BEVITAL AS

Cardiometabolic

65 biomarkers of 5 different classes from 200μl sample volume on GC- and LC-MS/MS platforms. Contact our experts for any questions or inquiries.

Why did we design this panel?

We developed this targeted metabolomics panel for investigating cardiometabolic health to achieve high specificity and sensitivity in identifying biomarkers and metabolites, understanding disease mechanisms, and supporting research and personalized medicine. This approach aids in:

Early Detection: Enabling early identification of individuals at risk of cardiometabolic diseases, such as diabetes, hypertension, and heart disease, before symptoms appear.
Precise Diagnosis: The panel provides a more accurate diagnosis by targeting specific biomarkers associated with cardiometabolic health, allowing for tailored interventions.
Monitoring Disease Progression: Longitudinal assessments can track changes in profiles over time, helping clinicians understand disease progression and the impact of lifestyle or therapeutic interventions.
Treatment Optimization: The panel can help in selecting the most effective treatment options and adjusting them according to the individual’s specific metabolic profile.
Integration with Other Omics: Combined with genomic, proteomic, or lipidomic data, the cardiometabolic panel can offer a more comprehensive understanding of the disease, advancing research and enabling the development of novel therapeutics.
Improved Outcomes in Population Health: On a larger scale, the cardiometabolic panel can help in population screening and identify trends or high-risk groups, informing public health strategies and interventions.

Applications: Atherosclerosis and peripheral artery disease (PAD), cardiovascular diseases, chronic kidney disease (CKD), metabolic syndrome, neurodegenerative diseases, metabolic dysfunction-associated fatty liver disease (MAFLD), obesity, polycystic ovary syndrome (PCOS), type 2 diabetes and prediabetes.

Amino acids and catabolites

31 markers by GC-MS/MS

Abnormal concentrations of free amino acids in plasma have been associated with risk of cancer, metabolic syndrome, diabetes. Low levels are observed in frail, elderly persons. Elevated branched chain amino acids (BCAA; Leu, Ile and Val) are associated with insulin resistance, diabetes type 2, cardiovascular disease and early kidney disease. The valine catabolite, 3-hydroxyisobutyrate (3HIB) is belived to play a key role in the development of insulin resistance. β-Aminoisobutyrate (BAIBA) increases with exercise and is inversely association with cardiometabolic risk factors.

Alanine, Arginine, Asparagine, Aspartic acid, Glutamic acid, Glutamine, Glycine, Histidine, Isoleucine, Kynurenine, Leucine, Lysine, Methionine, Ornithine, Phenylalanine, Proline, Sarcosine, Serine, Threonine, Total cysteine, Tryptophan, Tyrosine, Valine, 2-Aminoadipic acid, 2-Hydroxybutyrate, 3-Hydroxysiobutyrate, α-Hydroxyglutaric acid, β-Alanine, β-Aminoisobutyrate, β-Hydroxy B-methylbutyric acid, Phenylacetylglutamine

Acylcarnitines

23 markers by LC-MS/MS

Acylcarnitine esters are formed from the CoASH esters of acetate, propionate, butyrate, medium-chain, long-chain and very-long-chain fatty acids. Acylcarnitines cross the mitochondrial membrane, and such transport is required for beta-oxidation of long-chain fatty acids for energy production. Carnitine is mainly obtained through the diet, can be consumed as supplement, but about 30% is supplied by de novo synthesis from trimethyllysine (TML), which takes place in liver and kidney. The final step in the synthesis is catalyzed by the α-ketoglutarate-dependent enzyme, gamma-butyrobetaine  dioxygenase (BBOX) that converts gamma-butyrylbetaine (BB) into carnitine. Circulating levels of carnitine and acylcarnitines have been related to risk of insulin resistance, diabetes 2, MAFLD and cardiovascular disease.

BB, C0, C2, C3, C3-DC, C4, C4-OH, C4-DC, iC5, C5-DC, C5:1, C6, C8, C10, C12, C14, C14-OH, C16, C16-OH, C18, C18-OH, C18:1, C18:2

TCA metabolites

7 markers by GC-MS/MS

Studies on metabolomics involving Krebs cycle intermediates in relation to human health and disease usually include few patients and have been performed only recently. These metabolites have been related to BMI, cardiovascular disease (pyruvate, citrate, succinate), diabetes (pyruvate, isocitrate, succinate), MAFLD (isocitrate and citrate), longevity (isocitrate), asthma (succinate), disease activity in rheumatoid arthritis patients (itaconate), and worsening of clinical outcome in cancer patients (succinate, fumarate and α-hydroxyglutarate).

α-Ketoglutarate, Citrate, Fumarate, Isocitrate, Lactate, Malate, Pyruvate

Ketone bodies

2 markers by GC-MS/MS

3-Hydroxybutyrate (bHB) is the most abundant ketone body. It is synthesized from acyl-CoA primarily in the liver. Increasing serum/plasma bHB concentrations reflect upregulated fatty acid β-oxidation as well as ketogenic amino acids catabolism in the liver and skeletal muscle to compensate insufficient glucose supply. bHB synthesis is stimulated and serum/plasma levels increase under conditions of fasting, endurance exercise, malnutrition or metabolic disorders including diabetes mellitus. Acetoacetate (AcAc) is a ketone body primarily produced in the liver under conditions of excessive fatty acid breakdown, including diabetes mellitus leading to diabetic ketoacidosis. High levels of ketone bodies, like bHB and AcAc, are not only indicators of diabetic hyperglycemia, but also markers of disturbed glucose metabolism in the prediabetic state.

Acetoacetate, 3-Hydroxybutyrate

AGEs

2 markers by LC-MS/MS

N(ε)-(carboxymethyl)lysine (CML) and N(6)-(1-carboxyethyl)-L-lysine (CEL) are advanced glycation end products (AGEs) generated by the Maillard reaction (MR) during thermal treatment of foods or are formed in vivo by nonenzymatic chemical reactions, taking place in tissues or fluid where significant concentration of glucose, fructose, or more reactive dicarbonyls react with proteins. CEL is primarily formed by reaction between methylglyoxal and lysine (the AGE path), which is dependent on hyperglycaemia. Thus, the pathways contributing to CEL formation appear to be more limited compared with CML. Like CML, CEL in tissues and serum/plasma increase with age, and have been assigned a role in the pathogenesis of age-related, chronic diseases, including diabetes, cardiovascular disease, Alzheimer’s disease and renal dysfunction.

Carboxyethyllysine, Carboxymethyllysine

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Statistical power is the probability that a statistical test will correctly reject a false null hypothesis (H0​) when a specific alternative hypothesis (H1​) is true. H0​ is the null hypothesis, which states there is no effect or no difference. H1​ is the alternative hypothesis, which states there is a real effect or difference. Alpha (α) is the probability of a Type I error (a false positive), which is the risk of incorrectly rejecting the H0​ when it is actually true. You set this value before the experiment, commonly at 0.05. Beta (β) is the probability of a Type II error (a false negative), which is the risk of failing to reject the H0​ when it is actually false.

Power is calculated as 1−β. Increasing power means you are decreasing the probability of making a Type II error.

Several factors can be adjusted to increase the power of a statistical test:

  • Effect Size: This is the magnitude of the difference you are trying to detect. A larger effect size is easier to detect, thus increasing power. 

  • Sample Size: The number of observations in a study. A larger sample size provides more information about the population, reducing the margin of error and increasing the power to detect a true effect.

  • Variation: Refers to the spread or standard deviation of the data within the population. Less variation makes it easier to distinguish a real effect from random noise, thereby increasing power.

  • Alpha (): Increasing the alpha level (e.g., from 0.05 to 0.10) also increases power, but at the cost of a higher risk of a Type I error. This trade-off is often undesirable.

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541.

Refsum, H; Yajnik, C S; Gadkari, M; Schneede, J; Vollset, S E; Orning, L; Guttormsen, A B; Joglekar, A; Sayyad, M G; Ulvik, A; Ueland, P M

Hyperhomocysteinemia and elevated methylmalonic acid indicate a high prevalence of cobalamin deficiency in Asian Indians Journal Article

In: Am J Clin Nutr, vol. 74, no. 2, pp. 233–241, 2001, ISSN: 0002-9165.

Abstract | Links | BibTeX

542.

Vollset, S E; Refsum, H; Tverdal, A; Nygård, O; Nordrehaug, J E; Tell, G S; Ueland, P M

Plasma total homocysteine and cardiovascular and noncardiovascular mortality: the Hordaland Homocysteine Study Journal Article

In: Am J Clin Nutr, vol. 74, no. 1, pp. 130–136, 2001, ISSN: 0002-9165.

Abstract | Links | BibTeX

543.

Ulvik, A; Evensen, E T; Lien, E A; Hoff, G; Vollset, S E; Majak, B M; Ueland, P M

Smoking, folate and methylenetetrahydrofolate reductase status as interactive determinants of adenomatous and hyperplastic polyps of colorectum Journal Article

In: Am J Med Genet, vol. 101, no. 3, pp. 246–254, 2001, ISSN: 0148-7299.

Abstract | Links | BibTeX

544.

Chambers, J C; Ueland, P M; Wright, M; Doré, C J; Refsum, H; Kooner, J S

Investigation of relationship between reduced, oxidized, and protein-bound homocysteine and vascular endothelial function in healthy human subjects Journal Article

In: Circ Res, vol. 89, no. 2, pp. 187–192, 2001, ISSN: 1524-4571.

Abstract | Links | BibTeX

545.

Guttormsen, A B; Ueland, P M; Kruger, W D; Kim, C E; Ose, L; Følling, I; Refsum, H

Disposition of homocysteine in subjects heterozygous for homocystinuria due to cystathionine beta-synthase deficiency: relationship between genotype and phenotype Journal Article

In: Am J Med Genet, vol. 100, no. 3, pp. 204–213, 2001, ISSN: 0148-7299.

Abstract | Links | BibTeX

546.

El-Khairy, L; Ueland, P M; Refsum, H; Graham, I M; and, S E Vollset

Plasma total cysteine as a risk factor for vascular disease: The European Concerted Action Project Journal Article

In: Circulation, vol. 103, no. 21, pp. 2544–2549, 2001, ISSN: 1524-4539.

Abstract | Links | BibTeX

547.

Ueland, P M; Hustad, S; Schneede, J; Refsum, H; Vollset, S E

Biological and clinical implications of the MTHFR C677T polymorphism Journal Article

In: Trends Pharmacol Sci, vol. 22, no. 4, pp. 195–201, 2001, ISSN: 0165-6147.

Abstract | Links | BibTeX

548.

Nurk, E; Tell, G S; Nygård, O; Refsum, H; Ueland, P M; Vollset, S E

Plasma total homocysteine is influenced by prandial status in humans: the Hordaland Hhomocysteine Sstudy Journal Article

In: J Nutr, vol. 131, no. 4, pp. 1214–1216, 2001, ISSN: 0022-3166.

Abstract | Links | BibTeX

549.

Vollset, S E; Refsum, H; Ueland, P M

Population determinants of homocysteine Miscellaneous

2001, ISSN: 0002-9165.

Links | BibTeX

550.

Dekou, V; Whincup, P; Papacosta, O; Ebrahim, S; Lennon, L; Ueland, P M; Refsum, H; Humphries, S E; Gudnason, V

The effect of the C677T and A1298C polymorphisms in the methylenetetrahydrofolate reductase gene on homocysteine levels in elderly men and women from the British regional heart study Journal Article

In: Atherosclerosis, vol. 154, no. 3, pp. 659–666, 2001, ISSN: 0021-9150.

Abstract | Links | BibTeX

551.

Ueland, P M; Nygård, O; Vollset, S E; Refsum, H

The Hordaland Homocysteine Studies Journal Article

In: Lipids, vol. 36 Suppl, pp. S33–S39, 2001, ISSN: 0024-4201.

Abstract | Links | BibTeX

552.

Bolann, B J; Solli, J D; Schneede, J; Grøttum, K A; Loraas, A; Stokkeland, M; Stallemo, A; Schjøth, A; Bie, R B; Refsum, H; Ueland, P M

Evaluation of indicators of cobalamin deficiency defined as cobalamin-induced reduction in increased serum methylmalonic acid Journal Article

In: Clin Chem, vol. 46, no. 11, pp. 1744–1750, 2000, ISSN: 0009-9147.

Abstract | BibTeX

553.

Chambers, J C; Ueland, P M; Obeid, O A; Wrigley, J; Refsum, H; Kooner, J S

Improved vascular endothelial function after oral B vitamins: An effect mediated through reduced concentrations of free plasma homocysteine Journal Article

In: Circulation, vol. 102, no. 20, pp. 2479–2483, 2000, ISSN: 1524-4539.

Abstract | Links | BibTeX

554.

Louwman, M W; van Dusseldorp, M; van de Vijver, F J; Thomas, C M; Schneede, J; Ueland, P M; Refsum, H; van Staveren, W A

Signs of impaired cognitive function in adolescents with marginal cobalamin status Journal Article

In: Am J Clin Nutr, vol. 72, no. 3, pp. 762–769, 2000, ISSN: 0002-9165.

Abstract | Links | BibTeX

555.

Hustad, S; Ueland, P M; Vollset, S E; Zhang, Y; Bjørke-Monsen, A L; Schneede, J

Riboflavin as a determinant of plasma total homocysteine: effect modification by the methylenetetrahydrofolate reductase C677T polymorphism Journal Article

In: Clin Chem, vol. 46, no. 8 Pt 1, pp. 1065–1071, 2000, ISSN: 0009-9147.

Abstract | BibTeX

556.

Ueland, P M; Refsum, H; Beresford, S A; Vollset, S E

The controversy over homocysteine and cardiovascular risk Journal Article

In: Am J Clin Nutr, vol. 72, no. 2, pp. 324–332, 2000, ISSN: 0002-9165.

Abstract | Links | BibTeX

557.

Nexo, E; Engbaek, F; Ueland, P M; Westby, C; O'Gorman, P; Johnston, C; Kase, B F; Guttormsen, A B; Alfheim, I; McPartlin, J; Smith, D; Møller, J; Rasmussen, K; Clarke, R; Scott, J M; Refsum, H

Evaluation of novel assays in clinical chemistry: quantification of plasma total homocysteine Journal Article

In: Clin Chem, vol. 46, no. 8 Pt 1, pp. 1150–1156, 2000, ISSN: 0009-9147.

Abstract | BibTeX

558.

Mudd, S H; Finkelstein, J D; Refsum, H; Ueland, P M; Malinow, M R; Lentz, S R; Jacobsen, D W; Brattström, L; Wilcken, B; Wilcken, D E; Blom, H J; Stabler, S P; Allen, R H; Selhub, J; Rosenberg, I H

Homocysteine and its disulfide derivatives: a suggested consensus terminology Journal Article

In: Arterioscler Thromb Vasc Biol, vol. 20, no. 7, pp. 1704–1706, 2000, ISSN: 1079-5642.

Links | BibTeX

559.

Vollset, S E; Refsum, H; Irgens, L M; Emblem, B M; Tverdal, A; Gjessing, H K; Monsen, A L; Ueland, P M

Plasma total homocysteine, pregnancy complications, and adverse pregnancy outcomes: the Hordaland Homocysteine study Journal Article

In: Am J Clin Nutr, vol. 71, no. 4, pp. 962–968, 2000, ISSN: 0002-9165.

Abstract | Links | BibTeX

560.

Lien, E A; Nedrebø, B G; Varhaug, J E; Nygård, O; Aakvaag, A; Ueland, P M

Plasma total homocysteine levels during short-term iatrogenic hypothyroidism Journal Article

In: J Clin Endocrinol Metab, vol. 85, no. 3, pp. 1049–1053, 2000, ISSN: 0021-972X.

Abstract | Links | BibTeX

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