In years past, clinicians would utilize fasting serum cholesterol, HDL-C, and triglyceride values to assess vascular disease risk. The lab would automatically calculate the LDL-C which provided the highest degree of specificity in regard to future cardiac and vascular risk.
Recently, researches reviewed the findings of 68 long term studies (mainly North America and Europe) looking at approximately 300,000. patients with a mean follow-up period of 6 years to determine if non-fasting lipid profiles could provide similar, reliable, results. Their research did indicate that subtracting the non-fasting HDL from the total cholesterol would indeed yield a similar non-HDL cholesterol (similar to LDL-C) to that of the fasting results.
Coronary disease is associated with elevated levels of non-HDL and LDL-C and is a good marker for those post-treatment cardiac patients to determine progression of the disease. Triglycerides, fasting or not, are not a valuable marker in evalating cardiac or ischemic stroke tendencies.
This is a valuable tool for many clinicians given the difficulty in obtaining fasting labs on their patients, and an obvious benefit to patients who have had endure a 14 hour fast for an office visit that always seems to fall late in the day!
UW Term Du Jour:
HDL-C : high-density lipoprotein cholesterol
LDL-C : low-density lipoprotein cholesterol
non-HDL: value similar to LDL-C by subtracting a non-fasting HDL value from total cholesterol
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