Is Fasting Necessary in Clinical Biochemical Parameter Assessment?

Year 2021, Volume: 7 Issue: 2, 99 - 107, 25.06.2020

Berna Kus

https://doi.org/10.5455/umj.20210325092137online

Abstract

OBJECTIVE: Blood tests are usually requested for patients visiting polyclinics in the morning following fasting. However, as hospitals provide services for 24 hours, blood is collected from patients at every hour of the day, and fasting status cannot be completely ensured. Therefore, in our study, it was aimed to compare the fasting / non-fasting biochemical parameters of individuals.
MATERIALS and METHODS: Our retrospective study examined 18 different most frequently requested blood tests of patients who visited certain polyclinics at our hospital only once as fasting and non-fasting values based on their hours of being requested.
RESULTS: In our study which analyzed a total of 70,352 individuals, statistically significant differences were observed in the fasting/ non-fasting values of ALB, ALT, AST, BUN, CRE, CK, GGT, TP, GLU and Ca. However, when the effect size values were measured for the tests, it was determined that they were not clinically significant (0.006-0.104). In the values of AMYLASE, Pi, T-CHOL, IRON, LIP, TRIG, HDL- CHOL, and ALP, on the other hand, no statistically significant difference was observed.
CONCLUSION: It was observed that there was no noticeable difference between the fasting and non-fasting parameters, and the differences that had a statistical significance did not have a clinical significance. It was concluded that, as long as there is no doubt on routine results, individuals could give blood samples throughout the day with or without fasting.

Keywords

Fasting, non-fasting, biochemistry parameters, effect size

References

• 1. J. Koolman KHR. Color Atlas of Biochemistry. 2nd ed2005
• 2.Ferrier DR. Lippincott. 5 ed. Nobel Tıp Kitabevi2011
• 3.Telci Çaklılı Ö, İşbilen B, Yavuz G, Tülü S, Mesçi B, Oğuz A. Differences in leptin, ghrelin, and glucagon-like peptide-1 levels between religious fasting and normal fasting. Turk J Med Sci.2017;47(4):1152-1156
• 4.Pinkney J. The role of ghrelin in metabolic regulation. Curr Opin Clin Nutr Metab Care.2014;17(6):497-502
• 5.Nordestgaard BG, Langsted A, Mora S, et al. Fasting is not routinely required for determination of a lipid profile: clinical and laboratory implications including flagging at desirable concentration cut-points-a joint consensus statement from the European Atherosclerosis Society and European Federation of Clinical Chemistry and Laboratory Medicine. Eur Heart J.2016;37(25):1944-1958
• 6.Driver SL, Martin SS, Gluckman TJ, Clary JM, Blumenthal RS, Stone NJ. Fasting or Nonfasting Lipid Measurements: It Depends on the Question. J Am Coll Cardiol.2016;67(10):1227-1234
• 7.Warnick GR, Nakajima K. Fasting versus nonfasting triglycerides: implications for laboratory measurements. Clin Chem.2008;54(1):14-16
• 8.Cohen J. A power primer. Psychol Bull.1992;112(1):155-159
• 9.Gibson DB. Effect Size as the Essential Statistic in Developing Methods for mTBI Diagnosis. Front Neurol.2015;6:126
• 10.Cutter G. EFFECT size or statistical significance, where to put your money. Mult Scler Relat Disord.2019;38:101490
• 11. Sathiyakumar V, Park J, Golozar A, et al. Fasting Versus Nonfasting and Low-Density Lipoprotein Cholesterol Accuracy. Circulation.2018;137(1):10-19
• 12.Steiner MJ, Skinner AC, Perrin EM. Fasting might not be necessary before lipid screening: a nationally representative cross-sectional study. Pediatrics.2011;128(3):463-470
• 13.Ma I, Viczko J, Naugler C. Proportion of adults fasting for lipid testing relative to guideline changes in Alberta. Clin Biochem.2017;50(6):344-346
• 14.Plumelle D, Lombard E, Nicolay A, Portugal H. Influence of diet and sample collection time on 77 laboratory tests on healthy adults. Clin Biochem.2014;47 (1-2):31-37 15.Pasic MD, Colantonio DA, Chan MK, Venner AA, Brinc D, Adeli K. Influence of fasting and sample collection time on 38 biochemical markers in healthy children: a CALIPER substudy. Clin Biochem.2012;45(15):1125-1130
• 16.Langsted A, Nordestgaard BG. Nonfasting lipids, lipoproteins, and apolipoproteins in individuals with and without diabetes: 58 434 individuals from the Copenhagen General Population Study. Clin Chem.2011;57(3):482-489
• 17.Mora S, Rifai N, Buring JE, Ridker PM. Fasting compared with nonfasting lipids and apolipoproteins for predicting incident cardiovascular events. Circulation.2008;118(10):993-1001
• 18.Simundic AM, Cornes M, Grankvist K, Lippi G, Nybo M. Standardization of collection requirements for fasting samples: for the Working Group on Preanalytical Phase (WG-PA) of the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM). Clin Chim Acta.2014;432:33-37
• 19.Sennels HP, Jørgensen HL, Goetze JP, Fahrenkrug J. Rhythmic 24-hour variations of frequently used clinical biochemical parameters in healthy young males--the Bispebjerg study of diurnal variations. Scand J Clin Lab Invest.2012;72(4):287-295