Most people getting their cholesterol checked may not need to fast
beforehand, a new Canadian study suggests. Researchers found the blood tests
showed similar average total cholesterol and "good" HDL cholesterol
readings, in particular, regardless of whether patients had eaten recently or
avoided food for more than eight hours, as is typically recommended.
A pharmacist takes a bottle of cholesterol-reduction medication while filling prescriptions at a community health center (John Moore/Getty Images / November 12, 2012)
Eliminating the fasting requirement before cholesterol tests would be
more convenient for patients and for labs, which often get slammed with tests
in the morning when most fasting patients come in, researchers said. "There
are logistic challenges when you're going to get a fasting sample on
everybody," said Dr. J. Michael Gaziano, who wrote a commentary
accompanying the new study.
"It makes long lines and it makes long waiting times, and if that
in any way discourages patients from having these tests done, then that's
another downside," Gaziano, a preventive cardiologist at VA Boston
Healthcare System and Brigham and Women's Hospital, told Reuters Health.
Requiring a fasting cholesterol test may also mean patients have to
return for lab work after their initial appointment - and some may not come
back, Gaziano pointed out. For the new study, Dr. Davinder Sidhu and Dr.
Christopher Naugler from the University of Calgary in Alberta analyzed
cholesterol test results for more than 200,000 people who had most recently
eaten anywhere from less than one hour to more than 16 hours earlier.
They calculated the average cholesterol levels at a given fasting time
and found that both total cholesterol and HDL varied by less than two percent
across the range of fasting durations. Those numbers are typically the ones
doctors use to help calculate patients' risk of heart problems and whether they
should be on cholesterol-lowering statins.
"Bad" LDL cholesterol, on the other hand, varied by closer to
10 percent, and triglycerides by up to 20 percent, in relation to fasting time,
the researchers reported Monday in the Archives of Internal Medicine. That
suggests certain patients - such as those with high triglycerides or with
diabetes, which is linked to triglyceride and LDL levels - should continue to
fast before the tests. But that's the minority of people who have cholesterol
checks done. For most, a non-fasting test would be "a reasonable
alternative," the researchers reported.
Gaziano said patients can discuss with their doctors whether they really
need to fast before their own cholesterol test, but it may take a while for
non-fasting tests to become the norm. Participants in Sidhu and Naugler's study
were an average of 53 years old with an average total cholesterol of 183 milligrams
per deciliter (mg/dL).
Another commentary printed alongside the study noted that this is a
relatively low-risk group, and fasting and non-fasting results may not be as
similar for people with much higher cholesterol, for example. Total cholesterol
less than 200 mg/dL is considered "desirable" by the American Heart
Association.
Source: Chicago Tribune
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