You know your Social Security number, your ATM pin code, your mom’s phone number, but do you know your HbA1c?
Five numerical biomarkers can reveal how well you’re aging and warn of trouble long before symptoms of disease appear, according to Dr. Florence Comite, founder of the Comite Center for Precision Medicine & Healthy Longevity.
Comite — who wrote “Invincible: Defy Your Genetic Destiny to Live Better, Longer,” out April 28 — recommends starting to monitor these biomarkers between the ages of 25 and 30.
“By the time symptoms send you to a doctor, the process has often been underway for quite some time, usually decades,” Comite told The Post.
“If you want to be proactive to stop aging disorders rather than react to disease, you should establish your baseline early and track how your body changes over time.”
Here’s everything you need to know about these five key biomarkers, including the one that Comite deems the “most crucial” among the bunch.
Fasting glucose
A fasting glucose test measures blood sugar after an overnight fast to screen for prediabetes or diabetes.
A normal fasting glucose for adults without diabetes is 70–99 milligrams per deciliter, while levels between 100–125 mg/dL indicate prediabetes and 126 mg/dL or higher suggests diabetes.
“I like to see fasting glucose in a tighter, optimal range, based on research studies, 70s to 80,” Comite said.
“Once you are consistently above 80, into the 90s or above, especially paired with elevated insulin, that is an early warning sign of impending prediabetes with insulin resistance.”
Fasting insulin
“Fasting insulin is one of the most crucial — and most overlooked — biomarkers in medicine because it reveals how hard your body is working to stabilize your glucose,” Comite said.
“This biomarker is rarely ordered by physicians, yet it is an early warning sign of insulin resistance and prediabetes, giving you a heads up about brewing metabolic issues decades … before the usual fasting glucose.”
The pancreas produces insulin, which regulates blood sugar by allowing glucose to enter cells for energy.
A fasting insulin test measures the amount of insulin in the blood after an eight- to 12-hour fast to see how well the body manages blood sugar.
You can have healthy glucose values and elevated insulin, Comite said.
“In my clinical practice, I like to see fasting insulin less than 2, though reactive, conventional medical practitioners typically reference 2–5 [micro-international units per milliliter] as ‘normal,’” she added.
“Once you start creeping above that, into the high single digits or teens, it’s a red flag that metabolic dysfunction is already underway — even if other labs still look ‘normal.’”
Insulin injections are sometimes needed to keep high blood sugar under control.
HbA1c
“HbA1c reflects your average glucose over approximately three months, but like many tests, the so-called ‘normal’ ranges are inaccurate — they’re too broad, reflect large population studies that include many people who are unhealthy and skew the numbers,” Comite said.
“Normal” is generally considered below 5.7%; prediabetes is 5.7% to 6.4% and diabetes is 6.5% and higher.
Comite aims for under 5.0%.
“Once your hemoglobin A1c moves up above that, it signals changes in your system’s carbohydrate management, especially beyond 5.6%, at which you have become prediabetic with metabolic dysfunction,” she explained.
She recommends checking HbA1c at least once or twice a year and perhaps more often if you’re trying to optimize your metabolism.
Cholesterol risk ratio
Cholesterol, that waxy substance in your cells that’s important for producing hormones and synthesizing vitamin D, can be confusing because there’s a “good” cholesterol (HDL) and a “bad” cholesterol (LDL).
Your LDL “doesn’t tell the whole story,” Comite said.
Instead, you should look to your cholesterol risk ratio (CRR) — your total cholesterol divided by your HDL cholesterol — to get a better sense of your heart disease risk.
“Optimal CRR is 2 or under,” Comite said.
“A higher ratio, over 2, suggests increased cardiovascular risk, even if LDL isn’t dramatically elevated,” she continued. “Elevated CRR beyond 3.5 to 4 connotes even greater risk.”
Free testosterone
Testosterone is often thought of as a male hormone, but women need it too.
T drives energy, libido, muscle mass, metabolism and mood in both genders.
“As levels drop, we see loss of muscle, increased fat accumulation around the trunk, especially visceral fat, and worsening insulin resistance,” Comite said.
A free testosterone test measures the amount of biologically active, immediately usable testosterone in the blood that is not bound to proteins.
Taken together, these five biomarkers reveal how well or poorly your system is operating.
“You need to view these interconnected biomarkers in relation to one another and other factors such as body composition, personal medical and family health history and how you live your life,” Comite said.
“Sleep, food, exercise, stress and environment, such as toxins, all play a role and should be factored into an assessment.”
