to give you Instant Insights, we explore a vascular-specific inflammatory marker that can indicate risk for cardiometabolic disease and all-cause mortality—myeloperoxidase. In this episode, we break down the biology and function of MPO, its contribution to vascular inflammation, and its potential as a biomarker of vulnerable soft plaque in the arteries. This episode will Define myeloperoxidase (MPO) and describe its biological function (1:20) Explain the relationship between MPO and vascular inflammation (2:15) Recognize the role of MPO in cardiometabolic disease (2:55) Review treatment considerations for elevated MPO (3:45) The content was current as of the time of recording. To learn more, please review the additional resources below for information on our cardiovascular, metabolic, endocrine, and wellness offerings as well as educational resources and insights from our team of experts. At Quest Diagnostics, we are committed to providing you with results and insights to support your clinical decisions.   Date: 7/2025 Speaker(s):  Maeson Latsko, PhD Contributor(s):  Maeson Latsko, PhD; Trisha Winchester, PhD; Millicent Kee, MSN, FNP-BC   Additional Resources Ordering information: MPO ordering information MPO Test Summary Quest Diagnostics Clinical Education Center [Link]     References:    Iakoubova OA, Haji-Sheikhi F, Louie JZ, et al. Association of MPO levels with cardiometabolic disease stratified by atherosclerotic cardiovascular risk and intensity of therapy in a workforce population. Sci Rep. 2025;15(1):12244. Published 2025 Apr 10. doi:10.1038/s41598-025-89373-7

Inflammation plays a critical role in cardiometabolic diseases, but traditional risk markers like LDL-C and hs-CRP don’t tell the whole story. Myeloperoxidase (MPO), an enzyme linked to oxidative stress and immune activation, may offer a deeper look into hidden cardiovascular and metabolic risk. In this episode, Dr Marc Penn unpacks the new research examining the association between MPO and the risk for chronic kidney disease (CKD) and  nonalcoholic fatty liver disease (NAFLD) across atherogenic cardiovascular disease (ASCVD) risk groups and what it might mean for prevention and tailored treatment.   This episode will Define MPO (1:30, 5:00) Explain the role of MPO as an inflammatory biomarker and how it differs from traditional cardiometabolic risk markers (2:00) Reveal relationships between MPO, CKD, and NAFLD (7:00) Outline how providers can use MPO to enhance risk stratification and personalize treatment strategies (9:25) Inform listeners on the importance of early detection and prevention of risk factors for cardiometabolic risk (13:00)   The content was current as of the time of recording. To learn more, please review the additional resources below for information on our cardiovascular, metabolic, endocrine, and wellness offerings as well as educational resources and insights from our team of experts. At Quest Diagnostics, we are committed to providing you with results and insights to support your clinical decisions.   Date: 6/2025 Speaker(s):  Maeson Latsko, PhD; Dr Marc Penn Contributor(s):  Maeson Latsko, PhD; Trisha Winchester, PhD; Kathryn Morales, MS   Additional Resources Ordering information MPO ordering information  Quest Diagnostics Clinical Education Center [Link] References Iakoubova OA, Haji-Sheikhi F, Louie JZ, et al. Association of MPO levels with cardiometabolic disease stratified by atherosclerotic cardiovascular risk and intensity of therapy in a workforce population. Sci Rep. 2025;15(1):12244. Published 2025 Apr 10. doi:10.1038/s41598-025-89373-7

In this special episode of Healthier World designed to give you Instant Insights, we dive into advanced lipid testing—going beyond a standard lipid panel. Today, we will explore two powerful tools used to look at lipoprotein fractionation: ion mobility and nuclear magnetic resonance (NMR). We will look at how these tests work and how they can uncover hidden risk for cardiovascular disease. This episode will Expand on the importance of lipoprotein fractionation by ion mobility and nuclear magnetic resonance (NMR) (1:15) Interpret key lipid analytes provided using two methodologies, NMR and ion mobility, as they relate to cardiovascular disease risk (LDL: 3:00, HDL: 4:40, VLDL: 5:30, LDL pattern and LDL peak size: 6:00) Evaluate report analytes and risk cut points between methods (6:45) The content was current as of the time of recording. To learn more, please review the additional resources below for information on our cardiovascular, metabolic, endocrine, and wellness offerings as well as educational resources and insights from our team of experts. At Quest Diagnostics, we are committed to providing you with results and insights to support your clinical decisions. Date: 6/2025 Speaker(s):  Maeson Latsko, PhD Contributor(s):  Maeson Latsko, PhD; Trisha Winchester, PhD; Millicent Kee, MSN, FNP-BC; Abhi Patel   Additional Resources Ordering information: Quest Diagnostics Clinical Education Center [Link]   Fractionation, Ion Mobility Fractionation, NMR   References:           Cromwell WC, Otvos JD, Keyes MJ, et al. LDL Particle Number and Risk of Future Cardiovascular Disease in the Framingham Offspring Study - Implications for LDL Management. J Clin Lipidol. 2007;1(6):583-592. doi:10.1016/j.jacl.2007.10.001   German CA, Shapiro MD. Assessing Atherosclerotic Cardiovascular Disease Risk with Advanced Lipid Testing: State of the Science. Eur Cardiol. 2020;15:e56.  doi:10.15420/ecr.2019.18   Quesada JA, Bertomeu-González V, Orozco-Beltrán D, et al. The benefits of measuring the size and number of lipoprotein particles for cardiovascular risk prediction: A systematic review and meta-analysis. Clin Investig Arterioscler. 2023;35(4):165-177. doi:10.1016/j.arteri.2022.11.001

In this special episode of Healthier World designed to give you Instant Insights, we take a look at primary aldosteronism (PA)- an often underdiagnosed, yet prevalent cause of hypertension. In this episode, we challenge traditional screening methods and introduce a streamlined diagnostic approach. By recognizing the signs of Primary Aldosteronism earlier, providers can improve patient outcomes and avoid increased risk for cardiovascular and metabolic conditions associated with untreated PA. This episode will Explain the mechanisms underlying PA and how they disrupt the normal renin-aldosterone feedback system (1:15) Highlight the limitations of traditional methodology, including the aldosterone-renin-ratio (ARR) (2:25) Introduce a streamlined approach focused on the detection of suppressed renin followed by evaluation of aldosterone levels (3:00) Walk through an example comparing the ARR with the suppressed renin approach for assessing PA (5:05)   The content was current as of the time of recording. To learn more, please review the additional resources below for information on our cardiovascular, metabolic, endocrine, and wellness offerings as well as educational resources and insights from our team of experts. At Quest Diagnostics, we are committed to providing you with results and insights to support your clinical decisions. Date: 6/2025 Speaker(s): Maeson Latsko, PhD Contributor(s): Maeson Latsko, PhD; Trisha Winchester, PhD; Millicent Kee, MSN, FNP-BC; Akhil Singh Additional Resources: https://www.questdiagnostics.com/healthcare-professionals/about-our-tests/endocrine-disorders/primary-aldosteronism Ordering information: Plasma Renin Activity with Reflex to Aldosterone | Test Detail | Quest Diagnostics   References: Marcelli M, Bi C, Funder JW, McPhaul MJ. Comparing ARR Versus Suppressed PRA as Screening Tests for Primary Aldosteronism. Hypertension. 2024;81(10):2072-2081. doi:10.1161/HYPERTENSIONAHA.124.22884   Dogra P, Bancos I, Young WF Jr. Primary Aldosteronism: A Pragmatic Approach to Diagnosis and Management. Mayo Clin Proc. 2023;98(8):1207-1215. doi:10.1016/j.mayocp.2023.04.023

Understanding the diagnosis and treatment in primary aldosteronism (PA) often feels elusive to most providers. PA is marked by the elevation of aldosterone and the suppression of renin leading to a disproportionately higher risk of cardiovascular, kidney, and metabolic disease compared to those patients with essential hypertension, yet this condition is often undiagnosed. This episode will discuss the use of the Plasma Renin Activity lab to screen for primary aldosteronism and guideline-directed care of PA.  In today’s episode, Maeson Latsko, PhD and Millicent Kee, MSN, FNP-BC, Clinical and Education Specialists at Quest Diagnostics Center of Excellence at Cleveland Heartlab, will discuss the next steps in care once primary aldosteronism has been identified. This episode will Discuss the prevalence of PA and its impact on health (1:30) Discuss use of the PRA lab to screen for PA (4:15) Review current diagnosis and treatment guidelines for PA (mineralocorticoid receptor antagonist (MRA) treatment: 6:50, MRA considerations: 13:00) Discuss how providers can utilize current treatment guidelines (referral: 9:45, imaging: 11:00, surgical evaluation: 11:45) The content was current as of the time of recording. To learn more, please review the additional resources below for information on our cardiovascular, metabolic, endocrine, and wellness offerings as well as educational resources and insights from our team of experts. At Quest Diagnostics, we are committed to providing you with results and insights to support your clinical decisions. Date: 5/2025 Speaker(s):  Millicent Kee, MSN, FNP-BC; Maeson Latsko, PhD Contributor(s):  Maeson Latsko, PhD; Millicent Kee; MSN, FNP-BC; Trisha Winchester, PhD; Sanjay Dixit, MD; Akhil Singh   Additional Resources Ordering information: Quest Diagnostics Clinical Education Center [Link]   Plasma Renin Activity with Reflex to Aldosterone | Test Detail | Quest Diagnostics   https://www.questdiagnostics.com/healthcare-professionals/about-our-tests/endocrine-disorders/primary-aldosteronism   References:  Auchus RJ. Approaching Primary Aldosteronism as a Common Disease. Endocr Pract. 2023;29(12):994-998. doi:10.1016/j.eprac. 2023.08.014   Brown JM, Tsai LC, Abel EE, et al. Nationwide, Pragmatic, Direct-to-Patient Primary Aldosteronism Testing Program. Hypertension. 2025 Feb 21. doi: 10.1161/HYPERTENSIONAHA.125.24648.   Funder JW, Carey RM, Mantero F, et al. The Management of Primary Aldosteronism: Case Detection, Diagnosis, and Treatment: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2016;101(5):1889-1916. doi:10.1210/jc.2015-4061   Marcelli M, Bi C, Funder JW, McPhaul MJ. Comparing ARR Versus Suppressed PRA as Screening Tests for Primary Aldosteronism. Hypertension. 2024;81(10):2072-2081. doi:10.1161/HYPERTENSIONAHA.124.22884

Cardiovascular disease (CVD) is the leading cause of death in men and women, yet 45% of women don’t know it’s their leading cause of death. A staggering 71% of women never discuss heart health with their physicians. This episode will explore this gender disparity and elucidate why women carry unique risk for cardiovascular and metabolic diseases. Today’s episode is with clinical educators Trisha Winchester, PhD and Maeson Latsko, PhD. This episode will Discuss the gender gap in cardiovascular disease (1:15) Review risk factors for CVD that are unique to women (4:00), such as PCOS (6:00), adverse pregnancy outcomes (9:00, gestational diabetes: 13:00, pre-eclampsia 15:15), and menopause (19:30) Review what laboratory tools providers can utilize to better indicate and track risk in women overtime (14:30, 17:45) To learn more, please review the additional resources below for information on our cardiovascular, metabolic, endocrine, and wellness offerings, as well as educational resources and insights from our team of experts. At Quest Diagnostics, we are committed to providing you with results and insights to support your clinical decisions.   Date: 04/2025   Speaker(s): Trisha Winchester, PhD; Maeson Latsko, PhD Contributor(s): Maeson Latsko, PhD; Trisha Winchester, PhD; Millicent Kee, MSN, FNP-BC; Abhi Patel   Additional Resources: Women in CV risk article References: Cardiovascular Disease and Breast Cancer: Where These Entities Intersect: A Scientific Statement From the American Heart Association. Circulation. 2019;140(9):e543. doi:10.1161/CIR.0000000000000728 Vilmi-Kerälä T, Palomäki O, Vainio M, Uotila J, Palomäki A. The risk of metabolic syndrome after gestational diabetes mellitus - a hospital-based cohort study. Diabetol Metab Syndr. 2015;7:43. Published 2015 May 12. doi:10.1186/s13098-015-0038-z Vounzoulaki E, Khunti K, Abner SC, Tan BK, Davies MJ, Gillies CL. Progression to type 2 diabetes in women with a known history of gestational diabetes: systematic review and meta-analysis. BMJ. 2020;369:m1361. Published 2020 May 13. doi:10.1136/bmj.m1361 Kramer CK, Campbell S, Retnakaran R. Gestational diabetes and the risk of cardiovascular disease in women: a systematic review and meta-analysis. Diabetologia. 2019;62(6):905-914. doi:10.1007/s00125-019-4840-2 Brown MC, Best KE, Pearce MS, Waugh J, Robson SC, Bell R. Cardiovascular disease risk in women with pre-eclampsia: systematic review and meta-analysis. Eur J Epidemiol. 2013;28(1):1-19. doi:10.1007/s10654-013-9762-6 Leslie MS, Briggs LA. Preeclampsia and the Risk of Future Vascular Disease and Mortality: A Review. J Midwifery Womens Health. 2016;61(3):315-324. doi:10.1111/jmwh.12469 PCOS (polycystic ovary syndrome) and diabetes. Centers for Disease Control and Prevention. Reviewed March 24, 2020. Accessed August 18, 2022.https://www.cdc.gov/diabetes/basics/pcos.html  

Approximately 120 million people in the US have hypertension, which is about half of the adult population. Identifying the mechanisms that cause hypertension is crucial for the proper treatment of patients, yet 9 out of 10 patients do not know the origin of their hypertension. New research reveals that up to 30% of patients suffer from hypertension due to primary aldosteronism (PA). With less than 1% of patients with hypertension being screened for hypertension, today’s episode is designed to bring awareness to PA and discuss the breakthrough research that may help drive screening for PA. Today’s episode is with Maeson Latsko, PhD, Clinical and Education Specialist at Quest Diagnostics Center of Excellence at Cleveland Heartlab, Dr Sanjay Dixit, and Dr Marco Marcelli, board certified endocrinologists and medical directors with Quest Diagnostics. This episode will Define hypertension and PA (3:30, 6:15) Describe the intricate link between hypertension and PA (5:40) Review current screening tools for PA (6:35) Discuss how novel research can capture even more patients with hypertension due to PA (9:50) Discuss who should be screened for PA (17:15) Outline how a diagnosis of PA can influence treatment considerations (18:50) To learn more, please review the additional resources below for information on our cardiovascular, metabolic, endocrine, and wellness offerings as well as educational resources and insights from our team of experts. At Quest Diagnostics, we are committed to providing you with results and insights to support your clinical decisions. Date: 3/2025 Speaker(s): Sanjay Dixit, MD, Marco Marcelli, MD, Maeson Latsko, PhD Contributor(s): Trisha Winchester, PhD Additional Resources: Ordering information: Quest Diagnostics Clinical Education Center [Link] Plasma Renin Activity with Reflex to Aldosterone | Test Detail | Quest Diagnostics https://www.questdiagnostics.com/healthcare-professionals/about-our-tests/endocrine-disorders/primary-aldosteronism References: Marcelli M, Bi C, Funder JW, McPhaul MJ. Comparing ARR Versus Suppressed PRA as Screening Tests for Primary Aldosteronism. Hypertension. 2024;81(10):2072-2081. doi:10.1161/HYPERTENSIONAHA.124.22884   Brown JM, Siddiqui M, Calhoun DA, Carey RM, Hopkins PN, Williams GH, Vaidya A. The unrecognized prevalence of primary aldosteronism: a cross-sectional study. Ann Intern Med. 2020;173:10–20. doi: 10.7326/M20-0065   Vaidya A, Hundemer GL, Nanba K, Parksook WW, Brown JM. Primary Aldosteronism: State-of-the-Art Review. Am J Hypertens. 2022;35(12):967-988. doi:10.1093/ajh/hpac079 Auchus RJ. Approaching Primary Aldosteronism as a Common Disease. Endocr Pract. 2023;29(12):994-998. doi:10.1016/j.eprac.2023.08.014   Ostchega Y, Fryar CD, Nwankwo T, et al. Hypertension Prevalence Among Adults Aged 18 and over: United States, 2017-2018. April 2020. Accessed November 20, 2024. Products - Data Briefs - Number 364 - April 2020   Dogra P, Bancos I, Young WF Jr. Primary Aldosteronism: A Pragmatic Approach to Diagnosis and Management. Mayo Clin Proc. 2023;98(8):1207-1215. doi:10.1016/j.mayocp.2023.04.023   Funder JW, Carey RM, Mantero F, et al. The Management of Primary Aldosteronism: Case Detection, Diagnosis, and Treatment: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2016;101(5):1889-1916. doi:10.1210/jc.2015-4061

More than 1 in 7 US adults are estimated to have chronic kidney disease, or CKD, and as many as 9 in 10 don’t know they have it.  Damage to your kidneys cannot be reversed, but if found early, there are ways to prevent its progression such as following a healthy eating plan and being physically active.  Today’s episode is with Patty Bianchi, Registered Dietitian Nutritionist and Certified Diabetes Care and Education Specialist, and Maeson Latsko, PhD, Clinical and Education Specialist at Quest Diagnostics Center of Excellence at Cleveland HeartLab.  This episode will Review function of the kidneys (1:20) Identify causes and risk factors of chronic kidney disease (3:00) Review lifestyle changes to prevent the progression of kidney disease (7:50, 17:00) Discuss how limiting salt intake (10:00), animal protein (12:15), and mineral content (14:30) should be a focus for patients with CKD  The content was current as of the time of recording. To learn more, please review the additional resources below for information on our cardiovascular, metabolic, endocrine, and wellness offerings as well as educational resources and insights from our team of experts. At Quest Diagnostics, we are committed to providing you with results and insights to support your clinical decisions. Date:  03/2025 Speakers(s):  Patty Bianchi, RDN, CDCES; Maeson Latsko, PhD Contributor(s): Maeson Latsko, PhD; Patty Bianchi, RDN, CDCES; Trisha Winchester, PhD Additional Resources:   Instant Insights: Kidney Profile and eGFR with creatinine and cystatin-C Quest Diagnostics Clinical Education Center [Link]  References: National Institute of Diabetes and Digestive and Kidney Disease. Kidney Disease Statistics for the United States. September 9, 2024. Accessed February 2025 Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Kidney Int. 2024;105(4S):S117-S314. doi:10.1016/j.kint.2023.10.018 Key Takeaways People Living with CKD

As many as 45% of Americans have a chronic disease. Shared cardiometabolic risk factors contribute to related conditions, such as cardiovascular disease, poor glycemic control, chronic kidney disease, fatty liver disease, and common endocrine disorders. As evidence demonstrating the interrelationships between chronic cardiometabolic diseases continues to expand, establishing a personalized approach to reduce risk is crucial. This episode is with Quest Diagnostics® experts Maeson Latsko, PhD, Clinical and Education Specialist, and Dr Marc Penn, founder and chief medical officer for Cleveland Heart Lab at the Quest Cardiometabolic Center of Excellence™ in Cleveland, Ohio.  Dr Penn is also a board-certified cardiologist and director of research at Summa Cardiovascular Institute. This episode will Review how the risk factors for cardiovascular disease have changed (1:15) Discuss how the cardiometabolic approach brings attention to related conditions, such as cardiovascular disease, chronic kidney disease, fatty liver disease, and dysglycemia (3:00) Describe the importance of evaluating endocrine disorders when assessing risk for cardiometabolic conditions (6:45) Walk through a clinical example of how to implement the cardiometabolic approach (8:50) Discuss how to implement prevention with clinical solutions to improve patient care (3:45, 14:00) The content was current as of the time of recording. To learn more, please review the additional resources below for information on our cardiovascular, metabolic, endocrine, and wellness offerings as well as educational resources and insights from our team of experts. At Quest Diagnostics, we are committed to providing you with results and insights to support your clinical decisions. Date: 2/2025 Speaker(s): Maeson S Latsko, PhD; Marc Penn, MD, PhD Contributor(s): Maeson Latsko, PhD; Trisha Winchester, PhD; Mouris Saghir, PhD References:  Fuster V, García-Álvarez A, Devesa A, et al. Influence of Subclinical Atherosclerosis Burden and Progression on Mortality. J Am Coll Cardiol. 2024;84(15):1391-1403. doi:10.1016/j.jacc.2024.06.045 Correia LC. Ezetimibe: Clinical and Scientific Meaning of the IMPROVE-IT Study. Arq Bras Cardiol. 2016;106(3):247-249. doi:10.5935/abc.20160033 Randomised trial of cholesterol lowering in 4444 patients with coronary heart disease: the Scandinavian Simvastatin Survival Study (4S). Lancet. 1994;344(8934):1383-1389. Lincoff AM, Brown-Frandsen K, Colhoun HM, et al. Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes. N Engl J Med. 2023;389(24):2221-2232. doi:10.1056/NEJMoa2307563   Additional Resources: Website: Cardiometabolic disease | Quest Diagnostics

1in 7 US adults are estimated to have chronic kidney disease, or CKD. Because early stages of the disease are often clinically silent, 90% of individuals with CKD don’t know they have it. This podcast highlights the importance of early CKD detection and the need for proper screening, especially in individuals with hypertension and diabetes. The Kidney Profile aligns with guidelines and includes the urine-albumin-creatinine ratio and eGFR. The new 2024 guidelines recommend using both creatinine and Cystatin C in estimating eGFR in certain populations, which provides a more accurate risk assessment for CKD and other cardiometabolic conditions like heart disease and stroke. By adopting this dual approach, healthcare providers can improve early detection, staging, and management of CKD, leading to better patient outcomes. This episode will Explore the role of the Kidney Profile in CKD diagnosis and how it aligns with the 2024 KDIGO guidelines. (1:40, 5:15) Identify at-risk populations for CKD, including those with hypertension and diabetes, and understand the importance of early screening and management. (1:30) Investigate how combining creatinine and cystatin C in eGFR improves the prediction of CKD progression and associated cardiometabolic risks. (4:30) The content was current as of the time of recording. To learn more, please review the additional resources below for information on our cardiovascular, metabolic, endocrine, and wellness offerings as well as educational resources and insights from our team of experts. At Quest Diagnostics, we are committed to providing you with results and insights to support your clinical decisions. Date: 12/2024 Speaker(s): Maeson Latsko, PhD Contributor(s): Maeson Latsko, PhD; Trisha Winchester, PhD Additional Resources: Quest Diagnostics Clinical Education Center [Link] Ordering information:  Kidney Profile [link] Kidney Profile Test Summary [link] eGFR with Creatinine and Cystatin C [link] References:   Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Kidney Int. 2024;105(4S):S117-S314. doi:10.1016/j.kint.2023.10.018 National Kidney Foundation. Kidney Disease: Fact Sheet. National Kidney Foundation. August 6, 2024. Accessed December 19, 2024. https://www.kidney.org/about/kidney-disease-fact-sheet  

Increased rates of obesity and type 2 diabetes are increasing rates of cardiometabolic conditions. Identifying and intervening in early stages of metabolic dysfunction is crucial in order to delay and prevent disease progression. The Metabolic Risk Panel is a comprehensive test that helps identify individuals at risk for metabolic dysfunction, insulin resistance, and cardiovascular disease. The panel includes Hemoglobin A1C, Insulin Resistance Panel with Score, Lipid Panel, and Apolipoprotein B (apoB), which together provide a more detailed picture of cardiometabolic health than traditional tests alone. By incorporating these biomarkers, clinicians can detect metabolic risks earlier, enabling proactive interventions to prevent conditions like Type 2 Diabetes, Cardiovascular Disease, and other related cardiometabolic conditions.   This episode will Outline the components of the Metabolic Risk Panel, including Hemoglobin A1C, insulin resistance panel with score, lipid panel, and Apolipoprotein B, and how they improve risk assessment. (0:33) Explain the role of insulin resistance in the development of metabolic dysfunction and its connection to early signs of type 2 diabetes. (2:25) Recognize the importance of apolipoprotein B (apoB) in evaluating lipid metabolism and its role in cardiovascular risk assessment, especially in patients with insulin resistance or metabolic syndrome. (3:15) Identify how combining traditional and advanced biomarkers in the Metabolic Risk Panel helps clinicians catch metabolic and cardiovascular risks early, enabling more effective prevention and management. (4:30) The content was current as of the time of recording. To learn more, please review the additional resources below for information on our cardiovascular, metabolic, endocrine, and wellness offerings as well as educational resources and insights from our team of experts. At Quest Diagnostics, we are committed to providing you with results and insights to support your clinical decisions.  Date: 12/2024 Speaker(s): Maeson Latsko, PhD Contributor(s): Maeson Latsko, PhD; Trisha Winchester, PhD Additional Resources: Quest Diagnostics Clinical Education Center [Link] Ordering information: Metabolic Risk Panel [link] References:   Cannon A, Handelsman Y, Heile M, Shannon M. Burden of illness in type 2 diabetes mellitus. J Manag Care Spec Pharm. 2018;24(9-a Suppl):S5-S13. doi:10.18553/jmcp.2018.24.9-a.s5 Johannesen CDL, Langsted A, Nordestgaard BG, Mortensen MB. Excess apolipoprotein B and cardiovascular risk in women and men. J Am Coll Cardiol. 2024;83(23):2262-2273. doi:10.1016/j.jacc.2024.03.423   Centers of Medicare & Medicaid Services. Diabetes Screening & Definitions Update: CY 2024 physician fee schedule final rule. June 25, 2024. Accessed December 19, 2024. https://www.cms.gov/files/document/mm13487-diabetes-screening-definitions-update-cy-2024-physician-fee-schedule-final-rule.pdf   Centers for Disease Control and Prevention. (2017). National diabetes statistics report, 2017: Estimates of Diabetes and its Burden in the United States. Retrieved from https://www.cdc.gov/diabetes/pdfs/data/statistics/national-diabetes-statistics-report.pdf

Identifying insulin resistance offers significant—and often untapped—clinical value and can help healthcare providers and their patients take action with diet and lifestyle choices to avoid or change the progression to prediabetes and diabetes. Today’s episode features Patty Bianchi, Registered Dietitian Nutritionist and Certified Diabetes Care and Education Specialist and Trisha Winchester, PhD, Quest Diagnostics Sr Manager for Clinical & Education. This episode will Review glucose regulation by insulin (1:15)  Discuss how insulin resistance is measured (3:00)  Review actionable ways to reduce insulin resistance through lifestyle (4:00), exercise (6:30), diet (8:50), stress and sleep (11:50) Discuss the 4myheart patient education program offered through Quest Diagnostics Center of Excellence at Cleveland Heartlab (14:30) The content was current as of the time of recording. To learn more, please review the additional resources below for information on our cardiovascular, metabolic, endocrine, and wellness offerings as well as educational resources and insights from our team of experts. At Quest Diagnostics, we are committed to providing you with results and insights to support your clinical decisions.   Date: 11/2024 Speaker(s): Patty Bianchi, RDN, CDCES; Trisha Winchester, PhD Contributor(s): Trisha Winchester, PhD; Patty Bianchi, RDN, CDCES; Maeson Latsko, PhD   Additional Resources: Podcast: The Insulin Resistance Revolution: The Key to Preventing Chronic Conditions (17 min) Webinar: Early Identification of Type 2 Diabetes Risk for the Primary Care Setting Ordering information: Insulin Resistance Panel with Score | Test Detail | Quest Diagnostics Insulin Resistance Panel with Score | Test Summary | Quest Diagnostics

Metabolic dysfunction is a common root cause of many cardiometabolic conditions that burden the healthcare system. This episode will address insulin resistance, a syndrome that underlies metabolic dysfunction, and how tools can catch risk early, allowing actions that may prevent and reverse the onset of chronic illness. Today’s episode is with Quest Diagnostics experts Kenneth French, Senior Clinical Consultant, and Dr Maeson Latsko, clinical and education specialist.  This episode will Identify how early identification of insulin resistance can prevent the rise in metabolic dysfunction and Type II Diabetes (3:00) Describe the insulin resistance panel with score (8:11)  Elucidate how identifying insulin resistance can prevent other chronic illness, such as liver related disorders and kidney disease (12:41)  The content was current as of the time of recording. To learn more, please review the additional resources below for information on our cardiovascular, metabolic, endocrine, and wellness offerings as well as educational resources and insights from our team of experts. At Quest Diagnostics, we are committed to providing you with results and insights to support your clinical decisions.   Date: 09/2024 Speaker(s): Kenneth French; Maeson Latsko, PhD Contributor(s): Maeson Latsko, PhD; Trisha Winchester, PhD; Kenneth French   Additional Resources: Podcast: Action from Insight: Tackling Insulin Resistance (18 min) Webinar: Early Identification of Type 2 Diabetes Risk for the Primary Care Setting Ordering information: Insulin Resistance Panel with Score | Test Detail | Quest Diagnostics Insulin Resistance Panel with Score | Test Summary | Quest Diagnostics         References: Ward ZJ, Bleich SN, Cradock AL, et al. Projected U.S. State-Level Prevalence of Adult Obesity and Severe Obesity. N Engl J Med. 2019;381(25):2440-2450. doi:10.1056/NEJMsa1909301 Abbasi F, Shiffman D, Tong CH, et al. Insulin resistance probability scores for apparently healthy individuals. J Endocr Soc. 2018;2(9):1050-1057. doi:10.1210/js.2018-00107 Bril F, McPhaul MJ, Kalavalapalli S, et al. Intact fasting insulin identifies nonalcoholic fatty liver disease in patients without diabetes. J Clin Endocrinol Metab. 2021;106(11):e4360-e4371. doi:10.1210/clinem/dgab417 Healy, M. By 2030, nearly half of all U.S. adults will be obese, experts predict. New York Times. https://www.latimes.com/science/story/2019-12-18/nearly-half-of-us-adults-will-be-obese-by-2030 Khan RMM, Chua ZJY, Tan JC, et al. From Pre-Diabetes to Diabetes: Diagnosis, Treatments and Translational Research. Medicina (Kaunas). 2019;55(9):546. doi:10.3390/medicina55090546