A Test in Context: Lipid Profile, Fasting Versus Nonfasting
Open accessAbstract
Fasting for >8 h, as previously required for lipid profiles, normally only occurs a few hours before breakfast. By contrast, the nonfasting state predominates most of a 24-h cycle and better captures atherogenic lipoprotein levels. Plasma contains atherogenic lipoproteins of hepatic origin in the fasting state and additionally those of intestinal origin in the nonfasting state. Maximal mean changes for random, nonfasting versus fasting levels are +26 mg/dl for triglycerides, -8 mg/dl for total cholesterol, -8 mg/dl for low-density lipoprotein cholesterol, +8 mg/dl for remnant cholesterol, and -8 mg/dl for non-high-density lipoprotein cholesterol; lipoprotein(a), apolipoprotein B, and high-density lipoprotein cholesterol are largely unaffected. For patients, laboratories, and clinicians alike, nonfasting lipid profiles represent a simplification without negative implications for prognostic, diagnostic, and therapeutic options for cardiovascular disease prevention. Several societies' guidelines and statements in Denmark, the United Kingdom, Europe, Canada, Brazil, and the United States endorse nonfasting lipid profiles.
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Nonfasting lipid profiles can potentially be more relevant to the estimation of an individual's cardiovascular risk than fasting lipids since in real life the postprandial state predominates most of the 24-h cycle.
“Nonfasting lipid profiles, therefore, can potentially be more relevant to the estimation of an individual's cardiovascular risk than fasting lipids since in real life the postprandial state predominates most of our 24-h cycle [15,16].”
From Quantifying atherogenic lipoproteins for lipid-lowering strategies: Consensus-based recommendations from EAS and EFLM (2020) · cites this paper as [16]
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- Authors
- Nordestgaard, B. G.
- Affiliations
- University of Copenhagen (DK)
- Corresponding author
- Nordestgaard, Børge G.
- Venue
- Journal of the American College of Cardiology
- Publisher
- Elsevier BV
- Published
- 2017-09
- Volume
- 70
- Issue
- 13
- Pages
- 1637-1646
- ISSN
- 0735-1097 (ISSN-L)
- OpenAlex
- W2756375940
- Cited by
- 223
- References
- 58
- Citations by year
- 2026: 18 · 2025: 15 · 2024: 20 · 2023: 38 · 2022: 29 · 2021: 31 · 2020: 30 · 2019: 20 · 2018: 20 · 2017: 2
- FWCI
- 4.18
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of the American College of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Research at the University of Copenhagen (University of Copenhagen) (submittedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Lipid metabolism and disorders
- Keywords
- fasting lipid profile, atherogenic lipoproteins, triglycerides, remnant cholesterol, non-HDL cholesterol, lipoprotein(a), apolipoprotein B, cardiovascular risk assessment, cardiovascular disease prevention
- MeSH terms
- Cardiovascular Diseases, Fasting, Humans, Lipids, Reproducibility of Results, Dyslipidemias
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