Dr. James D. Otvos, professor of biochemistry and chief scientific officer of LipoMed Inc. of Raleigh, has received the 1999 Christopher Columbus Foundation Award for his invention of a diagnostic blood test that improves a doctor's ability to assess a patient's risk of heart disease by distinguishing between high-risk and low-risk forms of cholesterol.

The award, which carries a $100,000 prize, was presented to Otvos at the 1999 Discover Magazine Awards for Technological Innovation, an annual ceremony held June 5 at Walt Disney World. Otvos developed a method using nuclear magnetic resonance (NMR) technology to measure human lipoproteins — the first method to allow direct measurement of the various lipoprotein particles that determine heart disease risk. Called the NMR LipoProfile, the test can analyze the chemicals in a patient's blood sample in less than one minute and distinguish the low-risk and high-risk forms of cholesterol found there. Previous test methods typically required several days to produce equivalent information.

Almost half of all people who develop heart disease have "normal" cholesterol levels, while others with an unhealthy cholesterol profile remain disease-free. Using the NMR LipoProfile, doctors should now be able to make more accurate diagnoses of which patients are truly at risk.

The NMR technology improves the assessment of heart disease in just the same way that magnetic resonance imaging (MRI) improves a radiologist's ability to make a diagnosis — by giving a clearer picture — of a person's lipoprotein make-up. The size of lipoprotein particles — not just the number of particles — is a critical factor in heart disease risk, said Otvos.

Lipoproteins are complexes of fat joined with protein. They transport cholesterol in the bloodstream and may be high-density (HDL), low-density (LDL) or very low-density.

Otvos explained that, previously, risk assessment had been strictly a cholesterol story, since measuring the amount of cholesterol in LDL and HDL was the most convenient way of telling how many LDL and HDL particles are in a person's blood. For this reason, the terms good cholesterol and bad cholesterol came to be used to describe the levels of LDL and HDL.

However, scientists now know that LDL and HDL are composed of distinct particle subclasses, and these are not all equally "bad" or "good." According to Otvos, two individuals with the same LDL and HDL cholesterol levels might be at very different risk of heart disease because their lipoprotein subclass levels are different. Within the "good" HDL is a subclass of relatively small particles that are actually "bad" — or positively associated with heart disease.

Thus the new technology can be a tool to revolutionize how physicians characterize and monitor the influence of lipoproteins on human health, with the promise of improved health risk management. As physicians make use of more sophisticated technology for measuring blood lipoproteins, they will be able to refine their choices for drug, diet and exercise therapies for patients.

The Columbus Foundation Award is presented by the Christopher Columbus Fellowship Foundation, an independent government agency whose mission is to encourage and support research, study and labor designed to produce new discoveries for the benefit of mankind.