Many of us want simple, black-and-white answers when it comes to our health. Give us the good and the bad, and tell us how long we’ll live. Take cholesterol readings, for instance. The last time I had my cholesterol checked, I was told that my total blood cholesterol level was under 200, and, in my mind, that was all I needed to hear. I understood that HDL (high-density lipoproteins) was good cholesterol and that LDL (low-density lipoproteins) was bad cholesterol; however, since my cholesterol was under the magic number of 200, I was safe, I thought. I had my black-and-white answer.

Then came other numbers: Most clinicians agree that your LDL should be below 100 mg/dL and your HDL should be somewhere around 40 mg/dL or higher. However, according to Robert W. Ban, PhD, chairman/CEO of Quantimetrix Corp in Redondo Beach, Calif, it’s more important to measure the many subfractions of good and bad cholesterol. One could have normal cholesterol levels, but abnormal LDL subfractions, for example. These LDL subfractions, he says, provide a more in-depth assessment of coronary-artery-disease risk.

Now it seems that HDL, long regarded as medical knights in shining armor protecting us from dreaded heart disease and stroke, might not always be all good. Some believe there is bad HDL cholesterol as well as good HDL. Recent studies suggest that different HDL subclasses are associated with an increase in heart disease, and that measurement of these subclasses could be a better indicator of heart disease than measurement of total HDL alone. Nehemias Muniz and Jennifer Morais, PhD, Quantimetrix scientists, demonstrate in their study, “Differences in HDL Subfraction Distribution in Normolipidemic Versus Dyslipidemic Individuals,” that all HDL subclasses are not created equal.

On page 8 of this issue, we spotlight Quantimetrix’s Lipoprint® HDL system, the test that provided much of the information upon which the Muniz and Morais findings are based. The new test, which can resolve up to 10 subfractions of HDL, is expected to receive 510(k) approval from the US Food and Drug Administration later this year.

Another interesting read is our Disease Management feature on page 32, which underscores the importance of rapid diagnostic testing for pneumonia. Determining that a person has pneumonia is not a difficult diagnosis, but since there are more than 50 different types of pneumonia, quickly identifying the specific organism causing the disease can be a challenge. Because of a growing problem of antibiotic-resistant organisms, physicians need to prescribe targeted drugs instead of broad-spectrum antibiotics. Again, it’s not as simple as diagnosing and prescribing.

So much for black-and-white answers and hard-and-fast numbers; there aren’t many when it comes to health. There’s always a gray area or a new theory and a new product to accompany it. Maybe that’s part of what makes our industry so fascinating.

Carol Andrews
candrews@ascendmedia.com