Clinical Chemistry
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Clinical Chemistry 55: 845-847, 2009. First published March 12, 2009; 10.1373/clinchem.2008.123083
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(Clinical Chemistry. 2009;55:845-847.)
© 2009 American Association for Clinical Chemistry, Inc.

Editorials

Fasting and Nonfasting LDL Cholesterol: To Measure or Calculate?

Børge G. Nordestgaarda,1 and Marianne Benn1

1 Department of Clinical Biochemistry, Herlev Hospital, Copenhagen University Hospital, University of Copenhagen, Copenhagen, Denmark.

aAddress correspondence to this author at: Department of Clinical Biochemistry, Herlev Hospital, Herlev Ringvej 75, DK-2730 Herlev, Denmark. Fax +45 44883311; e-mail brno@heh.regionh.dk.

The first 20% of the full text of this article appears below.

Whether lipid profiles should be measured in the fasting or nonfasting state is a hot topic (1)(2). The fasting state is that used conventionally (3)(4); however, it would be much simpler for patients worldwide if a lipid profile could be taken at any time of the day, irrespective of the time since and the content of the last meal. In both the US and Europe, LDL cholesterol is currently considered the most important measurement in a lipid profile (3)(5).

Direct assays for measuring LDL cholesterol are widely available and used in many laboratories; however, even if LDL cholesterol measured with a direct method gives results similar to those calculated with the Friedewald equation, it is unclear how the 2 measurements compare in predicting ischemic cardiovascular disease. In this issue of Clinical Chemistry, Mora et al. report on an evaluation of fasting LDL cholesterol concentrations calculated with the Friedewald equation vs direct measurement of fasting and nonfasting LDL cholesterol concentrations for predicting cardiovascular disease in a prospective study of 27 331 women from the Women’s Health Study (6). They also examined misclassification of individuals into the National Cholesterol Education Program risk categories (3) with direct measurement of LDL cholesterol, compared with conventional Friedewald calculation of LDL cholesterol. These topics are timely and important.

In 1972, Friedewald, Levy, and Fredrickson presented a new method for estimating LDL cholesterol and compared it with the gold standard of preparative ultracentrifugation (7). The method . . . [Full Text of this Article]






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