Compatibility between an overnight fasting and random cholesterol tests in Asians

Area of Science:

• Endocrinology and Metabolism
• Cardiovascular Disease Management
• Clinical Biochemistry

Background:

• Western guidelines advocate for non-fasting lipid profiles for dyslipidemia management.
• The applicability of non-fasting lipid profiles in diverse Asian populations, particularly those with type-2 diabetes mellitus (T2DM), requires investigation.

Purpose of the Study:

• To evaluate the concordance between fasting and non-fasting lipid profiles in a multi-ethnic Asian population with T2DM in Singapore.
• To determine if non-fasting lipid profiles can reliably assess cholesterol treatment status in this demographic.

Main Methods:

• A study involving 470 multi-ethnic Asian adult patients with T2DM and dyslipidemia from two primary care clinics in Singapore.
• Comparison of lipid profiles from non-fasting blood specimens (collected within 6 hours of last meal) and fasting specimens (collected within 14 days).
• Intraclass correlation coefficient (ICC) used to assess the agreement between fasting and non-fasting lipid measurements.

Main Results:

• Mean differences between non-fasting and fasting lipid levels were minimal for Total Cholesterol (TC), High-Density Lipoprotein Cholesterol (HDL-C), and Non-HDL-C.
• Intraclass correlation coefficients (ICCs) indicated good to excellent agreement for TC (0.820), HDL-C (0.873), LDL-C (0.764), and Non-HDL-C (0.825).
• Triglyceride (TG) levels showed moderate agreement (ICC: 0.579), with a mean difference of +0.48 mmol/l.

Conclusions:

• Fasting and non-fasting lipid profiles demonstrate good similarity in local Asian patients with T2DM who are undergoing statin therapy.
• Non-fasting lipid profiles are a viable option for assessing cholesterol treatment status in this patient group.
• These findings support the adoption of non-fasting lipid profiles in clinical practice for managing dyslipidemia in Asian T2DM patients.