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Hemodilution is not the only reason of difference: Comparison of fasting and non-fasting lipoproteins in paired

Betül Özbek İpteç1, Ahmet Rıfat Balik1, Selcen Yüksel2

  • 1Ankara Yıldırım Beyazıt University, Department of Medical Biochemistry, Ankara, Turkey.

Clinical Biochemistry
|August 29, 2018
PubMed

Insights

Fasting and non-fasting LDL cholesterol levels differ significantly, even after adjusting for hemodilution. Non-fasting LDL and non-HDL cholesterol measurements cannot replace fasting values for cardiovascular disease risk assessment.

Area of Science:

  • Cardiovascular Medicine
  • Clinical Chemistry
  • Biochemistry

Background:

  • Low-density lipoprotein cholesterol (LDL) is a key cardiovascular disease (CVD) risk factor, typically measured after fasting.
  • Emerging evidence suggests non-fasting LDL may be a superior CVD and atherosclerosis predictor.
  • Previous studies proposed nutrition has minimal impact, attributing differences to hemodilution, correctable by adjustments.

Purpose of the Study:

  • To compare fasting and non-fasting LDL cholesterol levels in the same individuals.
  • To determine if non-fasting LDL results can substitute for fasting values, with or without hemodilution correction.
  • To evaluate the clinical implications for CVD risk stratification.

Main Methods:

  • Collected fasting and non-fasting blood samples from 248 healthy participants.
  • Analyzed lipid profiles, albumin, and hemoglobin.
  • Applied seven models to correct for potential hemodilution effects.
  • Assessed risk group concordance using National Cholesterol Education Program criteria.

Main Results:

  • Significant differences observed between fasting and non-fasting LDL and non-HDL cholesterol across all models (p < 0.001).
  • Concordance for LDL risk groups was 63.8%; for non-HDL risk groups, it was 77.9%.
  • Hemodilution correction did not align fasting and non-fasting values.

Conclusions:

  • Fasting and non-fasting LDL and non-HDL cholesterol concentrations are not interchangeable.
  • Adjustments for hemodilution do not resolve discrepancies between fasting and non-fasting measurements.
  • Current risk stratification protocols based on fasting LDL may require re-evaluation.
Abstract

Keywords:
Cardiovascular riskFastingLow-density lipoprotein cholesterol (LDL)Non-fastingNon-high density lipoprotein cholesterol (non-HDL)

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