A comparison of lipid and lipoprotein measurements in the fasting and nonfasting states in patients with type 2 diabetes.

Abstract

BACKGROUND:

Patients with diabetes often do not reach recommended lipid targets. This may be in part due to the difficulty of obtaining fasting measurements.

OBJECTIVE:

To compare fasting and nonfasting low density lipoprotein cholesterol (LDLc), non-high density lipoprotein cholesterol (non-HDLc), and low density lipoprotein particle number (LDLP) patients with type 2 diabetes (T2DM) and to determine the effect on assessing treatment success.

RESEARCH DESIGN AND METHODS:

Standard lipids and NMR lipoproteins were analyzed at baseline and following a standardized meal in patients with T2DM.

OUTCOMES MEASURES:

Primary outcomes were agreement between fasting and nonfasting LDLc, non-HDLc, and LDLP and the agreement between these measures for determining fasting LDLc treatment success. Direct LDL cholesterol (DLDL) was a secondary outcome.

RESULTS:

Of 31 patients, only 56% of LDLc measurements were equivalent in the fasting and nonfasting states, compared to 97% of DLDLc (p < 0.0001), 94% of non-HDLc (p < 0.001) and 77% of LDLP (p < 0.01) measurements. Assessment of nonfasting lipid values would have resulted in misclassification by treatment target in 15% of LDLc, 3.2% of DLDLc assessments (p < 0.05 vs. LDLc), and 0% of non-HDLc and LDLP assessments (p < 0.01 vs. LDLc). Nonfasting LDLc, non-HDLc, LDLP, and DLDLc correctly identified fasting LDLc classification in 23/27 (85%), 26/30 (87%, p = NS vs. nonfasting LDLc), 16/30 (53%, p < 0.001 vs. nonfasting LDLc), and 24/30 (80%, p = NS vs. nonfasting LDLc), respectively.

CONCLUSIONS:

If confirmed in larger studies, nonfasting non-HDLc may be a suitable proxy for fasting LDLc in patients with T2DM.

• Authors: Kathleen M Dungan, Tia Guster, Darren A DeWalt, John B Buse
• Journal: Current medical research and opinion (Curr Med Res Opin) Vol. 23 Issue 11 Pg. 2689-95 (Nov 2007) ISSN: 1473-4877 [Electronic] England
• PMID: 17892636 (Publication Type: Comparative Study, Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)

Chemical References

• Lipids
• Lipoproteins

Topics

• Diabetes Mellitus, Type 2 (blood)
• Fasting
• Humans
• Lipids (blood)
• Lipoproteins (blood)