What is the Difference Between Fasting and Nonfasting Cholesterol?

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The main difference between fasting and nonfasting cholesterol lies in the convenience and accuracy of the test results. Nonfasting cholesterol tests are more convenient for patients and provide accurate predictions of cardiovascular risk. Here are some key points regarding fasting and nonfasting cholesterol:

  • Nonfasting samples are more convenient for patients and have no appreciable difference compared to fasting results for total cholesterol or high-density lipoprotein cholesterol.
  • Nonfasting low-density lipoprotein cholesterol (LDL-C) has been shown to be a good predictor of cardiovascular risk in numerous clinical trials.
  • The Canadian Cardiovascular Society and the College of Family Physicians of Canada recommend nonfasting testing for baseline and follow-up complete lipid profiles, including LDL cholesterol and triglycerides.
  • Remnant cholesterol levels, which are associated with an increased risk of coronary heart disease, do not differ significantly between fasting and nonfasting tests.
  • Fasting lipid levels correlate well with nonfasting lipid levels, with similar linear correlations observed between the two methods.

In summary, nonfasting cholesterol tests are more convenient and provide accurate predictions of cardiovascular risk compared to fasting tests. They have been recommended by the Canadian Cardiovascular Society and the College of Family Physicians of Canada for baseline and follow-up testing.

Comparative Table: Fasting vs Nonfasting Cholesterol

The difference between fasting and nonfasting cholesterol levels is not significant, and both methods are acceptable for assessing cardiovascular risk. According to a study, nonfasting total cholesterol and high-density lipoprotein cholesterol are sufficient for most cardiovascular risk assessments. In fact, nonfasting lipids are more convenient for patients, and there is no appreciable difference between fasting and nonfasting results for total cholesterol.

Here is a table comparing fasting and nonfasting lipid levels:

Lipid Level Fasting Nonfasting Difference
Direct LDL-C 2.81 2.88 -0.07
Remnant cholesterol 0.34 0.40 0.06
Non-HDL-C 3.01 2.96 0.05
Calculated LDL-C 2.38 2.29 -0.10

In another study, it was found that among patients with LDL cholesterol less than 70 mg/dL, 19% of fasting and 30% of nonfasting patients had ≥10 mg/dL differences between LDL cholesterol levels. However, the overall risk association with coronary events was not significantly different between fasting and nonfasting lipid levels.