Hi Andrew
This paper may be of some interest but it is not going to help you easily set a reference interval for non-fasting TG, especially if you have to validate it for iso 15189(!).
I seem to remember another paper questioning the validity of fasting for LDL calculation but then the original Friedewald paper in 1972 looked at 448 samples with subsets in the various Fredrickson classification and was entitled "Estimation" of the concentration of LDL cholesterol in plasma...
Regards
Bob
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-----Original Message-----
From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of Iversen Andrew (BRIGHTON AND SUSSEX UNIVERSITY HOSPITALS NHS TRUST)
Sent: 02 July 2015 09:02
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Subject: Re: Lipid profile
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The LDL cholesterol calculation requires the TG present to be in VLDL of normal composition. This means fasting.
We are retaining our existing fasting and non-fasting lipid profiles, but adding TG to the non fasting profile and non HDL cholesterol calculations to both profiles.
Does anyone have a good reference range for non-fasting TG?
Kind regards
Andrew
-----Original Message-----
From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of Neely, Dermot
Sent: 01 July 2015 17:19
To: [log in to unmask]
Subject: Re: Lipid profile
NICE CG181 doesn't recommend removal of LDL-cholesterol and total cholesterol/HDL ratio from the lipid profile report Total:HDL-Cholesterol is required for QRisk2 assessment LDL-C is required for diagnosis of FH but should only be included on reports when the sample was fasting and Trigs<4.5 I don't see the point on making patients on statin fast to assess treatment response, non-fasting non-HDL-C is perfectly adequate.
Dermot Neely
-----Original Message-----
From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of Stephen Davis (Cwm Taf UHB - Biochemistry)
Sent: 01 July 2015 11:26
To: [log in to unmask]
Subject: Re: Lipid profile
Here in Wales we have recently added non-HDL cholesterol to the lipid profile but have removed neither LDL-C nor the cholesterol:HDL-C ratio. An automated comment goes out with the result explaining that NHDL-C is included in the profile in accordance with NICE CG181
Steve
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-----Original Message-----
From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of Mohammad Al-Jubouri
Sent: 01 July 2015 10:34
To: [log in to unmask]
Subject: Lipid profile
Dear All,
Nice guidance CG181 suggests measuring & reporting lipid profile on non fasting sample as below:
Lipid profile includes:
Total cholesterol
HDL cholesterol
Non-HDL cholesterol
Triglycerides
This means removal of LDL-cholesterol and total cholesterol/HDL ratio from the lipid profile report.
For those who have already done so, were there any feedback from the users on remving LDL and total cholesterol/HDL ratio? Do you include any autocomments regarding non-HDL cholestrol to guide the users?
I am also interested in what you currently include in your lipid profile reports, if you could let me know these please then I will be able to collate them and report back to the mailbase.
Many thanks
Mohammad
Dr. M A Al-Jubouri, MB ChB, MSc, EurClinChem, FRCP Edin, FRCPath Consultant Chemical Pathologist
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