Department of Clinical Biochemistry and the Copenhagen General Population Study, Herlev Hospital, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.
Clin Chem. 2011 Mar;57(3):482-9. doi: 10.1373/clinchem.2010.157164. Epub 2010 Dec 28.
Whether lipid profiles should be collected from fasting or nonfasting individuals is controversial, particularly in the diabetic population. We examined the influence of normal food intake on lipid profiles in diabetic and nondiabetic individuals.
We assessed plasma concentrations of lipids, lipoproteins, apolipoproteins, and albumin as a function of time since the last meal in 58 434 individuals (participation rate 45%) from the general population, 2270 of whom had diabetes mellitus.
Similar patterns in the measured constituents were observed in the diabetic and nondiabetic populations. Triglycerides remained increased for 6-7 h in both populations after the last meal, whereas LDL cholesterol and albumin but not apolipoprotein B were reduced in both populations up to 5 h after normal food intake; after adjustment for hemodilution on the basis of albumin concentrations, the LDL cholesterol reductions were no longer present. Maximum observed mean differences from fasting concentrations in diabetic patients were -0.6 mmol/L, 0 mmol/L, 0.2 mmol/L, and 0.08 g/L (8 mg/dL) for LDL cholesterol, HDL cholesterol, triglycerides, and apolipoprotein B, respectively, and, correspondingly, -0.3 mmol/L, 0 mmol/L, 0.2 mmol/L, and 0.03 g/L (3 mg/dL) in individuals without diabetes.
Triglycerides increased up to 0.2 mmol/L after normal food intake in individuals with and without diabetes, whereas the postprandial reductions in LDL cholesterol observed in both populations likely were caused by hemodilution due to fluid intake. No statistically significant differences in postprandial apolipoprotein B concentrations were found. These data may be useful for discussion during revisions of guidelines for lipid measurements in individuals with or without diabetes.
对于是否应在空腹或非空腹个体中采集脂质谱仍存在争议,尤其是在糖尿病患者中。我们研究了正常饮食对糖尿病和非糖尿病个体脂质谱的影响。
我们评估了 58434 名(参与率为 45%)来自普通人群的个体以及 2270 名糖尿病患者中,最后一次进食后不同时间点的血脂、脂蛋白、载脂蛋白和白蛋白的血浆浓度。
在糖尿病和非糖尿病人群中观察到相似的测量成分模式。在最后一次进食后,两组人群的甘油三酯水平持续升高 6-7 小时,而 LDL 胆固醇和白蛋白水平在正常饮食后 5 小时内均降低,在基于白蛋白浓度的血液稀释调整后,LDL 胆固醇的降低不再存在。与空腹浓度相比,糖尿病患者的最大观察到的平均差异分别为 -0.6mmol/L、0mmol/L、0.2mmol/L 和 0.08g/L(8mg/dL),LDL 胆固醇、HDL 胆固醇、甘油三酯和载脂蛋白 B,相应的在无糖尿病个体中分别为 -0.3mmol/L、0mmol/L、0.2mmol/L 和 0.03g/L(3mg/dL)。
在有或没有糖尿病的个体中,正常饮食后甘油三酯水平升高最高可达 0.2mmol/L,而两人群中观察到的 LDL 胆固醇餐后降低可能是由于液体摄入引起的血液稀释所致。未发现餐后载脂蛋白 B 浓度存在统计学差异。这些数据可能有助于在修订有或无糖尿病患者的脂质测量指南时进行讨论。