Compatibility between an overnight fasting and random cholesterol tests in Asians

Recent Western guidelines recommend non-fasting lipid profiles to manage dyslipidaemia. We explored its applicability to an Asian population. We determined the differences between an overnight fasting and non-fasting cholesterol profiles of patients with type-2 diabetes mellitus (T2DM) in Singapore. We studied 470 multi-ethnic Asian adult patients with T2DM and dyslipidaemia from 2 primary care clinics in Singapore. Non-fasting blood specimens were collected within 6 h after their last meal and within 14 days of a fasting specimen. The intraclass correlation coefficient (ICC) was used to compare the intraindividual lipid profiles. An ICC value > 0.75 implies good correlation. The mean age and T2DM duration of the study population were 62.5 years and 9.8 years respectively. Their mean non-fasting period was 2.46 h. The mean differences between non-fasting and fasting total cholesterol (TC), high-density lipoprotein (HDL-C), triglyceride (TG), low-density lipoprotein (LDL-C), and non HDL-C were + 0.04 mmol/l, - 0.001 mmol/l, + 0.48 mmol/l, - 0.15 mmol/l, and - 0.05 mmol/l respectively. The ICC (95% CI) for TC, HDL-C, TG, LDL-C and non-HDL-C were 0.820 (0.788-0.847), 0.873 (0.850-0.893), 0.579 (0.516-0.636), 0.764 (0.723-0.799), and 0.825 (0.794-0.852) respectively. The fasting and non-fasting lipid profiles were similar in our local Asian patients with T2DM taking statin. Their non-fasting lipid profile can be used to assess their cholesterol treatment status.