SAMPLEPatient Name: BMI: Batch Number:Patient DOB: Gender: Accession Number:Physician Date Received:

Report Date:

Insulin (µIU/mL)

Glucose (mg/dL)

Metabolic Syndrome Traits

Hemoglobin A1c (%)

Adiponectin (ug/ml) *

C-Peptide (ng/mL)

Clinical Indications: Pre-Diabetes Biomarkers

Cholesterol (mg/dL)

Triglycerides (mg/dL)

HDL (mg/dL)

LDL (mg/dL)

Non-HDL Cholesterol (nmol/L)

Clinical Indications: Lipid Panel

<21.0

<5.6

195

180

CardioMetabolic Report

5/10/1946B0000M00000

33M

Doe, Jon

30 - 150

48

2.69

<160

Patient Results

>40

Reference Value

5.5 - 26.0

0.70 - 7.10

<200

John Doe , MD

Reference ValuePatient Results

70 - 105

7.7

11/3/201410/31/2014

Low

228

7.6

1

Lipid Panel (mg/dL)

5.6

Pre-Diabetes Risk Factors

These tests identify metabolic abnormalities that may progress into diabetes. Pre-diabetes is a condition where the body cannot efficientlymetabolize foods, especially carbohydrates, resulting in impaired glycemic (blood sugar) control. Fasting glucose is a snapshot of bloodsugar levels at the time your blood is collected. Hemoglobin A1C reflects your blood glucose levels over the prior three months. Prolongedelevated blood sugar will raise your hemoglobin A1C. Metabolic syndrome traits increase if you have any of the following: elevatedtriglycerides, low HDL or high small-dense LDL. Adiponectin is a beneficial hormone that promotes healthy metabolism of carbohydrates(sugars) and triglycerides (fats).

Test

zero

160

The basic Lipid Panel is a very general marker for cardiometabolic risk. This lipid panel directly measures cholesterol, not lipoproteins(which carry cholesterol.) It is now recognized that measuring lipoproteins is a more accurate and precise way to evaluate yourcardiometabolic risk than measuring cholesterol since cholesterol values are normal in over 50% of people who have a heart attack orstroke. But this standard lipid panel is helpful when viewed in the context of other biomarkers, particularly your lipoprotein particle numbers.Lowering LDL-cholesterol is currently the primary target of treatment. However, elevated triglycerides and low HDL-cholesterol are highlyassociated with metabolic syndrome, which negatively impacts your pre-diabetic risk score.

116

40 - 130

CardioMetabolic Risk Score

This score is a way to estimate your risk of developing diabetes and associated complications such as heart disease or stroke. It is basedupon your test results in the pre-diabetes and lipoprotein profile sections of this report, which are indicators of your ability to metabolize food(glycemic control) and transport fats (lipoproteins) in your blood. The following tests have the largest impact on your pre-diabetes risk score:hemoglobin A1c, fasting blood sugar and metabolic syndrome traits. Factors that significantly affect your pre-diabetic risk but that are notincluded in this risk score include weight, blood pressure (hypertension), smoking, inflammation and family history.

3.0 High

Test

Moderate

0.0 2.0 4.0 6.0 8.0

0 80 160 240 320

0 65 130 195 260

020406080

0 75 150 225 300

0 100 200 300 400

0.00 2.50 5.00 7.50 10.00

0.06.513.019.526.0

1.0 5.0 9.0 13.0 17.0

0 1 2 3

30 73 115 158 200

2.0 11.5 21.0 30.5 40.0

10401 Town Park Drive, Houston, TX 77072 CLIA ID 7500710715Phone: 800-227-5227 / 713-621-3101 Lab Director: John F. Crawford, PhD

SAMPLEPage 2 Accession Number:

CRP-hs (mg/L)

Lipoprotein(a) (mg/dL)

Apolipoprotein B (mg/dL)

Homocysteine (umol/L)

Clinical Indications: Vascular Inflammation and Biomarkers

VLDL Particles (nmol/L)

Total LDL Particles (nmol/L)

Total HDL Particles (nmol/L)

Non-HDL Particles (nmol/L)

Remnant Lipoprotein (nmol/L)

Dense LDL III (nmol/L)

Dense LDL IV (nmol/L)

Buoyant HDL 2b (nmol/L)

Clinical Indications: Lipoprotein Particle Numbers

* For research use only

>7000

<150

1282

<1000

Patient name: Doe, Jon

7832

1369

<100

87

Comments: See Micronutrient Test report for additional vitamin, mineral, antioxidant and other micronutrients contributing topre-diabetes risk and lipid risk factors.

172

<85

It is now recognized that measuring cholesterol, which is carried by lipoproteins, is insufficient for accurately quantifying a person’scardiometabolic risk. Lipoproteins are significant factors in causing heart disease and stroke and your lipoprotein particle numbers areclinically relevant. In particular, elevated small-dense LDL and RLP are the most strongly linked to heart attack and stroke. Conversely,large-buoyant HDL2b indicates how well HDL is clearing excess cholesterol from the body. This information reveals potential cardiovascularproblems that are often missed when only using a standard lipid panel to assess risk

481 <300

104

2017 >1500

<900

ReferenceValue

PatientResults

ReferenceValue

PatientResults

11.9

Vascular Inflammation and Biomarkers

124

<11.0

Lipoprotein Particle Numbers (nmol/L)

3.79 <3.00

6.0 - 29.9

40 - 100

M00000

22.1

Test

Test

These factors are important determinants of cardiometabolic risk, particularly with respect to vascular + inflammation (health of bloodvessels). Apo-B (apolipoprotein B100) is a measure of all atherogenic (harmful) lipoprotein particles in the blood. Lp(a) is an extremelyatherogenic lipoprotein that is strongly linked to developing thrombosis (blood clots). C-reactive protein (CRP) is an indicator ofinflammation throughout the body, including the cardiovascular system. Regardless of the cause, both physical and mental stressors,infections and low grade chronic inflammation can all raise CRP, which increases cardiometabolic risk. Finally, homocysteine is a harmfulprotein that indicates a person’s ability to methylate (detoxify) substances in the body. Elevated homocysteine is linked to thrombosis,thyroid dysfunction and Alzheimers disease (dementia).

0.0 5.5 11.0 16.5 22.0

0 50 100 150 200

0.0 15.0 30.0 45.0 60.0

0.00 1.50 3.00 4.50 6.00

0750150022503000

0 50 100 150 200

0 150 300 450 600

0 75 150 225 300

0 500 1000 1500 2000

0350070001050014000

0 450 900 1350 1800

0 43 85 128 170

10401 Town Park Drive, Houston, TX 77072 CLIA ID 7500710715Phone: 800-227-5227 / 713-621-3101 Lab Director: John F. Crawford, PhD

SAMPLEPatient Name: :rebmuN hctaB:IMBPatient DOB: :rebmuN noisseccA:redneGPhysician Date Received:

Report Date:

* For research use only

5.5 - 26.0

<300

<11.0

Apolipoprotein B (mg/dL) H

Homocysteine (umol/L) 11.9

<21.0

70 - 105

zero

<5.6

>40

CRP-hs (mg/L)

40 - 130

6.0 - 29.9

40 - 100

<150

481

>1500

<3.00

124

0.70 - 7.10

<200

30 - 150

3.79

Lipoprotein(a) (mg/dL) 22.1

Dense LDL IV (nmol/L)

Buoyant HDL 2b (nmol/L) 2017

H

<100

Non-HDL Particles (nmol/L) H 1369

Remnant Lipoprotein (nmol/L) 172

<1000

104

Dense LDL III (nmol/L)

H 1282

Total HDL Particles (nmol/L) 7832

H

>7000

Non-HDL Cholesterol (nmol/L) H 180

VLDL Particles (nmol/L) 87 <85

Total LDL Particles (nmol/L)

LDL (mg/dL) H 160

<900

<160

Cholesterol (mg/dL) 228

Triglycerides (mg/dL) 116

HDL (mg/dL) 48

Adiponectin (ug/ml) * 7.6

C-Peptide (ng/mL) 2.69

Metabolic Syndrome Traits 1

Hemoglobin A1c (%) 5.6

Glucose (mg/dL) H 195

Insulin (µIU/mL) 7.7

Low Moderate High

M6491/01/5

CardioMetabolic Report

33 B0000

FlagTest Component

M00000John Doe, MD

CardioMetabolic Risk Score 3.0

10/31/201411/3/2014

Result Reference Range

0.0 2.0 4.0 6.0 8.0

10401 Town Park Drive, Houston, TX 77072 CLIA ID 7500710715Phone: 800-227-5227 / 713-621-3101 Lab Director: John F. Crawford, PhD

Doe, Jon

SAMPLEB0000M00000October 30, 2014

0.0598 November 3, 201420 1.10

00 ppm

Value Reference Value Alert (Notes Page 5)

VLDL Particles )21( hgiH enilredroB 58< 78

Total LDL Particles 1282 <900 Very High (13)

Non - HDL Particles 1369 )91( hgiH 0001<

RLP (Remnant Lipoprotein) 172 <150 Borderline High (14)

Small - Dense LDL III 481 <300 High (15)

Small - Dense LDL IV & HDL 2b 104 <100 Borderline High (16)

Total HDL Particles 7832 >7000 Borderline-M, Low-F (17)

Large - Buoyant HDL 2b 2017 >1500

Value Reference Value Alert (Notes Page 5)Apo B-100 (mg/dL) 124 )02( hgiH001 - 04

Lp(a) (mg/dL) 22.1 6.0 - 29.9 1

Metabolic Syndrome Traits 1 )8( elbissoPoreZ

C-Reactive Protein-hs (mg/L) 3.8 )9( hgiH0.3<

Insulin (ulU/mL) 7.7 2.0 - 21.0 2

Homocysteine (umol/L) 11.9 <11.0 Borderline High (11)

Reference Value Alert (Notes Page 5) Total Cholesterol 228 <200 Borderline High (1) LDL - Cholesterol 160 Very High (2) HDL - Cholesterol 48 >40 Borderline (3)

Triglycerides 116 30 - 150 Non - HDL- Chol (calc) 180 <160 High (5)

Value

40 - 130

Doe, JonMay 10, 1946John Doe , MD\\sdc1\Z_REPORTING\PDF\5005\N\20000-29999\N29773_5005_0.PDF

1. Reference Value for Blacks is 50.0 mg/dL2. Reference Value for Insulin has changed on 2-20-14

Biomarkers and Risk Factors

Lipid Panel (mg/dL)

1.023 1.034 1.063

HDL 3LDL III HDL 2b

Lipoprotein Particle ProfileTM

1.044l

LDL I & II1.019

A

ppro

xim

ate

LD

L

IDL

Report Date:

DOB:

l ll

LDL IV

l l

© SpectraCell Laboratories, Inc. 2014 All rights reserved Form Rev 38.2

900

Name:

Page 4

Borderline

Risk Factor

Normal

Draw Date:

1300

1.100l

Particle Numbers, nmol/L

Large LDL Small LDL

1.125l

App

roxi

mat

e H

DL

1500

6000

7500

1100

700

Lipoprotein Particle Numbers (nmol/L)

10401 Town Park Dr. Tel: 713-621-3101 800-227-5227 Houston, TX 77072 CLIA ID 45D0710715 Fax: 713-621-3234Laboratory Director: John F. Crawford, Ph.D. Lipid Science Director: Jan M. Troup, Ph.D.

Physician:

Accession No:

Batch:

Reference:

Large HDL RLP Small HDL

2a

40 102022 1225 818

VLDL

Average Size (nm)

1.200l

1 2 3

1.006

Lipoprotein Density g/ml

VLDL

60 30 23 1921

RLP Very Large HDL 2b

© 2010 SpectraCell Laboratories, Inc. All rights reserved. DOC 800 04.10

Visit us at www.spectracell.com or call us at 800.227.LABS (5227)

HS-Omega-3 Index®

OverviewDetermines the patient’s risk for sudden cardiac death (SCD). Half of all fatal heart attacks are due to SCD which is defined as death within one hour of the event. Most sudden cardiac deaths are due to cardiac arrhythmia. An adequate level of the omega-3’s EPA and especially DHA can reduce this risk by 90%. The HS-Omega-3 Index® measures the percentage of EPA and DHA levels in red blood cell membranes (RBC’s) which are highly correlated to myocardial membrane omega-3 levels. Most Americans have a 4% RBC omega-3 fatty acid percentage which represents normal risk; however an 8% RBC level may reduce the risk of SCD by 90%. The HS-Omega-3 Index® is a great compliment to the LPP™ test for cardiovascular risk reduction and the management and treatment of lipoprotein disorders.

Why is the HS-Omega-3 Index® a better technology?This specific method, developed by OmegaQuant, LLC, has more research behind it than any other method, with many more studies to be published in the coming years. A significant advantage of the HS-Omega-3 Index® is the ability to correlate it with clinical outcomes from major epidemiological and interventions studies.

What is the target range for the HS-Omega-3 Index®?The target HS-Omega-3 Index® is 8% and above, a level that current research indicates is associated with the lowest risk* for death from CHD. This is also a typical level in Japan, a country with one of the lowest rates of sudden cardiac death in the world. An Index of 4% or less (which is common in the US) indicates the highest risk. At present, there are no known sex- or age-specific values.

What can be done to correct an HS-Omega-3 Index®?Increase intake of EPA+DHA. The amount a patient would need to take in order to raise their HS-Omega-3 Index® into the target range (>8%) depends in part on the starting level, but it cannot be predicted with certainty. Nevertheless, if the HS-Omega-3 Index® is between 4% and 8%, we would recommend that you increase your current EPA+DHA intake by ½ -1 gram (500 - 1000 mg) per day. This can be accomplished in two ways: eating more oily fish and/or taking fish oil supplements. If it is less than 4%, our recommendation would be that you raise your intake by 1-3 g (1000 - 3000 mg) per day. Although this can be accomplished by eating more oily fish, fish oil supplements are usually necessary to achieve this level of EPA+DHA intake.

If patients are taking omega-3 supplements, won’t their HS-Omega-3 Index® be above 8%?NOT NECESSARILY. There is no way to predict – for any given person – what his/her HS-Omega-3 Index® will be just by knowing how much fish they eat or how many capsules they take.

How can HS-Omega-3 Index® be used to reduce cardiovascular risk?The HS-Omega-3 Index® is a great compliment with SpectraCell’s LPP™ test for cardiovascular risk reduction and the management and treatment of lipoprotein disorders. When treating triglycerides and/or RLP (remnant lipoprotein) as measured by the LPP™ test, omega-3’s and especially DHA should be considered due to the added benefit of SCD reduction. Often triglycerides are treated with fenofibrates or niacin which have no effect on the HS-Omega-3 Index®. In metabolic syndrome patients the omega-3 DHA will not only reduce triglycerides and RLP but will increase the size of LDL and increase HDL 2b as measured with the LPP™ test.® registered trademark of OmegaQuant, LLC

Visit us at www.spectracell.com or call us at 800.227.LABS (5227)

© 2010 SpectraCell Laboratories, Inc. All rights reserved. DOC 800 04.10

Specimen Requirements: FASTING REQUIRED. Fasting 9 to 12 hours prior to the blood collection is required. Whole blood is required. Collect one purple top (EDTA) tube. Do not centrifuge or freeze. Ship in the LPP™ kit or the micronutrient test kit provided.

Sample Report

Fatty Acid Profile