Friday, November 16, 2012

Blood Lipids: to fast or not to fast?

A new study published in JAMA weighs the pros and cons of performing fasting lipid profiles. According to the study, it is not necessary to fast because the variance in levels is not extreme enough to warrant the hassle. While total and HDL ticked only 2% higher, LDL was 10% higher, and triglycerides were 20% higher without fasting.

The skeptic in us sees more opportunity to put people on statins. For example, if a patient does not fast and tests 5% above normal levels, he or she becomes a candidate for life long statin therapy. If the patient had fasted, there level would have come 5% below high, and they would not be considered a candidate for statins. This is extremely significant given that the benchmarks for statin medication has continued to trend downward. 

In addition, with many experts believing that triglycerides are as much or more important than cholesterol, non fasting lipids is not ideal because it does not produce an accurate result. With non fasting triglycerides, a patient who may have consumed high refined carbs before the blood draw could have abnormally high triglycerides, whereas if they fasted, the triglycerides would be much more accurate.

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