Fasting Unnecessary Before Routine Lipid Testing

Fasting for routine lipid testing may be unnecessary. A large community-based study published in the Archives of Internal Medicine on Dec. 10 contributes to a growing body of literature demonstrating minimal differences between fasting and nonfasting mean cholesterol levels, leading many experts to say that nonfasting blood draws may be used for cardiovascular risk assessment and therapeutic decisionmaking. Laboratory data from 209,180 individuals (111,048 females and 98,132 males) seen by Calgary Laboratory Services over a six-month period were analyzed. A 2011 policy change permitted the laboratory to process patient samples for fasting lipid levels regardless of the duration of the fasting time as long as the patient-reported fasting time (in hours) was recorded. High-density lipoprotein (HDL) cholesterol and triglyceride levels were measured directly, while low-density lipoprotein (LDL) cholesterol levels were estimated. For total cholesterol and HDL cholesterol mean levels varied by less than 2 percent across various fasting times. Triglyceride levels varied by less than 20 percent and the calculated LDL cholesterol varied by less than 10 percent. “Most of the reasons that we measure a lipid profile depend on total and HDL cholesterol levels for most of our decision making. The incremental gain in information of a fasting profile […]