Key result
Postprandial fat loading increases triglycerides ~3-fold, substantially worsening calculated LDL-C accuracy above 2.0 mmol/L.
Why the study?
Non-fasting lipid testing is increasingly used in clinical practice, but postprandial triglyceride-rich lipoproteins may affect calculated LDL-C, prompting evaluation of triglyceride-dependent discordance among routine LDL-C reporting methods during postprandial lipaemia.
Does postprandial lipaemia cause triglyceride-dependent discordance between calculated LDL-C formulas (Friedewald, Vujovic, Sampson) and homogeneous assay LDL-C in Chinese adults?
Does postprandial lipaemia cause triglyceride-dependent discordance between calculated LDL-C formulas (Friedewald, Vujovic, Sampson) and homogeneous assay LDL-C in Chinese adults?
Postprandial hypertriglyceridaemia (≥2.0 mmol/L) causes substantial discordance between routine calculated and direct LDL-C methods, whereas non-HDL-C and apolipoprotein B remain stable.
Answers are grounded in this paper and cite their sources.
Postprandial triglycerides ≥2.0 mmol/L may compromise calculated LDL-C reliability; leaves open whether non-HDL-C or apoB should guide non-fasting assessment.
Background Non-fasting lipid testing is increasingly used in clinical practice, but postprandial triglyceride-rich lipoproteins may affect calculated low-density lipoprotein cholesterol (LDL-C). This study evaluated triglyceride-dependent discordance among routine LDL-C reporting methods during postprandial lipaemia.Methods Sixty-two Chinese adults underwent lipid profiling under three conditions: fasting, 4h after a habitual mixed meal test, and 4h after a standardised oral fat tolerance test. LDL-C measured by a homogeneous chemical masking assay was used as a routine comparator, not a reference method. Friedewald, Vujovic and Sampson estimates were compared with LDL-CCM using ±12% concordance, bias and triglyceride-stratified analyses. As a secondary analysis, non-HDL-C and apolipoprotein B were assessed for within-participant stability during the oral fat tolerance test.Results Median triglyceride concentrations increased from 1.23 mmol/L fasting to 2.16 mmol/L after the mixed meal test and 3.46 mmol/L after the oral fat tolerance test. Concordance between calculated LDL-C and LDL-CCM declined as triglycerides increased and was lowest after oral fat loading. Agreement was relatively preserved at triglycerides <2.0 mmol/L, decreased substantially at 2.0–4.52 mmol/L and was poor above formula applicability ranges. Non-HDL-C and apolipoprotein B showed limited median changes from fasting to 4h after the oral fat tolerance test (+2.1% and −4.3%, respectively).Conclusions Postprandial lipaemia was associated with triglyceride-dependent discordance among routine LDL-C reporting methods. Without a reference LDL-C method, these findings indicate inter-method discordance rather than absolute measurement error. Triglyceride concentration and formula applicability limits should be considered when interpreting LDL-C in lipaemic samples, with non-HDL-C and apolipoprotein B providing complementary information.
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Liang et al. (2026) studied Postprandial lipaemia (n=62). Calculated LDL-C equations (Friedewald, Vujovic, and Sampson) during postprandial lipaemia (habitual mixed meal test and standardised oral fat tolerance test) vs. LDL-C measured by a homogeneous chemical masking assay (LDL-CCM) and fasting state was evaluated on Discordance (±12% concordance and bias) between calculated LDL-C (Friedewald, Vujovic, Sampson) and homogeneous chemical masking assay LDL-C (LDL-CCM) across triglyceride strata. Postprandial fat loading increased median triglycerides from 1.23 to 3.46 mmol/L, substantially decreasing concordance between calculated LDL-C equations and homogeneous assay at ≥2.0 mmol/L.
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