The Top 10 Biomarkers: What They Mean and How to Act on Them

Why these ten

Together, these ten span the systems that quietly shape how you age: your heart and vessels, your metabolism, your level of inflammation, your kidney function, and your body composition. Some are names you’ll recognise; others less so — but each earns its place.

Whether this is your first look at your numbers or you already follow them, the same principle applies: a single measurement is a snapshot, and the real insight comes from knowing where you stand today and watching how each marker moves over time.

A quick note before we start. Most of these markers can be influenced by everyday factors — how you eat, move, sleep and recover — so throughout we’ve included both how to improve a marker that’s drifted and how to maintain one that’s already in a good range. And all of them are best read in context, with a doctor, rather than in isolation. This article is educational; it isn’t a diagnosis or medical advice.

A word on testing, too: these markers are covered across care’s check-ups and app-based follow-up tests — more on exactly how at the end.

This is health worth understanding well — so let’s dive in, starting at number one.

1. LDL — Low-Density Lipoprotein

LDL has earned a blunt reputation as the ‘artery clogger’. It is the main lipoprotein particle that carries cholesterol through your bloodstream and remains the most extensively studied lipid marker in cardiovascular research.

Why it matters. When the number of LDL particles exceeds what your body needs for normal cell function, some can enter the arterial wall. Over years, this contributes to the slow, silent development of atherosclerosis. Higher LDL particle exposure sustained over time is consistently linked to increased cardiovascular risk. In some individuals, very high levels are genetically driven (familial hypercholesterolaemia), which makes an unexpectedly elevated result worth taking seriously.

How your body actually regulates it. The most powerful lever for lowering your LDL load is your own metabolism — and exercise is what trains it. Regular Zone-2 endurance work (steady, conversational-pace cardio) builds the number and efficiency of mitochondria in your muscles, which burns fat — including visceral fat around your organs — and prompts your liver to clear LDL particles from your blood far more effectively. Strength training adds to this: more muscle means higher energy demand and better lipid handling throughout the body. In short, a metabolically “trained” body removes circulating LDL faster than diet alone can achieve.

2. ApoB — Apolipoprotein B

If LDL is the headline, ApoB is the particle counter. ApoB is the structural protein present on every atherogenic lipoprotein particle — LDL, VLDL, IDL, and Lp(a). Because each of these particles carries exactly one ApoB molecule, measuring ApoB directly reflects the total number of particles capable of entering and damaging the arterial wall.

Why it matters. Standard LDL cholesterol tests measure the amount of cholesterol inside the particles, not the number of particles themselves. These two values frequently diverge. Two people can have the same LDL cholesterol level but very different particle counts. It is the number of particles — not the cholesterol cargo — that repeatedly collides with the arterial wall, promoting atherosclerosis. For this reason, ApoB is increasingly regarded as a more precise marker of cardiovascular risk than LDL cholesterol alone, especially in people with metabolic syndrome, insulin resistance, high triglycerides, or elevated Lp(a).

How your body actually regulates it. Like LDL, ApoB is driven mostly by your metabolism rather than diet alone. Consistent Zone-2 endurance training sharpens your liver’s ability to clear ApoB-containing particles from your blood, while burning the visceral fat that fuels their production in the first place — less fat reaching the liver means fewer particles made. Strength training compounds this: more muscle raises your energy demand and improves how your body handles fats overall. Diet still matters (especially cutting saturated fat and adding soluble fibre), but the long-term drivers are steady aerobic training, visceral fat loss, and holding on to muscle.

3. Lp(a) — Lipoprotein(a)

Lp(a) is largely inherited — set in your DNA. It’s genetically determined and stays relatively stable throughout adult life.

Why it matters. Lp(a) is an LDL-like particle with an extra protein attached (apolipoprotein(a)). Elevated levels are independently associated with increased risk of atherosclerotic cardiovascular disease, including heart attack and stroke. Because elevated levels are common (roughly 20–30% of people have significant levels) and cause no symptoms, most people with it don’t know. A one-time test in adulthood is valuable: it can uncover a lifelong, otherwise hidden risk factor and help explain family patterns of early cardiovascular disease.

What you can actually change. Unlike LDL cholesterol or ApoB, Lp(a) is only minimally modifiable through lifestyle, diet, or standard lipid-lowering therapies. Its value lies mainly in risk stratification rather than direct treatment. If Lp(a) is elevated, the focus shifts to managing all other modifiable risk factors more aggressively (LDL/ApoB, blood pressure, glucose metabolism, inflammation, smoking, and visceral fat). In people with very high Lp(a) plus other risk factors, guideline-directed intensification of LDL-lowering therapy is currently the best-supported approach to reduce overall atherogenic burden. Specific Lp(a)-lowering therapies are in advanced clinical development but not yet routinely available.

Bottom line: get Lp(a) tested at least once. A high result doesn’t change what you can do about Lp(a) itself — but it should change how aggressively you approach everything else that is modifiable.

4. Blood Pressure

Blood pressure is reported as two numbers — systolic (pressure when your heart contracts) over diastolic (pressure when your heart relaxes) — and reflects the force blood exerts against your artery walls. It's one of the most important vital signs and a major driver of long-term cardiovascular and kidney health.

Why it matters. Sustained high blood pressure places continuous mechanical stress on arteries, the heart, brain, kidneys, and eyes. This "silent" damage often builds over years without noticeable symptoms, gradually contributing to atherosclerosis, heart failure, stroke, and/or kidney disease. Because hypertension is one of the most modifiable cardiovascular risk factors, regular measurement is key to catching it early and preventing complications.

A note on measurement, honestly. A single reading can be misleadingly high if you're stressed, rushed, or anxious at the doctor's office (so-called "white coat syndrome"). This is why blood pressure is best understood from multiple readings — often most reliably measured calmly at home.

How to influence it. Factors linked to blood pressure include sodium intake, potassium-rich foods, body weight, physical activity, alcohol, sleep, and chronic stress. To lower an elevated reading, the most common levers are reducing salt, moving regularly, moderating alcohol, and protecting sleep; to maintain a good one, it's often about keeping those habits and checking in periodically so a slow drift doesn't go unnoticed.

5. HbA1c — Long-Term Blood Sugar

HbA1c measures the percentage of haemoglobin that has glucose attached to it. Because red blood cells live about 120 days, HbA1c gives an integrated picture of average blood sugar over the past 8–12 weeks.

Why it matters. It's the standard marker for assessing long-term glucose control and for identifying prediabetes or diabetes. Elevated HbA1c reflects chronic hyperglycaemia and is strongly linked to microvascular complications (eyes, kidneys, nerves) and macrovascular risk (heart attack, stroke). Its biggest value is catching early, still-reversible stages of glucose dysregulation before full diabetes develops.

Important caveats. HbA1c can be misleading in conditions that alter red blood cell lifespan or turnover (e.g. certain anaemias, haemoglobinopathies, recent blood loss, or pregnancy). In these cases, it should be interpreted alongside fasting glucose, an oral glucose tolerance test, or fructosamine.

How to influence it. HbA1c responds well to sustained lifestyle change: regular activity (especially walking after meals and Zone-2 training), weight/visceral fat reduction, a fibre-rich, low-glycaemic-index diet, adequate sleep, and stress management. Medication support (e.g. metformin) is often added when lifestyle alone isn't enough. Because it reflects a 2–3 month window, meaningful change typically takes 8–12 weeks of consistent effort to show up.

6. Fasting Glucose

Fasting glucose measures blood sugar after at least 8 hours without caloric intake — a snapshot of your liver's glucose output and baseline insulin sensitivity.

Why it matters. It helps identify impaired fasting glucose and diabetes. Interpreted alongside HbA1c, it gives a fuller picture: HbA1c shows the trend, fasting glucose shows the current baseline. An elevated fasting glucose often signals early hepatic insulin resistance.

One reading doesn't tell the whole story. A single elevated result can stem from acute stress, poor sleep, illness, or medications. Diagnosis requires confirmation on a separate day unless classic symptoms are present.

How to influence it. Improvements come mainly from reducing visceral fat, building muscle through strength training, Zone-2 endurance training, a fibre-rich low-glycaemic-index diet, moderate alcohol intake, and better sleep. These changes improve insulin sensitivity and rein in excess hepatic glucose production.

7. Kidney Function — Creatinine

Creatinine is a waste product of muscle metabolism. Its serum level, combined with age, sex, and in some formulas ethnicity, is used to estimate glomerular filtration rate (eGFR) — the best routinely available indicator of kidney function.

Why it matters. The kidneys filter blood continuously and silently. A declining eGFR often produces no symptoms until advanced stages. Because high blood pressure, diabetes, and metabolic syndrome are leading causes of chronic kidney disease, regular eGFR monitoring rounds out the cardiometabolic picture.

Important context. Creatinine (and therefore eGFR) is heavily influenced by muscle mass, protein intake, creatine supplementation, hydration, and age. In muscular or athletic individuals, creatinine-based eGFR can underestimate true kidney function; cystatin-C-based eGFR is often more accurate in these cases.

How to influence it. Kidney health is mostly supported indirectly: through excellent long-term blood pressure and glucose control, a healthy body composition, adequate hydration, and avoiding chronic use of nephrotoxic medications (e.g. NSAIDs).

8. Visceral Fat

Visceral fat is the metabolically active fat stored deep in the abdominal cavity, around your internal organs, distinct from subcutaneous fat just under the skin.

Why it matters. Unlike subcutaneous fat, visceral fat releases free fatty acids and pro-inflammatory signals. It's strongly linked to insulin resistance, fatty liver disease (MAFLD), dyslipidemia, high blood pressure, and elevated cardiovascular risk — even in people who don't look overweight (the "TOFI" phenotype: thin outside, fat inside).

How to influence it. Visceral fat is among the most responsive fat stores to intervention. It's most effectively reduced through a combination of caloric deficit, regular Zone-2 endurance training (most effective for fat oxidation), strength training (improves muscle's metabolic capacity), stress reduction, and adequate recovery. Improvements in visceral fat often show up before the scale moves much and bring rapid metabolic benefits.

9. hs-CRP — High-Sensitivity C-Reactive Protein

hs-CRP is a sensitive marker of systemic, low-grade inflammation, produced by the liver in response to inflammatory signals (particularly IL-6).

Why it matters. Chronic low-grade inflammation plays a central role in the development and progression of atherosclerosis. Elevated hs-CRP is independently associated with increased cardiovascular risk, sometimes even when cholesterol looks normal. It adds an inflammatory dimension to risk assessment.

Important caveats. hs-CRP is non-specific. A recent infection, injury, intense exercise, or inflammatory conditions can cause temporary spikes. It should be interpreted in clinical context and ideally measured in a stable state.

How to influence it. Lifestyle levers that reliably lower hs-CRP include reducing visceral fat, regular moderate exercise, an anti-inflammatory, Mediterranean-style diet, avoiding smoking, adequate sleep, and stress reduction. Treating underlying inflammatory conditions (e.g. gum disease, autoimmune conditions) matters too.

10. Omega-3 Index

The Omega-3 Index measures the percentage of EPA + DHA in red blood cell membranes and reflects long-term omega-3 fatty acid status (roughly 3–4 months).

Why it matters. A higher Omega-3 Index (≥4.5%, ideally ≥8%) is associated with lower risk of cardiovascular events, less inflammation, and better membrane fluidity.

How to influence it. The index responds reliably to increased intake of EPA and DHA from fatty fish (salmon, mackerel, sardines) or quality supplements (fish or algae oil). Aim for 1–2g combined EPA+DHA daily for maintenance, higher doses for specific indications only under medical guidance.

Bringing it together

Knowing your numbers is the first step. What each of these ten markers offers on its own is a starting point — but the real picture comes from reading them together, and from watching how they move.

They also talk to each other. Visceral fat can nudge glucose and inflammation; lipids and inflammation compound each other’s effect on your arteries; blood pressure and kidney function are closely tied. Seen side by side, patterns emerge that no single value would reveal — which is why the ten are more useful as a panel than as ten separate facts.

That’s where following them over time matters. A single check-up tells you where you stand today; a second one shows you the direction of travel — which markers are settling into a good range, and which might need more attention. How often to re-test depends on the marker and on you: something like Lp(a) is largely a once-in-a-lifetime number, while the modifiable markers are worth revisiting periodically so you can see whether a change you’ve made is actually landing. Think of your care app as your health’s best friend — always in your pocket, keeping all your results in one place so you see the trend, not just the snapshot. It’s also where, as a customer, you can add markers over time through follow-up tests you book directly in the app, including ones like the Omega-3 Index.

This is exactly why interpretation together with a doctor is at the heart of meaningful health insights. These markers do not exist in isolation — they interact, and individual results always require context. What is “normal” or actionable for one person may differ for another. A care physician helps you connect the dots, identify what is truly relevant for your personal situation, and decide on the most effective next steps — whether that means lifestyle adjustments, further testing, or medical therapy.

See where you stand

At care, the full body check-up is the most comprehensive way to see these markers together — over 100 biomarkers in around 20 minutes, alongside a body-composition analysis, an ECG and a blood pressure measurement. The remainder are covered across our other check-ups and app-based follow-up tests, so nothing’s out of reach.

Whichever you start with, your results are structured clearly in the care app and come with a personalized medical report and concrete recommendations from your doctor.

Book your check-up

Already a care customer? Head to the services page in your care app to book your follow-up and any app-exclusive tests, then track your markers over time.

This article is for educational purposes and does not replace individual medical advice. Your biomarker results are best interpreted with your care doctor, who can place them in the context of your personal health.