Impact of fasting on lipid profile assessment of Brazilian adults

TL;DR

Fasting affects lipid profile results, with non-fasting states showing higher rates of dyslipidemia in Brazilian adults.

Contribution

This study quantifies how fasting status influences dyslipidemia diagnosis in adults.

Findings

Non-fasting states increased prevalence of low HDL-c and hypertriglyceridemia.

Triglyceride levels rose and LDL-c slightly decreased in non-fasting states.

Removing fasting requirements could improve cardiovascular risk detection.

Abstract

Dyslipidemia is a common cardiovascular risk factor, with ongoing debate over
whether lipid profile assessment, with or without fasting, affects the
accuracy of cardiovascular risk evaluation. The objective of this study is
to evaluate the effect of fasting status on lipid profile values and the
prevalence of dyslipidemia.

A total of 269 adults (20-69 years) from Vitória-ES (Brazil) were
included. Two blood samples were collected on the same day: one in the
morning after a 10-12-hour fast and the other in the afternoon, post-lunch
(1-5 pm). Dyslipidemias were classified according to the Brazilian
Guidelines.

The percentage of participants classified with low HDL-c (male: 54.2 vs.
38.2%, p < 0.001; female: 29.7 vs. 15.2%, p < 0.001) and
hypertriglyceridemia (male: 59.5 vs. 26.7%, p < 0.001; female: 50.0 vs.
22.5%, p < 0.001) was higher in the non-fasting state. Furthermore, HDL-c
levels were higher in after fasting. Triglyceride levels were higher in the
non-fasting state, while LDL-c concentrations were slightly reduced in the
non-fasting state. Without fasting, 85 individuals previously classified as
having normal TG were reclassified as having hypertriglyceridemia, and 41
individuals previously classified as having normal HDL-c were reclassified
as having low HDL-c.

The feeding state is key to detecting and managing dyslipidemias, especially
hypertriglyceridemia and low HDL-c. Removing the fasting requirement could
improve cardiovascular risk identification, increase patient adherence to
testing and treatment. However, the significant differences in the lipid
profile concentrations must be considered in the patient’s management in the
clinical practice.

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