马克海曼：心血管疾病需要做的一些检测

Functional-medicine doctors are using new metrics to measure heart health and disease risk.

功能医学医生正在使用更有效的指标来衡量心脏健康和疾病风险。

Getting the right tests is a big part of preventing, assessing, managing, and even reversing cardiovascular disease. Conventional medical wisdom tends to look at traditional metrics like cholesterol and blood-pressure levels, age, gender, family history, and whether or not you’re a smoker.

科学准确的检测是预防、评估、管理甚至逆转心血管疾病的重要一步。传统医学倾向于观察一些传统指标，比如胆固醇和血压水平、年龄、性别、家族史，以及你是否是吸烟者。

Progressive-minded docs look at those variables as well, but they dig deep for other cardiovascular risk factors, including inflammation, imbalances in blood sugar and insulin, and oxidative stress, which affect things like cholesterol and blood pressure.

随着医生理念和技术的不断进步，医生除了着眼于这些传统指标，同时也会深入探讨其他的心血管风险因素，包括炎症、血糖、胰岛素的失衡以及氧化压力，这些因素会影响胆固醇和血压。

Looking to measure your overall cardiovascular disease (CVD) risk? Here are some tests to consider in partnership with your healthcare provider.

想要衡量你的整体心血管疾病（CVD）风险？以下是医生推荐的一些检测。

Advanced Lipid Tests: Unlike the standard lipid panel, advanced tests like the NMR Lipid Profile or the Cardio IQ Lipoprotein Fractionation look at the all-important particle size of LDL and HDL. “You should have less than 1,000 total LDL particles and no more than 400 small particles (although ideally you shouldn’t have any!),” notes Mark Hyman, MD, director of the Center for Functional Medicine at the Cleveland Clinic, in his new book, Eat Fat, Get Thin: Why the Fat We Eat Is the Key to Sustained Weight Loss and Vibrant Health.

脂代谢能力评估：与标准脂质检测不同，脂代谢能力评估会考虑LDL和HDL所有颗粒的大小。克利夫兰诊所功能医学中心主任Mark Hyman博士说：“你应该有少于1000个LDL颗粒并且不超过400个小颗粒（尽管理想情况下你不应该有任何LDL颗粒）。”

High-Sensitivity C-Reactive Protein Test: This marker of inflammation is a big clue to your overall CVD risk. “When your inflammation is high for whatever reason — maybe it’s certain foods you eat, or gut dysbiosis, or the presence of pro-inflammatory visceral fat — it can cause the walls of our blood vessels to become leaky and inflamed as well, which makes it a lot easier for the tiny, dense LDL cholesterol particles to squeeze through the cracks and trigger the cycle of plaque buildup,” says functional-medicine internist Yousef Elyaman, MD, IFMCP, the founder and medical director of Absolute Health, a primary-care practice in Ocala, Fla.

超敏C反应蛋白检测：这种炎症标志物是你整体心血管疾病风险的重要线索。“无论什么原因，当你的炎症高时，可能是某些特定食物，或肠道菌群失调，或存在促炎内脏脂肪，它可能导致我们的血管壁变得渗漏和发炎，这使得小而致密的低密度脂蛋白胆固醇颗粒更容易挤入裂隙中并引发斑块积累循环。

Glucose and Insulin-Tolerance Test: Insulin resistance can cause elevated lipids and is associated with an increased risk of cardiovascular disease. “Your fasting sugar should be between 70 and 80 mg/dl and your one- and two-hour sugars should be less than 120 mg/dl,” Hyman notes.

葡萄糖和胰岛素耐受试验：胰岛素抵抗可引起血脂升高，并与心血管疾病风险增加有关。Mark Hyman博士指出：“你的空腹糖应该在70到80mg/dL之间，你餐后一小时和两小时血糖应该低于120mg/dl。“

Hemoglobin A1c Test: In order to identify CVD risks early, notes Hyman, it’s a good idea to do this test, which measures average blood sugar over the previous six weeks, as well as the above glucose- and insulin-tolerance testing. “Anything over 5.5 percent is high,” he notes.

血红蛋白A1c检测：为了尽早发现心血管疾病的风险，Hyman指出，做这项检测可以测量前六周的平均血糖，以及上述的葡萄糖和胰岛素耐受检测。“指标超过5.5％代表超标，”他指出。

Homocysteine, 25-Hydroxy Vitamin D, Vitamin B12 Tests: These tests measure levels of key heart-protective nutrients. “Your homocysteine measures your folate status and should be between 6 and 8 micromoles per liter,” Hyman states.

同型半胱氨酸、25-羟基维生素D、维生素B12检测：这些检测是衡量心脏保护营养素水平的关键。 Hyman说：“你的同型半胱氨酸测量你的叶酸状态，应该在每升6-8微摩尔之间。”

                                            

Carotid Intima-Media Thickness (CIMT) Test: This high-resolution ultrasound test identifies plaque in the arteries in your neck, which is associated with cardiovascular-disease risk. “We want to know how inflamed your major vessels are and how much plaque you are creating, so we look at your carotid arteries, which highly correlate with what’s happening in the heart vessels,” says P. Michael Stone, MD, MS, a family physician who practices functional medicine in Ashland, Ore., and a faculty member at the Institute for Functional Medicine.

颈动脉内膜-中膜厚度（CIMT）测试：这种高分辨率的超声检查可以识别颈部动脉中的斑块，这与心血管疾病风险相关。Hyman说：“我们想知道你的主要血管的发炎程度以及斑块的多少，所以我们需要监测你的颈动脉，这与心脏血管中发生的疾病高度相关。”