Singulex Blood Test Descriptions

The Singulex Clinical Laboratory offers more than 60 blood tests to provide a comprehensive view of your health, including five proprietary Singulex blood tests in the areas of heart health and inflammation. People with inflammatory conditions such as diabetes or rheumatoid arthritis are at higher risk for heart disease, so monitoring inflammatory, and cardiac function markers together is important. 1,2

Enhance your knowledge of the biology behind the blood biomarkers that are measured in the Singulex Clinical Laboratory. If you have additional questions, please contact us.

These tests measure how well your heart muscle is working.

SMC™ cTnI* — Cardiac troponin-I is released into the bloodstream when your heart muscle is injured or stressed. The SMC cTnI test is able to measure small amounts of cardiac troponin-I, potentially revealing early damage to the heart muscle that can sometimes be repaired or  reversed. 3,4

NT-proBNP (N-terminal pro b-type natriuretic peptide) is released into the blood stream when heart muscle cells are overly stretched because they are working too hard. High levels of NT-proBNP may prompt your doctor to do additional testing to determine the cause of any abnormal findings.

These tests show how inflammation may be impacting your health. Inflammation is the body’s natural response to injury or infection. However, chronic inflammation may lead to cholesterol-rich build-up (called plaque) in the arteries. This build-up may block arteries, trigger a heart attack or stroke, or cause other problems in the body.

SMC Endothelin* — can cause blood vessels to tighten, which can raise blood pressure. A high level may predict how far along blood vessel disease has progressed and may also be related to chronic heart failure, kidney disease, sleep apnea, or diabetes.

SMC IL-6* (interleukin- 6), SMC IL-17A* (interleukin- 17A), and SMC TNF-α* (tumor necrosis factor- alpha). These inflammatory markers are released into the bloodstream during the process of inflammation, which may cause plaque build-up in the arteries. If left untreated, this build-up can increase your risk of having a heart attack or stroke.

SMC IL-10*. This blood test is an anti-inflammatory marker. Low levels may indicate an inability to fight off inflammation.

Lp-PLA2 Activity (lipoprotein-associated phospholipase A2). High levels can be a warning sign that inflammation and rupture prone plaque may be present in arteries, increasing risk for heart attacks and strokes.

Homocysteine can be a risk marker for heart disease if the levels are elevated. High levels may also indicate that vitamin levels of B12 and B6 are too low.

hs-CRP (high-sensitivity c-reactive protein) – A high result is another warning sign of inflammation in your body, which may cause plaque build-up in your arteries, and increase your risk of a heart attack or stroke.

Anti-CCP and Rheumatoid Factor – These tests measure antibodies present in patients who may have rheumatoid arthritis (RA). A positive result for either test helps identify RA. When both tests are positive, the chance RA is present is even higher.5

These tests measure the size and amount of fat and protein parts (lipoproteins such as cholesterol) in your blood.

LDL (low density lipoprotein) – High LDL indicates that you have too much “bad cholesterol,” which increases your risk for cardiovascular disease (CVD).

HDL (high density lipoprotein) – Low HDL indicates increased risk because HDL (the “good” cholesterol) plays an important role in carrying cholesterol out of arteries to the liver for removal from the body.

HDL with Fractionation* (HDL + HDL2 + HDL3) measures your cholesterol subtypes to more accurately assess your risk level for cardiovascular disease.

Lp(a) [lipoprotein (a)] is an inherited cholesterol-carrying particle. A high level is a big risk factor for heart disease. Lifestyle changes usually do not affect Lp(a) levels, but medications may be considered.

Triglycerides – If you regularly eat more calories than you burn or are eating a diet high in carbohydrates, your triglycerides (a type of fat) can climb to unhealthy levels, increasing your risk for heart disease and diabetes.

sdLDL* (small dense LDL) can enter artery walls more easily, causing increased inflammation and heart disease risk. High levels are common for those at risk for diabetes.

Apo B (apolipoprotein B) is found on the surface of LDL. High levels have been shown to better predict increased heart and blood vessel disease risk than LDL measurements alone.

Apo A1 (apolipoprotein A1) is found on the surface of HDL, and is related to cholesterol removal. Therefore, a high level of apo A1 may help lower your heart disease risk.

These tests measure your diabetes risk and abnormalities that might impact weight management.

Glucose – A high glucose (blood sugar) level can mean there is significant risk of type 2 diabetes and heart disease.

Insulin is a hormone that controls the level of glucose in your blood. Elevated fasting insulin levels may mean that your body is having a difficult time controlling your blood sugar, which can put you at increased risk for type 2 diabetes and heart disease.

HbA1c (hemoglobin A1c) measures average blood sugar over the past 3 months. An elevated HbA1c may prompt your doctor to do more tests for type 2 diabetes.

Cortisol is a hormone that controls blood sugar, inflammation, and immune response. Constant stress can lead to regularly high levels, increasing risk for type 2 diabetes and heart disease. Getting more sleep, reducing stress and addressing sleep apnea may help lower cortisol levels.

Adiponectin* is a heart-protective hormone that may help fight inflammation. Low levels are related to obesity (especially abdominal fat), increased inflammation, heart disease, and type 2 diabetes.

Leptin* is a hormone that regulates normal appetite and energy use. High levels can indicate an increased risk of type 2 diabetes and heart disease. Maintaining a high-protein/low-carbohydrate diet may lower levels.

Ferritin – High levels can mean too much iron in the body, which can contribute to inflammation and increased risk for heart disease and type 2 diabetes. This condition can be improved by reducing consumption of red meat and “iron-fortified” foods or vitamins (cereals, energy bars, etc.).

These tests measure your bone health and hormones that balance calcium regulation in your body.

PTH (parathyroid hormone) – It is important to determine the cause of an abnormally high concentration of parathyroid hormone in the blood . Elevations may be caused by adenomas, kidney disease, and low vitamin D levels. Elevations in PTH have a pro-inflammatory effect, and have been associated with insulin resistance, type 2 diabetes, hypertension and heart disease.

Vitamin D – Low levels of vitamin D, or “vitamin D deficiency,” can occur in people who are obese or have dark skin, as well as those with poor diets, limited exposure to the sun, kidney and liver disease, impaired absorption (such as in Celiac disease), smoking and certain medications. Vitamin D deficiency decreases the body’s ability to process calcium and increases inflammation, which can contribute to high blood pressure and increase the risk of heart attack, heart failure, and low bone density. Safe sun exposure, a diet high in vitamin D, and supplements may help vitamin D levels.

Beta-CrossLaps (β-CTx) and Osteocalcin are bone markers that are used to evaluate how well a treatment plan is working for specific bone diseases such as osteoporosis.

These tests measure your kidney and liver health and abnormalities might be signs of an underlying condition.

Cystatin C – High levels of cystatin C are an early sign of kidney problems, as well as a risk factor for heart disease, heart attack, and stroke. Medications may be prescribed by your doctor and blood pressure control is suggested to lower levels.

GGT (gamma-glutamyl transferase) – This test measures the amount of the enzyme GGT in your blood. GGT plays a significant role in helping the liver metabolize drugs and other toxins. Elevations in GGT can be an early sign of liver damage which may lead to chronic liver disease, liver failure, hepatitis, bone diseases, and pancreatitis.

These tests measure the impact of thyroid abnormalities that might affect your overall health.

TSH (thyroid stimulating hormone), T3/Free T3 (triiodothyronine), T4/Free T4 (thyroxine) – These tests are used to determine thyroid function, aid in diagnosis of thyroid abnormalities, and  monitor thyroid treatment. Abnormalities may lead to abnormal cholesterol levels, altered metabolism, changes in weight, hair loss, cardiac disease, insulin resistance, and diabetes.

TgAb (thyroglobulin antibodies) – This autoimmune antibody targets thyroglobulin, the storage form of thyroid hormones. Thyroglobulin may leak into the bloodstream when there is inflammation of the thyroid gland or rapid growth of thyroid tissue.

TPOAb (thyroid peroxidase antibodies) – Thyroid antibodies develop when the immune system mistakenly targets the thyroid gland or thyroid proteins leading to chronic inflammation of the thyroid (thyroiditis), tissue damage, and/or disruption of thyroid function. TPOAb is the most common test for autoimmune thyroiditis disease; it can be detected in both Hashimoto’s thyroiditis and Graves’ disease.

These tests measure the impact of hormone imbalances that might affect your overall health.

Testosterone – Total testosterone is measured to detect hormonal levels in men and in women to evaluate for abnormally low levels of testosterone in men and for masculinization or polycystic ovarian syndrome in women. Low testosterone in men is related to increases in abdominal fat, blood pressure and cholesterol, which can be involved in increasing heart disease risk. The opposite is true in women, for whom high testosterone levels may be related to increased heart disease risk.

SHBG (sex hormone binding globulin) – A protein that attaches to three sex hormones (testosterone, DHT, and estrogen). Although SHBG binds 3 hormones, the hormone that is critically important in this test is testosterone. SHBG controls the amount of testosterone that your body tissues can use. Too little testosterone in men and too much testosterone in women can be a sign of disease.

FTI (free testosterone index) – A calculated value based upon total testosterone and SHGB. The FTI is the amount of the “working” testosterone.

DHEA-S (dehydroepiandrosterone sulfate) – A male sex hormone that is present in both men and women and is made in the adrenal glands, a small gland located on the top of the kidney. It is associated with the development of male secondary sexual characteristics. The DHEA-S test is used to help identify abnormal adrenal function.

Estradiol – Primarily produced in the ovaries in pre-menopausal women and in the testicles in men. It is mainly used to evaluate the health of the ovaries. Estradiol is associated with assessing hormonal imbalances such as infertility, menopause, and abnormal menstrual periods, and is also used to monitor pregnancy, bone metabolism, and metabolic conditions.

LH (luteinizing hormone) and FSH (follicle stimulating hormone) – LH and FSH are hormones associated with reproduction, such as the release of an egg from the ovary in women and testosterone production in men. These tests are used to evaluate the function of ovaries or testicles.

Progesterone – Progesterone is a female hormone produced by the ovaries during release of a mature egg from an ovary. This test is commonly used to help determine the causes of infertility.

PSA (prostate specific antigen) – PSA is produced by the cells of the prostate gland. Levels of PSA can be used for staging of prostate cancer and to predict response to therapy. Other causes for elevated PSA levels include a noncancerous enlargement of the prostate gland, having a urinary tract infection, and competitive cycling.

*This test was developed and its performance characteristic determined by the Singulex Clinical Laboratory. It has not been cleared or approved by the U.S. Food and Drug Administration. The laboratory is regulated under CLIA as qualified to perform high-complexity testing. This test is used for clinical purposes. It should not be regarded as investigational or for research.

1 Dhawan S and Quyyumi A. Curr Atheroscler Rep. 2008;10:128-33.
2 The American Heart Association. “Cardiovascular Disease and Diabetes”. Available at Accessibility verified April 1, 2016.
3 Apple F, et al. Clin Chem. 2012; 58: 930–935 .
4 Motiwala S, et al. J Cardiovasc Transl Res. 2015; 8: 164–72.
5 Venables, PJW. Diagnosis and differential diagnosis of rheumatoid arthritis. Romain, P (Ed) UpToDate, Waltham, MA, 2016.