PRO GLP & Cardio Panel
Metabolic, Cardiovascular, Liver, and Kidney Monitoring for Weight Management and GLP-1 Care
PRO Sports Medicine Learning Center
Introduction
Successful weight management is about much more than the number on the scale. When body weight changes, so do blood sugar regulation, insulin production, cholesterol particles, liver fat, kidney filtration, and inflammation. Some of these changes are the goal of treatment. Others are things we want to watch carefully along the way.
The PRO GLP & Cardio Panel is built for exactly that purpose. It reports 25 biomarkers, including measured and calculated values, from a single EasyDraw at-home collection device. It is designed for patients using GLP-1 based medications such as semaglutide or tirzepatide, patients in a medically supervised weight-loss program, and anyone focused on improving metabolic and cardiovascular health.
What the Panel Measures
Cardiovascular and cholesterol health: total cholesterol, HDL, LDL, triglycerides, apolipoprotein B (ApoB), VLDL (calculated), an LDL-to-HDL ratio, an LDL-to-ApoB ratio, and a triglyceride-to-HDL ratio (all calculated).
Blood sugar and metabolic health: hemoglobin A1c (HbA1c), C-peptide, and estimated average glucose (eAG, calculated).
Liver health: ALT, AST, GGT, alkaline phosphatase (ALP), and the AST-to-ALT ratio (calculated).
Kidney function: creatinine, blood urea nitrogen (BUN), the BUN-to-creatinine ratio (calculated), and estimated glomerular filtration rate (eGFR, calculated).
Inflammation and thyroid: hsCRP and TSH.
Additional chemistry: direct bilirubin and total protein.
Lipids and ApoB
The lipid section matches the PRO Core Health Panel and is explained in detail in that chapter. In weight-management care, a few patterns are especially relevant. Triglycerides often fall early as carbohydrate intake, alcohol, and insulin resistance improve. HDL may dip during active weight loss and recover once weight stabilizes. LDL cholesterol can rise temporarily in some people during rapid fat loss or very-low-carbohydrate eating. ApoB helps sort out what those changes mean, because it counts the atherogenic particles directly. See the PRO Core Health Panel for a full explanation of each lipid marker.
Hemoglobin A1c and Estimated Average Glucose
HbA1c reflects average blood sugar over roughly the past two to three months. It is one of the most useful markers to follow during GLP-1 care because these medications act directly on glucose regulation, and improvements often appear within a few months. Commonly cited categories are below 5.7% within the normal range, 5.7% to 6.4% elevated, and 6.5% or higher requiring medical evaluation.
Estimated average glucose (eAG) is calculated from HbA1c and expressed in mg/dL, the same unit used by glucose meters. An HbA1c of about 5.7%, for example, corresponds to an eAG of roughly 117 mg/dL. It adds no new information, but it makes HbA1c easier to picture.
C-Peptide
When the pancreas makes insulin, it releases an equal amount of C-peptide. Unlike insulin, C-peptide is cleared slowly and is not removed by the liver on first pass, so it is a steadier reflection of how much insulin your body is producing.
In metabolic care, C-peptide helps answer a key question: is the pancreas working overtime to keep glucose normal? A high C-peptide alongside normal glucose suggests insulin resistance, where tissues need more insulin to do the same job. Over time, effective weight management often reduces the insulin demand. C-peptide is strongly influenced by recent food intake, so collection timing, ideally fasting, matters for interpretation. It is also affected by kidney function, since the kidneys clear it.
Liver Markers
The liver is central to weight management. Excess body fat, insulin resistance, and alcohol can all lead to fat accumulating in liver cells, a condition now called metabolic dysfunction-associated steatotic liver disease (MASLD). It is common and often silent.
ALT (alanine aminotransferase) is an enzyme found mainly in liver cells. Mild ALT elevations are a common clue to liver fat. Intense exercise, some medications, and some supplements can also raise it.
AST (aspartate aminotransferase) is found in liver, muscle, and heart. Hard resistance training can raise AST for several days, which is important for athletes to know.
AST-to-ALT ratio (sometimes called the De Ritis ratio) compares AST with ALT. The pattern can help a provider decide whether a liver enzyme elevation is more likely related to fat, alcohol, muscle, or another cause.
GGT (gamma-glutamyl transferase) is a sensitive enzyme that rises with alcohol use, bile-flow problems, and fatty liver. It is also linked with metabolic risk.
ALP (alkaline phosphatase) comes from the liver and bone. It can rise with bile-duct issues, bone growth or remodeling, and certain conditions.
Direct bilirubin is the processed form of bilirubin that the liver sends into bile. A raised direct bilirubin points toward bile-flow issues. This matters during rapid weight loss, which is known to increase the risk of gallstones, a concern that has also been noted with GLP-1 medications.
Total protein reflects albumin plus globulins and gives broad context about nutrition, liver synthesis, and immune proteins. Adequate protein intake is a central focus in GLP-1 programs, because appetite falls and muscle needs to be protected.
Kidney Markers
Creatinine is a waste product of muscle metabolism cleared by the kidneys. Higher muscle mass, creatine supplements, and large meat meals can raise it without any kidney problem.
BUN (blood urea nitrogen) reflects protein breakdown and hydration as well as kidney filtration. Dehydration and high protein intake raise BUN.
BUN-to-creatinine ratio compares the two kidney markers and can help a provider distinguish dehydration from other causes of abnormal values.
eGFR is calculated from creatinine, age, and sex to estimate how well the kidneys filter blood. Values of 60 or higher are generally considered within the normal range for most adults, with lower values requiring evaluation over time.
Kidney monitoring is especially relevant during GLP-1 care. Nausea, vomiting, diarrhea, or reduced fluid intake can cause dehydration, which can temporarily affect kidney markers.
hsCRP and TSH
hsCRP reflects low-grade systemic inflammation. Excess visceral fat produces inflammatory signals, and hsCRP commonly improves as body composition improves. Values below 1 mg/L are commonly considered lower cardiovascular risk and above 3 mg/L higher risk.
TSH screens thyroid function. Thyroid dysfunction can contribute to weight gain, fatigue, and a weight-loss plateau, so it is a standard part of evaluating weight concerns. Some GLP-1 medications also carry specific thyroid-related warnings, which your provider will review with you separately.
Who the Panel Is For
Patients using or considering semaglutide, tirzepatide, or another GLP-based medication
Anyone in a medically supervised weight-management program
People concerned about insulin resistance or blood sugar regulation
Adults wanting a deeper cardiovascular picture, including ApoB
Patients who need liver and kidney monitoring during nutrition or medication changes
How to Prepare
Follow the kit instructions exactly.
Fast for 8 to 12 hours beforehand unless your provider advises otherwise; water is allowed and encouraged. A morning, fasted sample gives the most consistent triglyceride and C-peptide results.
Stay well hydrated in the day before collection, especially if you have had GI side effects.
Avoid heavy resistance training for one to two days before, because it can raise AST and creatinine.
Note any recent illness, which can raise hsCRP.
Tell your provider about all supplements, including creatine and biotin.
How Your Results Are Reviewed
A PRO Sports Medicine provider reviews your results in context. That may include interpreting abnormal values, assessing cardiovascular and cholesterol risk, evaluating glucose regulation, reviewing liver and kidney markers, discussing nutrition and hydration, discussing GLP medication management when clinically appropriate, and recommending follow-up testing. Clinical review is included for active PRO Foundations members.
How It Fits PRO Care
The GLP & Cardio Panel works best as a series: once at baseline and then at intervals your provider recommends. Paired with body composition tracking through PRO Foundations, it shows whether weight lost is coming mainly from fat while lean mass is protected, and whether metabolic and cardiovascular markers are improving. For the science of preserving muscle during weight loss, see Body Composition & Sarcopenia. For broader metabolic signaling, see Nutrient Sensing. Patients also on hormone therapy may prefer the PRO GLP + HRT Monitoring Panel.
Order the PRO GLP & Cardio Panel
Important Information
This article is educational and is not medical advice. The GLP & Cardio Panel provides information for clinical assessment and monitoring. It does not diagnose conditions or establish medication safety on its own. Reference ranges here are general context only. Testing frequency and medication decisions are individualized by a licensed PRO Sports Medicine provider.
Key References
Grundy SM, Stone NJ, Bailey AL, et al. 2018 AHA/ACC Multisociety Guideline on the Management of Blood Cholesterol. Circulation. 2019.
Sniderman AD, Thanassoulis G, Glavinovic T, et al. Apolipoprotein B Particles and Cardiovascular Disease: A Narrative Review. JAMA Cardiol. 2019.
American Diabetes Association Professional Practice Committee. Diagnosis and Classification of Diabetes: Standards of Care in Diabetes. Diabetes Care (updated annually).
Rinella ME, Lazarus JV, Ratziu V, et al. A Multisociety Delphi Consensus Statement on New Fatty Liver Disease Nomenclature. Hepatology. 2023.
Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO 2012 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Kidney Int Suppl. 2013.
Clinical Perspective
GLP-1 based medications have changed weight management, but they are most effective, and safest, inside a monitored program. The GLP & Cardio Panel pairs the markers that should improve, such as HbA1c, triglycerides, ApoB, and hsCRP, with the markers that deserve watching, such as liver enzymes, bilirubin, and kidney function. Interpreted alongside body composition and protein intake, it helps confirm that weight loss is translating into real metabolic health.