Fasting versus Non-fasting Lipid profile in the clinical practice

There are pros and cons doing fasting and random non-fasting lipid profile test. However, when we consider cardio vascular risk, non-fasting lipid test more reliable than fasting test. In current practice, using fasting lipid profile was challenged in 2007 by two studies that showed that random non-fasting triglyceride (TG) could be superior than fasting TG in predicting risk of cardiovascular risk. Postprandial concentrations of triglyceride were higher than fasting. However, levels of non-fasting triglycerides are better at predicting future cardiovascular events than levels of fasting triglycerides. Random non-fasting lipid test is not a new phenomenon, it already practicing in Denmark since 2009. Moreover, NICE guidelines have recommended non-fasting test in the primary prevention setting since 2014. As the major shift in newer guidelines reflects the changing focus of risk assessment from LDL to non-HDL cholesterol (apolipoprotein B) as a better predictor of cardiovascular risk, indirectly tell us non-fasting lipid level superior than fasting lipid. The aim of the review is to compare both fasting and non-fasting measurements in our clinical practice.