Fasting No Longer Necessary for Cholesterol Testing?

Until now, nurse practitioners have been taught that patients must fast before cholesterol testing to obtain accurate results.  New research debunks this teaching showing fasting before cholesterol testing may not be as important as once thought- great news for patients who come to your clinic disgruntled and famished as a result of skipping breakfast.

How Much Does Fasting Affect Cholesterol Readings?

Canadian researchers recently compared cholesterol test results of over 200,000 individuals who had eaten at varying intervals prior to their cholesterol lab draws making an interesting discovery.  HDL levels among the various fasting durations varied by less than two percent.  This shows fasting minimally effects HDL results.

Fasting affects LDL and triglyceride levels just slightly more.  LDL levels among the fasting durations varied by about 10 percent.  Triglyceride levels were affected 20 percent by fasting duration.

Which Patients Should Fast Before Getting Cholesterol Checked?

It looks like fasting prior to cholesterol testing is not as important as we originally thought.  In your otherwise healthy patients, drawing non-fasting cholesterols levels will give you a pretty accurate indication of their cholesterol status.  However, in patients with diagnosed hyperlipidemia or  with other risk factors you may consider continuing to use fasting cholesterol readings as they remain the most accurate, especially in assessing triglycerides.

How Will This Research Help Your Practice?

NP's all have patients who hate coming in for visits.  Maybe they are dragged in once a year for a physical by their significant other, or they have an unconventional work schedule making it more difficult to schedule a morning visit for a fasting cholesterol test.  Based on this research, you can check cholesterol levels on these types of patients without requiring them to fast.  This prevents multiple trips to the clinic and will result in higher numbers of your patients getting tested for hyperlipidemia. 

As long as you are OK with some slight inaccuracy in LDL and triglyceride readings, non-fasting cholesterol checks can be used in your clinic.