A Test in Context: Lipid Profile, Fasting Versus Nonfasting

63 Citations (Scopus)

Abstract

Fasting for >8 h, as previously required for lipid profiles, normally only occurs a few hours before breakfast. By contrast, the nonfasting state predominates most of a 24-h cycle and better captures atherogenic lipoprotein levels. Plasma contains atherogenic lipoproteins of hepatic origin in the fasting state and additionally those of intestinal origin in the nonfasting state. Maximal mean changes for random, nonfasting versus fasting levels are +26 mg/dl for triglycerides, -8 mg/dl for total cholesterol, -8 mg/dl for low-density lipoprotein cholesterol, +8 mg/dl for remnant cholesterol, and -8 mg/dl for non-high-density lipoprotein cholesterol; lipoprotein(a), apolipoprotein B, and high-density lipoprotein cholesterol are largely unaffected. For patients, laboratories, and clinicians alike, nonfasting lipid profiles represent a simplification without negative implications for prognostic, diagnostic, and therapeutic options for cardiovascular disease prevention. Several societies' guidelines and statements in Denmark, the United Kingdom, Europe, Canada, Brazil, and the United States endorse nonfasting lipid profiles.

Original languageEnglish
JournalJournal of the American College of Cardiology
Volume70
Issue number13
Pages (from-to)1637-1646
Number of pages10
ISSN0735-1097
DOIs
Publication statusPublished - 26 Sept 2017

Keywords

  • Cardiovascular Diseases
  • Dyslipidemias
  • Fasting
  • Humans
  • Lipids
  • Reproducibility of Results
  • Journal Article
  • Review

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