Nonfasting triglyceride levels may be superior indicators of cardiovascular risk than fasting levels, researchers in two separate studies found.
In the first study, Dr. Sandeep Bansal and associates at Brigham and Women's Hospital, Boston, used data from the Women's Health Study to examine the predictive ability of fasting and nonfasting blood testing for triglyceride levels.
The subjects were 20,118 healthy women aged 45 and older whose triglyceride levels were determined in blood samples drawn during fasting and 6,391 whose samples were drawn within 8 hours of a meal. Incident cardiovascular disease (CVD) events were tracked during a median of 11 years of follow-up. There were 276 nonfatal MIs, 265 ischemic strokes, 628 coronary revascularizations, and 163 cardiovascular deaths.
The robust association between nonfasting triglyceride levels and CVD events remained strong after adjusting the data to account for total cholesterol levels, HDL cholesterol levels, the presence of diabetes, a high body mass index, and elevated C-reactive protein levels. Nonfasting triglyceride levels were strong risk predictors independent of baseline CVD risk factors, levels of other lipids, and markers of insulin resistance, Dr. Bansal and his associates said (JAMA 2007;298:309–16).
In the second study, Dr. Børge G. Nordestgaard of Herlev (Denmark) University Hospital and associates compared the predictive ability of fasting and nonfasting triglyceride testing in 7,587 women and 6,394 men who participated in a cardiovascular study of the general Danish population from 1976 until the present.
High nonfasting triglyceride levels were found to be better independent predictors of the risk of MI, ischemic heart disease, and death than were fasting triglyceride levels, they said (JAMA 2007;298:299–308).