Cardiometabolic
Insulin resistance is the foundation. ApoB, Lp(a), particle count, and the inflammation that travels with them sit on top. Know your risk. Lower it before the event.
Questions about cardiometabolic risk? Contact Dr. Tagge or schedule a call.
If you’re concerned
The stakes
Insulin resistance, sarcopenia, and fatty liver begin years before any diagnosis and reverse cleanly when caught early. The atherogenic particles accumulate silently across the same window.
Cardiovascular disease is still the leading cause of death in the United States. Most of it is preventable, decades in advance, with the right read. Standard cholesterol panels miss the actual drivers. By the time something shows up on a treadmill stress test, the damage has been accumulating for twenty years. The earlier window is where this disease is most modifiable.
The outcome
These are targets we measure toward, traceable to a finding on your panel. Not a guarantee against a heart attack or stroke. Not a weight-loss promise. No physician can promise either of those.
The panels
The Core read covers the metabolic baseline. The Advanced read adds the lipid particle and genetic markers that earn their place when standard panels miss the picture.
A foundational metabolic read. Glycemic context, intact insulin, uric acid, lipids, and inflammation. Includes a physician's interpretation.
Includes a physician’s interpretation. Quest blood draw at 2,000+ locations. HSA / FSA eligible.
A comprehensive cardiometabolic read. Particle count, ApoB, Lp(a), omega-3 index, inflammation, and glycemic context. Includes a physician's interpretation.
Includes a physician’s interpretation. Quest blood draw at 2,000+ locations. HSA / FSA eligible.
When the case warrants it
A coronary artery calcium score (CAC), or a CT angiogram (CCTA) for a specific indication. Ordered to a local imaging partner, read by radiology, integrated into your Plan. Not performed in-house.
Imaging referral
Not performed in-house. This is a directed referral.
The markers
The pattern across all of them, against optimal, not disease cutoffs.
ApoB
The atherogenic particle count. Above everything.
Lp(a)
Genetic. Measured once. Reframes risk dramatically when elevated.
NMR particle count + size
What actually drives atherogenesis. Not the cholesterol concentration.
Fasting insulin
Moves years before HbA1c. The earliest reliable signal upstream of glucose.
Triglyceride-to-HDL ratio
A pragmatic read on insulin-driven dyslipidemia.
hs-CRP
Inflammation, directly measured.
Glycation markers
How sugar is landing on your proteins over months.
Body composition over BMI
Muscle mass and visceral fat tell the real story.
Inside the Partnership
When ApoB, particle count, or insulin resistance calls for it, the Plan moves to treatment. The pharmacotherapy is matched to the read and titrated against the markers, not prescribed by template.
Lipid ladder
Titrated against particle number and tolerance. Ezetimibe added when LDL or ApoB stays above optimal. PCSK9 inhibitors when the risk profile or Lp(a) burden warrants the next tier.
Metabolic management
GLP-1 prescribed inside a Plan, not in isolation. For sustained improvement in metabolic markers and body composition. Glycemic control and inflammation addressed at the source so the lipid story has somewhere to land.
Foundation
Addressed alongside the prescribing, not after it. The pharmacotherapy works harder when the foundation is doing its job, and the foundation is non-negotiable regardless of which tier the lipid ladder is on.
Questions about cardiometabolic risk? Reach Dr. Tagge directly.
The panel
A snapshot. Yours to keep. Includes the lab work and a physician’s interpretation. The right move when one read is the question.
The relationship
Direct access to Dr. Tagge for ongoing care. Whatever panel makes sense, whenever you need it, read in the context of the story you’re building together. The right move when one read isn’t the question.
Become a memberCommon questions
Insulin moves first. Years before glucose or HbA1c rises, your body compensates by producing more insulin to keep glucose in range. A fasting insulin above the optimal range is the earliest reliable signal that the system is straining.
Not always, but it is the best single read on body composition. It tells you muscle mass, visceral fat, and bone density in one pass. Worth doing as a baseline, then every two to three years if you are working on metabolic health intentionally.
Context matters. The right target depends on your age, sex, and goals. The actionable question is whether your VO2 max is improving, holding, or declining. That trajectory predicts more about your decade ahead than the absolute number.
They are real tools when the data supports them. I prescribe them as part of a Plan, not in isolation. The point is sustained improvement in metabolic markers and body composition, not just weight loss.
LDL-C tells you the cholesterol concentration in your LDL particles. ApoB tells you how many particles you have. Two people with identical LDL-C can have very different particle counts and very different risk. ApoB has been the better predictor in every head-to-head trial.
Useful in the right patient. A zero CAC score is genuinely reassuring; a high score sharpens the case for aggressive intervention. I order it when the clinical question warrants the radiation dose.
Lp(a) is genetic and not changed by lifestyle. The intervention is to drive everything else lower. ApoB target moves down. Lifestyle becomes non-negotiable. There are emerging Lp(a)-specific therapies in trials.
Yes, when the data supports them. I prescribe them based on ApoB and overall risk, not just LDL-C. The side-effect profile is real but smaller than internet discourse suggests, and the absolute risk reduction in the right patient is large.
A comprehensive cardiometabolic panel from Boston Heart Diagnostics. It reads advanced lipid sub-fractions, inflammation, insulin resistance, and genetic markers in one collection. I use it when the standard advanced lipid panel does not answer the question.
Catch the insulin resistance. Measure the particles. Move the modifiable drivers.
No charge. No card. No pressure.