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- Non-fasting lipid profiles: implications for lipoprotein testing and reporting
Consensus guideline of the European Atherosclerosis Society (EAS) and European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)
Presenter: prof. Michel Langlois MD,Ph.D.
Professor Langlois is Professor at Ghent University, Department of Cardiovascular Diseases and Vice-Director at the laboratory of AZ St-Jan hospital, Bruges. He is currently the President of the Belgian Atherosclerosis Society, Past-president of the Royal Belgian Society of Laboratory Medicine. He is the Chair of the EFLM-EAS Task and Finish Group on Laboratory Testing for Dyslipidemia and member of the EFLM WG-Guidelines as well as corresponding member for the EFLM WG-Cardiac Markers and WG-Congresses and Postgraduate Education.
Modrator: prof. Dr. Jerzy-Roch Nofer
Fasting blood samples have been the standard for measurement of triglycerides and cholesterol, despite the fact that we spend the vast majority of our time in non-fasting conditions. However, when recent studies suggest that postprandial effects do not substantially alter lipid concentrations and do not weaken, and even may strengthen, their association with cardiovascular risk, then a non-fasting blood draw has many practical advantages. Non-fasting cholesterol measurements include the ‘remnant cholesterol’ fraction, a strong risk factor for developing atherosclerosis independent of LDL cholesterol. Remnant cholesterol reflects the cholesterol in chylomicron- and VLDL-remnant particles and it is included in the ‘non-HDL cholesterol’ calculation.
Until recently, most guidelines focused on targeting primarily LDL cholesterol for the prevention of cardiovascular disease, but they now recognize that non-HDL cholesterol (or apolipoprotein B, the molecule carried by all non-HDL particles) is a more accurate and comprehensive predictor of atherogenic lipoprotein-related risk.
In 2016, the European Atherosclerosis Society (EAS) and EFLM Joint Consensus Panel recommended using non-fasting lipid testing for routine clinical practice and provided specific cutpoints for desirable fasting and non-fasting lipid concentrations to be reported by the laboratories uniformly.