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A Test in Context: Lipid Profile, Fasting Versus Nonfasting
Journal of the American College of Cardiology ( IF 24.0 ) Pub Date : 2017-09-01 , DOI: 10.1016/j.jacc.2017.08.006
Børge G. Nordestgaard

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.

中文翻译:

上下文测试:脂质特征,禁食与非禁食

禁食超过 8 小时,如之前的血脂要求,通常只发生在早餐前几个小时。相比之下,非禁食状态在 24 小时周期的大部分时间里占主导地位,并能更好地捕捉致动脉粥样硬化的脂蛋白水平。血浆含有在禁食状态下源自肝脏的致动脉粥样硬化脂蛋白,以及在非禁食状态下源自肠道的脂蛋白。随机、非空腹与空腹水平的最大平均变化为:甘油三酯 +26 mg/dl,总胆固醇 -8 mg/dl,低密度脂蛋白胆固醇 -8 mg/dl,残余胆固醇 +8 mg/dl,以及-8 毫克/分升非高密度脂蛋白胆固醇;脂蛋白 (a)、载脂蛋白 B 和高密度脂蛋白胆固醇在很大程度上不受影响。对于患者、实验室和临床医生,非空腹血脂谱代表了一种简化,对心血管疾病预防的预后、诊断和治疗选择没有负面影响。丹麦、英国、欧洲、加拿大、巴西和美国的几个学会的指南和声明都支持非空腹血脂。
更新日期:2017-09-01
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