The Synvista Heart Disease Risk Test
Given the importance of cardiovascular health for those of us with diabetes, we were particularly excited when we learned about a test that is intended to measure the risk of cardiovascular disease. This genetic test was created by Synvista Therapeutics to determine whether you are producing a particular variant of a blood protein that may increase your risk of heart disease. This protein is called haptoglobin (Hp for short) and the variant in question is haptoglobin 2-2 (Hp2-2). diaTribe editor-in-chief, Kelly Close, once again volunteered herself (or more accurately a blood sample) to get a better grasp on this test. Read her editor’s letter to find out how to win a free haptoglobin test.
what is haptoglobin?
To better answer this question, we must first understand what hemoglobin is. It’s a protein in your red blood cells that allows these cells to carry oxygen from the lungs to the rest of the body. The purpose of haptoglobin is to collect and hold any hemoglobin that is not attached to a red blood cell. Unattached hemoglobin has been linked to a damaging process called oxidative stress that might contribute to cardiovascular disease. Fortunately, hemoglobin that is attached to haptoglobin can be quickly removed from the blood, avoiding oxidative stress.
what is haptoglobin 2-2?
There are two haptoglobin genes, haptoglobin 1 and haptoglobin 2, that produce haptoglobin proteins. The two genes can produce three possible combinations of haptoglobin – haptoglobin 1-1, 2-2, or 1-2). Haptoglobin 2-2 is believed to be the least effective of the three types at protecting against cardiovascular disease related to oxidative stress. Synvista’s research suggests that individuals who predominantly produce haptoglobin 2-2 have up to five times greater risk of developing cardiovascular disease.
details about the haptoglobin genotyping test
Simply put, the Synvista test is a genetic test that tells you if you have the haptoglobin genes that produce the haptoglobin 2-2 protein. It involves a few simple steps:
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Get a blood draw prescription from your healthcare provider.
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Have your blood drawn at your local lab.
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Have your lab send the sample sent to the ARUP lab in Salt Lake City with a request for a Haptoglobin (HP) Genotyping PCR – code number 0040116
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The results will be sent to your physician in 2-7 days.
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Work with your physician and healthcare team to develop an appropriate plan of action based on the results.
results
Good news, it turns out that Kelly does not have the haptoglobin 2-2 combination! We’ve learned from Synvista that about 40% of people have the 2-2 variant, 15% have the (much safer) 1-1 variant, and 45% have the 1-2 variant, which is in between the other two but has not been shown to be much worse than 1-1. Kelly has the 1-2 type, and here’s her take:
So, I’m in this moderate risk category—while I am relieved I don’t have a dramatically increased risk of heart disease (five times higher than the average person with diabetes), I certainly wasn’t happy knowing I still have higher risk than people without diabetes! The whole process of getting the test and thinking about CV disease drove home the importance AGAIN of a good diet and regular exercise.
I’ve heard this SO many times and I know the landmark study results showing that tighter glycemic control lowers cardiovascular risk (this was proven in the EDIC study for type 1s and in the UKPDS study for type 2s). But this test really made me stop and think. I know I’m not doing nearly as much as I could do to be healthy. While it’s disappointing that it takes getting scared to be more motivated, I have to say that I am more motivated knowing this. I asked my husband to remind me of this test once a month! When thinking about diabetes management, knowledge is power – as long as I don’t bury my head in the sand!
We recommend that you discuss this test with your healthcare team to decide if it might be useful for you. The test costs $325, and a major disadvantage is that most insurance companies will not automatically reimburse it. Some might with the right letter from your doctor, so we think it is worth pursuing if you and your healthcare team decide it would be useful for you. Still, especially if your glycemic control isn’t where you want it to be, it may be worth getting this test to understand how high your other risk factors are. This may help you better manage your risk or may help your motivation (like in Kelly’s case). It’s so new that your healthcare team may not even know about it! If you or your doctor has more detailed questions, you can contact Synvista at (201) 934-5000.
