However, recent evidence has shown that nonfasting lipid testing is more suitable, and nonfasting testing for baseline and follow-up complete lipid profiles, including low-density–lipoprotein (LDL) cholesterol and triglycerides, is now recommended by the Canadian Cardiovascular Society 2 and the College of Family Physicians of Canada 3 guidelines for lipid testing. Physicians and patients are used to having lipid profiles measured when the patient has fasted because of the assumption that fasting lipid profiles avoid substantial variability in the results caused by eating. Hypercholesterolemia is the strongest modifiable risk factor for coronary heart disease, 1 and measurement of plasma lipid levels is an integral part of overall cardiovascular risk assessment. Removing the need to have the patient fast for testing of lipid profiles increases the convenience, safety, and timeliness of screening and follow-up testing, is appreciated by patients and may entirely remove the need for fasting prior to testing.
Nonfasting testing for baseline and follow-up complete lipid profiles, including LDL cholesterol and triglycerides, is recommended by the Canadian Cardiovascular Society and the College of Family Physicians of Canada guidelines for lipids.
Use of non-HDL cholesterol in a nonfasting plasma sample captures the atherogenic effect of remnant lipoproteins and is a better indicator of cardiovascular risk than LDL cholesterol. Large population studies have shown that total cholesterol and high-density–lipoprotein (HDL) cholesterol do not vary and low-density–lipoprotein (LDL) cholesterol and triglycerides vary slightly after eating.
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