I'm in agreement with Tim on the question of practicality and we adopt a
similar approach to the one outlined. There is also a policy locally to
accept non-fasting samples from Insulin dependant diabetics. But perhaps its
an area that needs re-examining. After all, with fat loading tests, peak
triglyceride levels occur about six hours after the meal is given. So how
much influence does a meal have on a triglyceride level taken 2 or 3 hours
later? Is the data there? My own anecdotal information suggests not a lot,
in those with normal triglyceride turnover. In those with
Hypertriglyceridaemia, TG levels can be very variable, even in the fasting
state so variable estimates of LDL may be obtained anyway.
But other benefits can follow from TG measurement -locally, I'm aware of a
number of diabetics first detected, not through glucose measurements but
through appropriate follow up of a detected mixed dyslipidaemia, some
measured in the non-fasting state.
Thank God it's Friday!
Joe Begley
Poole Hospital
----- Original Message -----
From: <[log in to unmask]>
To: <[log in to unmask]>
Sent: Friday, May 18, 2001 12:42 PM
Subject: Re: HDLs
> WE moved to allowing non-fasting lipid profiles as a pragmatic approach
rather than a dogmatic one: since most patients see GPs having eaten, and
frequently obly attend once - especially for men, it is essential to screen
when the patient is there because they won't come back. If the results of
the non-fasting test are sufficiently concerning to warrant more attention,
then a fasting test can be done.
>
> Sine perfection is not possible in a 'real world', you have to adapt to
fit in with what is practical...
>
> TIM
>
> **************************************************************************
> Prof. Tim Reynolds,
> Clinical chemistry Dept.,
> Queen's Hospital,
> Belvedere Rd.,
> Burton-on-Trent.
> tel: +44 (0) 1283 511511 ext 4035
> fax: +44 (0) 1283 593064
> email: [log in to unmask]
> [alternative email for when all too frequently NHS Net isn't working
[log in to unmask]]
>
>
> -----Original Message-----
> From: c=GB;a=NHS;p=NHS NATIONAL
> INT;dda:RFC-822=ACB-CLIN-CHEM-GEN(a)JISCMAIL.AC.UK;
> Sent: 18 May 2001 13:11
> To: c=GB;a=NHS;p=NHS NATIONAL
> INT;dda:RFC-822=ACB-CLIN-CHEM-GEN(a)JISCMAIL.AC.UK;
> Subject: HDLs
>
>
> I am passing this on because Shirley is having problems with her email. I
> apologise for the disclaimer etc. automatically added by my Trust.
>
> Trevor Tickner
>
> > -----Original Message-----
> > From: [log in to unmask]
> > [SMTP:[log in to unmask]]
> > Sent: 18 May 2001 10:58
> > To: [log in to unmask]
> > Subject: RE: Test 3
> >
> >
> >
> > Could I have your comments regarding measuring HDL in the non-fasting
> > state. My GPs would like total cholesterol (TC) and HDL-cholesterol
> > measurements in the non-fasting state in order to calculate the CHD risk
> > in their patients. At the moment the lab offers either TC (fasting or
> > non-fasting) or a fasting full lipid profile (ie TC, Trigs, HDL plus the
> > calculated LDL).
> >
> > I was under the impression that recent food intake would produce falsely
> > high Trigs and reduce HDL and the calculated LDL values. Can someone put
> > me straight? I understand some labs are offering non-fasting full lipid
> > profiles.
> >
> > Shirley
> >
> > Dr Shirley Spoors
> > Clinical Biochemist
> > Deputy Head of Department
> > Doncaster & Bassetlaw NHS Trust
> >
> >
> >
> --------------------------------------------------------------------------
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