Fasting is not necessary before lipid tests

A new analysis, published in JAMA Internal Medicine, adds to the evidence that nonfasting lipid measurements are as clinically useful as fasting measurements.

Nearly 8,300 adults at increased cardiovascular (CV) risk had fasting and nonfasting lipid levels measured 4 weeks apart. Participants' total, LDL, and HDL cholesterol levels showed "negligible" differences between their fasting and nonfasting samples, while triglycerides were "modestly higher" in nonfasting samples.

During a median 3 years' follow-up, some 210 major coronary events occurred. Nonfasting and fasting lipid levels were similarly associated with incident coronary events — a finding that persisted in a subanalysis of patients without prior vascular disease. Additionally, nonfasting and fasting levels showed high agreement in terms of classifying patients into CV risk categories.

The researchers say their findings "provide robust evidence and more impetus for physicians to more broadly adopt nonfasting measurement of lipid levels for routine practice, in a manner consistent with ... recent guideline recommendations."