Blood cholesterol screening - Influence of fasting state on cholesterol results and management decisions
Blood cholesterol screening - Influence of fasting state on cholesterol results and management decisions
复制标题
DOI：
10.1046/j.1525-1497.2000.03509.x
复制
发表时间：
2000-06-01
影响因子：
5.7
通讯作者：
Paradise, NF
中科院分区：
文献类型：
--
作者：
Craig, SR;Amin, RV;Paradise, NF
目的：比较成年人空腹和非空腹总胆固醇和高密度脂蛋白胆固醇（HDL）值，并确定基于非空腹血液检查的冠心病危险组分类与基于空腹研究的冠心病危险组分类的相似程度。181名年龄至少为20岁的患者在社区医院普通内科诊所接受医疗护理。每名患者在7天内测量两次总胆固醇和高密度脂蛋白胆固醇水平，一次在非禁食时，一次在至少禁食12小时后。比较空腹和非空腹总胆固醇和高密度脂蛋白胆固醇值，根据空腹和非空腹血液研究，将患者分为理想组、边缘高胆固醇组和高胆固醇组。总胆固醇的空腹和非空腹结果存在较小的统计学显著性差异，但无临床意义。非空腹HDL胆固醇水平与空腹HDL水平相似。空腹和非空腹血液检测将患者分为理想和高胆固醇组的一致性分别为86.7%和89.5%。在临界高胆固醇组，高密度脂蛋白胆固醇水平是决定后续管理的重要因素，空腹和非空腹高密度脂蛋白胆固醇结果之间有95%的一致性。只有一小部分患者通过非空腹评估被归类为低风险组，这可能会比使用空腹结果更不严格地监测和治疗他们的胆固醇状态。这些研究结果也证实了在这项研究中的亚组的男性年龄在35岁及以上和女性年龄在45岁及以上。结论：筛选非空腹成人的总胆固醇和高密度脂蛋白胆固醇是适当的决策，对冠心病的一级预防。
OBJECTIVE: To compare fasting and nonfasting total and high-density lipoprotein (HDL) cholesterol values in adults and to determine how closely classification into risk groups for coronary heart disease based on nonfasting blood tests compares with classification based on fasting studies.DESIGN: Cross-sectional study.SETTING: A community hospital general internal medicine clinic.PATIENTS: One hundred eighty-one patients at least 20 years of age receiving medical care at a community hospital general internal medicine clinic.INTERVENTIONS: Total and HDL cholesterol levels were measured twice in each patient within 7 days, once while not fasting and once after a minimum 12-hour fast.MEASUREMENTS AND MAIN RESULTS: Fasting and nonfasting total and HDL cholesterol values were compared, patients were classified into desirable, borderline-high, and high cholesterol groups on the basis of fasting and nonfasting blood studies. There were small, statistically significant but clinically insignificant differences in fasting and nonfasting results for total cholesterol. Nonfasting HDL cholesterol levels were similar to fasting HDL levels. The agreement in classification of patients into desirable and high-cholesterol groups between fasting and non-fasting blood testing was 86.7% and 89.5%, respectively. In the borderline-high group, for whom levels of HDL cholesterol are important in determining subsequent management, there was 95% agreement between fasting and nonfasting HDL cholesterol results. Only a small fraction of the patients were classified into lower-risk groups by the nonfasting assessment, creating the potential for less-rigorous monitoring and treatment of their cholesterol status than if fasting results were utilized. These findings were confirmed in this study also for the subgroups of men aged 35 years and older and women aged 45 years and older.CONCLUSIONS: Screening nonfasting adults for total and HDL cholesterol is appropriate for making decisions about primary prevention of coronary heart disease.