Fasting is not routinely required for determination of a lipid profile : clinical and laboratory implications including flagging at desirable concentration cut-points : a joint consensus statement from the European Atherosclerosis Society and European Federation of Clinical Chemistry and Laboratory Medicine
| Autor: | Nordestgaard, B.G., Langsted, A., Mora, S., Kolovou, G., Baum, H., Bruckert, E., Watts, G.F., Sypniewska, G., Wiklund, O., Boren, J., Chapman, M.J., Cobbaert, C., Descamps, O.S., Eckardstein, A. von, Kamstrup, P.R., Pulkki, K., Kronenberg, F., Remaley, A.T., Rifai, N., Ros, E., Langlois, M., European Atherosclerosis Soc EAS, European Federation Clinical Chem |
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| Přispěvatelé: | University of Zurich, Nordestgaard, Børge G, School of Medicine / Clinical Medicine |
| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
Apolipoprotein B
ELEVATED LIPOPROTEIN(A) 030204 cardiovascular system & hematology ISCHEMIC-HEART-DISEASE chemistry.chemical_compound 0302 clinical medicine Risk Factors Normal values 540 Chemistry Medicine and Health Sciences 030212 general & internal medicine FAMILIAL HYPERCHOLESTEROLEMIA 10038 Institute of Clinical Chemistry GENERAL-POPULATION biology medicine.diagnostic_test Fasting Cardiovascular disease Lipids REMNANT CHOLESTEROL Stroke Cholesterol DENSITY-LIPOPROTEIN CHOLESTEROL Current Opinion Cardiovascular Diseases CARDIOVASCULAR-DISEASE Apolipoprotein A1 lipids (amino acids peptides and proteins) Cardiology and Cardiovascular Medicine medicine.medical_specialty Consensus Lipoproteins 610 Medicine & health 2705 Cardiology and Cardiovascular Medicine Reference values 03 medical and health sciences RISK-FACTOR Internal medicine Plasma lipids medicine Humans Triglycerides Lipid metabolism Atherosclerosis Lipid Metabolism Endocrinology NONFASTING TRIGLYCERIDES chemistry MYOCARDIAL-INFARCTION Chemistry Clinical European atherosclerosis society biology.protein Lipid profile Lipoprotein |
| Zdroj: | EUROPEAN HEART JOURNAL European Heart Journal, 37(25), 1944-1958. OXFORD UNIV PRESS European Heart Journal Scopus-Elsevier |
| ISSN: | 0195-668X 1522-9645 |
| Popis: | Aims To critically evaluate the clinical implications of the use of non-fasting rather than fasting lipid profiles and to provide guidance for the laboratory reporting of abnormal non-fasting or fasting lipid profiles. Methods and results Extensive observational data, in which random non-fasting lipid profiles have been compared with those determined under fasting conditions, indicate that the maximal mean changes at 1–6 h after habitual meals are not clinically significant [+0.3 mmol/L (26 mg/dL) for triglycerides; −0.2 mmol/L (8 mg/dL) for total cholesterol; −0.2 mmol/L (8 mg/dL) for LDL cholesterol; +0.2 mmol/L (8 mg/dL) for calculated remnant cholesterol; −0.2 mmol/L (8 mg/dL) for calculated non-HDL cholesterol]; concentrations of HDL cholesterol, apolipoprotein A1, apolipoprotein B, and lipoprotein(a) are not affected by fasting/non-fasting status. In addition, non-fasting and fasting concentrations vary similarly over time and are comparable in the prediction of cardiovascular disease. To improve patient compliance with lipid testing, we therefore recommend the routine use of non-fasting lipid profiles, while fasting sampling may be considered when non-fasting triglycerides >5 mmol/L (440 mg/dL). For non-fasting samples, laboratory reports should flag abnormal concentrations as triglycerides ≥2 mmol/L (175 mg/dL), total cholesterol ≥5 mmol/L (190 mg/dL), LDL cholesterol ≥3 mmol/L (115 mg/dL), calculated remnant cholesterol ≥0.9 mmol/L (35 mg/dL), calculated non-HDL cholesterol ≥3.9 mmol/L (150 mg/dL), HDL cholesterol ≤1 mmol/L (40 mg/dL), apolipoprotein A1 ≤1.25 g/L (125 mg/dL), apolipoprotein B ≥1.0 g/L (100 mg/dL), and lipoprotein(a) ≥50 mg/dL (80th percentile); for fasting samples, abnormal concentrations correspond to triglycerides ≥1.7 mmol/L (150 mg/dL). Life-threatening concentrations require separate referral when triglycerides >10 mmol/L (880 mg/dL) for the risk of pancreatitis, LDL cholesterol >13 mmol/L (500 mg/dL) for homozygous familial hypercholesterolaemia, LDL cholesterol >5 mmol/L (190 mg/dL) for heterozygous familial hypercholesterolaemia, and lipoprotein(a) >150 mg/dL (99th percentile) for very high cardiovascular risk. Conclusion We recommend that non-fasting blood samples be routinely used for the assessment of plasma lipid profiles. Laboratory reports should flag abnormal values on the basis of desirable concentration cut-points. Non-fasting and fasting measurements should be complementary but not mutually exclusive. published version peerReviewed |
| Databáze: | OpenAIRE |
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