Healthier World with Quest Diagnostics

Unpacking Primary Aldosteronism: New insights and advances in diagnosis (23 min)

Approximately 120 million people in the US have hypertension, which is about half of the adult population. Identifying the mechanisms that cause hypertension is crucial for the proper treatment of patients, yet 9 out of 10 patients do not know the origin of their hypertension. New research reveals that up to 30% of patients suffer from hypertension due to primary aldosteronism (PA). With less than 1% of patients with hypertension being screened for hypertension, today’s episode is designed to bring awareness to PA and discuss the breakthrough research that may help drive screening for PA. Today’s episode is with Maeson Latsko, PhD, Clinical and Education Specialist at Quest Diagnostics Center of Excellence at Cleveland Heartlab, Dr Sanjay Dixit, and Dr Marco Marcelli, board certified endocrinologists and medical directors with Quest Diagnostics.
This episode will
Define hypertension and PA (3:30, 6:15)
Describe the intricate link between hypertension and PA (5:40)
Review current screening tools for PA (6:35)
Discuss how novel research can capture even more patients with hypertension due to PA (9:50)
Discuss who should be screened for PA (17:15)
Outline how a diagnosis of PA can influence treatment considerations (18:50)
To learn more, please review the additional resources below for information on our cardiovascular, metabolic, endocrine, and wellness offerings as well as educational resources and insights from our team of experts. At Quest Diagnostics, we are committed to providing you with results and insights to support your clinical decisions.
Date: 3/2025
Speaker(s): Sanjay Dixit, MD, Marco Marcelli, MD, Maeson Latsko, PhD
Contributor(s): Trisha Winchester, PhD
Additional Resources:
Ordering information:
Quest Diagnostics Clinical Education Center [Link]
Plasma Renin Activity with Reflex to Aldosterone | Test Detail | Quest Diagnostics
https://www.questdiagnostics.com/healthcare-professionals/about-our-tests/endocrine-disorders/primary-aldosteronism
References:
Marcelli M, Bi C, Funder JW, McPhaul MJ. Comparing ARR Versus Suppressed PRA as Screening Tests for Primary Aldosteronism. Hypertension. 2024;81(10):2072-2081. doi:10.1161/HYPERTENSIONAHA.124.22884
 
Brown JM, Siddiqui M, Calhoun DA, Carey RM, Hopkins PN, Williams GH, Vaidya A. The unrecognized prevalence of primary aldosteronism: a cross-sectional study. Ann Intern Med. 2020;173:10–20. doi: 10.7326/M20-0065
 
Vaidya A, Hundemer GL, Nanba K, Parksook WW, Brown JM. Primary Aldosteronism: State-of-the-Art Review. Am J Hypertens. 2022;35(12):967-988. doi:10.1093/ajh/hpac079
Auchus RJ. Approaching Primary Aldosteronism as a Common Disease. Endocr Pract. 2023;29(12):994-998. doi:10.1016/j.eprac.2023.08.014
 
Ostchega Y, Fryar CD, Nwankwo T, et al. Hypertension Prevalence Among Adults Aged 18 and over: United States, 2017-2018. April 2020. Accessed November 20, 2024. Products - Data Briefs - Number 364 - April 2020
 
Dogra P, Bancos I, Young WF Jr. Primary Aldosteronism: A Pragmatic Approach to Diagnosis and Management. Mayo Clin Proc. 2023;98(8):1207-1215. doi:10.1016/j.mayocp.2023.04.023
 
Funder JW, Carey RM, Mantero F, et al. The Management of Primary Aldosteronism: Case Detection, Diagnosis, and Treatment: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2016;101(5):1889-1916. doi:10.1210/jc.2015-4061

Actions from Insight: Your Kidney Friendly Nutrition Plan (20 min)

More than 1 in 7 US adults are estimated to have chronic kidney disease, or CKD, and as many as 9 in 10 don’t know they have it.  Damage to your kidneys cannot be reversed, but if found early, there are ways to prevent its progression such as following a healthy eating plan and being physically active.  Today’s episode is with Patty Bianchi, Registered Dietitian Nutritionist and Certified Diabetes Care and Education Specialist, and Maeson Latsko, PhD, Clinical and Education Specialist at Quest Diagnostics Center of Excellence at Cleveland HeartLab. 
This episode will
Review function of the kidneys (1:20)
Identify causes and risk factors of chronic kidney disease (3:00)
Review lifestyle changes to prevent the progression of kidney disease (7:50, 17:00)
Discuss how limiting salt intake (10:00), animal protein (12:15), and mineral content (14:30) should be a focus for patients with CKD 
To learn more, please review the additional resources below for information on our cardiovascular, metabolic, endocrine, and wellness offerings, as well as educational resources and insights from our team of experts. At Quest Diagnostics, we are committed to providing you with results and insights to support your clinical decisions. 
Date:  03/2025
Speakers(s):  Patty Bianchi, MS, RDN, Maeson Latsko, PhD
Contributor(s): Trisha Winchester, PhD
Additional Resources: 
 Instant Insights: Kidney Profile and eGFR with creatinine and cystatin-C
Quest Diagnostics Clinical Education Center [Link] 
References:
National Institute of Diabetes and Digestive and Kidney Disease. Kidney Disease Statistics for the United States. September 9, 2024. Accessed February 2025
Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Kidney Int. 2024;105(4S):S117-S314. doi:10.1016/j.kint.2023.10.018
Key Takeaways People Living with CKD

The Cardiometabolic Approach: A solution to modern disease risk assessment (20 min)

As many as 45% of Americans have a chronic disease. Shared cardiometabolic risk factors contribute to related conditions, such as cardiovascular disease, poor glycemic control, chronic kidney disease, fatty liver disease, and common endocrine disorders. As evidence demonstrating the interrelationships between chronic cardiometabolic diseases continues to expand, establishing a personalized approach to reduce risk is crucial. This episode is with Quest Diagnostics® experts Maeson Latsko, PhD, Clinical and Education Specialist, and Dr Marc Penn, founder and chief medical officer for Cleveland Heart Lab at the Quest Cardiometabolic Center of Excellence™ in Cleveland, Ohio.  Dr Penn is also a board-certified cardiologist and director of research at Summa Cardiovascular Institute.
This episode will
Review how the risk factors for cardiovascular disease have changed (1:15)
Discuss how the cardiometabolic approach brings attention to related conditions, such as cardiovascular disease, chronic kidney disease, fatty liver disease, and dysglycemia (3:00)
Describe the importance of evaluating endocrine disorders when assessing risk for cardiometabolic conditions (6:45)
Walk through a clinical example of how to implement the cardiometabolic approach (8:50)
Discuss how to implement prevention with clinical solutions to improve patient care (3:45, 14:00)
To learn more, please review the additional resources below for information on our cardiovascular, metabolic, endocrine, and wellness offerings, as well as educational resources and insights from our team of experts. At Quest Diagnostics, we are committed to providing you with results and insights to support your clinical decisions.
Date: 2/2025
Speaker(s): Maeson S Latsko, PhD; Marc Penn, MD, PhD
Contributor(s): Trisha Winchester, PhD
References: 
Fuster V, García-Álvarez A, Devesa A, et al. Influence of Subclinical Atherosclerosis Burden and Progression on Mortality. J Am Coll Cardiol. 2024;84(15):1391-1403. doi:10.1016/j.jacc.2024.06.045
Correia LC. Ezetimibe: Clinical and Scientific Meaning of the IMPROVE-IT Study. Arq Bras Cardiol. 2016;106(3):247-249. doi:10.5935/abc.20160033
Randomised trial of cholesterol lowering in 4444 patients with coronary heart disease: the Scandinavian Simvastatin Survival Study (4S). Lancet. 1994;344(8934):1383-1389.
Lincoff AM, Brown-Frandsen K, Colhoun HM, et al. Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes. N Engl J Med. 2023;389(24):2221-2232. doi:10.1056/NEJMoa2307563
 
Additional Resources:
Website: Cardiometabolic disease | Quest Diagnostics

Instant Insights: Kidney Profile and eGFR with creatinine and cystatin-C (7 min)

1in 7 US adults are estimated to have chronic kidney disease, or CKD. Because early stages of the disease are often clinically silent, 90% of individuals with CKD don’t know they have it. This podcast highlights the importance of early CKD detection and the need for proper screening, especially in individuals with hypertension and diabetes. The Kidney Profile aligns with guidelines and includes the urine-albumin-creatinine ratio and eGFR. The new 2024 guidelines recommend using both creatinine and Cystatin C in estimating eGFR in certain populations, which provides a more accurate risk assessment for CKD and other cardiometabolic conditions like heart disease and stroke. By adopting this dual approach, healthcare providers can improve early detection, staging, and management of CKD, leading to better patient outcomes.
Learning Objectives:
Understand the role of the Kidney Profile in CKD diagnosis and how it aligns with the 2024 KDIGO guidelines. (1:40, 5:15)
Identify at-risk populations for CKD, including those with hypertension and diabetes, and understand the importance of early screening and management. (1:30)
Learn how combining creatinine and cystatin C in eGFR improves the prediction of CKD progression and associated cardiometabolic risks. (4:30)
To learn more, please review the additional resources below for information on our cardiovascular, metabolic, endocrine, and wellness offerings, as well as educational resources and insights from our team of experts. At Quest Diagnostics, we are committed to providing you with results and insights to support your clinical decisions.
Date: 12/2024
Contributor(s): Dr. Maeson Latsko
Additional Resources:
Quest Diagnostics Clinical Education Center [Link]
Ordering information:
 Kidney Profile [link]
Kidney Profile Test Summary [link]
eGFR with Creatinine and Cystatin C [link]
References:
 
Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Kidney Int. 2024;105(4S):S117-S314. doi:10.1016/j.kint.2023.10.018
National Kidney Foundation. Kidney Disease: Fact Sheet. National Kidney Foundation. August 6, 2024. Accessed December 19, 2024. https://www.kidney.org/about/kidney-disease-fact-sheet
 

Instant Insights: Metabolic Risk Panel (5 min)

Increased rates of obesity and type 2 diabetes are increasing rates of cardiometabolic conditions. Identifying and intervening in early stages of metabolic dysfunction is crucial in order to delay and prevent disease progression. The Metabolic Risk Panel is a comprehensive test that helps identify individuals at risk for metabolic dysfunction, insulin resistance, and cardiovascular disease. The panel includes Hemoglobin A1C, Insulin Resistance Panel with Score, Lipid Panel, and Apolipoprotein B (apoB), which together provide a more detailed picture of cardiometabolic health than traditional tests alone. By incorporating these biomarkers, clinicians can detect metabolic risks earlier, enabling proactive interventions to prevent conditions like Type 2 Diabetes, Cardiovascular Disease, and other related cardiometabolic conditions.
 
Learning Objectives:
Understand the components of the Metabolic Risk Panel, including Hemoglobin A1C, insulin resistance panel with score, lipid panel, and Apolipoprotein B, and how they improve risk assessment. (0:33)
Explain the role of insulin resistance in the development of metabolic dysfunction and its connection to early signs of type 2 diabetes. (2:25)
Recognize the importance of apolipoprotein B (apoB) in evaluating lipid metabolism and its role in cardiovascular risk assessment, especially in patients with insulin resistance or metabolic syndrome. (3:15)
Identify how combining traditional and advanced biomarkers in the Metabolic Risk Panel helps clinicians catch metabolic and cardiovascular risks early, enabling more effective prevention and management. (4:30)
To learn more, please review the additional resources below for information on our cardiovascular, metabolic, endocrine, and wellness offerings, as well as educational resources and insights from our team of experts. At Quest Diagnostics, we are committed to providing you with results and insights to support your clinical decisions.
Date: 12/2024
Contributor(s): Dr Maeson Latsko
Additional Resources:
Quest Diagnostics Clinical Education Center [Link]
Ordering information:
Metabolic Risk Panel [link]
References:
 
Cannon A, Handelsman Y, Heile M, Shannon M. Burden of illness in type 2 diabetes mellitus. J Manag Care Spec Pharm. 2018;24(9-a Suppl):S5-S13. doi:10.18553/jmcp.2018.24.9-a.s5
Johannesen CDL, Langsted A, Nordestgaard BG, Mortensen MB. Excess apolipoprotein B and cardiovascular risk in women and men. J Am Coll Cardiol. 2024;83(23):2262-2273. doi:10.1016/j.jacc.2024.03.423
 
Centers of Medicare & Medicaid Services. Diabetes Screening & Definitions Update: CY 2024 physician fee schedule final rule. June 25, 2024. Accessed December 19, 2024. https://www.cms.gov/files/document/mm13487-diabetes-screening-definitions-update-cy-2024-physician-fee-schedule-final-rule.pdf
 
Centers for Disease Control and Prevention. (2017). National diabetes statistics report, 2017: Estimates of Diabetes and its Burden in the United States. Retrieved from https://www.cdc.gov/diabetes/pdfs/data/statistics/national-diabetes-statistics-report.pdf

Action from Insight: Tackling Insulin Resistance (18 min)

Identifying insulin resistance offers significant—and often untapped—clinical value and can help healthcare providers and their patients take action with diet and lifestyle choices to avoid or change the progression to prediabetes and diabetes. Today’s episode features Patty Bianchi, Registered Dietitian Nutritionist and Certified Diabetes Care and Education Specialist and Trisha Winchester, PhD, Quest Diagnostics Sr Manager for Clinical & Education.
This episode will
Review glucose regulation by insulin (1:15) 
Discuss how insulin resistance is measured (3:00) 
Review actionable ways to reduce insulin resistance through lifestyle (4:00), exercise (6:30), diet (8:50), stress and sleep (11:50)
Discuss the 4myheart patient education program offered through Quest Diagnostics Center of Excellence at Cleveland Heartlab (14:30)
To learn more, please review the additional resources below for information on our cardiovascular, metabolic, endocrine, and wellness offerings, as well as educational resources and insights from our team of experts. At Quest Diagnostics, we are committed to providing you with results and insights to support your clinical decisions.
 
Date: 11/2024
Contributor(s): Patty Bianchi, Trisha Winchester, PhD
Additional Resources:
Podcast: The Insulin Resistance Revolution: The Key to Preventing Chronic Conditions (17 min)
Webinar: Early Identification of Type 2 Diabetes Risk for the Primary Care Setting
Ordering information:
Insulin Resistance Panel with Score | Test Detail | Quest Diagnostics
Insulin Resistance Panel with Score | Test Summary | Quest Diagnostics

The Insulin Resistance Revolution: The Key to Preventing Chronic Conditions (17 min)

Metabolic dysfunction is a common root cause of many cardiometabolic conditions that burden the healthcare system. This episode will address insulin resistance, a syndrome that underlies metabolic dysfunction, and how tools can catch risk early, allowing actions that may prevent and reverse the onset of chronic illness. Today’s episode is with Quest Diagnostics experts Kenneth French, Senior Clinical Consultant, and Dr Maeson Latsko, clinical and education specialist. 
This episode will
Identify how early identification of insulin resistance can prevent the rise in metabolic dysfunction and Type II Diabetes (3:00)
Describe the insulin resistance panel with score (8:11) 
Elucidate how identifying insulin resistance can prevent other chronic illness, such as liver related disorders and kidney disease (12:41) 
To learn more, please review the additional resources below for information on our cardiovascular, metabolic, endocrine, and wellness offerings, as well as educational resources and insights from our team of experts. At Quest Diagnostics, we are committed to providing you with results and insights to support your clinical decisions.
 
Date: 09/2024
Contributor(s): Kenneth French, Maeson Latsko, PhD
Additional Resources:
Podcast: Action from Insight: Tackling Insulin Resistance (18 min)
Webinar: Early Identification of Type 2 Diabetes Risk for the Primary Care Setting
Ordering information:
Insulin Resistance Panel with Score | Test Detail | Quest Diagnostics
Insulin Resistance Panel with Score | Test Summary | Quest Diagnostics
 
 
 
 
References:
Ward ZJ, Bleich SN, Cradock AL, et al. Projected U.S. State-Level Prevalence of Adult Obesity and Severe Obesity. N Engl J Med. 2019;381(25):2440-2450. doi:10.1056/NEJMsa1909301
Abbasi F, Shiffman D, Tong CH, et al. Insulin resistance probability scores for apparently healthy individuals. J Endocr Soc. 2018;2(9):1050-1057. doi:10.1210/js.2018-00107
Bril F, McPhaul MJ, Kalavalapalli S, et al. Intact fasting insulin identifies nonalcoholic fatty liver disease in patients without diabetes. J Clin Endocrinol Metab. 2021;106(11):e4360-e4371. doi:10.1210/clinem/dgab417
Healy, M. By 2030, nearly half of all U.S. adults will be obese, experts predict. New York Times. https://www.latimes.com/science/story/2019-12-18/nearly-half-of-us-adults-will-be-obese-by-2030
Khan RMM, Chua ZJY, Tan JC, et al. From Pre-Diabetes to Diabetes: Diagnosis, Treatments and Translational Research. Medicina (Kaunas). 2019;55(9):546. doi:10.3390/medicina55090546

Instant Insights: Apolipoprotein B (7 min)

Despite advances in understanding the pathogenesis and prevention of atherosclerotic cardiovascular disease, coronary heart disease remains the leading cause of death in the United States. Apolipoprotein B (ApoB)—containing lipoproteins more closely identifies atherosclerosis and correlates to atherogenic particles in circulation.
This episode will:
Review the current state of cardiovascular risk assessment
Describe lipoprotein anatomy and ApoB
Identify discordance between LDL cholesterol and ApoB
Discuss the guideline recommended clinical utility of ApoB in risk identification
To learn more, please review the additional resources below for information on our cardiovascular, metabolic, endocrine, and wellness offerings, as well as educational resources and insights from our team of experts. At Quest Diagnostics, we are committed to providing you with results and insights to support your clinical decisions.
Date: 9/10/24
Contributor(s): Maeson Latsko, PhD
Additional Resources:
Quest Diagnostics Clinical Education Center [Link]
Ordering information: Apolipoprotein B | Test Detail | Quest Diagnostics
Apolipoprotein B | Test Summary | Quest Diagnostics
Apo B and cardiovascular risk | Quest Diagnostics | Quest Diagnostics
 
References:
 
Sniderman AD, Williams K, Contois JH, et al. A meta-analysis of low-density lipoprotein cholesterol, non-high-density lipoprotein cholesterol, and apolipoprotein b as markers of cardiovascular risk. Circ: Cardiovascular Quality and Outcomes. 2011;4(3):337-345. doi:10.1161/CIRCOUTCOMES.110.959247
 
Johannesen CDL, Langsted A, Nordestgaard BG, Mortensen MB. Excess apolipoprotein B and cardiovascular risk in women and men. J Am Coll Cardiol. 2024;83(23):2262-2273. doi:10.1016/j.jacc.2024.03.423
 
Grundy SM, Stone NJ, Bailey AL, et al. 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Blood Cholesterol: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2019;139(25):e1082-e1143. doi:10.1161/CIR.0000000000000625
 
Contois JH, McConnell JP, Sethi AA, et al. Apolipoprotein B and cardiovascular disease risk: position statement from the AACC Lipoproteins and Vascular Diseases Division Working Group on Best Practices. Clin Chem. 2009;55(3):407-419. doi:10.1373/clinchem.2008.118356

Instant Insights: Lipoprotein (a) (6 min)

Despite advances in understanding the pathogenesis and prevention of atherosclerotic cardiovascular disease, coronary heart disease remains the leading cause of death in the United States. Lipoprotein (a), or Lp(a), is a particularly atherogenic type of lipoprotein, where excess levels significantly influence cardiovascular risk.  
This episode will:
Review the significant cardiovascular implications of Lp(a) excess
Describe Lp(a) structure
Discuss how Lp(a) is measured
Review the treatment landscape for Lp(a)
To learn more, please review the additional resources below for information on our cardiovascular, metabolic, endocrine, and wellness offerings, as well as educational resources and insights from our team of experts. At Quest Diagnostics, we are committed to providing you with results and insights to support your clinical decisions.
Date: 9/10/24
Contributor(s): Dr. Maeson Latsko
 
Additional Resources:
Ordering information: Lipoprotein (a) | Test Detail | Quest Diagnostics
Lipoprotein(a) | Test Summary | Quest Diagnostics
 
Quest Diagnostics Clinical Education Center [Link]
 
 
References:
Wilson DP, Jacobson TA, Jones PH, et al. Use of Lipoprotein(A) in clinical practice: A biomarker whose time has come. A scientific statement from the National Lipid Association. J Clin Lipidol. 2019;13(3):374-392. doi:10.1016/j.jacl.2019.04.010 
 
Koschinsky ML, Bajaj A, Boffa MB, et al. A focused update to the 2019 NLA scientific statement on use of lipoprotein(a) in clinical practice. J Clin Lipidol. 2024;18(3):e308-e319. doi:10.1016/j.jacl.2024.03.001

Laboratory assessment in the diagnosis of male hypogonadism (16 min)

Hypogonadism is a common condition in the male population, impacting approximately 35% of men over 45 years of age. Today’s episode is with Quest Diagnostics experts Dr Sanjay Dixit, MD, medical director, and Maeson Latsko, PhD, clinical specialist.
This episode will:
Review the clinical and biochemical changes seen in male patients with hypogonadism (1:20)
Discuss the guideline-recommended methodologies for testosterone analysis (3:24)
Learn how to delineate between primary and secondary hypogonadism (7:38)
To learn more, please view the additional resources below for information on our cardiovascular, metabolic, endocrine, and wellness offerings as well as educational resources and insights from our team of experts. At Quest Diagnostics, we are committed to providing you with results and insights to support your clinical decisions.
Date: May 3, 2024
Contributor(s): Dr. Sanjay Dixit, MD, Maeson Latsko, PhD
Additional Resources:
Quest Diagnostics Clinical Education Center 
Quest Diagnostics Hypogonadism FAQs
Clinical Focus: Hypogonadism and Low Testosterone in Men 
Adult Male Hypogonadism Diagnostic Algorithm
References See Quest Diagnostics Clinical Education Center