Fasting time and lipid parameters: association with hepatic steatosis — data from a random population sample

Abstract

BackgroundCurrent guidelines recommend measuring plasma lipids in fasting patients. Recent studies, however, suggest that variation in plasma lipid concentrations secondary to fasting time may be minimal. Objective of the present study was to investigate the impact of fasting time on plasma lipid concentrations (total cholesterol, HDL and LDL cholesterol, triglycerides). A second objective was to determine the effect of non-alcoholic fatty liver disease exerted on the above-mentioned lipid levels.MethodSubjects participating in a population-based cross-sectional study (2,445 subjects; 51.7% females) were questioned at time of phlebotomy regarding duration of pre-phlebotomy fasting. Total cholesterol, LDL and HDL cholesterol, and triglycerides were determined and correlated with length of fasting. An upper abdominal ultrasonographic examination was performed and body-mass index (BMI) and waist-to-hip ratio (WHR) were calculated. Subjects were divided into three groups based on their reported fasting periods of 1–4 h, 4–8 h and > 8 h. After application of the exclusion criteria, a total of 1,195 subjects (52.4% females) were included in the study collective. The Kruskal-Wallis test was used for continuous variables and the chi-square test for categorical variables. The effects of age, BMI, WHR, alcohol consumption, fasting time and hepatic steatosis on the respective lipid variables were analyzed using multivariate logistic regression.ResultsAt multivariate analysis, fasting time was associated with elevated triglycerides (p = 0.0047 for 1–4 h and p = 0.0147 for 4–8 h among females; p < 0.0001 for 1–4 h and p = 0.0002 for 4–8 h among males) and reduced LDL cholesterol levels (p = 0.0003 for 1–4 h and p = 0.0327 for 4–8 h among males). Among males, hepatic steatosis represents an independent factor affecting elevated total cholesterol (p = 0.0278) and triglyceride concentrations (p = 0.0002).ConclusionTotal and HDL cholesterol concentrations are subject to slight variations in relation to the duration of the pre-phlebotomy fasting period. LDL cholesterol and triglycerides exhibit highly significant variability; the greatest impact is seen with the triglycerides. Fasting time represents an independent factor for reduced LDL cholesterol and elevated triglyceride concentrations. There is a close association between elevated lipids and hepatic steatosis.

Psoriasis and cardiovascular disease risk factors: the HUNT Study, Norway

“…Blood samples were drawn in a non-fasting state, and triglycerides are known to be sensitive to food intake, whereas total cholesterol and HDL are less influenced. 33,34 However, excluding participants who reported eating within the past 2 h did not influence the results. In addition, we had no information on the use of lipid lowering drugs and cannot rule out that the results are influenced by this.…”

“…Strength of our study is the use of standardized objective measures of cardiovascular disease risk factors, which reduces measurement error and possible misclassification. Blood samples were drawn in a non‐fasting state, and triglycerides are known to be sensitive to food intake, whereas total cholesterol and HDL are less influenced . However, excluding participants who reported eating within the past 2 h did not influence the results.…”

Metabolic syndrome and risk of incident psoriasis: prospective data from the HUNT Study, Norway

“…Another limitation of our study is the nonfasting state of the blood sampling. However, while glucose and triglycerides are known to be sensitive to food intake, HDL and total cholesterol are less influenced . Sensitivity analyses excluding individuals who had eaten in the last 2 h did not change the results for triglycerides and HDL cholesterol, but lack of information on lipid‐lowering drugs could potentially also have influenced the results.…”

Postprandial Lipid Concentrations and Daytime Biological Variation of Lipids in a Healthy Chinese Population

“…The change in postprandial TG concentration was highest at 12:00, while other lipid parameters were slightly decreased in most subjects, consistent with previous reports [ 22 ]. The mean change in the maximum fasting and postprandial TG concentration was 0.3–0.5 mmol/L following normal food intake [ 22 23 24 ]. However, studies that included oral fat tolerance tests in their protocol reported mean changes of 1.06–1.6 mmol/L [ 8 25 ].…”