Arch Intern Med：血脂常规检查或不需空腹

　　加拿大学者的一项研究表明，在社区人群中空腹时间与脂蛋白亚类水平相关性甚微，提示脂蛋白水平常规检测时空腹并无必要。论文于2012年11月12日在线发表于《内科医学文献》（Arch Intern Med）杂志。

　　此项研究在大型社区人群中对包括空腹持续时间和血脂结果在内的实验室数据进行了横断面评估。主要转归指标为空腹间隔为1至16小时时高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、总胆固醇和甘油三酯的平均水平。对个体年龄差异进行校正之后，利用线性回归模型估算不同空腹时间下胆固醇亚类平均水平。

　　结果显示，共有209180例受试者（女性111048例）被纳入研究。在空腹时间不同的受试者中，总胆固醇和高密度脂蛋白胆固醇平均水平差异甚微。在空腹时间不同的患者组中，平均计算低密度脂蛋白胆固醇的变异性稍大，最高可达10%；平均甘油三酯的水平差异最高为20%。

Fasting Time and Lipid Levels in a Community-Based Population
A Cross-sectional Study 

Background 

Although current guidelines recommend measuring lipid levels in a fasting state, recent studies suggest that nonfasting lipid profiles change minimally in response to food intake and may be superior to fasting levels in predicting adverse cardiovascular outcomes. The objective of this study was to investigate the association between fasting times and lipid levels.

Methods

Cross-sectional examination of laboratory data, including fasting duration (in hours) and lipid results, was performed over a 6-month period in 2011 in a large community-based cohort. Data were obtained from Calgary Laboratory Services, Calgary, Alberta, Canada, the sole supplier of laboratory services for Calgary and surrounding areas (source population, 1.4 million persons). The main outcome measures were mean levels of high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, total cholesterol, and triglycerides for fasting intervals from 1 hour to more than 16 hours. After differences in individual ages were controlled for, linear regression models were used to estimate the mean levels of cholesterol subclasses at different fasting times.

Results

A total of 209 180 individuals (111 048 females and 98 132 males) were included in the study. The mean levels of total cholesterol and high-density lipoprotein cholesterol differed little among individuals with various fasting times. The mean calculated low-density lipoprotein cholesterol levels showed slightly greater variations of up to 10% among groups of patients with different fasting intervals, and the mean triglyceride levels showed variations of up to 20%.

Conclusion

Fasting times showed little association with lipid subclass levels in a community-based population, which suggests that fasting for routine lipid levels is largely unnecessary.