Louter L, Visseren F L J, Roeters van Lennep J E
Albert Schweitzer Ziekenhuis, afd. Geriatrie, Dordrecht.
Contact: L. Louter (
Ned Tijdschr Geneeskd. 2020 May 20;164:D4394.
For decades, a fasting lipid profile was required to predict the cardiovascular risk of patients. This was due to the assumption that if low-density lipoprotein cholesterol (LDL-C) is calculated with the Friedewald Formula, LDL-C is dependent on the triglycerides concentration, which can vary after fat consumption. However, several prospective studies show minimal differences of lipid values in fasting and non-fasting lipid profiles. There is also evidence that a non-fasting lipid profile is equally accurate in the prediction of cardiovascular risk. Only in select cases, such as non-fasting triglycerides > 8 mmol/l (708 mg/dl), it is advised to obtain a fasting lipid profile. In conclusion, it is not a necessity to obtain a fasting lipid profile for determining cardiovascular risk. This has many advantages for patients, laboratories and physicians.
几十年来,一直需要通过空腹血脂检查来预测患者的心血管风险。这是因为人们假定,如果用弗里德瓦尔德公式计算低密度脂蛋白胆固醇(LDL-C),LDL-C会依赖于甘油三酯浓度,而甘油三酯浓度在摄入脂肪后会发生变化。然而,多项前瞻性研究表明,空腹血脂检查和非空腹血脂检查的血脂值差异极小。也有证据表明,非空腹血脂检查在预测心血管风险方面同样准确。只有在某些特定情况下,比如非空腹甘油三酯>8 mmol/L(708 mg/dl)时,才建议进行空腹血脂检查。总之,测定心血管风险并非必须进行空腹血脂检查。这对患者、实验室和医生都有诸多益处。