The incidence of lifestyle-related diseases has gradually increased during the last years, thus becoming a major social issue. The anti-aging medical check-up analyses the physiological activity in terms of functional age, promoting patients’ understanding of their real health condition as compared to a regular check-up. The anti-aging medicine is therefore a kind of preventive medicine whose goal is to affect aging, making every passing year as serene and disease-free as possible. In this peculiar context, the most innovative approach comes directly from the intersection of two types of information: on the one hand, today’s medical data, given either by blood tests or by other kind of examinations and on the other hand our genetic inheritance, which comes from the past and affects our future. The interaction between our genetic inheritance and lifestyles has become more and more important in recent decades, as it correlates with the risk of developing chronic degenerative diseases in old age.
Our DNA doesn’t foreshadow our destiny, however genes may represent reliable indicators of our chances to develop well-defined diseases. The genomic approach is therefore very useful as it allows to pinpoint many individual predispositions towards diseases, regardless of age. This kind of analysis doesn’t constitute a positive predictive factor of disease, but provides information concerning the adoption of targeted and personalized preventive measures in order to keep well, both physically and aesthetically. Genomic tests allow us to discover, for example, what is interfering with a correct weight control, which factors can affect skin ageing, how to optimize our psycho-physical performances and which kind of proactive strategies could be useful to prevent the onset of many chronic degenerative diseases. Let’s have a look at an essential anti-aging medical check-up.
The term “oxidative stress” refers to an imbalance between reactive oxygen species concentration and the ability of our organism to detoxify excesses of these species. The oxidative profile therefore correlates with the delicate equilibrium between free radicals on one side and the defensive capability of our plasma barrier on the other side.
The free radicals analytical system consists of a dedicated photometer with an incorporated centrifuge, designed for evaluating oxidative stress by means of two simple tests, called d-ROM and BAP, in blood samples obtained from fingertip puncture. The d-ROM test measures the oxidant capacity of a plasma sample toward a particular substance, which acts as indicator (chromogen). In healthy subjects, the average d-ROM ranges between 250 and 300 CARR units. Values greater than 300 CARR units suggest an oxidative stress that should be evaluated in the clinical context for every single patient. In general terms, the exposure to risk factors for oxidative stress (like smoke, alcohol excess, inadequate physical activity, top-heavy dietary intake) implies higher d-ROM values; similar results correlate also with oxidative imbalance-related pathologies (cardiovascular, neurodegenerative, metabolic diseases and tumours) and with medical treatments increasing the number of oxidative species (chemotherapy, radiotherapy, oral contraceptives, dialysis, coronary bypass surgery).
As the d-ROM test is an indicator of reactive oxygen species and free radicals produced in our organism, so BAP test correlates with the biological antioxidant potential of our natural barrier, by determining the blood concentration of many antioxidants like bilirubin, uric acid, vitamin C and E and proteins, able to reduce ferric ion to ferrous. In healthy subjects, the average results are usually higher than 2200 micromoles/L, i.e. 1 mL of plasma is able to reduce 2.2 micromoles of iron per litre. An oxidative stress occurs in case of lower values and has to be evaluated like d-ROM in light of the same clinical considerations.
Thanks to these simple tests, widely mentioned in scientific literature, it is possible to make a safe and reliable diagnosis even at an outpatient clinic, evaluating pro-oxidant activity separately from anti-oxidant capacity.
Lab tests include the evaluation of aging biomarkers and of endocrine senescence. They are particularly useful in the assessment of the real biological age, as compared with chronological age. The most important of these tests are listed below:
Glycation indices: it is well known that abnormal blood sugar levels, due to irregular fluctuations in insulin secretion or reduced sensitivity of insulin peripheral tissues receptors, can promote cross-linking protein phenomena (collagen, haemoglobin, albumin, immunoglobulins), with negative consequences on genic expression, protein synthesis and immune system functionality. The glycation indices include glycaemia, fruttosamine, glycated haemoglobin, basal and post prandial insulin levels.
Inflammaging indices: an increase in inflammatory processes leads to rising cytokines, “bad” eicosanoids and interleukins, quickening the aging process. These indices include the Omega-3 test or plasma fatty acids pattern.
Methylation indices: methylation is the main process which regulates genic expression and is involved also in apoptosis, with serious consequences on the development of tumours and on cardiovascular diseases. These indices include the dosage of homocysteine, folic acid, Vitamin B12, zinc.
Endocrine senescence indices: dhea-s, basal and post prandial cortisol, free and total testosterone, estrone, estradiol, progesterone, TSH, androstenedione.
Dismetabolic indices: serum cholesterol (including LDL), triglycerides, transaminase, gamma-GT, CPK, creatinine, blood urea nitrogen, blood count, electrolyte, serum protein electrophoresis, Vitamin D3, ferritin, erythrocyte sedimentation rate.
Besides these tests, there are also tests performed on saliva:
Distress profile: some saliva samples are taken at different times during the day. This is particularly useful in the evaluation of two hormones (cortisol and dhea) involved in the mechanism of stress, whose fluctuations may constitute an important hint of impaired adrenal function.
Quality sleep profile: some saliva samples are taken at different times in the evening, to evaluate quality of sleep based on melatonin and night cortisol secretion.
Physical performance profile: some saliva samples are taken before, during and after a sparring session, to evaluate the reaction of the body to physical activity.
Body mass examination
The body impedance assessment (BIA) analyses the composition of human body in terms of body fat, muscle mass and total body water.
This kind of assessment allows to calculate precisely the metabolic rate, hence to implement training and/or nutrition programmes that are really effective. The body mass examination includes BIA, anthropometric and skin-fold measurements, giving at last an indication of the ideal bodyweight.
The whole method, supported by a dedicated software, evaluates sequentially statural and weighing indices, the constitutional and somatic biotype, measurements of limbs, body fat and lean body mass, the ideal bodyweight, waist/hips and waist/thigh ratio.
This includes the analysis of the main fragment length polymorphisms, in order to evaluate potential effects of clinical relevance. A counselling service should be ideally set as appropriate in compliance with the relevant ethical and legal rules, to ensure the patient to be properly informed about positive or negative implications that have come out from the test.