Fasting time and lipid parameters: association with hepatic steatosis — data from a random population sample

Lipids in Health and Disease

Atilla Serif Akinli⁴  Wolfgang Kratzer⁴  Richard Andrew Mason¹  Bernhard Otto Boehm⁴  Armin Imhof³  Wolfgang Koenig³  Mark Martin Haenle⁴  Suemeyra Oeztuerk⁴  Tilmann Graeter²  Martin Gruchot⁴ 

[1] Louis Stokes Cleveland Department of Veterans Affairs Medical Center, 10700 East Boulevard, Cleveland, OH 44106 USA;Department of Diagnostic and Interventional Radiology, University Hospital Ulm, Albert-Einstein-Allee 23, 89081 Ulm, Germany;Department of Internal Medicine II - Cardiology, University Hospital Ulm, Albert-Einstein-Allee 23, 89081 Ulm, Germany;Department of Internal Medicine I, University Hospital Ulm, Albert-Einstein-Allee 23, 89081 Ulm, Germany

关键词: Non-alcoholic fatty liver disease (NAFLD);    Cross-sectional;    Population-based;    Fasting time;    Triglycerides;    HDL cholesterol;    LDL cholesterol;    Total cholesterol;    Lipids;   

Others  :  811700
DOI  :  10.1186/1476-511X-13-18

 received in 2013-11-06, accepted in 2014-01-18,  发布年份 2014

【 摘 要 】

Background

Current guidelines recommend measuring plasma lipids in fasting patients. Recent studies, however, suggest that variation in plasma lipid concentrations secondary to fasting time may be minimal. Objective of the present study was to investigate the impact of fasting time on plasma lipid concentrations (total cholesterol, HDL and LDL cholesterol, triglycerides). A second objective was to determine the effect of non-alcoholic fatty liver disease exerted on the above-mentioned lipid levels.

Method

Subjects participating in a population-based cross-sectional study (2,445 subjects; 51.7% females) were questioned at time of phlebotomy regarding duration of pre-phlebotomy fasting. Total cholesterol, LDL and HDL cholesterol, and triglycerides were determined and correlated with length of fasting. An upper abdominal ultrasonographic examination was performed and body-mass index (BMI) and waist-to-hip ratio (WHR) were calculated. Subjects were divided into three groups based on their reported fasting periods of 1–4 h, 4–8 h and > 8 h. After application of the exclusion criteria, a total of 1,195 subjects (52.4% females) were included in the study collective. The Kruskal-Wallis test was used for continuous variables and the chi-square test for categorical variables. The effects of age, BMI, WHR, alcohol consumption, fasting time and hepatic steatosis on the respective lipid variables were analyzed using multivariate logistic regression.

Results

At multivariate analysis, fasting time was associated with elevated triglycerides (p = 0.0047 for 1–4 h and p = 0.0147 for 4–8 h among females; p < 0.0001 for 1–4 h and p = 0.0002 for 4–8 h among males) and reduced LDL cholesterol levels (p = 0.0003 for 1–4 h and p = 0.0327 for 4–8 h among males). Among males, hepatic steatosis represents an independent factor affecting elevated total cholesterol (p = 0.0278) and triglyceride concentrations (p = 0.0002).

Conclusion

Total and HDL cholesterol concentrations are subject to slight variations in relation to the duration of the pre-phlebotomy fasting period. LDL cholesterol and triglycerides exhibit highly significant variability; the greatest impact is seen with the triglycerides. Fasting time represents an independent factor for reduced LDL cholesterol and elevated triglyceride concentrations. There is a close association between elevated lipids and hepatic steatosis.

【 授权许可】

   
2014 Gruchot et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]Grundy SM, Becker D, Clark LT, Cooper RS, Denke MA, Howard J, Hunninghake DB, Illingworth DR, Luepker RV, McBride P, McKenney JM, Pasternak RC, Stone NJ, Van Horn L: Third report of the national cholesterol education program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III) final report. Circulation 2002, 106:3143-3421.
• [2]Sidhu D, Naugler C: Fasting time and lipid levels in a community-based population: a cross-sectional study. Arch Intern Med 2012, 172:1707-1710.
• [3]Warnick GR, Nakajima K: Fasting versus nonfasting triglycerides: implications for laboratory measurements. Clin Chem 2008, 54:14-16.
• [4]Schaefer EJ, Audelin MC, McNamara JR, Shah PK, Tayler T, Daly JA, Augustin JL, Seman LJ, Rubenstein JJ: Comparison of fasting and postprandial plasma lipoproteins in subjects with and without coronary heart disease. Am J Cardiol 2001, 88:1129-1133.
• [5]Craig SR, Amin RV, Russell DW, Paradise NF: Blood cholesterol screening. J Gen Intern Med 2000, 15:395-399.
• [6]Mora S, Rifai N, Buring JE, Ridker PM: Fasting compared with nonfasting lipids and apolipoproteins for predicting incident cardiovascular events. Circulation 2008, 118:993-1001.
• [7]Steiner MJ, Skinner AC, Perrin EM: Fasting might not be necessary before lipid screening: a nationally representative cross-sectional study. Pediatrics 2011, 128:463-470.
• [8]Langsted A, Freiberg JJ, Nordestgaard BG: Fasting and nonfasting lipid levels: influence of normal food intake on lipids, lipoproteins, apolipoproteins, and cardiovascular risk prediction. Circulation 2008, 118:2047-2056.
• [9]Eberly LE, Stamler J, Neaton JD: Relation of triglyceride levels, fasting and nonfasting, to fatal and nonfatal coronary heart disease. Arch Intern Med 2003, 163:1077-1083.
• [10]Bansal S, Buring JE, Mora S, Sacks FM, Ridker PM: Fasting compared with nonfasting triglycerides and risk of cardiovascular events in women. JAMA 2007, 298:309-316.
• [11]Nordestgaard BG, Benn M, Schnohr P, Tybjærg-Hansen A: Nonfasting triglycerides and risk of myocardial infarction, ischemic heart disease and death in men and women. JAMA 2007, 298:299-308.
• [12]Branchi A, Torri A, Berra C, Colombo E, Sommariva D: Changes in serum triglycerides and high-density lipoprotein concentration and composition after a low-fat mixed meal. Effects of gender and insulin resistance. Intern Emerg Med 2006, 1:287-295.
• [13]Adiels M, Matikainen N, Westerbacka J, Söderlund S, Larsson T, Olofsson S-O, Borén J, Taskinen M-R: Postprandial accumulation of chylomicrons and chylomicron remnants is determined by the clearance capacity. Atherosclerosis 2012, 222:222-228.
• [14]Nigam PK: Serum lipid profile: fasting or non-fasting? Indian J Clin Biochem 2011, 26:96-97.
• [15]Martin SS, Blaha MJ, Jones SR: Nonfasting lipids: there is the population and then there is the patient. JAMA Intern Med 2013, 173:935-936.
• [16]Khera AV, Mora S: Fasting for lipid testing - is it worth the trouble? Arch Intern Med 2012, 172:2010-2012.
• [17]Wilder LB, Bachorik PS, Finney C a, Moy TF, Becker DM: The effect of fasting status on the determination of low-density and high-density lipoprotein cholesterol. Am J Med 1995, 99:374-377.
• [18]Kolovou GD, Anagnostopoulou KK, Pavlidis AN, Salpea KD, Iraklianou SA, Hoursalas IS, Mikhailidis DP, Cokkinos DV: Metabolic syndrome and gender differences in postprandial lipaemia. Eur J Cardiovasc Prev Rehabil 2006, 13:661-664.
• [19]Branchi A, Torri A, Berra C, Colombo E, Sommariva D: Changes in serum lipids and blood glucose in non diabetic patients with metabolic syndrome after mixed meals of different composition. J Nutr Metab 2012, 2012:8.
• [20]Kolovou GD, Anagnostopoulou KK, Pavlidis AN, Salpea KD, Iraklianou SA, Tsarpalis K, Damaskos DS, Manolis A, Cokkinos DV: Postprandial lipemia in men with metabolic syndrome, hypertensives and healthy subjects. Lipids Health Dis 2005, 4:8. BioMed Central Full Text
• [21]Van Oostrom AJHHM, Alipour A, Plokker TWM, Sniderman AD, Cabezas MC: The metabolic syndrome in relation to complement component 3 and postprandial lipemia in patients from an outpatient lipid clinic and healthy volunteers. Atherosclerosis 2007, 190:167-173.
• [22]Perez-Caballero AI, Alcala-Diaz JF, Perez-Martinez P, Garcia-Rios A, Delgado-Casado N, Marin C, Yubero-Serrano E, Camargo A, Caballero J, Malagon MM, Tinahones FJ, Perez-Jimenez F, Lopez-Miranda J, Delgado-Lista J: Lipid metabolism after an oral fat test meal is affected by age-associated features of metabolic syndrome, but not by age. Atherosclerosis 2012, 226:258-262.
• [23]Cassader M, Gambino R, Musso G, Depetris N, Mecca F, Cavallo-Perin P, Pacini G, Rizzetto M, Pagano G: Postprandial triglyceride-rich lipoprotein metabolism and insulin sensitivity in nonalcoholic steatohepatitis patients. Lipids 2001, 36:1117-1124.
• [24]Matikainen N, Mänttäri S, Westerbacka J, Vehkavaara S, Lundbom N, Yki-Järvinen H, Taskinen M-R: Postprandial lipemia associates with liver fat content. J Clin Endocrinol Metab 2007, 92:3052-3059.
• [25]Musso G, Gambino R, De Michieli F, Cassader M, Rizzetto M, Durazzo M, Fagà E, Silli B, Pagano G: Dietary habits and their relations to insulin resistance and postprandial lipemia in nonalcoholic steatohepatitis. Hepatology 2003, 37:909-916.
• [26]Friedewald WT, Levy RI, Fredrickson DS: Estimation of the concentration of low-density-lipoprotein cholesterol in plasma, without use of preparative ultracentrifuge. Clin Chem 1972, 18:499-502.
• [27]Martin SS, Blaha MJ, Elshazly MB, Brinton EA, Toth PP, McEvoy JW, Joshi PH, Kulkarni KR, Mize PD, Kwiterovich PO, Defilippis AP, Blumenthal RS, Jones SR: Friedewald estimated versus directly measured low-density lipoprotein cholesterol and treatment implications. J Am Coll Cardiol 2013, 62:732-739.
• [28]Tremblay AJ, Morrissette H, Gagné J-M, Bergeron J, Gagné C, Couture P: Validation of the friedewald formula for the determination of low-density lipoprotein cholesterol compared with beta-quantification in a large population. Clin Biochem 2004, 37:785-790.
• [29]Haenle MM, Brockmann SO, Kron M, Bertling U, Mason RA, Steinbach G, Boehm BO, Koenig W, Kern P, Piechotowski I, Kratzer W, EMIL-Study Group: Overweight, physical activity, tobacco and alcohol consumption in a cross-sectional random sample of German adults. BMC Public Health 2006, 6:12. BioMed Central Full Text
• [30]Physical Status: The Use and Interpretation of Anthropometry. Report of a WHO Expert Commitee World Health Organ Tech Report Ser 1995, 854:1-452.
• [31]Hamaguchi M, Kojima T, Itoh Y, Harano Y, Fujii K, Nakajima T, Kato T, Takeda N, Okuda J, Ida K, Kawahito Y, Yoshikawa T, Okanoue T: The severity of ultrasonographic findings in nonalcoholic fatty liver disease reflects the metabolic syndrome and visceral fat accumulation. Am J Gastroenterol 2007, 102:2708-2715.
• [32]Saverymuttu SH, Joseph AE, Maxwell JD: Ultrasound scanning in the detection of hepatic fibrosis and steatosis. Br Med J 1986, 292:13-15.
• [33]Charatcharoenwitthaya P, Lindor KD: Role of radiologic modalities in the management of non-alcoholic steatohepatitis. Clin Liver Dis 2007, 11:37-54.