Key result
Non-fasting lipid profiles show poor agreement with fasting values for LDL-C and triglycerides.
Why the study?
Traditional lipid profiles obtained after a 10-12-hour fast may not reflect the full spectrum of daily lipid and lipoprotein levels, motivating an evaluation of the agreement between fasting and non-fasting lipid profiles.
Do non-fasting lipid profiles collected 3-4 hours after breakfast demonstrate acceptable agreement with overnight fasting lipid profiles in outpatient participants in Bangladesh?
Cross-Sectional
No
Do non-fasting lipid profiles collected 3-4 hours after breakfast demonstrate acceptable agreement with overnight fasting lipid profiles in outpatient participants in Bangladesh?
Non-fasting lipid profiles demonstrate acceptable agreement with fasting profiles for total cholesterol and HDL-C, but poor agreement for LDL-C and triglycerides, indicating that non-fasting testing cannot fully replace fasting lipid panels for all parameters.
Answers are grounded in this paper and cite their sources.
Should not yet replace fasting panels in practice; leaves open targeted non-fasting use pending prospective validation.
BACKGROUND: Dyslipidemia is a major global public health challenge. Lipid profiling is a key screening tool for early detection and management. Traditionally, lipid profiles are obtained after a 10-12-hour fast; however, this may not reflect the full spectrum of lipid and lipoprotein levels throughout the day. This study aimed to evaluate the agreement between fasting and non-fasting lipid profiles.METHODS: This cross-sectional observational study was conducted in the Bangladesh Medical University. Participants were recruited from the outpatient departments. After consenting and examinations, overnight fasting blood samples were collected. Non-fasting samples were collected from the same individuals 3-4 hours after breakfast. Statistical analysis included assessing the agreement between fasting and non-fasting lipid parameters using Bland-Altman analysis, correlation tests, and quantile regression.RESULTS: We found no statistically significant difference between fasting and non-fasting total cholesterol levels. Nevertheless, Pearson’s correlation and Bland-Altman analyses showed a strong correlation and good agreement, with quantile regression confirming consistency. Differences were statistically significant for high-density lipoprotein - cholesterol (HDL-C), and correlation indicated a strong association; Bland-Altman and quantile regression demonstrated good agreement at the 1st and 2nd quartiles. Differences were also significant for low-density lipoprotein - cholesterol (LDL-C), with strong correlations but poor overall agreement. Triglycerides differed significantly between states, with positive correlations but poor agreement.CONCLUSIONS: In this study, we found a varied agreement between fasting and non-fasting lipid parameters. Total cholesterol (TC) and HDL-C demonstrated acceptable agreement, whereas LDL-C and triglycerides (TG) did not. It reflects that non-fasting lipid profiles cannot fully replace fasting profiles for all parameters.
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Jesun et al. (2026) conducted a cross-sectional in Dyslipidemia screening. Non-fasting lipid profile (3-4 hours after breakfast) vs. Overnight fasting lipid profile (10-12-hour fast) was evaluated on Agreement between fasting and non-fasting lipid parameters (TC, HDL-C, LDL-C, triglycerides). Non-fasting lipid profiles 3-4 hours post-breakfast showed acceptable agreement with fasting profiles in 2 of 4 parameters (TC and HDL-C at the 1st and 2nd quartiles), but poor agreement for LDL-C and TG.
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