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


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


METHODS
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.
Dungan
Kathleen M
KM
Ohio State University School of Medicine, Columbus, OH, USA. kathleen.dungan@osumc.edu
Guster
Tia
T
DeWalt
Darren A
DA
Buse
John B
JB
D003924:Diabetes Mellitus, Type 2 / Q000097:blood*; D005215:Fasting; D006801:Humans; D008055:Lipids / Q000097:blood*; D008074:Lipoproteins / Q000097:blood*
D008055:Lipids; D008074:Lipoproteins