Fasting versus Nonfasting Lipids for Cardiovascular Disease Risk Estimation among healthy adults in Ibadan, Nigeria: A cross-sectional study

Abstract

Objective: Risk assessment at the individual level requires incorporating lipid profile results into several cardiovascular disease (CVD) risk estimating equations. Traditionally, fasting is usually required before the lipid profile studies. Recent guidelines have recommended the acceptability of non-fasting lipids for this assessment based on reports from several countries. We aimed to compare the agreement between 10-year risk estimates obtained using fasting and non-fasting lipids from apparently healthy Nigerians. Methods: This was a cross-sectional study of 111 participants. Serum blood lipids were measured after a 12-hour overnight fast and after a standard local Nigerian meal. Risk estimations with the pooled cohort equations (PCE) and the Framingham risk score (FRS) equation were done with fasting and non-fasting lipid results. Correlations were done with Pearson’s coefficient and agreement of proportions with McNemar’s test. Results: Comparing fasting versus non-fasting values, total cholesterol was within 10% for 58 (52.3%), triglycerides were >30% for 65 (58.6%), and high-density lipoprotein cholesterol was <30% in 60 (70.0%) participants. An increase in Low-density lipoprotein cholesterol was seen in 93 (82.8%) participants. With the PCE, 3 (2.7%) persons, had borderline risk with both their fasting and non-fasting samples. With the FRS, 1 participant who was categorised as moderate risk with the fasting sample was classified as low risk with the non-fasting sample. There was no significant difference in risk categorisation by the equations, p =1.0. Conclusion: Risk categorisation by two (2) CVD risk estimating equations was not significantly affected by the fasting or non-fasting status of a healthy population.

Keywords

• Lipids
• Nonfasting
• Cardiovascular
• Risk Assessment